Feature Articles

The Utopia of Unique Patient Identifiers

The subject of Unique Patient Identifiers pops up with clockwork regularity in the healthcare discourse. A recent article in the New England Journal of Medicine (NEJM) titled Has the Time Come for a Unique Patient Identifier for the U.S.? points out that HIPAA initially mandated patient identifiers. Reason prevailed and the requirement was abandoned. The article goes on to list, correctly, all the issues related to duplicates and split records and their dire consequence from financial costs to potential loss of life. Just a few short years ago the American Health Information Management Association (AHIMA) issued a petition calling for unique patient identifiers citing much of the same issues and making a proposal for a voluntary solution. That effort also failed to get much traction either. While the problems cited are very real, it is not at all clear how a unique identifier would solve the problem, in spite of the very bold claims.

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Been there, Done that, Doesn’t Work: Veterans Health Administration IT goes back in time

If you have an interest in the worlds of economics, healthcare or technology, here’s a story that’s emerged this month that is worth noting for the record books. In the US, amidst the chaos of the Trump administration, yet another mistake has been made this month. For the record, it is worth noting that the US Department of Veterans Affairs (VA) Veterans Health Administration (VHA) ended up with a contract for a large IT solution for the next 10 years worth about $10 billion as of May 2018. On the face of it that may appear to be unremarkable news: just another big expensive contract for an IT system. Yet there is a part sad/part silly dimension to it that is well worth flagging up at this point.

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HLN and Oregon Health Authority Present Optional Approaches to Oregon's School Immunization Reporting Process at Atlanta Conference

At the 2018 National Immunization Conference (NIC) held in Atlanta May 15-17, HLN co-presented Diverse Stakeholder Perspectives to Improve Oregon’s School Immunization Reporting Process in collaboration with the Oregon Immunization Program (OIP). Aaron Dunn, Oregon’s Immunization Program Manager, and Marcey Propp, HLN Project Manager, presented the project context, approach, and outcomes as part of the segment for Improving measurement and reporting to foster clear vaccine communication. The project context included antiquated technology, the growing complexity of vaccine requirements, and excessive, redundant and unnecessary workload that culminated in making the current school immunization reporting process unsustainable.

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Top 8 Open Source Artificial Intelligence (AI) Technologies in Machine Learning

Artificial intelligence (AI) technologies are quickly transforming almost every sphere of our lives. From how we communicate to the means we use for transportation, we seem to be getting increasingly addicted to them. Because of these rapid advancements, massive amounts of talent and resources are dedicated to accelerating the growth of the technologies. Here is a list of 8 best open source AI technologies you can use to take your machine learning projects to the next level.

Edge computing and the importance of open infrastructure

The "edge" is diverse, dispersed, often independently owned and operated, and comes with a set of constraints not addressed in the average data center. Old sci-fi films painted a picture of how computers would permeate every facet of life in the future. It has come to pass, and it happened almost without us noticing: having PCs at home became commonplace, our mobile phones turned into small smart devices, and our cars began making decisions for us, controlled by thousands of sensors and controllers. Self-driving cars, augmented and virtual reality, smart homes and more all underscore our rapidly emerging dependence on distributed computing infrastructure.

A Look at Open Source Image Recognition Technology

Image recognition technology promises great potential in areas from public safety to healthcare...At the Supercomputing Conference in Denver last year, I discovered an interesting project as I walked the expo floor. A PhD student from Louisiana State University, Shayan Shams, had set up a large monitor displaying a webcam image. Overlaid on the image were colored boxes with labels. As I looked closer, I realized the labels identified objects on a table. Of course, I had to play with it. As I moved each object on the table, its label followed. I moved some objects that were off-camera into the field of view, and the system identified them too.

How Citizens Become Scientists with Open Hardware

Eymund Diegel, a research coordinator for Gowanus Canal Conservancy, shares this tidbit during the first clip of the new Open Source Stories documentary, "The Science of Collective Discovery." He's setting out in a canoe on an inner-city canal that is polluted and struggling to get the help it needs. That's the theme of citizen science it seems: people and places in need who are not getting the help and resources they deserve taking matters into their own hands. Why are they not getting the help they need in the first place? The reason is shockingly simple yet a typical problem: Where's the evidence?

12 Students Picked to Work on OpenMRS Projects as Part of the Google Summer of Code 2018 Program

Congratulations and a warm welcome to the 12 students selected for Google Summer of Code 2018, and extended thanks to our fantastic group of OpenMRS project mentor volunteers, as well as all students that submitted applications this year! A total of 1,264 students from 64 different countries have been accepted to work with more than 200 open source projects for GSoC 2018. Since 2007, OpenMRS has enjoyed participating in this great program, and we’re thrilled to be involved again this year, marking our 12th year of participation. We’re looking forward to working with a diverse set of students and mentors across a range of exciting and impactful projects.

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On the Need to Improve User-Centered Design (i.e. Design Thinking) for Healthcare IT Usability

The lack of usability of electronic health records (EHRs) and healthcare IT applications, in general, has been in the news a lot again. This time it is a research report published in the Journal of the American Medical Association (JAMA) on March 27. The study analyzed voluntary error reports associated with EHR systems and found that problems with EHR usability may have directly resulted in patient harm. Unfortunately, this situation is all too common in the healthcare industry. Numerous health care systems are designed and created ad hoc, or with a very engineering-centric approach. End users are dissatisfied and often systems or workflows are abandoned and/or dangerous work-a-rounds created. A lot of people are saying Healthcare IT needs a disruption. What HealthIT needs is to begin to learn about and understand the needs, goals, and methods of the actual end-users, like doctors, nurses, medical assistants, etc.

US Core Data for Interoperability Task Force Delivers its Recommendations

On April 18, 2018 the HHS Health Information Technology Advisory Committee (HITAC) US Core Data for Interoperability Task Force delivered its recommendations on the draft US Core Data for Interoperability (USCDI) and Proposed Expansion Process which had been published for public comment back in January 2018. HITAC promptly accepted the Task Force’s recommendations. The Task Force focused almost exclusively on the process for identifying the USCDI rather than the proposed USCDI data itself. I especially appreciated their introduction of some key concepts related to how USCDI should be organized and understood.

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Why the VA Should Stick with VistA and Not Waste $16 Billion on an Attempt to Replace It

This VA leadership lull provides an opportunity for reflection. Specifically, it’s worth asking while we have the time whether Cerner is the right path for the VA to take. While the decision may seem like a no-brainer to some, the VA’s situation is unique and arguably calls for a singular approach to both existing organizational issues and a major healthcare IT decision. Specific to the Cerner decision, what should the new VA secretary consider?

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Signatures are No Longer Required for Credit Card Transactions...How Come Most Medical Records Exchanges Still Require Fax Machines?

If you live in the U.S., you've probably had the experience of paying for a meal using a credit card. The server takes your card, disappears to somewhere in the back, does something with it that you can't see, and returns with your card, along with two paper receipts, one of which you need to sign. Everything that happens to me, I think, what is this, the 1960's?As of last week, the major credit card companies -- American Express, Discover, Mastercard, and Visa -- are no longer requiring that signature. As a Mastercard person told CNET, "It is the right time to eliminate an antiquated practice."

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Healthcare Has Cost Problems, but IT and EHRs Do Not Have to be One of Them

I’m proud to lead a group of intelligent and energetic technology professionals committed to developing a robust healthcare IT system that is (1) easy for clinicians to use, (2) improves patient health and (3) doesn’t bankrupt hospital budgets. We think any sustainable system must have those three key requirements. And how is healthcare doing thus far? The EHRs available today are developing rapidly. Vendors are making frequent and impactful improvements to improve system usability. Clinicians are getting better at maximizing the contribution healthcare IT makes to patient health and safety. It’s not hard to see how healthcare IT can meet the first two requirements and broadly contribute to improved healthcare.

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Mainstream Academia Embraces Open Source Hardware

Twenty years ago, even staunch proponents of free and open source software like Richard Stallman questioned the social imperative for free hardware designs. Academics had barely started to consider the concept; the number of papers coming out annually on the topic were less than could be counted on someone's fingers. Not anymore! Not only has the ethical authority of Stallman embraced free hardware and free hardware design, but so has the academic community. Consider the graph below, which shows the number of articles on open source hardware indexed by Google Scholar each year from 2000 to 2017. In the last 17 years, the concept of open source hardware has erupted in ivory towers throughout the world. Now more than 1,000 articles are written on the topic every year.

New Modalities for Technical Assistance Consulting

Technical assistance (TA) is provided by expert consultants to public health systems projects in order to improve their performance against functional standards or to help solve recurring or one-time problems or issues. Unlike other forms of training or support, TA is usually focused or tailored to a specific circumstance or situation. Common examples of TA include assistance to a jurisdiction in migrating from one product to another, consultation related to a specific programmatic initiative such as school immunization health compliance, EHR interoperability implementation, or data quality review.

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