This week I’ve taken vacation time to help my colleagues in Japan and New Zealand with national IT planning. As I often say, the healthcare IT challenges are the same all over the world, but the cultural context is different. In Japan, I spent 2 days in Tokyo and 1 day in Kyoto, lecturing, meeting, and listening to stakeholders. There is a great desire to share data for care coordination and clinical trials/clinical research. Telemedicine/telehealth is increasingly important in an aging Japanese society that has increasing healthcare needs but a limited number of caregivers and few opportunities to increase healthcare budgets. Here are a few of the current issues we discussed...
Feature Articles
Asking Better Questions and Improving Patient Engagement
By Kim Bellard | February 13, 2017
I've been thinking about questions. A few things I read helped spur this. The first was a blog post entitled "Asking the Wrong Questions" by Benedict Evans, of VC firm Andreessen Horowitz, Mr. Evans looked at a couple of long range technology forecasts (from as long ago as 1964 and as recently as 1990), and pointed out how they both managed to miss several key developments. He attributed this to "this tendency to ask the wrong questions, or questions based on the wrong framework." And we're still at it. Mr. Evans, whose background is mobile technologies, said that people are now doing a lot of speculating about what comes "after mobile," such as AR and VR...
Nanopillars Help Orthopaedic Implants Resist Infection
By Madhukara Putty | May 18, 2017
Inspired by insect wings that kill bacteria on contact, Indian researchers have developed a method to treat the surface of titanium orthopaedic implants at nano-scales so that they resist bacterial infection — a complication that often develops following surgery. Orthopaedic implants like hip joints, knee joints, plates and screws can be treated to resist bacteria without the use of antibiotics, says a paper published online in Scientific Reports...
Halamka's Health IT Observations from Japan and New Zealand
By John D. Halamka, MD | February 8, 2017
Can the Healthcare System Change Its Spots?
By Kim Bellard | February 7, 2017
Just a few years ago, things were looking up for the American health care system. We were going to start finding better ways to pay for care: call it pay-for-performance (P4P), value-based purchasing (VBP), or similar terms. We were going to nudge -- or, rather, push -- providers into more clinically integrated systems (e.g., ACOs) to help improve outcomes and to control costs. And, of course, with wider use of electronic health records (EHR), we'd be able to better coordinate care and make decisions based on actual data. It all sounded very promising. Now, though -- what's that old expression about the leopard not being able to change its spots?...
How the University of Hawai'i Is Solving Today's Higher Ed Problems
By Don Watkins | June 3, 2017
Openness invites greater participation and it takes advantage of the shared energy of collaborators. The strength of openly created educational resources comes paradoxically from the vulnerability of the shared experience of that creation process. One of the leaders in Open Educational Resources (OER) is Billy Meinke, educational technologist at the University of Hawai'i at Manoa. The University's open creation model uses Pressbooks, which Billy tells me more about in this interview...
Dedicated Engineering Team in South Africa Deploys Open Source Tools, Save Lives
By Simon de Haan | February 20, 2017
In 2006, a groundbreaking TED talk used statistics to reveal surprising insights about the developing world, including how many people in South Africa have HIV despite free and available anti-retroviral drugs. Gustav Praekelt, founder of Praekelt.org, heard this TED talk and began tenaciously calling a local hospital to convince them to start an SMS program that would promote anti-retrovirals. The program that resulted from those calls became txtAlert—a successful and widely recognized mobile health program that dramatically improves medical appointment adherence and creates a free channel for patients to communicate with the hospital...
Halamka Says "We Must Think and Act as One Planet"
By John D. Halamka, MD | February 1, 2017
Over the past few days, several journalists have asked me to comment about travel bans, immigration policy changes, and trends in isolationism. My opinions are my own and do not reflect any official position from my employer or my academic affiliation. Information Technology is global. We hire the best talent regardless of nationality, gender identity, sexual orientation, religion, or race/ethnicity. Having worked in 75+ countries in my adult life, I can say that innovation crosses all boundaries and cultures. It’s just as likely that next big breakthrough will come from EMEA as it is from APAC. I cannot imagine restricting the flow of collaboration among academics and technology professionals from any country...
Diagnosing the Problem with Direct-to-Consumer Pharmaceutical Ads
By Kim Bellard | January 31, 2017
Quick: turn on the TV (no, streaming doesn't count!). You won't have to wait too long before an ad for some prescription drug comes on. Watch long enough and pretty soon you'll suspect that you have a variety of conditions that you may have never realized before and need to do something about immediately. Fortunately for you, of course, the pharmaceutical industry has solutions for you. It's all there in those ads. Whether we really understand them or not is another question. Direct-to-consumer (DTC) ads for prescription drugs are booming. After a brief respite during the most recent recession, they're back up, with spending estimated at some $5.2b in 2015 (amazingly, the DTC ads are less than 20% of pharma's overall marketing budget, with the majority of that going to face-to-face "educational" efforts with physicians)...
Postmodern EHR: Solving the feral systems dilemma
By Tomaž Gornik | February 2, 2017
Feral systems are software solutions developed by individuals or groups to help with day-to-day activities. They are called feral (or “wild”) because they are used in addition to core IT systems, working around key system architecture – more often than not without the blessing of management. I was first made aware of this expression a couple of years ago by Ewan Davis, who wrote a blog post about it stating: “The hundreds of “Feral Systems” in an average large hospital represent a goldmine of knowledge and innovation that could be harnessed in the design of digital systems that really work, but as they are today they also create a massive technical debt and create safety, governance and reputational risks for the organisation in which they are used.”
How Open Source Communities in India Support Privacy and Software Freedom
By Subhashish Panigrahi | February 14, 2017
The free and open source communities in India, particularly Mozilla and Wikimedia communities, are leading two unique global events for better privacy and in support of free software. January Privacy Month is led by the Mozilla community in India to educate the masses about online privacy via both online and offline outreach events. And, Freedom in Feb is led by the Centre for Internet and Society to educate content producers like bloggers and photographers on how to donate their content under open licenses...
How to Successfully Enter Emerging Markets in Open Source Software
By VM (Vicky) Brasseur | February 12, 2017
In business speak, an "emerging market" is a market that is not yet well developed but on the rise and shows strong potential to be as robust as other developed markets. The Wikipedia definition focuses purely on countries, but this is a limited view of the meaning of "market." Whether a market is developed or emerging depends entirely on the product or service being offered and the receptiveness and awareness of a market to that product or service. For instance, Italy would not qualify as an emerging market by the Wikipedia definition. Yet, with an Internet penetration of only 58.5% of the country, it could be considered one for broadband Internet providers...
Halamka's Recommendations for Effective Care Management
By John D. Halamka, MD | January 25, 2017
I recently joined the advisory board of Arcadia Healthcare Solutions, a leading provider of analytics, decision support, and workflow enhancement services. At my first advisory board meeting there was a rich debate about the marketplace for care management and population health tools. I’ve spent years studying such solutions at HIMSS and found most of the products are “compiled in Powerpoint”, which is a very agile programming language, since it’s so easy to change…
Making Personal Health Data Available During an Emergency
By Lee Stevens | March 26, 2017
If you or your family were injured during a disaster like a hurricane, earthquake or forest fire, wouldn’t you want your health data to be available to first responders and others who are there to provide care? We thought you might, and we are partnering with the State of California to pilot just such a project. Working at the Office of the National Coordinator for Health Information Technology (ONC), we have had the opportunity to leverage investments in health information technology to spur innovation in public health and preparedness...
School Systems Desperate for Standards-Aligned Curricula Find Hope
By Don Watkins | February 16, 2017
Open Up Resources is a nonprofit collaborative formed by 13 U.S. states that creates high-quality, standards-aligned open educational resources (OERs) that are openly licensed under CC BY 4.0. Unlike other providers, Open Up Resources provides curriculum-scale OER options; they believe that while many people seem to know where to find supplemental materials, most curriculum directors would not know where to look if they were planning a textbook adoption next year. After an article I wrote about OERs last year, I had the opportunity to interview their community evangelist and Chief Marketing Officer, Karen Vaites. In this interview, Karen elaborates on this...
Do I Need to Provide Access to Source Code Under the AGPLv3 License?
By Jeffrey Robert Kaufman | April 20, 2017
The GNU Affero General Public License version 3 (AGPLv3) is a copyleft license nearly identical to the GPLv3. Both licenses have the same copyleft scope, but materially differ in one important way. The AGPLv3's Section 13 states an additional condition not present in GPLv2 or GPLv3: "Notwithstanding any other provision of this License, if you modify the Program, your modified version must prominently offer all users interacting with it remotely through a computer network (if your version supports such interaction) an opportunity to receive the Corresponding Source of your version by providing access to the Corresponding Source from a network server at no charge, through some standard or customary means of facilitating copying of software"...
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