Tuesday, March 03, 2015

#Health Articles saved on Delicious by @ekivemark

It’s Tuesday, March 03, 2015 at 09:00AM
and time to bring you some Delicious #Health posts

  • claims/README.md at master · ekivemark/claims February 11, 2015
    In my work at CMS as Entrepreneur-in-Residence I am working on updating BlueButton to become a Data Service. This requires that the BlueButton file be enhanced to become a structured file (XML and JSON formats). My hope is that the payer community will contribute to this work so that we can have a common format. The current CCDA format as a clinical format d […]
  • Direct Certificate Discovery RESTFul Webservice February 11, 2015
    This is a great piece of work by Alan Viars. it provides code to help you validate a direct project email address.
  • Anthem Was Right Not to Encrypt | The Health Care Blog February 9, 2015
    A great post from Fred Trotter pointing out how the Mainstream media is focusing on the wrong issues in the wake of the Anthem hacking episode. When you are held up at gun point and your car keys are demanded then having a stronger, more secure car key is not going to help.



via WordPress http://2.healthca.mp/1NchySb

Friday, February 27, 2015

#OpenHealthData Roundtable w/@AneeshChopra and other Health luminaries

Earlier this week I attended a Roundtable event at Harvard hosted by Aneesh Chopra and Nick Sinai. The topic was open health data. The Roundtable had a jam-packed room of some of the best minds in the #OpenHealthData community. It was a high energy session and it demonstrates how this country can do amazing things when we work together.

So here is my personal perspective as I reflect on those fascinating discussions:

Patients at the center:

One of the participants made a most astute comment. “We have to put the consumer/patient at the center.” This is absolutely critical.

The industry has spent far too long and far too many resources to organize for outcomes without involving the patient. To correct that we have to treat the patient as a true peer in what we are building. That does not mean the patient has to self manage but instead means that they can choose a service like PicnicHealth, MedYear, HealthVault or any other service that comes along that they choose to trust with their data. This is where earlier iterations have stumbled. Direct is an example, where the industry is closing ranks to apply authentication that is hard to scale in the consumer space, leaving the consumer as a second class citizen in the network – a receive only node.

Avoiding a repeat of this outcome requires that we set two “stretch goals”:

  1. We push FHIR implementers to include write access in their FHIR Implementation. Write functionality is an Implicit feature of the FHIR spec but I fear that most implementers will resist implementing this part of the spec. Privately I see this as a stretch goal for my CMS BlueButton assignment. I want to push for beneficiaries to be able to trust applications to update the self entered data In their CMS personal health record.

Bi-directional data transfer is critical to pushing the interoperability envelope but it is the key to making step changes in the efficient operation of the healthcare system. Bi-directional data flows open up the possibility for patients to submit corrections to their records. Think of what that could do to save money by adding an extra data point to fraud, waste and abuse analysis.

  1. Accomplishing objective 1 requires that we also push forward with User Managed Access and convert the HEART workgroup efforts from policy discussion to pilot implementation. This will provide a framework whereby beneficiaries can choose which applications they trust to: read, write or read and write to any particular FHIR implementation. Ie. Something they choose when they connect an app to a FHIR data stream.

I think that these two objectives will go a long way to giving control of their data to patients and making them a true peer in the network.

BlueButton on FHIR

For my part as HHS Entrepreneur-in-Residence at CMS I am actively working on building “BlueButton on FHIR”. My personal goal is to create a prototype service using fake/test data that could be demonstrated at a Developer.HealthCa.mp collaborative learning event that would precede the Health Data Palooza (May 30 or 31st, 2015). I welcome any help and support to get the Prototype operational and to organize the HealthCa.mp event.

To move this forward I have published a draft Medicare BlueButton Plus file format in JSON and XML. Check out the repository on Github: http://2.healthca.mp/1FEyrz3

Provider Directories:

I have also been thinking about the Provider Directory issue. I remember from my time with the Blues how I would have earnest discussions with the team responsible for Provider Directories. The payers will argue that their directories are up to date. They update them as soon as they receivers formation from the provider. The problem is that the providers have no incentive to update the numerous payer directories they belong to. That is unless their checks stop arriving.

Consequently I think the idea of tagging web pages with meta data has some legs. However, I think we need to produce a set of open source tools that Providers can use to maintain their own records. If the medical professional maintains the information on the plans they participate in this can be crawled by the payer organizations who then cross check with their own records that the provider is in fact included in specific plans. Unless we go down to the facility/provider level to enable easy publication we will always be fighting the CICO issue (crap in-crap out).

Alan Viars,Fred Trotter and others have already done some work on this Association/Linkages issue. Using machine readable meta tags should provide a mechanism whereby providers can declare an association to a payer/plan and linking to a payer/plan dataset allows a cross-check to show that the plan recognizes the payer as part of the relevant plan. A bi-directional handshake. I am sure it wouldn’t take much for a Google or other search engine to use this tagging to create a dual certified (provider/payer) directory.

I can’t speak for CMS but they could kickstart this approach by requiring providers to record in their NPI record not just their direct email address but also the uri where their plan reference data is stored. This could be their own web site or a third party site they defer to (eg. A payer directory).

[category News, Health, BlueButton]

[tag health, cloud, ONC, opendata, BlueButton]

Mark Scrimshire
Health & Cloud Technology Consultant

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://2.healthca.mp/1b61Q7M
email: mark@ekivemark.com
Stay up-to-date: Twitter @ekivemark

Disclosure:
I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries.

The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.

Medyear: Less hassle. Better care.



via WordPress http://2.healthca.mp/1wuyHBB

Tuesday, February 24, 2015

#Health Articles saved on Delicious by @ekivemark

It’s Tuesday, February 24, 2015 at 09:01AM
and time to bring you some Delicious #Health posts
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via WordPress http://2.healthca.mp/1EMuZCs

#openhealthdata roundtable (Harvard) w/@aneeshchopra

Open health data roundtable

Today I am taking a quick trip to Boston to take part in an Open Health Data roundtable at the Kennedy School of Government. The session is organized by Aneesh Chopra and Nick Sinai.

I am looking forward to catching up with old friends from HealthCa.mp and to meet new people who are thought leaders in this space.

This roundtable event ties in directly with the work I am doing at CMS to build a BlueButton Data Service for Medicare Beneficiaries.

Since Regina Holliday will be there I felt honor-bound to wear my HealthCa.mp Walking Gallery Jacket that symbolizes the power of BlueButton to benefit patients.

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[category News, Health]

[tag health, cloud, opendata]

Mark Scrimshire
Health & Cloud Technology Consultant

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your heWalth applications in the cloud let’s talk.
Blog: http://2.healthca.mp/1b61Q7M
email: mark
Stay up-to-date: Twitter @ekivemark

Disclosure:

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries.

The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.

Medyear: Less hassle. Better care.



via WordPress http://2.healthca.mp/1acmNlK

Tuesday, February 17, 2015

#Health Articles saved on Delicious by @ekivemark

It’s Tuesday, February 17, 2015 at 09:17AM
and time to bring you some Delicious #Health posts
Unable to display feed at this time.



via WordPress http://2.healthca.mp/1Fnf40R

Thursday, February 12, 2015

@onc_healthit @bryansivak moderates the open data session

Q and A moderated by Bryan Sivak

startups – were you aware of all the data resources Available

Park service data is really interesting.

Quality indicators are important.

what data sets could be better used.

Park service: a lot of data is for internal management of resources. But they are publicly available.

OMB requires all agencies to maintain an enterprise dataset inventory.

ACF – majority of data is supporting reports to congress. They want to make this data more useful.

ACL – a lot of data available for correlation research. Eg nutrition, transportation, caregiver services.

CMS – states have datasets that are available. Hospital compare. Many other datasets. Challenges are to be responsible from a hipaa perspective.

Data is being incorporated into other datasets from CMS.

Niall Brennan gets a shout out from Bryan – complete with his email address:Niall.brennan@cms.hhs.gov

Startups are interested in outcomes data. In standard formats.

how do we measure effectiveness of datasets

ACF – find out if datasets are useful via humans….

[editors note:] it seems that oauth process for registered developers could allow data downloads by rest api To be better measured.

Bryan Sivak: thinking about revamping healthdata.gov to be a central hub for the community

CMS has a challenge to match data to the delivery reforms and the core objectives.

Think about data solutions from day 1.

CMS medicaid systems for monitoring and measuring are “archaic”

questions from the crowd

do they release raw data?

ACL some data is available in raw format.

what determines whether raw data is released

Hrsa – huge privacy concerns. Also some data is reported on a different basis eg. By grant.

Greg Bloom – leading open referral initiative.

Getting data is costly and inefficient.
1. What is role for Feds to support data standards?
2. Where are the low hanging fruits?

ACF – low hanging fruit: tell the Feds what data is wanted.

CMS: provider directories – we need to do a better job

what are upcoming priorities in CMS around medicaid innovation accelerator Program

  • Substance abuse disorders
  • Super utiliZers
  • behavioral health
  • Mental health disorders

ASPE looking across hhs to evaluate initiatives

Telehealth opportunities

A Lot of medicaid activity around Telehealth. The challenge is thinking about standards for Telehealth.

Standards are needed to define what is good practice.

Project Echo: addressing limited access to specialists. Focusing on hepatitis-C initially.

ACL – think about community engagement and use of Telehealth for engagement and not just for clinical uses. Eg. Social service delivery.

Hrsa – very active in Telehealth in rural areas.

[category News, Health]

[tag health, cloud, ONC, opendata]

Mark Scrimshire
Health & Cloud Technology Consultant

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://2.healthca.mp/1b61Q7M
email: mark
Stay up-to-date: Twitter @ekivemark

Disclosure:

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries.

The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.

Medyear: Less hassle. Better care.



via WordPress http://2.healthca.mp/1B3SHvQ

@onc_healthit presenting an open data boot camp @1786DC

innovating for the underserved with open federal data

I am at 1776 in Washington DC for an innovation boot camp organized by the ONCHIT.

Mark Greenberg sets the scene for how innovators can help the underserved.

Healthdata.gov is a great resource to kickstart health innovation ideas.

Damon Davies urges developers to tell HHS if there are datasets that are needed.

Susan Jenkins: Administration for Community Living – maximize the independence for aging population and the disadvantaged.

Encouraging and enabling independent living.

Since this is a new administration they are still developing plans for data sets to be released but they do have data on the aging population.

Jennifer King: administration for children and families

Datasets are available at data.gov and healthdata.gov

Machine readable open data is the standard for government as a result of a 2013 presidential executive action.

The next step after improving sharing is to make the data useful.

The government needs inter-agency tools because agencies are also users of public data.

Adam Kramer: national parks service office of public health.

405 national park units:
The unit focuses on disease prevention and health promotion.

NPS publishes >1400 data sets.

Includes maps and history data.

DC Park Rx is an example of an application that brings data together to prescribe nature to encourage healthy living. Eh. Where can you take a walk…

Paul Mandsager: health resources and services administration (hrsa)

Improve health and health equity.

Primarily a grant agency. Mainly information about grants and grantees.

Collect data about te populations they serve. Eg providers. Down to county level.

Healthify:

Buding solutions to address social determinants.

Started in E Baltimore.

Social determinants: 20% of healthcare spending and 60% of health outcomes.

Impossible to map needs to resources.

Creating a “yelp” for social services.

Manage and engage populations
Coordinate and follow up.

Shelley Milosevich Johnson: purplebinder.com

Helping people who have no support network.

Finding community services

Post-ACA: keeping People healthy outside the walls of the hospital.

Using open health data. Social workers augment data as a crowd-sourced effort.

Contributing data back to the community in an open referral format.

Dr Stephen Cha – CMS and CHIP

Federal and state resources pay for case management but we don’t get value for money.

What is happening under delivery reform:
– better incentives
– change the delivery of care
– support data and quality information

The future of medicaid data:
– more integrated, more real time, more useful and more public.

Transformed Medicaid Statistical Information Services – gaining better insight in to how educator services are used.

Liz Polener Hall – ONC
New standards initiative focusing on long term care coordination in the community: S and I framework initiative: eLTSS

Mobile solutions will play an important role.

Now Bryan Sivak moderates this panel….

[category News, Health]

[tag health, cloud, ONC, opendata]

Mark Scrimshire
Health & Cloud Technology Consultant

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://2.healthca.mp/1b61Q7M
email: mark
Stay up-to-date: Twitter @ekivemark

Disclosure:

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries.

The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.

Medyear: Less hassle. Better care.



via WordPress http://2.healthca.mp/1D0VR47

Tuesday, February 10, 2015

#Health Articles saved on Delicious by @ekivemark

It’s Tuesday, February 10, 2015 at 09:02AM
and time to bring you some Delicious #Health posts
Unable to display feed at this time.



via WordPress http://2.healthca.mp/1FtT1ms

Thursday, February 05, 2015

#health2stat Stacey Palosky – the real cost

the real cost

Engaging youth online.
Experimenting with tumblr.
Great reception to interactive Fifa.

Tumblr is anonymous and so teens are more comfortable to engage with anonymity.
It is a great platform to get influencers to engage.

Twitter is used to. Teens may engage but don’t follow the account.

YouTube has an 86% video completion rate. Very good
Using #therealcost hashtag

Campaign is reaching 90% of target audience more than 15x per quarter.

[category News, Health]

[tag health, cloud, ONC2015, health2stat]

Mark Scrimshire
Health & Cloud Technology Consultant

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://2.healthca.mp/1b61Q7M
email: mark@ekivemark.com
Stay up-to-date: Twitter @ekivemark

Disclosure:

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries.

The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.

Medyear: Less hassle. Better care.



via WordPress http://2.healthca.mp/1zlVXk7

#health2stat @AneeshChopra – innovative state

how new technologies can transform government

This is the decade we will solve big problems in government…

An innovative is defined by a government that is open and a people that take a handshake to run with the enabling ingredients for innovation.

Standards are applied to lower the barriers to entry

Challenges and prizes to find non-traditional problem servers

Agile approach to development -iterate to the solution.

we need to inspire the handoffs

Tapping expertise to serve smarter

Precision medicine: the key factors are the ensuring that consumers have access to their own health data.

AND connecting to the applications and services that they trust to put their data to use for their better health.

Open data + interoperable health IT + payment reform = innovation

CMS driving towards value based payments (50% by 2018)

Project Argonaut – a public/private effort to accelerate open data.

Data use involves sharing.

All the leading EHR vendors are supporting Argonaut.

How many people will develop apps to consume data from EHRs to drive better health.

Borrowing page from DARPA:

Implement apps store where many apps compete and get paid for use where they are built to meet a set of standards.

Government sis starting to work again…

Rockstar developers are coming to government

We all have to take part. No more bystanders!

[category News, Health]

[tag health, cloud, ONC2015, health2stat]

Mark Scrimshire
Health & Cloud Technology Consultant

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://2.healthca.mp/1b61Q7M
email: mark@ekivemark.com
Stay up-to-date: Twitter @ekivemark

Disclosure:

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries.

The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.

Medyear: Less hassle. Better care.



via WordPress http://2.healthca.mp/1KwrRMx