News

Anatomy of a Public Health Open Source Project: HLN's Immunization Calculation Engine (ICE)

An immunization information system (IIS) aggregates immunization information for children (and some adults) living or receiving immunization services in a jurisdiction. One of the core components of an IIS is its immunization evaluation and forecasting system: the computerized algorithm that is used to determine if vaccine doses that were administered to the patient are clinically valid (evaluation) and to project what doses are due now and in the future (forecasting). These algorithms are used to support clinical decision support (CDS) at the point of care and also to help public health agencies understand and manage the immunization status of whole populations.

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Is Machine Learning for the Birds?

Cacophony Project uses the latest technology to monitor and protect endangered bird populations against predators. The Cacophony Project's broad vision is to bring back New Zealand's native birds using the latest technology to monitor bird populations and humanely eliminate the introduced predators that are endangering them. The project started in our founder's backyard to measure the effectiveness of his efforts to protect the birds on his property. From this simple beginning, the project has quickly grown into a system that includes two edge devices, a cloud server, and automatic identification of animals using machine learning. The project has been completely open source from the beginning and sees regular contributions from a wide variety of volunteers.

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AHRQ Releases Draft Guide for Registry Interoperability: Does Public Health Have a Role?

On January 11, 2019, the Agency for Healthcare Research and Quality (AHRQ) released a draft Addendum to the Third Edition of Registries for Evaluating Patient Outcomes: A User's Guide called Tool and Technologies for Registry Interoperability. AHRQ has long written about registries - largely from a research standpoint - and I have been following this from afar for some time. This new guide is focused on helping those who both create and use registries understand the issue surrounding leveraging external data to improve registry completeness, accuracy, and usefulness. This report covers lots of ground and does a good job of summarizing important subtopics. Each chapter is overflowing with footnotes and sources.

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Do Unto Robots As You...

We're going to have robots in our healthcare system (Global Market Insights forecasts assistive healthcare robots could be a $1.2b market by 2024), in our workplaces, and in our homes. Some of them will be unobtrusive, some we'll interact with frequently, and some we'll become close to. How to treat them is something we're going to have to figure out. Written by Alex Williams, Do You Take This Robot...focuses on people actually falling in love with (or at least preferring to be involved with) robots. Sex toys, even sex robots, have been around, but this takes it to a new level. The term for it is "digisexual." As Professor Neil McArthur, who studies such things, explained to Discover last year...

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The Shutdown Will Harm the Health and Safety of Americans, even After it's Long Over

With the U.S. federal government shutdown now the longest in history, it's important to understand what a shutdown means for the health and safety of Americans. The good news is that in the short run, the consequences are relatively few. But, as a researcher who studies natural disaster planning, I believe that Americans should be worried about the federal government's long-term ability to ensure good public health and protect the public from disasters. As the shutdown drags on, it increasingly weakens the government's ability to protect Americans down the road, long after federal workers are allowed to go back to work. Many of these effects are largely invisible and may feel intangible because they don't currently affect specific individuals...

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It's 2019. Smartphones are Out...On to the Next Big Thing...

It's amusing to watch old movies where plot points often involved someone's inability to talk to the person they needed, in the pre-mobile phone era. We take our smartphone's omnipresence and virtual omnipotence as a given in our daily lives and treat even its temporary loss as a major inconvenience. So why are people already wondering if the smartphone era is almost over? Speculation on this is not new (voice has been touted as the next big platform for years), but intensified after Apple announced reduced revenue expectations earlier this year -- the first time in 16 years. It specifically cited slower iPhone sales in China and, even more jarring, said it would no longer break out unit sales of iPhones...

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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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