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National Patient Identifier with FHIR is the answer
Direct Secure messaging has been implemented across the country by many physicians and hospitals due to ONC Meaningful Use requirements. Direct is great for clinician to patient interaction or even consults in some cases. Is this really the way that we should be sharing patient information? Ideally, we want the information in the patient record not just between two clinicians out of band and not stored in the patient history. This way anyone entering later in the patient care scenario has access to the information should it become necessary and the patient has also consented to the release. Read More »
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The Postmodern EHR: What can Health IT Learn from the Evolution of the ERP Market?
It seems the pattern is clear. From best of breed to integrated (mega)suite to a new world of innovative, agile, mostly cloud based and multivendor solutions. This is what Gartner calls “Postmodern”. According to Christensen, disruption like this becomes possible when the established players start exceeding the requirements and expectations of their customers, providing only sustaining innovation – i.e. adding more and more features to their products. This is what was happening in the personal productivity space with the Office products. Similarly, the ERP market today has well defined requirements and this allows the newcomers to disrupt, meeting the base expectations and adding innovation and agility while lowering costs.
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Using Blender to Prepare for Orthopedic Surgeries
The planning of orthopedic surgeries is a difficult process. In a lot of ways, it's like working while wearing a blindfold; a surgeon can't see the bone that needs to be worked on until during the actual surgery, when time is most critical. Even with X-rays and CT scans, the raw data can be difficult to interpret correctly. Fortunately, open source software can (and does!) help reduce the guesswork. At the 2015 Blender Conference, Vasily Shishkin gave a very interesting talk on his research project and use of Blender and 3D printing in the planning and guiding of orthopedic surgery...You may find yourself thinking, "Wait a minute. Blender? The same Blender that's used for making pretty images and animations? That Blender?" Yes. That Blender...
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Bingo Medicine: Are EHRs Oppressive Straightjackets?
For several decades, software builders have tried to help doctors practice medicine more efficiently and more effectively. As is often the case with good intentions, the results turned out to be a mixed bag of goods, with paternalistic overtones from the helpers and mostly resentment and frustration from those supposedly being helped. Whether we want to admit it or not, the facts of the matter are that health IT and EHRs in particular have turned from humble tools of the trade to oppressive straightjackets for the practice of medicine. Somewhere along the way, the roles were reversed, and clinicians of all stripes are increasingly becoming the tools used by technology to practice medicine.
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Python-based Open Source Eye Tracking Tool
I have a deep interest in educational psychology, and so I was fascinated by what I read about PyGaze—an open source toolbox for eye tracking in Python. The website told me that it runs on Linux, but I wanted to learn more about eye tracking and the role it plays in psychological research. I also wanted to know more about the project and how it is contributing to research and its implications for open source. In this interview, the lead developer for the project, Edwin Dalmaijer, who works at the University of Oxford's Department of Experimental Psychology doing research and programming, provides a fascinating description of PyGaze and the significance of eye tracking in research...
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Halamka: 2015 In Review
It’s now December and as each year ends, I always look back on the challenges and achievements of the past 12 months. Here’s my sense of 2015. ICD10 - billions were spent, countless other projects were delayed, and the transition occurred on October 1 without a major incident...Did we get our money’s worth? I have argued and will continue to assert that ICD-10 benefited no one. The diagnoses used are more variable so there is less precision in their use. Clinical documentation (in general in the industry) does not have the specificity needed to justify the more granular ICD-10 codes. The notion that quality measures can now be computed more accurately from ICD-10 coded administrative data is just not true...
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On A Mission To Make Linux As Accessible As Possible
This article details the circumstances behind my switch away from proprietary operating systems and my switch to Linux. Like many, I switched out of frustration with other operating systems and not directly because of Linux's open source model. I developed my passion for that after the switch was made. It was August 18, 2011. I had just completed the umpteenth restoration from factory of Windows 7 on my HP laptop. I had just installed the open source screen reader I was using at the time, NVDA, as well as some of the applications I used on a daily basis, such as the Mush-Z MUSHClient...
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How Do We Balance Civil Liberties With Treatment Of The Mentally Ill?
In January of this year, political analyst Norman Ornstein lost his 34-year-old son, Matthew, to accidental carbon monoxide poisoning. While Matthew’s death was a tragic blow to family and friends, it was not the kind of out-of-the-blue shock that comes with absolutely no forewarning. Matthew, as Ornstein says in a New York Times op-ed published last month, had struggled with mental illness for 10 years, which contributed to poor decision making and his untimely death. A resident scholar with the American Enterprise Institute and writer for The Atlantic and Washington Post, Ornstein says that perhaps the most difficult aspect of Matthew’s death was the inability of family and friends to help treat Matthew’s mental health challenges after he had his initial psychotic break.
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Using the Open Source Way to Solve the Innovation Problem
A couple of weeks ago a Chief Digital Officer (CDO) of one of the largest mobile telecommunications companies in the world asked me how a large organization such as hers should think about organizing itself to maintain control over costs and risks while still giving their global organization the freedom to innovate...When asked if I had any insights from my work with other large global organizations, it occurred to me the ideal model she is seeking is very aligned to how an Open Source project like Drupal is managed (a subject I have more than a passing interest in).
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How I Ended Up Working in Open Source Healthcare
These days I am one of a small handful of core committers to OpenEMR, but more importantly I am the visible face of the project through my role as the current president of the OEMR.org 501(c)(3), standing on the contributions of a respectable, worldwide, community of active users, contributing developers, and vendors. We have done some seemingly impossible things, like get the OpenEMR project through the ONC's "Meaningful Use" Certification, without which it would have all but died out in the United States. Now, with the project 14 years old and about to be recertified under Meaningful Use Stage 2, it's time to reimagine and reengineer the core without losing the goodness we have and the good will of the community...
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