Saving Healthcare Quality
Saving Healthcare Quality
This week I am talking to Fred Trotter (@fredtrotter), CTO CareSet Systems – the first commercial Medicare Data company. Fred has a long and fascinating background that unlike many healthcare Cybersecurity experts started in the security field and transitioned to healthcare and healthcare data. You can read his musings on Hacking Healthcare here.
We talked about Fred’s coordination of the Save the Agency for Healthcare Research and Quality (AHRQ) data project that took off online using twitter and other social channels as an unofficial mechanism. The AHRQ and the National Guideline Clearinghouse (NGC) was expected to be taken offline earlier this year as part of budget cuts and there was a significant concern that the 1,500+ clinical guideline summaries currently available would disappear forever. Some of us might think its a simple thing to copy content thus preserving the material but as Fred explains it was not that simple
In fact he contributes to the Internet Archive project (aka the Way back Machine) on a regular basis as one fo the important community projects that is workmen to preserve the digital history fo the web. Listen in to find out why the internet archive copy that was stored on this site was not enough and how Fred and the others used the insights and data from the Archive site to improve their data capture and storage. You can access the data on Guidelines here and the Quality Measures here – all sourced from this GitHub Project
We also talk about his history and involvement in the Health Care Industry Cybersecurity Task Force that was convened under President Obama’s administration by the DHS in March 2016. They issued their report to congress June 2017: Report on Improving Cybersecurity in the Health Care Industry. Listen in to hear about the experience of bringing this diverse group together as they attempted to predict future attacks (Hint – many of the things they predicted came true that same year!)
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Saving Healthcare Quality was originally published on Dr Nick – The Incrementalist
Consumer Rights Driven Data Access
The Bluebutton Innovator
This week I am talking to Mark Scrimshire (@eKiveMark) a fellow Walking Gallery member and Entrepreneur in Residence at NewWave and on assignment as Medicare Blue Button 2.0 Innovator at CMS where he is designing and implementing the new API to enable 53 million Medicare Beneficiaries to share their claims information with the applications, services and research programs they choose to trust.
His work extends back to 2010 when the initial concept of the Blue Button was conceptualized but it took several years before this started to really take off with the concept of View, Download and Transmit. One of the key Incremental Steps to get this interoperability rolled out centered on changing the positioning of HIPAA from a barrier to sharing and portability to an enabler. Ironic when you consider that it stands for “Health Insurance Portability and Accountability Act”! Listen in to find out the details behind the change and a key incremental step to progress – changing the messaging
Part of this changed messaging centers on the Office of Civil Rights (OCR) and the clear guidance to direct consumers to have the right to access their data in electronic format. As promised in the broadcast here is the Rights to Access Memo they issued in September 2015 and something I carry with me to all my medical appointments.
He shares his view on how to move toward interoperability and his incremental step connected with the Fast Healthcare Interoperability Resources (FHIR, pronounced “Fire”) set of Resources and removing complexity and simplifying the approach the is a recurring theme for Incremental Improvements.
Don’t let perfection stand in the way of progress
You can read more about the project in the FHIR Wiki he mentioned here. Listen in to hear Mark talk about the new project and how he is turning the oxymoron of Explanation of Benefits (EOB) which fails to provide insights to the people it is directed at and how the DaVinci project. The move from the old model of Fee for Service (FFS) to paying for outcomes is also driving a whole shift in data accessibility and utility and willingness to share which is exciting for our the consumer rights driven access movement.
Their Incremental steps to improvement include the huddle but listen in to hear what other incremental steps you may be missing that has added significantly to their team-based approach, coordination and success
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Consumer Rights Driven Data Access was originally published on Dr Nick – The Incrementalist
Interoperability in Healthcare
Getting to Nationwide Interoperability
Unfortunately, the existing healthcare system incentives behavior that is in opposition to the goal of scalable, nationwide, vendor-neutral interoperability. Our model has multiple groups who have a vested interest in the control and ownership of data (for example Payors, Providers, Patients). Each has their own economic and commercial drivers and in many instances, these do not coincide with the open sharing of data. In a system that is driven by activity and delivering care (Fee for Service) sharing data could mean a reduction in work and income. Until our reimbursement system moves to a more holistic care model that focuses on wellness and outcomes and incentivizes behavior that delivers better health and outcomes for patients through cooperative and coordinated care and ultimately equitably rewards all the contributors to these outcomes we will remain stuck in the quagmire of limited interoperability.
The Patient at the Center of Data Exchange
I believe as do many others that the patient is at the center of everything we do and deliver in healthcare. By placing the patient and their information at the center of care we empower them and enable a model that moves away from the historical paternalistic delivery of healthcare to patient-centered and enabled care. It does come with challenges since many people contribute to that care and the current administrative and financial configuration focus the management and ownership of data with providers, healthcare systems and payors. While many patients want access to their data and some even want to own and manage it, many do not and are ill-equipped to be responsible for this data. What may emerge are independent services and providers who aggregate, manage, secure and service patient data on behalf of patients – much as banks do with our money. There are many technologies on the horizon that offer a potential path to achieve this and blockchain represents an interesting innovation of decentralized secured data that offers individualized control and dynamic revocation options for access.
Frictionless Data Flow
The key to an interconnected care model is the free flow of data between all the various areas that are responsible for delivering care. We moved away from the single index card medical record held by your personal physician who was the focal point of your care and care coordination to a distributed team-based model of care that encompasses multiple areas and people. The only way this team can deliver excellent care is through the frictionless flow of enhanced data and knowledge. This information flow must include the patient and all their family members that are authorized, interested and engaged in their care. Data should be shared with the patient’s consent with everyone concerned and available for as long as it is needed to deliver care but this access should be flexible enough to allow it to be revoked or removed when it is no longer needed or necessary
Interoperability in Healthcare was originally published on Dr Nick – The Incrementalist
Incremental Steps to Health
Incremental Steps to Health
This week I am talking to Dr Khan Siddiqui (@DrKhan ) radiologist, programmer, serial entrepreneur, and Founder, CTO, and CMO of HIGI – the company that is taking the concepts of consumer engagement and tracking to the next level and creating actionable insights that patients and their care team can use
Much of Khan’s journeys mirrors my journey into the space of Digital Health – starting as a programmer in school where he was building applications on a PDB-11 using punch cards and continuing on through his early work on the Electronic Health Record mining data and applying machine learning and deep learning as far back as 2005 to healthcare data.
Microsoft Kinect
Listen to his story of a turnabout of shared innovation at Microsoft where the work the healthcare team had done on image analytics was applied to the Kinect bar and gaming solving one of the challenging problems of “missing body parts”
He was involved in the early work of Microsoft Health Vault and like others believed in the mission of sharing clinical data with patients and getting them engaged was a key requirement to solving health challenges – many of which are tied up with personal behavior. Frustrated by the lack of uptake compared to the Xbox gaming system he took this experience with him to found Higi and replicate the gaming user engagement and bring this to healthcare
Listen in to gain a different perspective to Xbox gaming and how healthcare has contributed and learned from this world.
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Incremental Steps to Health was originally published on Dr Nick – The Incrementalist
Artificial Intelligence in Medicine
Artificial Intelligence in Medicine – Better More Rewarding Medicine
It was great to catch up with colleague and friend Dr. Anthony Chang (@AIMed_MD) Pediatric Cardiologist, Founder of Artificial Intelligence in Medicine (AIMed) and Director of Medical Intelligence and Innovation Institute (MI3) .
How did a pediatric cardiologist find his way into the field of Artificial Intelligence, Machine and Deep Learning?
Those of you that saw the original Watson Jeopardy Challenge
Anthony like me had the same reaction to this incredible achievement by the IBM Watson team that beat out the top 2 Jeopardy champions with an Artificial Intelligence Computer system that consumed the contents of the internet library and tested out the correct answers more frequently than the two human champions.
With a background teaching statistics augmented with an MS in Biomedical Data Science/Artificial Intelligence, he has blazed a path to attract colleagues and data geeks from around the world to participate in the future of healthcare augmented by data
For those of you challenged understanding the terminology of the space this Venn diagram is helpful in putting the various disciplines in perspective
Along the way, he like many of my other guests has discovered the value of the adjacent possible – in his case adjacent to data scientist and technologists with clinicians deeply invested in day to day clinical care – both learning from each other
We cover everything from machine learning and data science through the requirements for clinicians (or not) to gain qualifications in data science. Hear his eloquently answers the age-old question of
Will I still have a job once AI has replaced me
TL;dr – yes and it will be more rewarding
Join me as you hear how and why you should change the way you think of medicine and data. The good news is – you can participate in the next AI Med event which mixes specialist, clinicians, data geeks and patients from around the world in a unique experience that offers a great learning and mind opening experience.
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Artificial Intelligence in Medicine was originally published on Dr Nick – The Incrementalist
Navigating Healthcare - Patient Safety and Personal Healthcare Management 
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