News

Apple Watch Leaves Patients Connected with Nowhere To Go

The highly anticipated unveiling of the Apple Watch Series 4 caused a news and social media sensation. Apple coined the iconic timepiece as the "guardian of your health", with health tracking functionalities such as the ability to detect atrial fibrillation (AFib) by a self-performed electrocardiogram (ECG). But from patients' and carepartners' perspectives, there is a long road to a universally accessible, seamlessly implemented, mass-adoption, and meaningful use for this wearable technology...Unfortunately, the vast majority of concerns in the public domain haven't emphasized the risks to health due to poor implementation, integration, and adoption strategies of digital tools and wearables.

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The Story of How our Health Informatics Textbook Came into Being

I have been asked many times how and why I became interested in Health Informatics and how that led to the writing and self-publication of our textbook, Health Informatics: Practical Guide. The textbook is now in its 7th edition and has been adopted by a large number of universities for their health informatics courses. More co-authors have come on board, and we are now looking at publishing other textbooks. Thus we thought this would be a good point to tell the story.

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How are Clinical Decision Support Artifacts Tested Today?

In October 2018 the Centers for Disease Control and Prevention (CDC) issued a Request for Information (RFI) for a Natural Test Collaborative (NTC). Through a series of questions, the RFI seeks opinions and information about "The development of a national testbed (notionally called the National Test Collaborative (NTC)) for real-world testing of health information technology (IT)" and "Approaches for creating a sustainable infrastructure" to achieve it. The scope of this RFI is daunting. It might be useful, rather than to try to tackle this whole topic broadly but superficially, to take just one Clinical Decision Support (CDS) domain and show as completely as possible how testing is currently done.

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The Empire Strikes Back

It seems deeply ironic that a week after I wrote about how even giant companies eventually get surpassed, I'm writing about the resurgence of one such giant, Microsoft. Last week Microsoft won back the title of world's most valuable company (as measured by market cap), passing Apple. Apple had that distinction since 2012; Microsoft hasn't had it since 2002. Admittedly, Microsoft was only able to pass Apple because a recent tech stock downturn dropped Apple from its record trillion-dollar valuation, and, as of this writing, Apple has pulled back in front again, but the fact that it is a race again says a lot about Microsoft.

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Using the Open Source LibreHealth EHR for Education in Academic Settings

Traditionally, access to EHRs has been viewed as important only for software training, particularly order entry. What seems to be overlooked is the potential for education, analytics and research. Additionally, one could argue that there should be an open-source “EHR Sandbox” so multiple external EHR integrations could be studied and reported. Furthermore, many EHR users view the software as a means to enter or extract data on one patient at a time and fail to see the benefit in analyzing their entire clinic population (population health). The following diagram displays how an EHR could be used for education, training, analytics and research.

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How Cyber Hardening Can Protect Patient Privacy And Treatment

The abundance of internet-connected devices that collect and share patient data has greatly increased the “attack surface” (where an attacker inserts or extracts data) and number of possible vulnerabilities within a system. Now that medical devices can connect to home-based routers, public Wi-Fi or cellular networks to relay data to hospitals, specialists, and care providers. In addition, the software in those devices lacks cybersecurity and can be updated and reprogrammed remotely. Thus, sensitive patient information is even more prone to data breaches, and the safety of the devices can be compromised. Recent supply chain compromises, and the migration of health applications and platforms to the cloud, also add to the threat equation. This article looks at why the medical community is so vulnerable and suggests how it can better protect life-saving equipment and sensitive data from unprecedented cyberattacks.

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CDC Issues RFI for Real-world Testing of Health Information Technology

In October the Centers for Disease Control and Prevention (CDC) issued a Request for Information (RFI) for a Natural Test Collaborative (NTC). Through a series of questions, the RFI seeks opinions and information about "The development of a national testbed (notionally called the National Test Collaborative (NTC)) for real-world testing of health information technology (IT)" and "Approaches for creating a sustainable infrastructure" to achieve it. The scope of the questions is somewhat confusing and quite broad, starting with Clinical Decision Support (CDS) and electronic Clinical Quality Measures (eCQMs) but quickly expanding to Electronic Health Records (EHR) and interoperability (not precisely defined).

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The Big Get Bigger, Until They Don't

You may have missed it, but the Open Markets Institute released a report on what it calls "America's Concentration Crisis." The report begins bluntly: "Monopoly power is all around us: as consumers, business owners, employees, entrepreneurs, and citizens." As David Leonhardt wrote in his op-ed about the report, "The federal government, under presidents of both parties, has largely surrendered to monopoly power." Their associated data set details market concentration within 32 industries, several of which are health related. For example, in electronic health record systems, the top 3 firms account for 58% of the market, whereas in pharmacies/drugstores, the top 3 control 67% (and the top 2 alone have 61% share).

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Is the US Finally Ready to Get Serious About Biodefense?

Biological and other disaster threats - whether accidental, driven by forces of nature, or intentional - pose fairly grave risks to the United States and the world. Situational awareness has been a conspicuous topic ever since the 9/11 attacks and the anthrax scare that followed shortly thereafter. Since then we have experienced numerous disasters: health impacts of major weather events such as hurricanes and earthquakes, new virus outbreaks like Ebola in Africa, raging wildfires on the West Coast (I live in California), and the ever-present threat of pandemic flu which a hundred ago infected some 500 million people across the globe and killed an estimated 50 million people worldwide, according to the Center for Disease Control and Preparedness (CDC). But since the initial flurry of public health preparedness funds in the ensuing several years after the 9/11 attacks, this topic has not had a high priority at CDC nor the funding necessary to implement it successfully.

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The Business of Healthcare Is Business

Hmm, that headline doesn't seem right, does it? I mean, shouldn't the business of healthcare be, well, health? Or, at least, caring? Actually, shouldn't the business of healthcare be patients? After all, everyone in healthcare says it's all about patients. Everyone says they're patient-centered, whatever that means. But think about this: who in healthcare gets paid for you to be healthy? Or, conversely, who in healthcare doesn't get paid when you get sick, or when you don't improve under their care? Whether we planned it or not, whether we admit it or not, or whether we like it or not, our healthcare system is a business that has become about making money.

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