Noam ArztA recent article in HealthAffairs describes a significant decline in the number of both operational HIEs and HIEs in the planning stage from several years earlier. The authors note continuing barriers to broad-based HIE and a shift to vendor-driven exchange which diminishes the effectiveness of community-based networks. In effect, this translates to a shift away from geographic-based/dominated HIEs to product-dominated HIEs. We have already noted (see The Interoperability of Things) the lack of a national strategy on HIE, and ONC’s Nationwide Interoperability Roadmap barely mentions the concept.
public health
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The Appeal of Graph Databases for Health Care
A lot of valuable data can be represented as graphs. Genealogical charts are a familiar example: they represent people as boxes, connected by lines that represent parent/child or marriage relationships. In mathematics and computer science, graphs have become a discipline all their own. Now their value for health care is emerging. Graph computing made a significant advance this past February in the form of a Graph Data Science (GDS) library for the free and open source Neo4j graph database. Graph databases are proving their value in clinical research and public health; I wonder whether they can also boost analytics for providers. This article explains what's special about graph databases, and some applications in health care highlighted by recent webinars offered by the Neo4j company.
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The Best Open Data Releases Of 2012
Last year, Cities named ten of its favorite metro datasets of 2011 from cities across North America, illustrating the breadth of what we might learn (regarding mosquito traps! misplaced vehicles! energy consumption!) in the still relatively young field of urban open data. For this year's installment, we're going one step further... Read More »
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The Case Against Sugar
‘Virtually zero.’ That’s a reasonable estimate of the probability that public health authorities in the foreseeable future will successfully curb the worldwide epidemics of obesity and diabetes, at least according to Margaret Chan, the director general of the World Health Organization (WHO) – a person who should know. Virtually zero is the likelihood, Chan said at the National Academy of Medicine’s annual meeting in October, that she and her many colleagues worldwide will successfully prevent ‘a bad situation’ from ‘getting much worse’...
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The Changing Face of Public Health System Procurement
The development and acquisition of public health systems is poised to change. Historically, public health agencies had the classic choice when it came to acquiring a new data system. Either they developed the system themselves – usually based on a belief that their requirements were “unique” – or they licensed a COTS/GOTS product from the limited choices available in a small market. Typically, agencies that chose to develop solutions were forced to use a waterfall approach as government procurement is not well suited to the flexibility of Agile systems development. Some agencies have been able to leverage open source offerings. While most do not have the wherewithal to support open source products themselves, many have formed strong partnerships with other organizations, both for-profit and nonprofit, to take advantage of these systems.
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The Extraordinary Science Of Addictive Junk Food
On the evening of April 8, 1999, a long line of Town Cars and taxis pulled up to the Minneapolis headquarters of Pillsbury and discharged 11 men who controlled America’s largest food companies. [...] Rivals any other day, the C.E.O.’s and company presidents had come together for a rare, private meeting. On the agenda was one item: the emerging obesity epidemic and how to deal with it... Read More »
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The FDA Ban On Trans Fat Should Be Just The Beginning
It’s been clear for more than a decade that trans fat is a dangerous substance that increases the risk of heart disease. Denmark banned its use in 2003. Several American cities and states have followed suit, but the use of trans fat is still widespread despite the availability of suitable substitutes. Read More »
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The FDA Takes On Mobile Health Apps
The mobile health industry has a problem: It has grown too quickly. Consumers can now download medical apps for at-home monitoring of just about any obscure ailment, and apps for general wellness, diet, and fitness are proliferating... Read More »
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The Forgotten History Of Vaccinations You Need To Be Aware Of
Vaccines are one of the most controversial medical therapies, and it's impossible to make an informed decision unless you know both sides of the story. In the process of knowing both sides, the historical context is critical...
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The Grim Future If Ebola Goes Global
If you listened hard over the weekend to the chatter around the political theater of detaining a nurse returning from the Ebola zone in a tent with no heat or running water, you might have heard a larger concern expressed. It was this: What happens if this kind of punitive detention — which went far beyond what medical authorities recommend — deters aid workers from going to West Africa to help?...
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The Grim Propect of Antibiotic Resistance
When people hear about antibiotic resistance creating “superbugs”, they tend to think of new diseases and pandemics spreading out of control. The real threat is less flamboyant, but still serious: existing problems getting worse, sometimes dramatically. Infections acquired in hospital are a prime example. They are already a problem, but with more antibiotic resistance they could become a much worse one. Elective surgery, such as hip replacements, now routine, would come to carry what might be seen as unacceptable risk. So might Caesarean sections. The risks of procedures which suppress the immune system, such as organ transplants and cancer chemotherapies, would increase...
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The Growing Field of Ecotherapy
The first time J. Phoenix Smith told me that soil has healing properties that can help thwart depression, I just nodded slowly. Smith is an ecotherapist, a practitioner of nature-based exercises intended to address both mental and physical health. Which means she recommends certain therapies that trigger in me, as a medical doctor, more skepticism than serenity: Listen to birdsong, in your headphones if necessary. Start a garden, and think of the seeds’ growth as a metaphor for life transitions. Find a spot in a park and sit there for 20 minutes every week, without checking your phone, noting week-to-week and seasonal changes in a journal...
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The Next Generation: A Comprehensive Electronic Health Record
The Network for Public Health Law is holding their 2012 Public Health Law conference this week in Atlanta, focusing on the Practical Approaches to Critical Challenges in Public Health Law, and I have been in attendance...But what struck me, was how little we really take time to think about the impact the work we are doing has upon our individual lives and those of our families. Read More »
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The Pentagon Contract That Could Shape EHRs For Years To Come — Epic Pays Out To Win Friends And Influence Congress
GENTLEMEN (AND WOMEN) START YOUR (INTEROPERABLE) ENGINES: The Department of Defense’s $11 billion, 10-year contract for a new electronic health records system won’t just shape military health for the next decade, reports Ashley Gold, it could very well predict the future of electronic health records and their handling of interoperability. Read More »
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The Ransomware Attacks on Hospitals Are (Cyber) Criminal
One of the redeeming aspects of crises is that, amidst all the confusion, suffering, and loss, there are usually moments of grace, of humans showing their best nature... Unfortunately, crises also tend to bring out the worst of our natures... And then there are the cyberattacks. Last week the federal Cybersecurity & Infrastructure Security Agency, the FBI, and HHS issued a joint alert Ransomware Activity Targeting the Healthcare and Public Health Sector, warning that they have "credible information of an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers." I'll spare you the technical details of the expected attack strategies or suggested mitigation efforts, but I will note that they warned: "CISA, FBI, and HHS do not recommend paying ransom." Read More »
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The Reduction of State-coordinated HIE: How Should Public Health React?
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