Feature Articles

AMA Call To Action On Health Records Should Tell Doctors To Heal Themselves

The American Medical Association (AMA) is one of the most powerful and well-known institutions in this country. Opposition from the AMA helped to bury hopes for universal healthcare back in the Harry Truman presidency, and now the AMA maintains a stranglehold on Current Procedural Terminology (CPT) codes and therefore on any innovation in reporting medical services. So when the AMA puts out a press release titled AMA Calls for Design Overhaul of Electronic Health Records to Improve Usability, describing the serious usability problems of EHRs, and announcing the release of their “solution” white paper titled Improving Care: Priorities to Improve Electronic Health Record Usability, headlines get made and policy-makers start to stir. Can a snap of the fingers by the AMA bring the EHR industry in line? Read More »

The 5 Essentials of Cloud Computing For Clinical Trials

The pharmaceutical industry has been historically slow in adopting new technologies and it is only now that we are beginning to see the emergence of cloud based eClinical systems for the clinical trial industry. This article explores the true definition of cloud computing as defined by the National Institute of Standards and Technology (NIST) and applies it to eClinical systems. Read More »

OSEHRA 2014: Modernizing the VistA GUI

As we approach the 2014 OSEHRA EHR Summit, the topics of EHR Usability and EHR web enablement have become major points of discussion. This article is a quick attempt to summarize one of the key developments in this area. Sidney Tarason from Astute Semantics has produced groundbreaking prototypes for VistA that could shape the modernization effort moving forward for not just VistA, but for all EHRs based on the polymorphic MUMPS database (about 95% of all electronic health record (EHR) systems in the United States). Read More »

Using Open Source PDF Technology to Solve the Unstructured Data Problem in Healthcare

If there’s one major challenge to single out in healthcare IT today, it would be leveraging the growth and usage of big data. While consumer IT made big advances in the past decade to get a handle of data by marking up content, indexing it, and annotating it for use, enterprise, and healthcare IT in particular, still need to catch up on making data actionable...This article provides insights into how using the Portable Document Format (PDF) and accompanying tools within healthcare organizations can be a powerful way to help solve the unstructured data challenge, speed up processes, and reduce the costs for document handling.

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Standards and Open Source Make Advances in Apps and Data Exchange for Health

I try to be optimistic about health care, and I managed to move my mood meter in that direction last month after talking about advances in data sharing, standards, and interoperability with a few people involved in the open FHIR standard: Grahame Grieve from the Core FHIR Development Team, David Hay from the FHIR Management Group, and Josh Mandel, a research scientist working on the open-source SMART Platform. Read More »

Open Source Electronic Health Records For Education And Training

In spite of being very involved in the field of Health Informatics I only recently became aware of VistA for Education (VFE), which has all of the aforementioned attributes of an  excellent solution for EHR education purposes. VFE was developed as a result of a grant from the Office of the National Coordinator (ONC) to supplement the ONC Health Information Technology (HIT) curriculum. Electronic health records (EHRs) are more than just the electronic equivalent of paper-based health records. Electronic health data is easier to search, share and archive, compared to paper records. Additionally, EHRs can be embedded with clinical decision support to alert and remind physicians of patient safety and preventive medicine measures.

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Three Areas Where Health Information Technology Needs to Get its House in Order

Health reform is taking off, thanks to pressure from insurers, the promise with which innovative technologies tease us for low-cost treatments, and regulatory mandates dating back to the HITECH act of 2009. Recent hopeful signs for wider adoption of health technologies include FDA forebearance from regulating consumer health apps, calls for more support for telemedicine, and new health announcements from tech giants such as Apple and Google. While technologists push forward in all these areas, we need to keep in mind that several big unsolved problems remain. Let's not get lost in the details--these major issues have to be tackled head on. Read More »

Coalescing Interest in Geospatial Standards for Health Domain

During the recent OGC Health DWG meeting, participants supported advancing the HL7 – OGC Statement of Underst...The OGC geospatial standards are expected to enrich health information. Guest presenters provided insight on potential alignment of OGC Health DWG activities with health domain requirements for standardization and interoperability.

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Halamka on the JASON Report

On 4/09/2014, AHRQ released the JASON report, facilitated by Mitre. JASON is an independent group of scientists who advise the United States government on matters of science and technology. The intent of the report is to make recommendations for a new healthcare IT architecture to accelerate interoperability. Read More »

The Maker Movement Helps Transform Our Public Libraries

The small town of Bethlehem, New York purchased a 3D printer and started teaching classes at its public library recently—jumpstarting the community's knowledge of advanced manufacturing and building upon a new way of doing things in a world where physical bookstores are dissappearing...

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An Unfunded EHR Mandate for Behavioral Health: All Stick, No Carrot

Why politics, parity and performance requirements mean behavioral health hospitals should adopt now Read More »

Notes on the April Meeting of the HIT Standards Committee

The April Standards Committee began with a tribute to Jon Perlin, who is leaving his chair role of the HIT Standards Committee so that he can focus on his chair role at the American Hospital Association. Jacob Reider, Deputy National Coordinator will serve as the Standards committee chair. I will continue as vice-chair. Read More »

Chromecast: Understanding its Potential beyond Video Streaming

Google launched the $35 Chromecast into the US market in July 2013 and it became available in the UK in March 2014.  It’s primarily marketed as a device for streaming video to your TV, and, as such, is usually compared with the Roku streamer, Apple TV and the new Amazon Fire TV. Once you look under the covers, you discover that such comparisons are misleading: unlike the other devices, the Chromecast is actually much more than just a streaming device for TV.

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The ICD 10 Extension: For whatever reasons, Congress did the right thing!

Did you hear the one about the CMS administrator who was asked what it would take to delay the 2014 ICD-10 implementation deadline? An act of Congress, he smugly replied, according to unverified reports. Good thing he didn’t say an act of God. So, now that CMS has been overruled by Congress, who wins and who loses? Who’s happy and who’s not?

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Heartbleed, an Apache License Business Model Failure?

The two year old HeartBleed bug that was recently discovered in OpenSSL and that affects millions of internet users, reveals a similar problem that could have a serious impact on the way we look at open source software. Companies such as Cisco have built expensive applications on top of OpenSSL. Security consultants have been paid good money to guarantee that OpenSSL was safe. But the OpenSSL project itself was driven by a core of only four unpaid volunteers. The German engineer Robin Seggelmann is now taking the blame for the error. His code was verified by Dr. Stephen Henson who overlooked the bug. It would be unfair to blame these two individuals for the problems caused by Heartbleed. They made two mistakes. The second mistake was a minor error in their code. Although this error took huge proportions, they should be forgiven for that error. Their first mistake was their choice to make their code available under the Apache Software License. That mistake is more problematic.

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