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Key Articles in Health IT from 2017 (Part 2 of 2)

Posted on January 4, 2018 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.

The first part of this article set a general context for health IT in 2017 and started through the year with a review of interesting articles and studies. We’ll finish the review here.

A thoughtful article suggests a positive approach toward health care quality. The author stresses the value of organic change, although using data for accountability has value too.

An article extolling digital payments actually said more about the out-of-control complexity of the US reimbursement system. It may or not be coincidental that her article appeared one day after the CommonWell Health Alliance announced an API whose main purpose seems to be to facilitate payment and other data exchanges related to law and regulation.

A survey by KLAS asked health care providers what they want in connected apps. Most apps currently just display data from a health record.

A controlled study revived the concept of Health Information Exchanges as stand-alone institutions, examining the effects of emergency departments using one HIE in New York State.

In contrast to many leaders in the new Administration, Dr. Donald Rucker received positive comments upon acceding to the position of National Coordinator. More alarm was raised about the appointment of Scott Gottlieb as head of the FDA, but a later assessment gave him high marks for his first few months.

Before Dr. Gottlieb got there, the FDA was already loosening up. The 21st Century Cures Act instructed it to keep its hands off many health-related digital technologies. After kneecapping consumer access to genetic testing and then allowing it back into the ring in 2015, the FDA advanced consumer genetics another step this year with approval for 23andMe tests about risks for seven diseases. A close look at another DNA site’s privacy policy, meanwhile, warns that their use of data exploits loopholes in the laws and could end up hurting consumers. Another critique of the Genetic Information Nondiscrimination Act has been written by Dr. Deborah Peel of Patient Privacy Rights.

Little noticed was a bill authorizing the FDA to be more flexible in its regulation of digital apps. Shortly after, the FDA announced its principles for approving digital apps, stressing good software development practices over clinical trials.

No improvement has been seen in the regard clinicians have for electronic records. Subjective reports condemned the notorious number of clicks required. A study showed they spend as much time on computer work as they do seeing patients. Another study found the ratio to be even worse. Shoving the job onto scribes may introduce inaccuracies.

The time spent might actually pay off if the resulting data could generate new treatments, increase personalized care, and lower costs. But the analytics that are critical to these advances have stumbled in health care institutions, in large part because of the perennial barrier of interoperability. But analytics are showing scattered successes, being used to:

Deloitte published a guide to implementing health care analytics. And finally, a clarion signal that analytics in health care has arrived: WIRED covers it.

A government cybersecurity report warns that health technology will likely soon contribute to the stream of breaches in health care.

Dr. Joseph Kvedar identified fruitful areas for applying digital technology to clinical research.

The Government Accountability Office, terror of many US bureaucracies, cam out with a report criticizing the sloppiness of quality measures at the VA.

A report by leaders of the SMART platform listed barriers to interoperability and the use of analytics to change health care.

To improve the lower outcomes seen by marginalized communities, the NIH is recruiting people from those populations to trust the government with their health data. A policy analyst calls on digital health companies to diversify their staff as well. Google’s parent company, Alphabet, is also getting into the act.

Specific technologies

Digital apps are part of most modern health efforts, of course. A few articles focused on the apps themselves. One study found that digital apps can improve depression. Another found that an app can improve ADHD.

Lots of intriguing devices are being developed:

Remote monitoring and telehealth have also been in the news.

Natural language processing and voice interfaces are becoming a critical part of spreading health care:

Facial recognition is another potentially useful technology. It can replace passwords or devices to enable quick access to medical records.

Virtual reality and augmented reality seem to have some limited applications to health care. They are useful foremost in education, but also for pain management, physical therapy, and relaxation.

A number of articles hold out the tantalizing promise that interoperability headaches can be cured through blockchain, the newest hot application of cryptography. But one analysis warned that blockchain will be difficult and expensive to adopt.

3D printing can be used to produce models for training purposes as well as surgical tools and implants customized to the patient.

A number of other interesting companies in digital health can be found in a Fortune article.

We’ll end the year with a news item similar to one that began the article: serious good news about the ability of Accountable Care Organizations (ACOs) to save money. I would also like to mention three major articles of my own:

I hope this review of the year’s articles and studies in health IT has helped you recall key advances or challenges, and perhaps flagged some valuable topics for you to follow. 2018 will continue to be a year of adjustment to new reimbursement realities touched off by the tax bill, so health IT may once again languish somewhat.

Alexa, Can You Heal Me Now? The Power of Voice Assistant Technology in Healthcare

Posted on January 26, 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.

On Thursday, February 9, 2017 at 1:00 PM ET (10:00 AM PT) I’ll be hosting a live video interview with Nathan Treloar, President and COO at Orbita. In our discussion, we’ll be diving into voice assistant technology in healthcare including the breakout hit from Amazon known as Alexa. This has so much potential in healthcare. Join us as we talk about Alexa and other voice assistant technologies in healthcare and how more organizations can leverage voice assistant technology in their product offerings.

The great part is that you can join my conversation live and even add your own comments to the discussion or ask your own questions. All you need to do to watch live is visit this blog post on Thursday, February 9, 2017 at 1:00 PM ET (10:00 AM PT) and watch the video embed at the bottom of this post or you can watch on YouTube directly. The conversation will be recorded as well and available on this post after the interview.

About Nathan Treloar
Nate Treloar is co-founder and president of Orbita, which provides the first secure (HIPAA-compliant) cloud-based platform for creating and managing digital home healthcare applications. Previously, he held key executive positions at FAST Search, Microsoft, RAMP, and, Ektron. He is a respected expert and speaker on consumer IoT trends, search, text and data mining, content management, and knowledge management and has advised hundreds of the world’s largest companies and government agencies on their applications.

We hope you’ll join us live using the video below or enjoy the recorded version of our conversation.


(To Ask Questions, visit the YouTube page)

If you’d like to see the archives of Healthcare Scene’s past interviews, you can find and subscribe to all of Healthcare Scene’s interviews on YouTube.

The Speed of Innovation in Mobile Networks – Enabling The Future of Healthcare

Posted on September 8, 2016 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.

I’ve been attending the CTIA Super Mobility Conference in Las Vegas today and it’s been eye opening to say the least. The efforts they’re making to make wireless networks work for the IOT (internet of things) and even things like drones is incredible. Much of the buzz at the event has also been around the coming 5G networks.

Matt Grop EVP and CTO at Qualcomm offered this comparison of the progression from voice to 4G LTE to 5G:

Later, Rajeev Suir, President and CEO of Nokia, then suggested that we need 5G networks because the applications of the future will require it. This is an interesting statement to consider. Today during my Healthcare API discussion the need for faster connections came up and illustrated how healthcare could benefit from this additional speed. In fact, the innovations in healthcare are likely going to be facilitated or even demand the faster speeds to become a reality.

Think about neural networks and genomic medicine. That type of processing isn’t going to happen on the phone. The data for those won’t be stored on your phone, laptop, or desktop. It’s going to be stored and processed in the cloud and then sent back to your phone. The exchange of data that is going to need to happen is going to be huge and we’re going to need really fast networks to enable this future.

Think about all of the sensor data that is going to be reporting up to the cloud to be processed by these neural networks and pharmacogenomic processing engines. We’re not going to plug in to transfer this data. It’s going to use these ubiquitous wireless networks that currently connect our smart phones.

This all certainly leads to a fascinating future. I love the way technology can open the door to opportunities that would have never been thought possible previously. New high speed mobile networks like 5G are an example of that. The only question is if even 5G will be fast enough.

Is Lack of Mobile Health Interoperability Holding Us Back?

Posted on August 19, 2015 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.

Today during the #HITChicks chat, there was a great discussion with two really amazing healthcare IT professionals, Patty Sheridan and Tamara StClaire, about the need for interoperability between mobile health apps. Here’s where it started:

Then, I pushed Tamara a bit to talk more about the subject:

What a strong and important statement from Tamara. I agree completely that we’ll miss out on so much of the value that mobile health apps can provide if we don’t find out a way for apps to share data. Interoperability of health data has been an extremely important topic. In fact, ONC has put out a 10 year plan on how to have interoperability in healthcare. However, in all of the things I’ve read about interoperability of healthcare data, they’re always talking about sharing healthcare data between healthcare providers and provider data with patients. I don’t remember anyone ever talking about sharing health data between mobile health apps. The closest I’ve seen is making the patient the HIE of one that gathers and shares data between apps.

If no ones talking about mobile health data sharing, will it ever happen? Since Tamara tweeted her comment. I’ve been trying to think of the pathway to achieve her vision of shared mobile health data between disparate applications. Will it happen? Who will make it a reality? What are your thoughts?

Cerner Wellness Integrates with Apple’s HealthKit

Posted on October 1, 2014 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.

When Apple announced HealthKit, they announced a few healthcare partners including Epic. Many thought this was an interesting announcement, but I was (and still am) skeptical that anything really meaningful will come. As one person put it, we’re suppose to be excited that two of the most closed companies in the world are working together?

I recently saw the news come out that Epic’s main competitor, Cerner, announced that they’d integrated with Apple’s HealthKit. In fact, I believe their integration seems to have come out before Epic’s integration (unless I missed it, or maybe Epic just likes to keep quiet). Here’s a short excerpt from the Cerner announcement:

To me, HealthKit is about making it more convenient to manage your health and wellness, and share that information with the people that are helping you reach your goals. It’s less about trying to get real-time clinical insights or make new diagnoses. HealthyNow has the features that consumers and wellness experts are looking for in these apps, and by integrating with HealthKit, we’ve opened up the experience to a whole array of health apps for our members to choose from. This integration enables the feeding of key health metrics into our platform for sharing with health coaches, earning of incentive points, and identification of new opportunities to improve your health. By promoting healthier habits, consumers lower their premiums, health plans reduce their spend on treating avoidable diseases, and everyone lives a healthier life. (emphasis added)

The details on what Apple’s HealthKit would really do have been pretty foggy. Although, this paragraph illustrates where I figured HealthKit was going. Notice the part of the quote where I added emphasis. Cerner is just looking to suck data from HealthKit into Cerner. Maybe they have future plans to make Cerner data available to HealthKit, but the announcement seems to say they haven’t done so yet. This one way interface is exactly why I’m skeptical that HealthKit will really have a huge impact on healthcare.

What do you think? Have any of you integrated with HealthKit? I’d love to see if you have other views of where HealthKit might be headed.

Aetna Shuts Down CarePass – What’s It Mean?

Posted on August 27, 2014 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.

Looks like MobiHealthNews was the first to break the story that Aetna had chose to shutdown their CarePass product. This is big news since CarePass was Aetna’s baby and calling card in the mobile health world. They had a lot riding on it. Although, I think that iTriage, which Aetna acquired, was certainly the most used app under their umbrella.

If you’ve been on the mobile health/mHealth conference circuits you know that Aetna has been everywhere. Plus, the CEO of Aetna was even a keynote speaker at HIMSS (makes you wonder how much they paid for that spot). Without their CarePass product I’ll be interested to see what Aetna does in this space. Will they basically pull out almost completely?

Sure, Aetna will always take part in some way or another, but will they be pumping money into it like they’d been doing for a while now? I don’t think they will. I think we’ll see Aetna take a backseat approach to the IT part of the industry and just hop on board other people’s work like they did with iTriage.

Another piece of the MobiHealthNews article mentioned above that really intrigued me is this:

The company found no shortage of willing partners to feed data into the app. Over the two years of its existence, CarePass interfaced with MapMyFitness, LoseIt, RunKeeper, Fooducate, Jawbone, Fitbit, fatsecret, Withings, breathresearch (makers of MyBreath), Zipongo, BodyMedia, Active, Goodchime!, MoxieFit, Passage, FitSync, FitBug, BettrLife, Thryve, SparkPeople, HealthSpark, NetPulse, Earndit, FoodEssentials, Personal.com, Healthline, GoodRx, GymPact, Pilljogger, mHealthCoach, Care4Today, and meQuilibrium.

I think there’s a lesson here when it comes to API integrations. Who would have guessed that after making such a huge investment in CarePass, Aetna would just close up shop? I’m quite sure none of these companies that integrated with CarePass’ API thought CarePass would be gone. These types of integrations can be very time consuming and now all that effort is down the drain.

Although, the bigger lesson here is that just because you integrate a bunch of data from other applications doesn’t mean your app is going to be a success. It’s what you do with the data that’s integrated that matters. That’s why I’m really skeptical about Apple Health and HealthKit. Getting the data is one thing. Making that data useful is something very different.

Apple Health and HealthKit – I’m Extremely Skeptical

Posted on June 4, 2014 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.

Everyone is buzzing over the latest announcement from Apple at the World Wide Developers Conference (WWDC) that an Apple Health app and HealthKit (for healthcare developers) will be included in the latest iOS release (iOS8). The announcement was a little weak for me because it had already been leaked that the announcement was coming and also because the details of what it will do are really glossed over.

Whenever I hear an announcement without many details I start to wonder if it’s just vaporware right now. I think it is in this case. Instead of Apple offering a healthcare product that they know people need and will use, it feels like they’ve seen the growth of the health tracker and wearables market and they’re just throwing something out there to see if it works.

This HuffPo article compared the Apple HealthKit to what Apple did in iTunes. That’s so out of touch with the reality of healthcare apps. Music is a simple thing (not the rights part, but the usage part) that everyone understands. If you give them the music, then the consumer can go to town with it. Health data is much more complex.

The reality of health data is that it often has little value without some sort of outside expert analysis. This becomes even more important when you start mixing multiple sources of data into one interface like Apple will be doing with HealthKit. Sure, if Apple was focused on making all of the data they collected from all these third parties into smart, actionable data, then I’d be really excited. However, they’re not doing this at all. They’re just going to be a dumb platform that anyone can connect to and the smartest thing it will do is send you a notification. However, the outside application will have to prompt it to even do that.

I don’t think that Apple HealthKit is all bad. Maybe it will make it easier for developers to code their application once and then be able to connect their application to any blood pressure cuff out there. If they can do that, it would provide a lot of value to entrepreneurs in the space. However, it won’t transform health as we know it the way some people are describing it.

I also love people propping up the names of the Mayo Clinic and Epic. Google Health and Microsoft HealthVault had some similar names as well. How are they doing? A name doesn’t mean you’ll get a result.

The Epic name is interesting. However, I’m not very confident that bringing one closed garden together with another closed garden is really going to produce a lot of results. I’ll get back to you when I actually see them announce what they’re really doing together. Until then, this just feels like Epic and Apple had dinner together and said that it would be great if they could work together. If they had more, they sure didn’t talk about it on stage. So, I’m skeptical of what will really come out of the partnership.

Killer NPI API – BloomAPI

Posted on September 18, 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.

The foundation of many mobile physician applications is some sort of NPI lookup. In many ways, the NPI is the social security number for clinicians. It’s a unique identifier for a clinician and pretty much all of them have one. The good part is that the NPI data is downloadable for those who want to use it. Here’s Michael Wasser’s description of the NPI data:

The NPI is downloadable and is made up of basic demographics (name, sex), location information (business address, practice address), affiliations, and details of their practice (taxonomy codes). It is maintained by Cognosante for the federal government. Weekly disseminations are available at http://nppes.viva-it.com/NPI_Files.html. The total size of the NPI is about 4.5 Gigabytes.

The problem: The data isn’t huge, but its too big for excel or to just casually include in an application.

Like any good hacker, Michael Wasser saw this problem and decided to create a solution. That solution is called the BloomAPI (see also the github repository). I think this NPI lookup tool is a really great offering to the healthcare IT community. I’m sure we’ll see many applications use this going forward.

Jawbone Acquires BodyMedia and Launches Partner API

Posted on April 30, 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.

Today it was announced that Jawbone has acquired BodyMedia. Here’s an excerpt on the acquisition and announcement from pandydaily.

Today Jawbone, the company that makes the wearable “quantified self” band UP, issued two announcements: it’s rolling out an API so the device can integrate with other apps and connected devices relating to health and wellness. It’s also acquiring BodyMedia, which makes an FDA-approved weight-loss device called FIT that’s been used on the TV show “The Biggest Loser.”

The BodyMedia acquisition is a talent and intellectual property grab – it has 87 patents in its IP portfolio – but it will retain its name, continue producing the FIT, and keep its office in Pittsburgh open. The company would not disclose any other terms of the sale. The acquisition is a smart move in building out the product’s abilities in the future. BodyMedia has a medical bent, so surely future iterations of UP will pay more attention to things like disease monitoring.

But the really intriguing news is the API. It will allow partner apps to be able to tap into a user’s Jawbone data so she can find out more about her health and wellness habits. For example, a user can log onto MapMyFitness and view workout data in UP. Or he can step on a Withing scale – another connected device – and import his weight into up and see it in the context of sleeping and eating habits.

I think the article is right that the biggest asset that Jawbone is acquiring is the patent portfolio of BodyMedia. The other hard part is that I think the BodyMedia brand is better known than the Jawbone brand. So, the company will have a tough decision in how to go forward. It will take some time for them to work through the existing inventories and merge the product lines. It will be fun to watch.

I find the Jawbone API a little disappointing since it’s just a partner API. I know they say their intent is to eventually open up the Jawbone data to anyone, but I don’t understand why they wouldn’t do this from the start.

FitBit API and Other Healthcare APIs

Posted on April 12, 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.

I’ve long been a big fan of APIs in technology. It’s really powerful to open up your software so that outside developers can create really cool applications on top of your software. Think where Twitter would be today if it weren’t for their API. Most of the best Twitter clients were not built by Twitter. That’s just one simple example.

With that in mind, I was interested to see how the FitBit API was doing in its development. It’s been around for a couple years, so my hope was that I’d find a mature API with some good documentation and most importantly a strong developer community around it.

It seems like Fitbit has made it really easy to sign up and start using their API. That’s a good thing. Far too many in healthcare have an API, but they put up these enormous barriers for developers to start using it. When you’re dealing with PHI, you do have to take a serious approach to access, but the intent should be to create as many of those trusted API relationships as possible.

Next, I took a look at the Fitbit API documentation. Most of you won’t want to look at the API documentation since you’re not a developer. However, if you look at this Fitbit API Explorer page, you’ll get a good view of what functions are possible with the Fitbit API. They have a set of Ruby, PHP, and .Net Client libraries which is great (Although they’re not directly developed or supported by Fitbit). I do wish they had a really good sample app that uses their API. I’ve found a great sample application is incredibly valuable to developers that want to start using that API.

Finally, I took a look at the Fitbit discussion group. I was a little disappointed that there wasn’t more activity here. It does seem that the questions in the group do get eventually answered, but I’d have like to see a bigger Fitbit presence in the forum. The most active threads are the feature requests and announcements threads which isn’t too much of a surprise. There were only 15-20 active threads in April.

All in all, it looks like Fitbit has created a pretty solid API. I could see myself using it for a future project.

I’m interested to know what other APIs you’ve found in healthcare. What other healthcare companies are putting out really good APIs? Have you used the Fitbit API? What was your experience? Is it reliable? What are the best apps in healthcare that leverage someone’s API?