It is widely agreed that competition, or lack thereof, in health care is a problem. The Wall Street Journal recently showed how Viagra and Cialis prices seem to move -- up, of course -- in lockstep. USA Today found Walgreens charging 1237% more than Costco, for the same drug. Economists like Martin Gaynor have been discussing problems with competition in health care for years. The Harvard Business Review just published a lengthy article on the problem. But, it turns out, we may be ignoring an important competition that has real impacts on our health: with each other...
Feature Articles
How to Care for the Community Over the Code
At All Things Open 2016, Joe Brockmeier answers the question: How can companies can work effectively with open source communities? In his talk, Joe reminded us of the #1 open source myth: Open source is comprised of mostly volunteers. The truth is, these days, pretty much any major open source project has people who are paid to work on it. There are always people who do it because they love it, but these days most of us are paid (and still love it). Over the years we have learned that if you want patches in a timely manner, you need people who are paid to do it...
11 Wonderful Wearable Open Source Projects
LEDs are on everything, and almost everyone you know has at least tried a FitBit or similar device, whereas Google Glass didn't really take off. Despite several years of growth, whether wearable electronics are a fad, or here to keep growing from fun to truly functional is too early to tell. Judge for yourself—read through a few of our favorite wearable projects from 2016. You might even get inspired to start creating...
Under Cures Law Interoperability Will No Longer Be Voluntary
Passed easily on Wednesday by the U.S. House, the bill is expected to sail through the Senate next week. It is supported by President Obama, who undoubtedly will sign it. Much of the bill focuses on significant FDA regulatory changes, support of mental and substance abuse-related healthcare, and funding for programs such as Vice President Biden’s Precision Medicine Initiative, the Brain Research Through Advancing Innovative Neurotechnologies Initiative, cancer research and regenerative stem cell-based medicine. It also includes mandates to improve healthcare IT — most notably, in relation to nation wide interoperability and information blocking. Suddenly, those “Interoperability Pledges” that EHR vendors signed earlier this year will not be toothless expressions of good will.
Open Source Dependency Management As A Balancing Act
During my career I have spent a lot of time packaging other people's code, writing my own, and working on large software frameworks. I have seen projects that still haven't released a stable version, never quite hitting 1.0, while others made 1.0 releases within months of beginning development, and then quickly moving on to 2.0, 3.0, etc. There is quite a variance in these release cycles, and this coupled with maintaining large projects can make things difficult. I will go through some of the decisions we have faced in projects I have worked on and the pressures on the project. On the one extreme, users would like to have a stable API that never changes, with dependencies that don't specify a minimum version so that they can choose whatever version works best...
I'm OK -- You, Maybe Not So Much
Get Emotional: Tips for Open Source Communities
Humans are driven quite a bit by emotions. You may be a rational human being, but your emotions will still drive many of your choices. You can be excited, angry, interested, or sad about things—it doesn't matter—you'll react to those emotions and you'll very often leak that into your communications. You'll likely leak your emotions, and so will other members of the community. If you think humans should suck it up and act like nothing is happening, I'm afraid you are living in a bubble. That is not how humans operate. That's not how humans interact...
Tools for Collecting and Analyzing Open Source Community Metrics
Thus far, we've discussed the importance of setting goals to guide the metrics process, avoiding vanity metrics, and outlined the general types of metrics that are useful for studying your community. With a solid set of goals in place, we are now ready to discuss some of the technical details of gathering and analyzing your community metrics that align with those goals. The tools you use and the way in which you collect metrics depend heavily on the processes you have in place for your community. Think about all of the ways in which your community members interact with each other and where collaboration happens...
Beth Israel's CareKit App Leverages FHIR for Patient Engagement
The following is a guest blog post from Seth Berkowitz, MD, who authors many of the innovative apps in the BIDMC Crowdsourcing program: Beth Israel Deaconess Medical Center, a teaching hospital of Harvard Medical School, has developed BIDMC@home, a new app for engaging patients using Apple’s CareKit and ResearchKit frameworks and the HealthKit API. The app provides a flexible framework to help patients manage their health from home, as directed by their physicians. The app will be piloted in several specific patient populations and will eventually be offered to BIDMC’s entire network of over 250,000 patients...
Python Versus R for Machine Learning and Data Analysis
Machine learning and data analysis are two areas where open source has become almost the de facto license for innovative new tools. Both the Python and R languages have developed robust ecosystems of open source tools and libraries that help data scientists of any skill level more easily perform analytical work. The distinction between machine learning and data analysis is a bit fluid, but the main idea is that machine learning prioritizes predictive accuracy over model interpretability, while data analysis emphasizes interpretability and statistical inference. Python, being more concerned with predictive accuracy, has developed a positive reputation in machine learning. R, as a language for statistical inference, has made its name in data analysis...
Education Management with Moodle: The Beginning, Middle, and Today
Moodle is the de facto standard in open source learning management systems. It is described as "a learning platform designed to provide educators, administrators and learners with a single robust, secure and integrated system to create personalised learning environments." Plus, Moodle is free software, licensed under the GPL. Martin Dougiamas, Moodle's founder and lead developer, generously took time from his busy schedule to have a good, long talk with me about why he created it, where it is today, and what's next in open education. First let me give you a little background. I was introduced to Moodle in 2005 while visiting a public school district in Portland, Oregon, which was using Moodle as part of their instructional delivery...
How to Use Sphinx to Give an Old Book New Life
The Internet Archive, Project Gutenberg, and Google Books are wonderful sources of historical books, but the finished products of their digitization efforts, while thorough and functional, lack that last bit of polish. For example, one of my interests is historical cooking, specifically Georgian and Regency British cookery and the contemporary period in American cookery, but the PDF versions of the relevant cookbooks are usually just basic black and white scans with no features that aid findability or searchability. The plain text versions, while more searchable, are not aesthetically pleasing and often contain numerous optical character recognition errors...
4 Ways to Open Up Your Project's Infrastructure
Open source isn't just about opening up your code—it's also about building a supporting infrastructure that invites people to contribute. In order to create a vibrant, growing, and exciting project, the community needs to be able to participate in the governance, the documentation, the code, and the actual structures that keep the project alive. If the overall "hive" is doing well, it attracts more individuals with diverse skills to the project. Although many projects strive for "open everything," infrastructure is often closed to contribution. Usually, only a few people run the infrastructure and keep the lights on. They're sometimes unable to recruit help because, well, you can't really give the keys to the kingdom to everyone. A certain level of trust is needed before granting a contributor access to project infrastructure...
Make No Little Plans
Ever seen the new TV show 'Pure Genius'? Probably not; its ratings are dismal. I've seen it, and, well, it isn't very good. But what I like is the premise: a young tech billionaire builds a hospital using only the latest technology, and treats patients regardless of cost. Gotta give the creators props for trying to re-imagine hospitals. The health care industry could do with some serious attempts at re-imaging, and not just for hospitals. What made me think about this were two stories about the auto industry, which is desperately trying to remain relevant in a world of Uber, self-driving cars, and our love affair with our various digital devices...
What Does the Trump Presidency Imply for Healthcare and Healthcare IT?
Many organizations have asked me to comment on the impact of the Trump Presidency on Healthcare and Healthcare IT. I served the Bush administration for 4 years and the Obama administration for 6 years. I know that change in Washington happens incrementally. There is always an evolution, not a revolution, regardless of speechmaking hyperbole. What am I doing in Massachusetts? I’m staying the course, continuing my focus on social networking for healthcare, mobile, care management analytics, cloud, and security while leaving the strategic plan/budget as is...
No Thanks, I Already Have a Number
Health care has a problem. Well, of course, it has many problems, but one of them is that the various parties involved in the health care system can't agree on who we are. Twenty years ago HIPAA called for creation of unique patient identifiers to accomplish this task, but within two years Congress put this on hold until further notice, and we're still waiting. Everyone used to use social security numbers for this purpose, until we finally figured out the folly of that (especially since that number was never intended to be used as a national identification number). The private sector continues to clamor for federal action, while CHIME launched a National Patient ID Challenge in order to come up with solutions. News flash; we already have a unique, non-government-issued identifier: it's called a cell phone number...