Saturday, June 04, 2016

Weekly Overseas Health IT Links - 4th June, 2016.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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Providers need to embrace social media for patient engagement

Published May 26 2016, 6:42am EDT
If physicians want to reach today’s consumers, they need to leverage social media to target women who are making the healthcare decisions for their families and households.
That’s the contention of Geeta Nayyar, MD, chief healthcare and innovation officer at Femwell Group Health, one of the largest management services organizations in Florida.
 “Fifty-nine percent of women are making healthcare decisions for others in the United States, and that number shoots up to 94 percent among working moms with kids under 18,” said Nayyar, a practicing physician and mother who was one of the keynote speakers at WEDI’s 25th Annual National Conference in Salt Lake City. Mothers who are 25 to 45 years old are the ones who are hiring and firing doctors, and using social networking to post online testimonials—both positive and negative, which can make or break physicians’ reputations.
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OpenNotes makes strides but misgivings linger

New research published in the Journal of the American Medical Association found mostly positive feedback from both doctors and patients, though there are still some clinicians who prefer to keep their notes from patients.  
May 27, 2016 09:30 AM
OpenNotes continues to earn acceptance and accolades from clinicians and patients alike — but there are still some doctors concerned about enabling patients to view those notes.
 “Sharing medical notes with patients is a trend more health institutions are adopting as they foster transparency in medical records,” Julie Jacob, wrote in the Journal of the American Medical Association (JAMA) article “Patient Access to Physician Notes Is Gaining Momentum.”
Positive feedback from participants in the program shows that a growing number of health systems across the country are making physician notes easily available to patients, Jacob wrote. She cites a January 2016 study in BMJ Open that found that patients who frequently read their physician’s notes reported they better understood their health condition, took better care of themselves, and had a more effective relationship with their physician. The BMJ study mirrors other reports conducted since OpenNotes was launched in 2010 by clinicians and researchers at Beth Israel Deaconess Medical Center in Boston.
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Andy Slavitt: Interoperability not like 'sending a man to the moon'

May 27, 2016 | By Katie Dvorak
Interoperability in healthcare is not as big a feat as sending a man to the moon, says Andy Slavitt, and technology should be able to do the things "that it already does for us every day."
Slavitt, the Centers for Medicare & Medicaid Services' acting administrator, says bad business practices are one impediment to interoperability, according to a recent interview with the Massachusetts Medical Society.
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FHIR rapidly advancing as healthcare data exchange standard

Health Level Seven International’s Fast Healthcare Interoperability Resources (FHIR) application programming interface is making significant progress on the road to becoming a mature standard, with the normative version slated for release early next year.
According to HL7’s CEO Chuck Jaffe, MD, the normative version of FHIR will be “backward-compatible with all the existing trial use standards and will be stable enough for large vendors to incorporate into their platforms.”
Until then, he said HL7 will continue to refine the draft standard for exchanging healthcare information that is seen as a promising solution to the complex challenges of health IT interoperability facing the industry.
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White House releases final Precision Medicine Initiative data security framework

The document outlines eight guidelines for achieving precision medicine principles, including a ‘participant-first’ system.
May 26, 2016 11:18 AM
The White House unveiled the final data security framework for its Precision Medicine Initiative on Wednesday.
The framework, which was outlined by Health and Human Services Secretary Sylvia Burwell and Assistant to the President for Homeland Security and Counterterrorism Lisa O. Monaco, provides risk management guidelines to achieve PMI principles and applies to all participating institutions.
According to the authors there are eight guidelines in the framework: a 'participant first' system; identify key risks; provide clear expectations; share experiences; recognize rapidly-evolving security needs; best security practices; act responsibly; and preserve data integrity.
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Alder Hey works with Watson on 'cognitive hospital'

Ben Heather
26 May 2016
While many NHS organisations are still grappling with shifting their core systems into the digital age, developments at Alder Hey Children’s NHS Foundation Trust point to a future where big data and “cognitive programming” will inform nearly every health decision.
The trust has entered into a multi-year collaborative programme with Hartree Centre, which will use IBM’s artificial intelligence programme Watson to create what they have labelled the “first cognitive hospital” in the UK.
In the United States, Watson’s ability to understand and respond to natural language questions by drawing on a massive trove of data has already been used to support clinical decision making.
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Raspberry Pi-based EPR in a box wins NHS Hack Day 13

Jon Hoeksma
23 May 2016
A go anywhere, Raspberry Pi-based, electronic patient record in a box for emergency medical teams to use when responding to emergencies like the Ebola outbreak, won the latest NHS Hack Day London.
The 'Outbreak' system is designed for use in contaminated ‘dirty rooms’ in which medical staff treating patients must wear hazard suits and from which no equipment, even pieces of paper, can leave the room. 
“We wanted to design a system so that a response team has a fully functioning IT system on the back of their Land Rover,” said Dr Michael Marks, an epidemiologist member of the team, who has worked for organisations such as Medecins Sans Frontieres.
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'Mere humans' could tackle big health problems with the help of this supercomputer

May 26, 2016, 4:54 AM
Dr. Paul Tang is six weeks into a new job at the company where he started his career.
The 30-year health-tech veteran who is also a practicing doctor is coming on as Watson Health’s “chief health transformation officer.” His job? To find ways to use Watson that will help set up a “personalised healthcare” system.
Personalised healthcare means pulling together all the information available about a person: not just their clinical and genetic information but also their social, behavioural, demographic and personal preferences.
“Instead of saying ‘what’s the matter with you,’ which is a disease focused way, I like to think of ‘what matters the most to you?’ I think we would be better clinicians better doctors if we knew that,” Tang told Business Insider.
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Why unique patient identifer is needed to cut errors

Published May 24 2016, 3:26pm EDT
With an epidemic of medical errors killing more than 250,000 Americans annually, the healthcare industry needs to make patient identification a national priority, according to Russ Branzell, president and CEO of the College of Healthcare Information Management Executives (CHIME).
Speaking at WEDI’s 25th Annual National Conference in Salt Lake City, Branzell told the audience that the problem of patient misidentification is as pervasive today as it has ever been, and he contends it directly impacts patient safety, referencing a study published earlier this month by Johns Hopkins researchers who found that medical errors are now the third leading cause of death in the United States.
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Special report: patient level information costing

Feature
On one reading, everything is in place for all trusts to finally start using PLICS. On another, mistakes are being made on crucial details and the timetable is too protracted. Daloni Carlisle reports and Patrick McGinley of Maidstone and Tunbridge Wells NHS Trust gives a personal view.
It’s a big year for patient level information costing. After many years in which regulatory and financial bodies have urged trusts to get a handle on their real costs, and to be paid by them, a shift towards this actually happening is underway.
There is a timetable, draft standards, minimum software requirements and a group of trusts acting as “roadmap partners” to influence NHS Improvement’s evolving costing transformation programme. Despite this, some have serious concerns about the detail and that timetable.
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'Trigger tool' identifies harm caused to hospitalized patients

May 25, 2016 | By Marla Durben Hirsch
A new trigger tool can help identify adverse events in pediatric inpatients, according to a new study published in Pediatrics.
Efforts to advance patient safety have been hampered by a lack of high quality measures of adverse events, which is particularly problematic in pediatrics. However, hospitals mainly identify adverse events by relying on passive voluntary reporting systems, which detect only a small percentage of adverse events.
In a study funded by the Agency for Healthcare Research and Quality (AHRQ), the researchers, from Boston Children's Hospital, created an active surveillance trigger tool to look for signals that suggest adverse events in medical records as a way to quickly and reliably identify adverse events, according to an announcement.
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Docs: Laws are hindering patient access to records

May 24, 2016 | By Marla Durben Hirsch
The increased use of electronic health records and other technology provides patients with more access to their medical information, but several legal issues are creating obstacles that should be re-examined, according to a viewpoint published in the Annals of Internal Medicine.
The article, written by several physicians, points out that patients can theoretically view data via online portals, add patient-generated information to their records and read physicians' clinical notes. However, various laws, some written before the advent of EHRs, restrict or prohibit patients from seeing all of their records.
For instance, allowing patients to view their records increases the chances the patient will catch an error, enabling the record to be made more accurate. While the Health Insurance Portability and Accountability Act (HIPAA) requires patients to have access to their information and to request amendments made to the record, HIPAA reserves most decision-making authority to providers on the theory that they own the record. However, as more patient-generated information is added to the record, it is less clear as to who the owner is, according to the authors.
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Geisinger working toward real-time use of patient data

May 24, 2016 | By Susan D. Hall
Geisinger Health System is pressing forward in using patient data in real time, according to John Kravitz, senior vice president and CIO of the organization.
In a recent interview with Healthcare Informatics, Kravitz says one of the Danville, Pennsylvania-based provider's new data projects, CareGaps, will roll out by September or October. Patients will be handed a tablet computer in the waiting room where they will be surveyed about chronic diseases, with the information going automatically into the electronic health record before their doctor visit. The enterprise data warehouse already flags needed blood work or other tests in that system.
Geisinger will have programs available for collecting data in the waiting room from patients with various chronic illnesses such as congestive heart failure, asthma and rheumatoid arthritis, Kravitz says. Another priority project, called SuperNote, will make the most important patient data readily visible to physicians in the EHR, he adds.
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Electronic surveillance helps Alabama hospital reduce sepsis deaths

May 25, 2016 | By Susan D. Hall
A Huntsville, Alabama, hospital was able to reduce sepsis-related deaths by 53 percent through a program focused on staff education and an electronic surveillance system, according to research published at the Journal of the American Medical Informatics Association.
The effort included creating discrete data elements in the electronic health record to achieve high sensitivity and specificity for automated sepsis screening. A clinical decision support system then trolled the records for signs of sepsis and alerted nurses either through mobile devices or their desktop computers.
Huntsville Hospital devoted two floors--two respiratory units and one general medicine unit comprising 58 beds--to the study, which compared the results to those of a control period.
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More on Operations

Most financially strapped hospitals regret pricey electronic health record purchases, Black Book says

Also, 90 percent of nurses said the EHR process changes diminished their ability to deliver the best hands-on care.

Four years after what Black Book called the "replacement frenzy," a recent survey from the market research firm has found that that 87 percent of financially struggling hospitals now regret changing their EHR systems due to higher than expected costs, layoffs, declining inpatient revenues, disenfranchised clinicians and doubts over the benefits of switching systems.
The survey, which polled 1,204 hospital executives and 2,133 information technology staff users, found that 14 percent of all hospitals that replaced their original EHR since 2011 were losing inpatient revenue at a pace that wouldn't support the total cost of their replacement EHR.
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How much health IT do consumers use? 7 survey takeaways

Written by Max Green | May 24, 2016
The gap between how much the over 65 crowd uses health IT compared to younger generations isn't so large — 33 percent, compared to 54.8 percent — according to new data from a national CDC survey.
Here are six other numbers to know from the data
  • 4.1 percent of respondents aged 18-64 participated in online chat groups to learn about a health topic, compared to 2 percent of respondents aged 65 and over.
  • 8.8 percent of respondents aged 18-64 filled a prescription online, compared to 8.6 percent of respondents aged 65 and over.
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Intermountain Health Launches $49 Telemedicine Visits

John Commins, May 25, 2016

The Salt Lake City, UT-based health system wants to tear down silos that often isolate telemedicine visits from the patient's continuum of care.

Over the past several months, Intermountain Healthcare has quietly rolled out its Connect Care telehealth platform for patients in Utah and Idaho.
Program Medical Director William Daines, MD, says Connect Care clinicians will have access to Intermountain patients' medical files as part of a greater effort to include telehealth in the continuum of care. Daines spoke with HealthLeaders Media. The following is a lightly edited transcript.
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Wearables in the workplace: Treat health data with careful consideration

May 24, 2016 | By Katie Dvorak
As use of wearables in the workplace grows, concerns loom about the collection of private health information by employers.
Chris Brauer, director of innovation and senior lecturer at Goldsmiths, University of London, told the Wall Street Journal that eventually the industry will reach a point where requiring wearables won't even be a question.
Last fall, Barclays and 20 other companies signed on to bring Fitbits to their employees, buying the wearables company's devices in bulk, FierceMobileHealthcare reported. Barclays announced it would provide the devices to 75,000 employees through a cost-sharing plan before expanding that to its 140,000 global employees.
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GIS maps hospital efforts to healthier populations

By Meg Bryant | May 22, 2016
For years, providers have used GIS software to map disease outbreaks and monitor the effectiveness of interventions. Now, with the Affordable Care Act and the push for accountable care, it’s proving to be a valuable tool in population health efforts.
GIS — short for geographic information system — is software that is capable of capturing, storing, analyzing, and displaying geographically referenced data.
While global health organizations and public health agencies in the U.S. have long used it for population health purposes, its use in the private sector has mostly been limited to strategic planning and marketing. But that’s starting to change as hospitals take on more risk for health outcomes and cost, says Danny Patel, account executive for health and human services at GIS software maker Esri.
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New Chips Propel Machine Learning

Nvidia microchips are helping in detection of anomalies on CT scans

By Don Clark
May 22, 2016 6:47 p.m. ET
Computer users have long relied on Nvidia Corp. ’s technology to paint virtual worlds on the screen as they gunned down videogame enemies. Now some researchers are betting it can also help save lives—of real people.
Massachusetts General Hospital recently established a center in Boston that plans to use Nvidia chips to help an artificial-intelligence system spot anomalies on CT scans and other medical images, jobs now carried out by human radiologists. The project, drawing on a database of 10 billion existing images, is designed to to “train” systems to help doctors detect cancer, Alzheimer’s and other diseases earlier and more accurately.
“Computers don’t get tired,” said Keith Dreyer, the center’s executive director and vice chairman of radiology at Mass General. “There is no doubt that this will change the way we practice health care, and it will clearly change it for the better.”
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Smartwatch tells ‘what’s going on in your body’

Published May 24 2016, 3:34pm EDT
 (Bloomberg) -- The health monitoring market is ready for new technology innovation, and Apple CEO Tim Cook believes your body should be more like keeping tabs on the performance of your car.
“If you drive for a while and your car gets too hot, it says pull over. If you need an oil change, it says check your oil. What’s the equivalent for the body?” Cook said Tuesday in Amsterdam at a conference. “We believe health is a huge issue around the world, and we think it’s ripe for simplicity and a new view.”
Apple’s smartwatch already tells people to get up, walk around or exercise, but in the future, such devices will know more about the body and could advise users on getting a doctor’s check-up, for example, Cook said. While full monitoring won’t necessarily fit into a single device and is more likely to be a result of experiments with several solutions, health is part of the end-game for the Apple Watch, he said.
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How virtual reality will change the face of healthcare

Published May 24 2016, 3:59pm EDT
Virtual Reality—the term conjures up a number of images. For the millennial, it’s gaming; for those of a certain age, it’s 3D glasses; and for all of us, it’s an ever-expanding template for immersive entertainment.
“VR” is rapidly evolving however, and today serves as an umbrella for related technologies, including augmented reality (“AR”) and 3D. These collective components of VR can be described as:
Virtual Reality. An artificial environment created with software and presented to the user in such a way that the user suspends belief and accepts it as a real environment.
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How an FQHC Uses Technology to Accelerate a Population Health Initiative

Scott Mace, May 24, 2016

A new breed of population health solutions enabled an eight-clinic network in Indiana to implement a quality improvement program and determine how to reach at-risk patients sooner.

At first glance, the terms "population health" and "Federally Qualified Health Center" do not seem to go together. FQHCs are still considered part of healthcare's safety net, while population health is still not a widespread phenomenon, even at better-capitalized healthcare institutions.
And yet, here and there, population health, and the technology enabling it, have arrived in the safety net. One such arrival occurred at HealthLinc, an eight-clinic network in northwestern Indiana.
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Risky data practices jeopardize providers’ security

Published May 23 2016, 6:44am EDT
With provider attention focused on ransomware attacks and the havoc they can cause, other dangerous security practices are placing healthcare organizations at risk for breaches, healthcare security experts say.
While ransomware incidents are high profile and gain national attention in the business and popular press, healthcare information security officers need to pay attention to several risks that have lower profiles but carry just as much risk to patient information, they say.
For example, Kate Borten, president of the Marblehead Group consultancy, is concerned about the massive amounts of data being shared with lax security practices by healthcare organizations. Hospitals continue to acquire medical practices, along with their data, and share the data via a health information exchange.
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System provides doctors with instant drug history information

May 23, 2016 | By Joanne Finnegan
Doctors cite myriad reasons for not taking advantage of state prescription drug databases, even though health officials encourage the use of such tools more than ever in light of the country's opioid crisis.
In North Carolina, where it's voluntary and the prescription drug monitoring program database is used for only about 6 percent of prescriptions docs write, many complain that the computer program is cumbersome and time-consuming, according to a report in the Charlotte Observer. But that doesn't prove true when physician Don Teater, M.D., a primary care physician and drug addiction specialist, can call up a patient's information on the state's prescription database in about 60 seconds, the newspaper says.
But whatever the reason, two researchers from the Carolinas Healthcare System are leading a pilot project, which is now limited mainly to the metro area of Charlotte, to help solve the problem. With a $400,000 grant from the Centers for Disease Control and Prevention, they have devised a system that provides doctors with instant information about a patient without having to log into the state's database, the newspaper said.
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Researchers: OpenNotes strengthens patient-doctor relationships

May 23, 2016 | By Dan Bowman
Transparency via the OpenNotes initiative is creating stronger patient-physician relationships in the face of concern that note sharing might be offensive to patients, new research shows.
The study, published in BMJ, finds that both doctors and patients are optimistic about the initiative's results, so far. Of 99 doctors who were surveyed, 53 percent said they thought patient satisfaction increased after one year, while just over half (51 percent) said they thought their patients trusted them more.
Meanwhile, although nearly one-third of 4,592 patients surveyed said they read their notes to check accuracy, only 7 percent said they reached out to their doctor to discuss the note, 29 percent of whom discovered errors. However, 85 percent of those patients said they were "satisfied" with how their doctor handled the issue, with most feeling the same (62 percent) or better (37 percent) about their physician.
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Poor need ongoing help with online health resources

May 23, 2016 | By Susan D. Hall
Simply providing Internet access isn't enough to equalize access to online health information for the urban poor, according to research in the Journal of the American Medical Informatics Association.
For the study, the researchers examined the online information-seeking behaviors of 118 people without a high school degree who had no Internet access at home and limited experience with computers. They were provided a computer, broadband Internet access, access to a web portal designed specifically for low-literacy populations, 24-hour tech support and nine classes on basic Internet skills.
The researchers relied on real-time tracking, call logs and reported problems to understand how the individuals' limited computer knowledge affected their search for health information.
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Telehealth Shifts its Focus

By Eric Wicklund on May 19, 2016

A new survey of healthcare execs finds that today's provider-facing telehealth platforms will soon be replaced by mHealth efforts targeting the consumer.

Today’s telehealth solution may soon evolve into tomorrow’s mHealth platform.
That’s the conclusion drawn by a recent survey of some 280 healthcare executives by Avizia and Modern Healthcare. Their findings indicate that current provider-facing telehealth programs, hindered by a lack of funding, will give way to mobile platforms that cater more to the patient.
Consider it the next wave of telehealth, says Mike Baird, Avizia’s co-founder and CEO, and Alan Pitt, MD, the company’s chief medical officer and an attending physician and professor of neuroradiology at the Barrow Neurological Institute. Stung by the challenges of implementing an electronic medical records platform, providers are looking for more ROI from their technology. They want platforms that improve clinical care, address population management and reach out to consumers in their homes.
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Clinical Grade Wearables Will Accelerate Growth Opportunities for Internet of Medical Things

The global healthcare wearable devices market earned $5.1 billion and is expected to reach $18.9 billion in 2020, at a compound annual growth rate (CAGR) of 29.9%, according to new analysis from Frost & Sullivan. Additionally, consumer health wearables are expected to grow at a CAGR of 27.8%, and medical and clinical-grade wearables are expected to grow at a CAGR of 32.9%.
The report finds wearables dedicated to chronic disease monitoring and other clinical applications are expected to transform care provision models, due to newly commercialized solutions and pent up demand. Clinical grade wearables technologies enable care anywhere-anytime support paradigms. Market dynamics in high-acuity or other medical use cases dictate attention towards interoperability, affordability and data accuracy.
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Healthcare Ransomware, Connected Devices Top Security Issues

By Elizabeth Snell on May 19, 2016

Healthcare ransomware threats, the increase in connected devices, and more IoT initiatives are top security concerns in the industry, a study found.

While the increase in connected devices and more options for Internet of Things (IoT) create massive streams of data and options for productivity, they also create more openings for security threats, according to a recent study. Furthermore, healthcare ransomware threats are also one of the top data security concerns for healthcare providers.
The second annual National IT Trends in healthcare study from Peak 10 found that 59 percent of respondents said that data privacy and security are still primary concerns due to recent ransomware attacks on hospitals.
Peak 10 interviewed 157 C-level executives and information technology professionals across the country for the report, and found that healthcare leaders are working to keep pace with big data, interoperability, as well as current data security threats.
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How to beat ransomware with security best practices

Published May 23 2016, 4:31pm EDT
Ransomware has emerged as one of the largest concerns for healthcare organizations this year. An increasing number of incidents this year show that hackers are particularly targeting the healthcare sector, because of porous defenses and an apparent willingness to get critical systems up and running as quickly as possible.
There are many variants of ransomware, but all have the same modus operandi—they’ll prevent you from using your PC normally, and they all will ask you to do something before you can use your PC again. It’s a class of malware that holds a computer "hostage" until the user pays a particular amount or abides by specific instructions. Cybercriminals use online payment methods such as Ukash, PaySafeCard, MoneyPAK or Bitcoin as a way for users to pay the ransom.
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Health care data as a public utility: how do we get there?

Forty-six million Americans use mobile fitness and health apps. Over half of providers serving Medicare or Medicaid patients are using electronic health records (EHRs). Despite such advances and proliferation of health data and its collection, we are not yet on an inevitable path to unleashing the often-promisedpower of data” because data remain proprietary and fragmented among insurers, providers, health record companies, government agencies, and researchers.
Despite the technological integration seen in banking and other industries, health care data has remained scattered and inaccessible. EHRs remain fragmented among 861 distinct ambulatory vendors and 277 inpatient vendors as of 2013. Similarly, insurance claims are stored in the databases of insurers, and information about public health—including information about the social determinants of health, such as housing, food security, safety, and education—is often kept in databases belonging to various governmental agencies. These silos wouldn’t necessarily be a problem, except for the lack of interoperability that has long plagued the health care industry.
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Enjoy!
David.

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