Harvard Medical School conference lays out uses for a health data platform
This week has been teaming with health care conferences, particularly in Boston, and was declared by President Obama to be National Health IT Week as well. I chose to spend my time at the second ITdotHealth conference, where I enjoyed many intense conversations with some of the leaders in the health care field, along with news about the SMART Platform at the center of the conference, the excitement of a Clayton Christiansen talk, and the general panache of hanging out at the Harvard Medical School.
SMART, funded by the Office of the National Coordinator in Health and Human Services, is an attempt to slice through the Babel of EHR formats that prevent useful applications from being developed for patient data. Imagine if something like the wealth of mash-ups built on Google Maps (crime sites, disaster markers, restaurant locations) existed for your own health data. This is what SMART hopes to do. They can already showcase some working apps, such as overviews of patient data for doctors, and a real-life implementation of the heart disease user interface proposed by David McCandless in WIRED magazine.
How patient pseudonyms can inspire trust in the Direct Project's network.
Yesterday, Meaningful Use Stage 2 was released.
As we read and parse the 900 or so pages of government-issued goodness, you can expect lots of commentary and discussion. Geek Doctor already has a summary and Motorcycle Guy can be expected to help us all parse the various health IT standards that have been newly blessed. Expect Brian Ahier to also be worth reading over the next couple of days.
I just wanted to highlight one thing about the newly released rules. As suspected, the actual use of the Direct Project will be a requirement. That means certified electronic health record (EHR) systems will have to implement it, and doctors and hospitals will have to exchange data with it. Awesome.
More importantly, this will be the first health IT interoperability standard with teeth. The National Institute of Standards and Technology (NIST) will be setting up an interoperability test server. It will not be enough to say that you support Direct. People will have to prove it. I love it. This has been the problem with Health Level 7 et al for years. No central standard for testing always means an unreliable and weak standard. Make no mistake, this is a critical and important move from the Office of the National Coordinator for Health Information Technology (ONC).
OpenPlans looks to improve transportation infrastructure with open data and open source code.
Earlier this year, the news broke that Apple would be dropping default support for transit in iOS 6. For people (like me) who use the iPhone to check transit routes and times when they travel, that would mean losing a key feature. It also has the potential to decrease the demand for open transit data from cities, which has open government advocates like Clay Johnson concerned about public transportation and iOS 6.
“From the public perspective, this campaign is about putting an important feature back on the iPhone,” wrote Kevin Webb, a principal at Open Plans, via email. “But for those of us in the open government community, this is about demonstrating why open data matters. There’s no reason why important civic infrastructure should get bound up in a fight between Apple and Google. And in communities with public GTFS, it won’t.”
Open Plans already had a head start in creating a patch for the problem: they’ve been working with transit agencies over the past few years to build OpenTripPlanner, an open source application that uses open transit data to help citizens make transit decisions.
Report from the field by Tony McCormick
The concept of an Accountable Care Organization (ACO) reflects modern hopes to improve medicine and cut costs in the health system. Tony McCormick, a pioneer in the integration of health care systems, describes what is needed on the ground to get doctors working together.
Highlights from the full video interview include:
- What an Accountable Care Organization is. [Discussed at the 00:19 mark]
- Biggest challenge in forming an ACO. [Discussed at the 01:23 mark]
- The various types of providers who need to exchange data. [Discussed at the 03:08 mark]
- Data formats and gaps in the market. [Discussed at the 03:58 mark]
- Uses for data in ACOs. [Discussed at the 5:39 mark]
- Problems with current Medicare funding and solutions through ACOs. [Discussed at the 7:50 mark]
You can view the entire conversation in the following video:
Data as a platform, patient control, and partnerships are key
The quantum leap we need in patient care requires a complete overhaul of record-keeping and health IT. Leaders of the health care field know this and have been urging the changes on health care providers for years, but the providers are having trouble accepting the changes for several reasons.
What’s holding them back? Change certainly costs money, but the industry is already groaning its way through enormous paradigm shifts to meet current financial and regulatory climate, so the money might as well be directed to things that work. Training staff to handle patients differently is also difficult, but the staff on the floor of these institutions are experiencing burn-out and can be inspired by a new direction. The fundamental resistance seems to be expectations by health providers and their vendors about the control they need to conduct their business profitably.