Tuesday, December 16, 2014

#Health Articles saved on Delicious by @ekivemark

It’s Tuesday, December 16, 2014 at 09:02AM
and time to bring you some Delicious #Health posts

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Friday, December 12, 2014

Dear Foursquare (@4sq) you are confusing me…

Today an email arrived from Foursquare. It was encouraging me to add comments on Foursquare. What??? I am totally confused.
Foursquare, You took the Foursquare app away from us and gave us Swarm! I can’t remember the last time I loaded Foursquare. Indeed I opened my phone to check if the app was even still on my phone. Foursquare isn’t Yelp and I, probably like may people who still do check-ins, I use swarm.
This e-mailshot seems like a desperate act. You blew Foursquare away but now you want us to use it again. This is nonsensical. If you want to encourage us to leave tips why aren’t you encouraging us to do it through your Swarm app.

Foursquare wants me to use their app again?

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Tuesday, December 09, 2014

#Health Articles saved on Delicious by @ekivemark

It’s Tuesday, December 09, 2014 at 09:02AM
and time to bring you some Delicious #Health posts

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Friday, December 05, 2014

Microsoft Exchange Trials and Tribulations of Mail.app on OS X Yosemite

I have been a long time user of Mail.app on OS X. It goes through it’s ups and downs. While on Mavericks there seemed to be real issues with gmail. It was a case of mail deja-vu. You would delete an email and it would magically re-appear. I recently upgraded to OS X Yosemite and Mail.app seemed to be working well. That was until I needed to connect to an Exchange server,

I have successfully linked my iPhone running iOS 8 to the exchange server. Sending and receiving email works fine for exchange on iOS as far as I can tell. However, After adding the Exchange Server in Mail.app and through the Internet Accounts section in System Preferences I can successfully access my Exchange Calendar. Mail is a different story.

Mail.app steadfastly refuses to recognize the Exchange account. The setup process works and the account is recognized but the Exchange inbox will not come up in the list of mailboxes.
I have tried to configure using the “Other” Option but using IMAP fails. And now mail.app refuses to let me delete the “Other” account.

I even closed mail.app and went to ~/Library/Mail/V2/MailData/Accounts.plist and found the bad entry. I deleted it from the plist file but the imap item is still lurking. Trying to delete it and you get the error:

Account removal failed with error: “The operation couldn’t be completed. Unable to find an account for the UID given.”.

It looks like the only options on Mac OS X Yosemite for exchange is to use the Exchange OWA web client through the browser, or use Outlook for Mac. These options do work. I hope Apple sorts out these Exchange issues in an update to 10.10.1 because mail.app is currently broken for Exchange users. It is apparent that I am not alone in this check out the forum messages here: http://2.healthca.mp/1wEWaPc

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Tuesday, December 02, 2014

#Health Articles saved on Delicious by @ekivemark

It’s Tuesday, December 02, 2014 at 09:01AM
and time to bring you some Delicious #Health posts

via WordPress http://2.healthca.mp/1pN55f3

Tuesday, November 25, 2014

#Health Articles saved on Delicious by @ekivemark

It’s Tuesday, November 25, 2014 at 09:02AM
and time to bring you some Delicious #Health posts

via WordPress http://2.healthca.mp/15mXIBZ

Tuesday, November 18, 2014

@IBX #BlueButton Workshop

Harm Scherpbier recaps the morning session:

  • The Government is behind the initiative to unleash the power of the patient through their data
  • There are tools like iHumetrix and Medyear that are available now

This is not a solution looking for a problem.

Two discussion points:

- Status of implementing BlueButton initiative
- Groundwork for a BlueButton pilot in PA

  1. What are the opportunities for a Philly Regional next generation BB Pilot

Lessons from the morning

  • Too many portals for the patient
  • Portals aren’t sticky
  • Open up and let innovators solve the problem
  • Let the patient unify
  • Look at BlueButton as the Mint for health
  • How do we connect everyone
  • Market is creating solutions for patients
  • [Abington] Portal is ready for BlueButtonPlus but portals still needed for Prescription refills, appointments etc.
  • Are portals ready to allow patients to enter their direct address and to setup the system to push
  • BlueButton needs to be a noun and a verb.
  • Not just a technical problem – need to encourage and support and engage patients on how to do this.
  • Portals were for View Download Transmit as part of MU2
  • What can we use today to get going? Direct? Portals?
  • Where is the economic value proposition for all participants
  • Direct is the unique patient address. Patients can have multiple direct addresses – if they choose.

Mainline Health is able to send via Direct
Abingdon uses Cerner and they are a HISP
Einstein is able to send via Direct
Penn – TBD
IBX – yes

Every Vendor that is certified to View Download AND Transmit.
All can technically Transmit. It is down to the customer vendor relationship as to whether you have implemented the AND Transmit functionality.

Step 1 is to accomplish data transmission outbound to patients via Direct

We have to address the workflows on the provider end.

Opportunities for a Philly Regional Pilot

  • Improving health, saving lives, saving money
  • Improve quality, up the HEDIS levels, reduce readmissions
  • Higher Patient Engagement and HCAPS Scores
  • Philly as Hip healthcare town
  • Connect the patient activity out of network
  • Environment for innovation
  • Reduce redundancy, save cost
  • Bring together payors, providers, innovators
  • Leveraging patient as connector
  • Lead the nation

- Need vendor help to enable BlueButtonPlus and Patient Direct features in portals/EHRs
- How does BB+ fit in to Provider workflow
- How do Care Gaps get to the physician where it is actionable with the patient.
- Find use cases with specific benefits
- Easy access to patient direct addresses
- Align incentives
- Patient engagement – incentivize them

What does a pilot look like?

  • Build around specific target populations
  • Build around specific provider groups
  • Get recent labs and x-rays to the patient. This is number 1 pain point for providers.
  • Curated Medications Lists – Very important.
  • Don’t make it too narrow – we need critical mass
  • Define target population. Complex, costly, chronic patients.

- Strong leadership
- PHR Community coordinator (Nurse to train patients on using PHR) – We need to avoid this. It has to be simple.
- Start small to solve technical issues

  • Small, quick pre-pilot. Small incentives to fill out surveys for feedback

Next Steps

  • Captive population Mainline and Jefferson employees come onboard in January. Pick 50-100 participants.
  • All participants go to BlueButtonConnector.healthit.gov and fill out their profile.
  • HSX to convene groups with common interests to define needs
  • Define the sustainable business model as part of the pilot
  • Multiple providers and tools involved.
  • Include IBCs app and their target patients. Will include Humetrix and Medyear. Patients will pick their chosen app.
  • User experience survey for both patients and providers
  • Timebox the pre-pilot
  • Tightly define use-case for the pilot

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@ibx #bluebutton @AneeshChopra wrapping up the morning session

Aneesh Chopra: “There has never been a better time to be an innovator in healthcare”

The patient is the secret weapon in transforming healthcare. If the patient has the data they become key in your mission.

Innovations needed:

  • Data minig/tools
  • Care Integration tools

BlueButton emerged because the VA and DoD couldn’t share data despite spending billions of dollars.

The patient is the unifier!

There is a fine for NOT providing patient data they have requested:

$20,000 per patient per day Fine.

Use the standards that are out there

OAuth is already in use on thousands of sites.

The next step is approving app sharing with bluebutton.

Check out smartplatforms.org @SmartHealthIT

A Public API is a basic conduit of interoperability.

A coalition of the willing….

Healthcare’s Open API : SMART on FHIR -

SOA Orchestration
Clinical Element Models
SMART Web Apps

The key building blocks:

  • The patient having access to their data
  • Using internet security protocols.

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@IBX #BlueButton Workshop Jane Sarasohn-Khan (@healthyThinker) giving the patient view

From the @IBX #BlueButton Workshop

“Every person has their own Personal Health Ecosystem”

The 2008 Recession changed things for Americans.

Ogilvy Survey revealed:
- Sustainability is the new happiness

Moving from Passive, careless, simple to:
- Active, Deliberate, Complex

Out of pocket costs for american workers have doubled in the last 5-6 years (in the region of $23K for family of four with workers carrying 40% of the cost).

We are all embracing the Triple Aim:
- Better Experience
- Better Care
- Lower Cost

Activated patients have lower health care costs.

Patient Engagement is a good thing. It saves money.

People want to share in decision making. People need on-ramps to engagement. Design is critical.

We are moving to Retail health…

BlueButton is part of the personal health ecosystem. Downloading our data is key.

We have to be Human-centered.

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@IBX #BlueButton workshop

Demonstrating how Patients can use BlueButton

Humetrix demonstrated their iBlueButton app
Medyear – Panha Chheng demonstrates the Medyear Consumer-Mediated Health Information Exchange

Humetrix – Humans + Metrics

Started in 1990 with a diet smartwatch.
In 2006-2009 this evolved to USB enabled Web-based applications

iBlueButton is an iOS App that pulls BlueButton file from a datasource. Data is only stored on the user’s phone.
Data can be pushed by Provider using Direct.
Data can be pulled by the app from a data source.

iBlueButton supports the CMS BlueButton ASCII text file.

  • using MedlinePlus for Drug information.

Allows you to reconcile allergies/conditions etc.

  • Pulls Medicare, DOD and VA records.

Some challenges:
- 87% of eligible providers attesting for MU2 received exclusions for sending summaries of care.
- Only 2% of providers were able to get patients to download data.

The challenge for the IBX BlueButton Workshop: How can we close care gaps with the patient using BlueButton.

IBX Presenting their work on Care Gaps and BlueButton

The Clinical Care Report (CCR)

  • Data is aggregated by Informatics including member level information:
    (Disease conditions, ER Visits, Hospitalizations, Outpatient procedures, specialist visits, Imaging stuies, Gaps in care)
  • Daily reports generated every evening
  • CCR called up by Providers via Navinet

Providers do 0.5M eligibility checks each month. Only a few percent of those checks also pull the CCR information.

[Editor’s Note: Isn’t the gap that this is going to the Provider and not engaging the patient. BlueButton opens the channel to the patient.]

IBX offers a mobile and desktop portal. They are moving the web/desktop portal to the mobile codebase.

The mobile app is adding a BlueButton section
There will be an option to email but it will be unsecured (ie. Not using Direct Standards)
The BlueButton attachment is encrypted with a password.

Over 50% of patients have a care gap (based on HEDIS measures).

Medyear demo by Panha Chheng

The Patient is the De facto Health Information Exchange

see more at Medyear.com

[category News, Health]

[tag health cloud, bluebutton]

Mark Scrimshire
IT and Health Data Ninja

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 began as a Patient Engagement Advisor and am now CTO to Personiform, Inc. and their Medyear.com platform. 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.

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