News

Eaten Alive: A Patients’ Perspective on De-Identification of Personal Health Information

In 2018, the majority of people do not know that their PHI, like their EHR data, prescription data, insurance claims, and genetic data via direct-to-consumer (DTC) tests, are de-identified and sold for research and commercial purposes at massive profits. Medical health data trading is a multi-billion dollar industry. The process of de-identification supplies data that may be aggregated for a variety of analyses, such as basic scientific discoveries, policy & legal reviews, process refinement, pharmaceutical marketing, and other efforts. Data de-identification isn’t new but it is rampant. I’m gravely concerned about the free-for-all that is de-identification. You should be too.

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Preliminary Thoughts on CMS Proposed MIPS IP Rule Changes: A Public Health Perspective

Well, here we go again. The Centers for Medicare and Medicaid Services (CMS) has now released a new Notice of Proposed Rulemaking (NPRM)...The purpose of this NPRM is to address proposed changes for Year 3 of the Merit-based Incentive Payment System (MIPS), the provider (as opposed to hospital) side of the Quality Payment Program. The part that is most relevant to public health is the Medicaid Promoting Interoperability (IP) Program for Eligible Professionals (EP)” (the EHR Incentive Programs have been renamed). A major goal of this NPRM is to synchronize as much as possible the EP program with the hospital-based program that was addressed in a previous NPRM just a few months ago.

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An interoperability update: Do we need more carrots and sticks?

Earlier this year, the ONC released the Trusted Exchange Framework and Common Agreement (TEFCA), which responds to a mandate included in 2016’s 21st Century Cures Act and lays out principles, terms and conditions on which to base an interoperability framework that healthcare organizations can embrace. “This means patients who have received care from multiple doctors and hospitals should have their medical history electronically accessible on demand by any other treating provider in a network that signed the Common Agreement,” said National Coordinator for Health IT Donald Rucker in a recent blog post. To achieve that goal, TEFCA is divided into parts A, the principles, and B, the terms and conditions, which is also where the rubber meets the road for many who live in the healthcare IT world...

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CMS Goes Live with Blue Button - With Life and Cost Saving Applications for 53 Million Americans to Use

On August 13 at the White House in Washington, D.C., the Office of American Innovation and the Center for Medicare and Medicaid Services (CMS) will host the first Blue Button 2.0 conference. This event will highlight CMS’ strong investment and leadership in Blue Button as a patient driven means for interoperability, cost-effective care and patient safety. Eight years after President Obama’s announcement of the Blue Button initiative to give Veterans, military beneficiaries and Medicare beneficiaries “easy access to their health information” with the use of a “Blue Button”, CMS Administrator Seema Verma took action with “Blue Button 2.0” so that 53 million Medicare beneficiaries can now make use of CMS approved patient facing Blue Button applications, turning a four-year history of claim data into actionable longitudinal health records to prevent costly medical errors, unnecessary redundant care or other harmful and wasteful care.

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Is it Finally Time to Reinvent the Wheel?

When people talk about "reinventing the wheel, " it is often meant to discourage, even disparage. As in, "why reinvent the wheel?" It usually refers to a technology or a process that works well enough and is widely enough distributed that trying to replace it would be a fool's errand. Fortunately, the folks at DARPA aren't afraid of fool's errands -- and they are literally reinventing the wheel. Healthcare could use some fool's errands of its own. We all know what a wheel is. We know a wheel when we see one, we know what one does, we know how they do it. We've all traveled on wheels -- skates, bikes, cars, buses, whatever. It's hard to imagine a world before the wheel, before that beautiful circular shape, and it's hard to imagine improving on it.

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OpenStax Provides Cheaper Textbooks and Better Access for Higher Ed Students

OpenStax was founded by Rice University engineering professor Richard Baraniuk in 1999 under the name Connexions. It started like most open source projects: To scratch an itch and address a problem. In this case, Rice University wanted to do something on the web related to education. A grad student suggested that they take the model used to develop Linux and apply it to create textbooks, and Connexions was born. They decided on a license that allowed for reuse with attribution—in essence, this was the first use of the Creative Commons license even before the license existed.

The Evolution of Blockchain - A Quick Guide and Why Open Source is at the Heart of It

It isn't uncommon, when working on a new version of an open source project, to suffix it with "-ng", for "next generation." Fortunately, in their rapid evolution blockchains have so far avoided this naming pitfall. But in this evolutionary open source ecosystem, changes have been abundant, and good ideas have been picked up, remixed, and evolved between many different projects in a typical open source fashion. In this article, I will look at the different generations of blockchains and what ideas have emerged to address the problems the ecosystem has encountered. Of course, any attempt at classifying an ecosystem will have limits—and objectors—but it should provide a rough guide to the jungle of blockchain projects.

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Holochain – the Perfect Framework for Decentralized Cooperation at Scale

Holochain is a new technology project with huge potential for the cooperative economy. Members of The Open Co-op have been promoting the idea that new software could, potentially, revolutionize both our failing democracies and our predatory capitalist economies, since 2004. Back then we weren’t quite so clear on exactly how the required information architecture should be designed – but we knew what we wanted it to do and how it should work. In 2004, I published a paper entitled Participatory Democracy Networks, which explained how I thought some new information architecture could facilitate participatory democracy worldwide.

Major German research project chooses openEHR

I just returned from Heidelberg, where another very successful ‘openEHR day’ was held, this time by the HiGHmed research consortium, with 100 attendees. HiGHmed is funded with 20m€ by the German Federal Ministry of Education and Research (BMBF) under the “Medical Informatics” funding scheme, and has as its goal..... to develop and use innovative information infrastructures to increase the efficiency of clinical research and to swiftly translate research results into validated improvements of patient care...

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Towards a Fortnite Healthcare System or how Gen X and Millenials will demand Gamification in Medicine

The World Health Organization (WHO) just included "gaming disorder" as a new mental health condition, listing it is its 11th edition of the International Classification of Diseases. My first reaction was, oh, good, now I have a good excuse to write about Fortnite. A year ago I hadn't even heard of Fortnite. That's no surprise, because few had; it wasn't officially released until July 2017, and even then the free, most popular version -- Fortnite Battle Royale -- wasn't released until last September. It was an immediate sensation, with over a million players within the first month. It has been smashing numbers ever since.

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