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What’s a Patient?

Posted on May 10, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

For quite a while I’ve been pushing the idea that healthcare needs to move beyond treating patients. Said another way, we need to move beyond just helping people who have health problems which are causing them to complain and move into treating patients that otherwise feel healthy.

Said another way, Wanda Health once told me “The definition of a healthy patient is someone who’s not been studied long enough.”

If you look long enough and hard enough, we all have health issues or we’re at risk for health issues. There’s always something that could be done to help all of us be healthier. That’s a principle that healthcare hasn’t embraced because our reimbursement models are focused on treating a patients’ chief complaint.

In another conversation with NantHealth, they suggested the idea that we should work towards knowing the patient so well that you know the treatment they need before you even physically see the patient.

These two ideas go naturally together and redefine our current definition of patient. In the above context, all of us would be considered patients since I have little doubt that all of us have health issues that could be addressed if we only knew the current state of our health better.

While NantHealth’s taken a number of stock hits lately for overpromising and under delivering, the concept I heard them describe is one that will become a reality. It could be fair to say that their company was too early for such a big vision, but it’s inspiring to think about creating technology and collecting enough data on a patient that you already know how to help the patient before they even come into the office. That would completely change the office visit paradox that we know today.

This is an ambitious vision, but it doesn’t seem like a massive stretch of the imagination either. That’s what makes it so exciting to me. Now imagine trying to do something like this in the previous paper chart world. Yeah, it’s pretty funny to just even think about it. Same goes with what we call clinical decision support today.

Healthcare Ransomware

Posted on May 8, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Health Data Management has a nice article up with insights on healthcare ransomware from GreyCastle Security’s CEO, Reg Harnish. Reg made a great case for why healthcare is seeing so much ransomware:

He contends that healthcare isn’t any more vulnerable to ransomware than other industries. But Harnish observes that—given the value of patient data and medical records—providers are the focus of cyber criminals who are targeting them with file-encrypting malware.

“You take their data away, and it literally threatens lives, patient safety and patient care, so they are much more likely to pay a ransom,” he adds.

I think healthcare organizations do respond differently to ransomware than other organizations and that makes them more vulnerable to an attack since many healthcare organizations feel it’s their obligation to maintain patient safety and that the ransom is worth the money so they can do no harm to patients.

Reg also addressed whether paying the ransom in a ransomware incident was a good idea (it’s not):

On the question of whether or not organizations should give in to the demands of cyber criminals using ransomware, Harnish says that GreyCastle never recommends paying a ransom. “There’s no guarantee that the ransom will work,” he warns. “If you pay the ransom, you may not get decryption keys. And even if you do get decryption keys, they may not be the right ones.”

Further, Harnish cautions that those organizations that pay a ransom then get put on a list of victims who have complied with ransomware demands. As a result, he says they are much more likely to be targeted again as a “paying” customer. “None of our clients have ever paid a ransom,” he adds.

I agree that in 98% of cases, paying the ransomware is a bad idea. Plus, every healthcare organization that pays the ransomware makes it worse for other healthcare organizations. Instead, the key is to have a great backup and disaster recovery strategy if and when ransomware occurs in your organization.

As Reg also points out, ransomware most often comes into your organization through your users. So, it’s worth the investment to educate your end users on possible hacking/ransomware attempts. Education isn’t perfect, but it can help decrease your chances of a ransomware incident.

#TransformHIT Think Tank Hosted by DellEMC

Posted on April 5, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


DellEMC has once again invited me back to participate at the 6th annual #TransformHIT Healthcare Think Tank event happening Tuesday, April 18, 2017 from Noon ET (9 AM PT) – 3 PM ET (Noon PT). I think I’ve been lucky enough to participate 5 of the 6 years and I’ve really enjoyed every one of them. DellEMC does a great job bringing together really smart, interesting people and encourages a sincere, open discussion of major healthcare IT topics. Plus, they do a great job making it so everyone can participate, watch, and share virtually as well.

This year they asked me to moderate the Think Tank which will be a fun new adventure for me, but my job will be made easy by this exceptional list of people that will be participating:

  • John Lynn (@techguy)
  • Paul Sonnier (@Paul_Sonnier)
  • Linda Stotsky (@EMRAnswers)
  • Joe Babaian (@JoeBabaian)
  • Dr. Joe Kim (@DrJosephKim)
  • Andy DeLaO (@cancergeek)
  • Dan Munro (@danmunro)
  • Dr. Jeff Trent (@TGen)
  • Shahid Shah (@ShahidNShah)
  • Dave Dimond(@NextGenHIT)
  • Mike Feibus (@MikeFeibus)

This panel is going to take on three hot topics in the healthcare industry today:

  • Consumerism in Healthcare
  • Precision Medicine
  • Big Data and AI in Healthcare

The great thing is that you can watch the whole #TransformHIT Think Tank event remotely on Livestream (recording will be available after as well). We’ll be watching the #TransformHIT tweet stream and messages to @DellEMCHealth during the event as well if you want to ask any questions or share any insights. We’ll do our best to add outside people’s comments and questions into the discussion. The Think Tank is being held in Phoenix, AZ, so if you’re local there are a few audience seats available if you’d like to come watch live and meet any of the panelists in person. Just let me know in the comments or on our contact us page and I can give you more details.

If you have an interest in healthcare consumerism, precision medicine, or big data and AI in healthcare, then please join us on Tuesday, April 18, 2017 from Noon ET (9 AM PT) – 3 PM ET (Noon PT) for the live stream. It’s sure to be a lively and interesting discussion.
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IBM Watson Partners With FDA On Blockchain-Driven Health Sharing

Posted on January 16, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

IBM Watson Health has partnered with the FDA in an effort to create scalable exchange of health data using blockchain technology. The two will research the exchange of owner-mediated data from a variety of clinical data sources, including EMRs, clinical trial data and genomic health data. The researchers will also incorporate data from mobiles, wearables and the Internet of Things.

The initial project planned for IBM Watson and the FDA will focus on oncology-related data. This makes sense, given that cancer treatment involves complex communication between multispecialty care teams, transitions between treatment phases, and potentially, the need to access research and genomic data for personalized drug therapy. In other words, managing the communication of oncology data is a task fit for Watson’s big brain, which can read 200 million pages of text in 3 seconds.

Under the partnership, IBM and the FDA plan to explore how the blockchain framework can benefit public health by supporting information exchange use cases across varied data types, including both clinical trials and real-world data. They also plan to look at new ways to leverage the massive volumes of diverse data generated by biomedical and healthcare organizations. IBM and the FDA have signed a two-year agreement, but they expect to share initial findings this year.

The partnership comes as IBM works to expand its commercial blockchain efforts, including initiatives not only in healthcare, but also in financial services, supply chains, IoT, risk management and digital rights management. Big Blue argues that blockchain networks will spur “dramatic change” for all of these industries, but clearly has a special interest in healthcare.  According to IBM, Watson Health’s technology can access the 80% of unstructured health data invisible to most systems, which is clearly a revolution in the making if the tech giant can follow through on its potential.

According to Scott Lundstrom, group vice president and general manager of IDC Government and Health Insights, blockchain may solve some of the healthcare industry’s biggest data management challenges, including a distributed, immutable patient record which can be secured and shared, s. In fact, this idea – building a distributed, blockchain-based EMR — seems to be gaining traction among most health IT thinkers.

As readers may know, I’m neither an engineer nor a software developer, so I’m not qualified to judge how mature blockchain technologies are today, but I have to say I’m a bit concerned about the rush to adopt it nonetheless.  Even companies with a lot at stake  — like this one, which sells a cloud platform backed by blockchain tech — suggest that the race to adopt it may be a bit premature.

I’ve been watching tech fashions come and go for 25 years, and they follow a predictable pattern. Or rather, they usually follow two paths. Go down one, and the players who are hot for a technology put so much time and money into it that they force-bake it into success. (Think, for example, the ERP revolution.) Go down the other road, however, and the new technology crumbles in a haze of bad results and lost investments. Let’s hope we go down the former, for everyone’s sake.

Newly Released Open Source Libraries for Health Analytics from Health Catalyst

Posted on December 19, 2016 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

I celebrate and try to report on each addition to the pool of open source resources for health care. Some, of course, are more significant than others, and I suspect the new healthcare.ai libraries released by the Health Catalyst organization will prove to be one of the significant offerings. One can do a search for health care software on sites such as GitHub and turn up thousands of hits (of which many are probably under open and free licenses), but for a company with the reputation and accomplishments of Health Catalyst to open up the tools it has been using internally gives healthcare.ai great legitimacy from the start.

According to Health Catalyst’s Director of Data Science Levi Thatcher, the main author of the project, these tools are tried and tested. Many of them are based on popular free software libraries in the general machine learning space: he mentions in particular the Python Scikit-learn library and the R language’s caret and and data.table libraries. The contribution of Health Catalyst is to build on these general tools to produce libraries tailored for the needs of health care facilities, with their unique populations, workflows, and billing needs. The company has used the libraries to deploy models related to operational, financial, and clinical questions. Eventually, Thatcher says, most of Health Catalyst’s applications will use predictive analytics based on healthcare.ai, and now other programmers can too.

Currently, Health Catalyst is providing libraries for R and Python. Moving them from internal projects to open source was not particularly difficult, according to Thatcher: the team mainly had to improve the documentation and broaden the range of usable data connections (ODBC and more). The packages can be installed in the manner common to free software projects in these language. The documentation includes guidelines for submitting changes, so that an ecosystem of developers can build up around the software. When I asked about RESTful APIs, Thatcher answered, “We do plan on using RESTful APIs in our work—mainly as a way of integrating these tools with ETL processes.”

I asked Thatcher one more general question: why did Health Catalyst open the tools? What benefit do they derive as a company by giving away their creative work? Thatcher answers, “We want to elevate the industry and educate it about what’s possible, because a rising tide will lift all boats. With more data publicly available each year, I’m excited to see what new and open clinical or socio-economic datasets are used to optimize decisions related to health.”