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Farzad Mostashari Tweets #HDPalooza

Posted on June 4, 2013 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 geeks from across the US have descended on Washington DC this week for what’s called Health Datapalooza. It’s a sort of Mecca for healthcare data sharing where health data geeks virtually hold hands and sing koombaya as they circle around blue buttons and hard drives full of granular health data. As someone who believes that health data liberacion is the right direction for healthcare, this is a great event and this year it seems to have really hit its stride.

One of the biggest advocates of using healthcare data for good is ONC’s own Farzad Mostashari. Never someone afraid to tweet or Retweet health data related topics, Farzad’s twitter account has been incredibly active during Health Datapalooza. So, I thought I’d use it to illustrate some of the messages Farzad found important enough to share from the event. Plus, I’ll throw in my commentary after each tweet as appropriate. (Note: when the tweet is from someone else it’s because Farzad retweeted it.)


If you want to stop reading here you could, because it’s the core of Farzad’s message. Although, if you want to go into depth on the topic, keep reading. At least Farzad has made clear that he’s going to use whatever methods he has available to make patients’ health data available.


I’ve said this a few times recently as well. I have an extreme belief in the creativity and drive of entrepreneurs. We just need more of them to be able to do their work in healthcare.


Amen! The challenge is getting this message to consumers. If you tell them that their data will be kept private, but will be shared where appropriate to provide better care, every patient wants this to happen. In fact, most already assume this is what’s happening.


Healthcare problems are still a HUGE challenge. We don’t need any more barriers than we already have to overcome.


I wish the $36 billion in EHR incentive money would have been spent on standardization. We’d have had better results. I’m still not sure how we’re going to get to future payment models. Govt could play a role in it.


Speaking of changing payment models. Seems like government doesn’t know how to get their either. A fundamental delivery system transformation could be translated as impossible.


The ladies will love Farzad in his bowtie. I love people who aren’t afraid of trying what seems impossible. Who in health IT is doing that today? I guess looking at the last tweet CMS and ONC are trying.


I’m not sure if we should be proud or sad at the 8% number. Granted, it’s a lot of people that have to learn about it. Although, since many don’t care about their health data, 8% is pretty good.


I’ll be interested to see this number post-meaningful use stage 2. Doctors will be really encouraging their patients to get their health data so they can meet MU stage 2.


This isn’t actually from Health Datapalooza, but Farzad did just retweet it. I haven’t dug into Obama’s plan to deal with patent trolls, but I’m really glad more of a spotlight is being put on this challenging problem. In the case of software, I’m really against patents because as the tweet says they do stifle innovation. It’s ironic because they’re suppose to encourage innovation, but it’s just not the reality of how they’re being used.

What SaaS EHR Users Can Learn from the Megaupload Takedown

Posted on July 5, 2012 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.

It’s time to talk about a subject near and dear to my readers hearts: SaaS EHR. In this article, we’re going to take a serious look at some of the risks associated with the pure SaaS EHR model. I’m sure this will leave many concerned about SaaS EHR software. Before I get into that, I want to be clear that I can (and probably will) make a future post about client server EHR software that will likely leave you just as concerned.

The point isn’t that SaaS EHR or client server EHR is better than the other. I take a much more “switzerland” approach to the topic. I think both approaches to EHR have their risks, challenges, benefits and advantages. To me it’s much more important that users are educated on the risks of each so that they can address them properly.

With that in mind, I was recently reading one of my favorite venture capital bloggers, Brad Feld, who posted a guest post by Dave Jilk about what SaaS software vendors can learn from the Megaupload and its impact on the future of Multi Tenant Services. For those not familiar with the Megaupload situation, the Feds basically took down Megaupload and seized everything they had in response to copyright infringement violations. Wired has an interesting article about the case.

What then can we learn from the Megaupload case that applies to SaaS EHR companies. I think Dave Jilk describes the SaaS risks better than I could:

What this particular case illustrates is that a company that provides your online service is a single point of failure. In other words, simply offering multiple data centers, or replicating data in multiple locations, does not mitigate all the risks, because there are risks that affect entire companies. I have never believed that “availability zones” or other such intra-provider approaches completely mitigate risk, and the infamous Amazon Web Services outage of Spring 2011 demonstrated that quite clearly (i.e., cascading effects crossed their availability zones). The Megaupload situation is an example of a non-technical company-wide effect. Other non-technical company-wide effects might be illiquidity, acquisition by one of your competitors, or changes in strategy that do not include the service you use.

So again, while this is a striking and unfortunate illustration, the risk it poses is not fundamentally new. You need to have an offsite backup of your data and a way to use that backup. The situation where the failure to do this is most prevalent is in multi-tenant, shared-everything SaaS, such as Salesforce.com and NetSuite. While these are honorable companies unlikely to be involved in federal data confiscations, they are still subject to all the other risks, including company-wide risks. With these services, off-site backups are awkward at best, and more importantly, there is no software available to which you could restore the backup and run it. In essence, you would have to engage in a data conversion project to move to a new provider, and this could take weeks or more. Can you afford to be without your CRM or ERP system for weeks? By the way, I think there are steps these companies could take to mitigate this risk for you, but they will only do it if they get enough pressure from customers. Alternatively, you could build (or an entrepreneurial company could provide) conversion routines that bring your data up and running in another provider or software system fairly quickly. This would have to be tested in advance.

As many of you know, I’ve been quite interested in this topic and risk for quite a while. I’m sympathetic to those doctors that want at least a copy of their data stored somewhere that they control. Yes, most SaaS EHR vendors have a good set of backup, disaster recovery and business continuity plans. However, as the above quote points out so well, that doesn’t deal with the “non-tecnical company-wide effects.”

I’ve long considered the idea of creating a set of standards that SaaS EHR vendors could adopt. Things like making a practice’s entire EHR data available in an easily downloadable XML format. That could be the starting point. I think it would also create a real competitive advantage to those EHR vendors that adopted these type of common sense, good customer service practices.

I’d even be happy to lead the EHR agnostic team that it would take to make this happen. Client Server EHR software vendors could be involved as well. Not to mention I’d be happy to provide a voice to the movement on my network of EMR websites. I think the key to success would be getting a couple EHR vendors to get on board with the idea and fully invested in seeing this happen. The challenge is that too many EHR vendors are blinded by the meaningful use lights.

Let’s just imagine for a minute that doctors that select an EHR didn’t have to worry about their data being safe. They knew that they could have their data available to them when they needed it where they needed it regardless of what happened to the vendor. I have that with my blog data. Although, instead of that making me wanting to change blogging platforms, it’s endeared me to WordPress even more.

I wonder if Todd Park could add this idea to his concept of EHR Data Liberacion.

Government Healthcare IT Dashboard from ONC

Posted on May 14, 2012 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.

One movement that I and I’m sure many of you have seen unfolding by HHS and ONC in particular is what Todd Park calls Data Liberacion. As Todd Park has moved to CTO of the US, I expect he’s going to take the data liberation movement beyond healthcare.

The latest addition to the Healthcare Data Liberation movement by ONC is the Health IT Dashboard that was put up by ONC.

Here’s the description of what’s possible for the website:
The Dashboard currently provides summary information about all ONC HITECH grant programs, and detailed data from the Regional Extension Center, and Community College Consortia to Educate Health IT Professionals programs.

Using ONC’s Health IT Dashboard, you can:

  • Generate maps of health IT adoption statistics for common groups of health care providers & hospitals,
  • Examine the impact of ONC’s Recovery Act grant programs implementation at national and local levels
  • Download and analyze the data for your own research projects.

I haven’t had much chance to dig into the data. As I do, I’ll write future posts on what I find. Also, there’s nothing better than crowd sourcing the look at large amounts of data. So, if you’ve found some data that’s interesting, let us know in the comments.