News

ONC Releases 2018 HITECH Report

In early January the Office of the National Coordinator for Health Information Technology (ONC) issued its annual report to Congress for 2018 on the adoption of electronic health records (EHR) and interoperability. This report is required under the HITECH Act and is further informed by requirements of the later 21st Century Cures Act...One thing that I think is notable was a short discussion about barriers to interoperability that we have heard before. The report identifies three types: technical barriers, financial barriers, and trust barriers. Within trust barriers the report mentions legal incentives to keep data from moving (I guess that would have better been phrased as legal disincentives to sharing), but this misses the point: It is the patchwork of inconsistent and incompatible State and local laws and regulations - not intentional information blocking - that presents a bigger challenge and barrier.

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Open Source Space Academy Opens in Nairobi

Nairobi's Tunapanda Institute has been using open source tools to provide technology, design, and business training in East Africa since its inception in 2013. Next year the school will launch a "space academy" to inspire young people to think about some of the most critical challenges facing humanity on this planet and beyond. Tunapanda's founders believe that everyone should have the opportunity to help shape the future, and in order for that to happen there must be learning materials and tools that are open, shareable, and unrestricted so that anyone, no matter their financial or educational background, can learn and be inspired.

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In God We Trust, All Others (Don't) Pay Cash

I was intrigued by a recent Wall Street Journal article about how some retail establishments won't accept cash as a form of payment, citing Drybar, Sweetgreen, and at least one Starbucks location. Cashless is touted as faster, safer, easier to administer, and in line with most customers' preference. Indeed, a new study from the Pew Research Center found that 29% of all U.S. adults don't use cash at all in their typical week, up from 24% in 2015. The higher the household income, the less cash was used. Alistair Johnson writes in Forbes that, hey, if we're going to a cashless society, we should make it a cardless one as well, not simply replace our cash with those pieces of plastic we use for debit/credit. I think he's on to something there, and both discussions made me think about how we change the constructs of our everyday lives -- including in healthcare.

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HHS Releases Landmark Report: Reforming America's Healthcare System

On December 3, 2018, the Department of Health and Human Services (HHS) released an extensive, 120-page report on the administration's proposals to reform the healthcare system. The report, titled Reforming America's Healthcare System Through Choice and Competition, is divided into four major sections. The report that government policy of the last few years has suppressed competition, increased prices for healthcare, and limited choices for consumers. Though rich in detail as it tries to prove each of these points, the more than fifty recommendations are often broad and aspirational rather than practical. Since I am not a health economist, I will leave the market issues to others to discuss (many of the ideas in this report have been vetted and discussed by others previously). But there are two sections of the report which make direct mention of Health IT.

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Why Data Scientists Love Kubernetes

Let's start with an uncontroversial point: Software developers and system operators love Kubernetes as a way to deploy and manage applications in Linux containers. Linux containers provide the foundation for reproducible builds and deployments, but Kubernetes and its ecosystem provide essential features that make containers great for running real applications...What you may not know is that Kubernetes also provides an unbeatable combination of features for working data scientists. The same features that streamline the software development workflow also support a data science workflow! To see why, let's first see what a data scientist's job looks like...

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2019 Forecast: Amara's Law

I have two predictions for 2019. One is that at the end of 2019 our healthcare system will still look a lot like it looks now. Oh, sure, we'll see some cool new technologies, some innovative start-ups, some surprising corporate pairings, some moves by Big Tech, and some promising clinical findings. But our healthcare system moves slowly, and many in it have strongly vested interests in the status quo. The second prediction is that, more than ever, Amara's Law still prevails. In case you don't know this "law," it is attributed to Roy Amara, who was President of the Institute for the Future, among other things, and goes like this...

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Bio-Linux: A Stable, Portable Scientific Research Linux Distribution

Bio-Linux was introduced and detailed in a Nature Biotechnology paper in July 2006. The distribution was a group effort by the Natural Environment Research Council in the UK. As the creators and authors point out, the analysis demands of high-throughput "-omic" (genomic, proteomic, metabolomic) science has necessitated the development of integrated computing solutions to analyze the resultant mountains of experimental data. From this need, Bio-Linux was born. The distribution, according to its creators, serves as a "free bioinformatics workstation platform that can be installed on anything from a laptop to a large server." The current distro version, Bio-Linux 8, is built on an Ubuntu 14.04 LTS base. Thus, the general look and feel of Bio-Linux is similar to that of Ubuntu.

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3 Emerging Tipping Points in Open Source

Over the last two decades, open source has been expanding into all aspects of technology-from software to hardware; from small, disruptive startups to large, boring enterprises; from open standards to open patents. As movements evolve, they reach tipping points-stages that move the model in new directions. Following are three things that I believe are now reaching a tipping point in open source. As the name suggests, the open source model has mainly been focused on the source code. On the surface, that's probably because open source communities are usually made up of developers working on the source code, and the tools used in open source projects, such as source control systems, issue trackers, mailing list names, chat channel names, etc., all assume that developers are the center of the universe.

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A Public Health Perspective on ONC's Strategy to Reduce Burden on Physicians

On November 28, 2018, the Office of the National Coordinator for Health Information Technology (ONC) released a draft Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs for public comment. The strategy aims to reduce the time and effort and improve the functionality of electronic health records (EHRs) for clinicians, hospitals, and other healthcare organizations. This strategy was developed primarily through the efforts of ONC-convened workgroups in response to requirements laid out by Congress in the 21st Century Cures Act (Section 13103). The report itself does not identify who exactly served on these workgroups and what organizations were represented.

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Creating EHRs that Doctors Don't Hate

It may be difficult to recall now, what with the ongoing Cerner deployment and recent challenges that had little to do with technology, but there was a time when the Department of Veterans Affairs was considered the gold standard for healthcare IT. VA was out front with the initial development in the 1970s of the VistA system, which would come to be widely recognized and frequently honored. Indeed, when VA was overhauled in the 1990s, VistA was the primary tool that enabled the success of new policies. Without question, much of the effectiveness and durability of VA's VistA can be attributed to the way it was developed, specifically to the collaboration between technologists and clinicians that defined the process.

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