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Transforming Health Care Through A 360-Degree View Of Data

How medical care can be substantially improved through a full spectrum view of all factors that affect health was the topic of Payam Etminani's presentation at the 2019 IDGA Veterans Benefits Conference in Washington D.C. Etminani, the CEO of Bitscopic, argued that the ability to view all health data including social, environmental and genomic information in addition to the traditional clinical measures (vital signs, blood work, history of illness etc), would lead to significant improvement in care. Etminani described how recent advances in Big Data and Artificial Intelligence (AI) make combining and using these large and widely varied sets of information possible. Read More »

Let's Place Some Big Bets - Reinventing Medical Care

When we think about market research and Big Data, think about Henry Ford's (possibly apocryphal) quote: Most of our healthcare innovations and reforms take the existing healthcare system as a given and try to build upon it in some way. They add more on-ramps to the healthcare superhighway, widen its lanes, try to smooth the pavements, maybe even automate our driving on it. But sometimes we need to tear the highway down. Here, in brief, are some big bets I'd like to see someone take on...

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What Blockchain and Open Source Communities Have in Common

One of the characteristics of blockchains that gets a lot of attention is how they enable distributed trust. The topic of trust is a surprisingly complicated one. In fact, there's now an entire book devoted to the topic by Kevin Werbach. But here's what it means in a nutshell. Organizations that wish to work together, but do not fully trust one another, can establish a permissioned blockchain and invite business partners to record their transactions on a shared distributed ledger. Permissioned blockchains can trace assets when transactions are added to the blockchain. A permissioned blockchain implies a degree of trust (again, trust is complicated) among members of a consortium, but no single entity controls the storage and validation of transactions.

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New Report: Top Challenges Facing HHS Includes Harnessing Data

In November 2019 the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) released a new report, Top Management and Performance Challenges Facing HHS. Divided into six major sections, this report reviews the OIG's observations with respect to financial integrity of HHS programs, value and quality, protecting the health and safety of beneficiaries as well as the public at large, harnessing data to achieve these goals, and working across government. The fifth challenge, "Harnessing Data To Improve Health and Well-Being of Individuals," is particularly foundational. Read More »

An introduction to Hyperledger Fabric

One of the biggest projects in the blockchain industry, Hyperledger, is comprised of a set of open source tools and subprojects. It's a global collaboration hosted by The Linux Foundation and includes leaders in different sectors who are aiming to build a robust, business-driven blockchain framework. There are three main types of blockchain networks: public blockchains, consortiums or federated blockchains, and private blockchains. Hyperledger is a blockchain framework that aims to help companies build private or consortium permissioned blockchain networks where multiple organizations can share the control and permission to operate a node within the network. Since a blockchain is a transparent, immutable, and secure decentralized system, it is considered a game-changing solution for traditional supply chain industries. It can support an effective supply chain system by:

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Towards a New EHR Metaphor - Or, How to Fix Unusable EHRs

News flash: docs hate Excel! In a recent study, which included researchers from Yale, the Mayo Clinic, Stanford, and the AMA, physicians rated it only at 57% on a usability rating, far below Google search (93%), Amazon (82%), or even Word (76%). But, of course, Excel wasn't their real problem; the study was aimed at electronic health records (EHRs), which physicians rated even lower: 45%, which the study authors graded an "F." If we want EHRs get better, though, we may need to start with a new metaphor for them.Lead author Edward Melnick, MD, explained the usability issue: "A Google search is easy. There's not a lot of learning or memorization; it's not very error-prone. Excel, on the other hand, is a super-powerful platform, but you really have to study how to use it. EHRs mimic that."

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Getting Started With Pimcore: An Open Source Alternative For Product Information Management

Product information management (PIM) software enables sellers to consolidate product data into a centralized repository that acts as a single source of truth, minimizing errors and redundancies in product data. This, in turn, makes it easier to share high-quality, clear, and accurate product information across customer touchpoints, paving the way for rich, consistent, readily accessible content that's optimized for all the channels customers use, including websites, social platforms, marketplaces, apps, IoT devices, conversational interfaces, and even print catalogs and physical stores...For years, there have been proprietary products that address some of these needs, like Salsify for data management, Adobe Experience Manager, and SAP Commerce Cloud for experience management, but now there's an open source alternative called Pimcore. Read More »

It's Time To Pay The Maintainers

Earlier this year, Tidelift conducted a survey of over 1,200 professional software developers and open source maintainers. We found that 83% of professional software development teams would be willing to pay for better maintenance, security, and licensing assurances around the open source projects they use. Meanwhile, the same survey found that the majority of open source maintainers receive no external funding for their work, and thus struggle to find the time to maintain their open source projects. So, to put what we learned succinctly...It's time to pay the maintainers. Not just because they deserve to be compensated for their amazing work creating the software infrastructure our society relies on (they do!). But also because there is a ready-made market of professional developers willing to pay for assurances they are in the best position to provide. Here's an idea for how to do it...

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Instead of Medicare for All, How about VA for All?

I wonder -- why would people be calling for a new system that would still have thousands of private hospitals/facilities and millions of healthcare professionals, practicing FFS medicine using countless systems and data structures? In short, why aren't people calling for VA for All? Like Medicare, the VA -- more especially, its healthcare component, the Veterans Health Administration -- is charged with providing healthcare to a designed population, in this case, veterans. Unlike Medicare, though, it does so as an integrated health system (by far the largest in the U.S.), with 170 VA Medical Centers, over a thousand outpatient facilities, and somewhere over 100,000 physicians...it offers some of the finest care in the world. It offers a range of services that Medicare can only dream of, and it does so at, it is believed, lower costs than private coverage or even Medicare. Plus, it also was an innovator in electronic health records and is today in telehealth. What's not to like?

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ONC Patient Matching Project Moving Forward...Slowly

Last week, the Office of the National Coordinator for Health Information Technology (ONC) released the final report from its Patient Matching, Aggregation, and Linking (PMAL) Project, as well as an additional report describing a pilot project to test the Patient Demographic Data Quality Framework (PDDQ) to Support Patient Matching that was released several years ago. Funded from June 2015 through September 2018 by the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) through the Patient-Centered Outcomes Research (PCOR) Trust Fund, PMAL was one of the activities I described in an earlier post. The Final Report reviews the four challenged of patient matching and linking that the PMAL project attempted to address...

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