The list
of sessions at the Open Source convention’s health care track was
published this week. We found it wonderfully gratifying to get so many
excellent submissions in the brief three weeks that the Request for
Proposals was up. Although the credentials of the presenters cover a
lot of impressive accomplishments, my own evaluation focused on how
the topics fit into four overarching areas we’re following at
O’Reilly:
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Patient-centered records, education, and activity
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Mobile devices to collect and distribute health care information
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Administrative efficiencies, which could range from automating a
manual step in a process to revising an entire workflow to eliminate
wasteful activities -
The collection, processing, and display of statistics to improve
health care
Our OSCon track has something to say in all these areas, and lots
more. Here’s what I like about each of the proposals we chose.
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Nobody sees just one doctor or stays in just one hospital. So one of
the pressing needs in health care is to remove the barriers to
exchanging patient records, while ensuring they go only to authorized
recipients. A project called the Nationwide Health Information Network
(NHIN), currently run by the U.S. Department of Health and Human
Services, acts as a broker for the authorizations and data exchanges
between health care providers.NHIN has taken on a new excitement over the past couple years for two
reasons involving the two great motivators in policy work: people and
money. The people-based motivator came when HHS opened up key parts of
the NHIN software and actively built a nationwide community to make it
more usable. The money-based motivator came from the federal stimulus
bill, which allocated billions to promote electronic records and data
exchange.While HHS’s Centers for Medicare and Medicaid handle the incentives
for providers accepting Medicare and Medicaid, the HHS Office of the
National Coordinator leads the programs to make information exchange
possible. NHIN work includes two major initiatives taking on the
challenge of data exchange. (Note: When originally posted, this
blog incorrectly attributed the incentives to the ONC as well.)The first initiative is NHIN CONNECT, a platform for interconnecting
the patient health data systems of hospitals, health care providers,
and federal health agencies. David Riley and Brian Behlendorf,
contractors to HHS on this project, will
recount the steps in creating a robust community around
CONNECT. Will Ross will give us the view from the ground, as a regional
Health Information Exchange sets up and carries out data transfers
among clinics in a rural area. Nagesh Bashyam will give more insight
into the CONNECT development process.The second initiative is a new project called NHIN Direct, which is focused on a
more “push”-oriented approach to secure messaging in the healthcare
industry. Its core principles include “rough consensus and running
code”, and is on a breakneck pace to get from user stories to
production implementation by the end of the year. Arien Malec, a
health IT industry entrepreneur who leads the NHIN Direct effort as a
contractor to HHS, will describe the
history and mission of the project. -
The Veterans Administration went over a ten- or fifteen-year period
from being one of the least satisfactory health care providers in the
US to one of the most highly praised. Its classic electronic medical
system, VistA, is a key component of that success, and VistA has been
open source for several years. None of the leading-edge initiatives
mentioned earlier in this blog can be accomplished without an
electronic medical system, and proprietary ones have the disadvantages
not only of high cost but of being silo’d. Open source systems
facilitate both innovative enhancements and data exchange.Ben Mehling will
introduce VistA, its open source distributions, and how community
contributors are adapting it to civilian use. Joseph Dal Molin
will show how
it improves patient care and the health care delivery
process. David Uhlman will continue the discussion with lessons
from working with VistA code. -
OpenEMR is one of the most
ambitious projects started by an open source community in health care.
Like VistA, OpenEMR is being prepared for certification along the
“meaningful use” criteria defined by HHS, so doctors can get federal
funds for using it. Tony McCormick and Samuel Bowen will
talk about advances in OpenEMR. -
In an age where people are talking back to the experts and striving to
gain more control as consumers, citizens, and patients, we can no
longer treat health care as a one-way delivery system administered by
omniscient, benevolent providers. Sam Faus will describe a open
source system for maintaining and delivering data to
patients. Teddy Bachour will cover APIs
and open source toolkits from Microsoft for clinical documentation and
sharing of patient records, and Roni Zeiger will cover how
Google Health’s API facilitates interactions with mobile devices,
thus supporting one of the key trends in health care mentioned earlier
in this blog. -
Scientific research can deliver almost futuristic advances in health
care, although the gap between promising lab results and effective
treatments is always frustrating and difficult to bridge. In addition,
statistics are critical for clinical decision support, now popularized
under the term “evidence-based medicine.”Melanie Swan shows how to bring
ordinary people into the research process in genetics. Chris
Mattmann, David Kale, and Heather Kincaid will describe a partnership
between NASA and Children’s Hospital Los Angeles to master and
harness the recalcitrant mass of clinical data and data formats.
Thomas Jones will talk about an open
source system to link patient information with research to improve
care. -
Medicine is moving from coarse-grained, invasive treatments such as
surgery and drugs to subtler, data-driven interventions using a
variety of devices. Karen Sandler will describe a personal
experience that led her to a campaign for open source medical
devices. -
Privacy is one of the touchiest subjects in health care. Few of us
risk real harm–such as losing our jobs or having our names splayed
across tabloid headlines–from privacy breaches, but there have been
instances of snooping and embarrassing breaches that make us skittish.Thomas Jones will describe
efforts to secure patient records in the Netherlands and how they
can apply to US needs. The talk shows the potential that comes from
giving patients access to their records, as well as the the advanced
state of some foreign initiatives in health care are. -
While we argue over access and costs in the US, most of the world has
trouble seeing a doctor at all. Dykki Settle and Carl Leitner will
describe tools
that can help underserved areas recruit and manage critical health
care staff. The talk will be a sobering reminder of the state of
health care across continents, and a ray of hope that technology
offers even in situations of great deprivation. The talk is also an
illustration of the use of technology to improve an administrative
process. -
Fred Trotter, a long-time leader in open source health care, and open
source advocate Deborah Bryant will provide overviews of open
source health care IT. David Uhlman summarizes open
source technologies for interpreting health care data.
The health care track takes a proud place as part of a huge,
diverse conference program at this year’s Open Source
convention. I’m sure discussions at the sessions and BOFs will
reveal connecting threads between health care IT and the other classic
open source topics at the conference.