open health
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Taking Lessons from the Open Source Movement & Craft Brewers, Doctor Revolutionizing Healthcare
Pioneering doctors are showing the way to a much higher performing system as I highlighted in Doctors' Declaration of Independence. They understand that every example of great societal movements to our toughest challenges have come from the bottom up. The fundamental structure of politics is to cement the status quo. If the status quo was performing well that would be OK, but it's clearly failing miserably. In fact, Chapter 1 of my new book is "America Has Gone to War for Less" (link to free copy of the book below) referring to the collateral damage from this wildly underperforming status quo. Fortunately, doctors are collaborating to change this such as the Direct Primary Care conference starting today in Orlando.
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Taking medical records into the digital age
...With a growing population and an increase in the number of patients, the pressure on doctors and hospital staff has increased drastically in the last decade. It has become very difficult for a physician to track a patient's medical history (including past visit information, lab results, previous medications, and drug allergies) through a traditional system. Read More »
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Team Bahmni at the OpenMRS Worldwide Summit
ThoughtWorks first began contributing to OpenMRS in 2006 and since that time, we've had over fifty committers to OpenMRS in GitHub. Incidentally, one in every seven OpenMRS contributor in GitHub is a ThoughtWorker! Naturally, in 2013, when we had the opportunity to build Bahmni, an open source hospital information system, we choose OpenMRS as the underlying Electronic Medical Records System (EMR). Bahmni leverages the mature data model and APIs of OpenMRS, whilst providing an out-of-the-box system that can be immediately used by hospitals.
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Tech Giants Back White House Open Source Health IT Initiative
Six major technology companies have thrown their support behind the White House's initiative to use an open source, collaborative, approach to accelerate the progress of health data standards and interoperability and to give patients access and control of their medical records. The companies; Amazon, Google, IBM, Microsoft, Oracle, and Salesforce signed a pledge that was presented at the White House's Blue Button 2.0 developer conference. The conference took place last Monday. Dean Garfield, president and CEO of the Information Technology Industry Council (ITI) told the press that “As transformative technologies like cloud computing and artificial intelligence continue to advance, it is important that we work towards creating partnerships that embrace open standards and interoperability.
- The Future Is Open
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The (Awesome) Economics of Open Source
Successful open source software companies "discover" markets where transaction costs far outweigh all other costs, outcompete the proprietary alternatives for all the good reasons that even the economic nay-sayers already concede (e.g., open source is simply a better development model to create and maintain higher-quality, more rapidly innovative software than the finite limits of proprietary software), and then-and this is the important bit-help clients achieve strategic objectives using open source as a platform for their own innovation. With open source, better/faster/cheaper by itself is available for the low, low price of zero dollars. As an open source company, we don't cry about that. Instead, we look at how open source might create a new inflection point that fundamentally changes the economics of existing markets or how it might create entirely new and more valuable markets.
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The Appeal of Graph Databases for Health Care
A lot of valuable data can be represented as graphs. Genealogical charts are a familiar example: they represent people as boxes, connected by lines that represent parent/child or marriage relationships. In mathematics and computer science, graphs have become a discipline all their own. Now their value for health care is emerging. Graph computing made a significant advance this past February in the form of a Graph Data Science (GDS) library for the free and open source Neo4j graph database. Graph databases are proving their value in clinical research and public health; I wonder whether they can also boost analytics for providers. This article explains what's special about graph databases, and some applications in health care highlighted by recent webinars offered by the Neo4j company.
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The Changing Face of Public Health System Procurement
The development and acquisition of public health systems is poised to change. Historically, public health agencies had the classic choice when it came to acquiring a new data system. Either they developed the system themselves – usually based on a belief that their requirements were “unique” – or they licensed a COTS/GOTS product from the limited choices available in a small market. Typically, agencies that chose to develop solutions were forced to use a waterfall approach as government procurement is not well suited to the flexibility of Agile systems development. Some agencies have been able to leverage open source offerings. While most do not have the wherewithal to support open source products themselves, many have formed strong partnerships with other organizations, both for-profit and nonprofit, to take advantage of these systems.
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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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The Growing OpenEMR Business Community
The OpenEMR community has been very active over this past year. This 'open source' electronic medical record (EMR) system continues to be enhanced by developers around the globe, the number of healthcare providers that have installed and begun using the system (over 15,000 sites world-wide) continues to grow, and a fairly robust business community of companies offering services and support is now in place. Read More »
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The Ontario Institute for Cancer Research and the Structural Genomics Consortium develop and give away new drug-like molecule to help crowd-source cancer research.
Through a novel open source approach the molecule has been made freely available to the cancer research community to help discover new therapeutic strategies for cancer patients sooner...Researchers from the Ontario Institute for Cancer Research (OICR) and the Structural Genomics Consortium (SGC) at the MaRS Discovery District in Toronto have developed a new drug prototype called OICR-9429 and made it freely available to the research community. Already research conducted by international groups using OICR-9429 has shown it to be effective in stopping cancer cell growth in breast cancer cell lines and a specific subtype of leukemia cells.
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The Open Patient: Advocating for Open Access to Medical Data
Steven Keating had always been interested in data and learning about things, which is why he volunteered to do a research scan when he was a student. The scan revealed an abnormality. In 2014, the abnormality had grown into a massive tumor. Soon he learned that there were many barriers keeping him from accessing his own data. "And that's what I've been sharing, which is this question: How come as a patient we're last in line for our own data? How come my doctors and my university researchers can see my tumor genome and I can't?"
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The Patient-Data Pipeline: The Missing Juncture of Flow and Connectivity in Healthcare IT Systems
Part of today’s complexity in healthcare stems from the way our healthcare IT systems have emerged. There are multiple entry points for patients into the healthcare system, from a relationship with a primary care physician to the sporadic, disconnected and random interaction with emergency departments, urgent care and wellness clinics. Based on current technology and the overall nature of the beast, it is highly doubtful that a single point of entry into the healthcare delivery system will ever occur and is actually less important than the quality and cost of the care delivered. The key is the understanding of how patients’ data flows through healthcare IT systems and building an infrastructure that optimizes that flow of data and information.
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The Postmodern EHR: What are the Enablers?
Traditional monolithic EHR architectures focus on stability and standardization at the expense of agility. Along with innovation, cloud based deployment and integration of things, agility is the main differentiator when describing the requirements of application architecture for the Postmodern EHR. Achieving agility is impossible for the vast majority of healthcare applications today as they are an inseparable mix of code for user interface, decision logic, workflows and data definitions. New architectures promote agility and reuse by turning the applications inside out and layering the four types of programming into portals, rule engines, process engines and XML data. Let’s look at some examples, layer by layer:
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The Postmodern EHR: The Data Layer
This second approach entails defining a data layer, which is the most important aspect of the Postmodern EHR architecture from my previous post. Why is this the most important layer? Most healthcare organizations are beginning to realize that their data is more valuable than their applications. Data has become a key asset, since good data is key to improving outcomes, managing chronic disease and enabling population health management. And it needs to be managed for the lifetime of the patient. Which application is going to last that long? What happens to health data when we switch applications?
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The Right Way to Modernize VA's VistA EHR: Shift Development to the Private Sector and the Cloud
While changes to VistA are warranted and necessary, trashing the entire system because one component may be flawed makes little sense from technological or financial perspectives. The VA scheduling scandal was the product of an agency overwhelmed by veterans returning from two theaters of war. In that scenario, the scheduling system became a scapegoat for organizational and human resources challenges that were bound to manifest in one way or another.The VA should not heed calls to replace VistA for these key reasons...
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