Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

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.

Growth of the Wearables Market Dominated by Healthcare

Posted on September 21, 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.

wearable-market-growth

This chart illustrates an incredible explosion in the wearables market and illustrates how it’s likely to continue to grow for years to come. The big takeaway for me is how healthcare totally dominates these graphs. The two biggest growth markets for wearable are “Healthcare” and “Sports/Activity Trackers.” Many would argue that Sports/Activity trackers should be included in healthcare. That’s amazing.

The only other wearable that gets reasonably close is the smart watches, but even those could be argued as healthcare devices as well. Sure, they do a lot more, but they all have some sort of health component to them as well.

I’m going to point to these graphs from now on when I talk about the impact of wearables on healthcare. Although, I guess I could also say that the wearables market is largely healthcare. I’m excited by this continued growth and I still think we’re just getting started on what will be possible. Watch out for wearables major impact on healthcare. I think it’s inevitable.

The Promise of Wearables for Healthcare

Posted on June 29, 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.

In a recent interview I did with Dr. Rhew, Chief Medical Officer of Samsung, and Dr. Nick, CMO of Dell, we got this great insight from Dr. Rhew on the promise of wearables for healthcare (only takes 45 seconds):

It’s worth listening to the full discussion with Dr. Rhew and Dr. Nick so you have context, but I love how he framed the promise of wearables for healthcare. I especially like how he talks about these devices just being integrated into our lifestyle.

The challenge with this promise is that many of the current wearables have fallen short. They don’t integrate well with our lifestyle. They’re a pain to connect to get the data (although, that’s gotten better). The data they collect has questionable accuracy. The data they collect isn’t clinically relevant. I could keep going, but you get the idea.

While many of the wearables have fallen short, that’s a necessary part of the learning process. We’re going through a wearable revolution and that requires a product evolution. Many of the things we see as failings today will be considered laughable in the future.

Like Dr. Rhew, I think the promise of wearables is extremely exciting for healthcare. The integration of wearables into your lifestyle is happening. It’s not going to happen overnight, but each of these products will lay the groundwork for wearables that will become invisible to our day to day life.

Samsung CMO Uses Gear S2 to Monitor Passed Out Patient on Plane

Posted on March 24, 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.

This post is sponsored by Samsung Business. All thoughts and opinions are my own.

I’m always impressed by stories of doctors doing amazing things on airplanes. So, you can imagine my interest in this tweet from Dr. Rhew, Samsung’s Chief Medical Officer.

A doctor doing something to help someone who’s sick on a flight is nothing new. Some of you might remember that Colin Hung wrote about how Dr. Rasu Shrestha helped a passenger during his flight to HIMSS. Eric Topol is also famous for saving someone’s live on a flight and for averting an emergency landing after using his AliveCor ECG to help a man who lost consciousness.

Each of these stories should be applauded. I can only imagine how grateful these people were to have a doctor on their flight that could help. Although, the stories about Dr. Topol and the one from Dr. Rhew from the tweet above are particularly interesting to me since they both used a piece of mobile health technology to assist them in their work with the patient. In Dr. Topol’s case it was an Alivecor ECG and in Dr. Rhew’s Case it was the Samsung Gear S2 watch.

I’ve actually heard from doctors that the medical kit on an airplane is surprisingly good. However, they no doubt don’t have an ECG or heart rate monitor. So, it’s pretty amazing that each of these doctors had these tools at their disposal and that each of us could easily be carrying one of them around with us now with no trouble at all. In fact, in the case of the heart rate monitor, a lot of us are already carrying one around.

This will get even more exciting as more sensors go mainstream and are able to monitor other parts of our health. Of course, use of these sensors doesn’t have to be on a plane. It could just as well have been on a soccer field at your kid’s soccer game. In that case, you may not even need one of the other parents to be a doctor. Your cell phone could quickly Skype/Facetime in an emergency response doctor who could walk you through what was needed and assist you with the injured child. Plus, that doctor could remotely see the vital sign readings coming from sensors on/in your phone and on/in the injured person.

We’re not there yet organizationally and politically with some of what I described, but the technology is definitely there for everything I described. It’s just a matter of time for it to become a reality.

It’s an exciting time to be working in healthcare.

For more content like this, follow Samsung on Insights, Twitter, LinkedIn , YouTube and SlideShare

Update: Here’s a nice little postscript from Dr. Rhew:


I agree with the passenger. That is so cool!

The Key to Successful Health Wearables and Apps

Posted on March 16, 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.

Yesterday I took part in the Dell #DoMoreHIT Healthcare Think Tank event. This was my 4th year participating in the event which always provides a rich discussion of important health IT topics.

This year, one of the topic areas was around wearables and how wearables are part of healthcare. We had a great discussion including insights from Stacey Burr, Digital Sports Managing Director at Adidas, which I found very helpful in my understanding of how a brand like Adidas is approaching wearables.

As the discussion progressed, I made the comment that I’ve come to realize that for a wearable or health app to be extremely successful it’s going to require one of two things: Fun or Invisible.

I want to be careful on the fun angle. I’m not talking about an app that applies gamification. Sure, gamification might be part of it, but people want to have fun. If a wearable or health app can’t make something fun, then more people are going to use it. In our current society we’re spoiled by so much stimulus and so we’re always interested in new ways to have fun. If you can incorporate some health or wellness into that, then we’ll like it even more. However, we’ll keep doing it because it’s fun, not because of the health and wellness benefits.

The other option is for the wearable or health app to be invisible. Say what you want about society (and there are some notable exceptions), most people don’t care about their health. At least they don’t care enough to really do something about it. Sure, we all want to be healthy, but not enough to inspire action. I’ve seen it over and over again with apps. That’s why the health wearable or app has to be invisible and do its work without the need of intervention by the human.

Dr. Wen Dombrowski (Better known as @HealthcareWen) argued that there were other reasons too and then explained that her GPS wasn’t fun or invisible, but she used it. I think she’s right that there could be some areas where an app could provide a specific utility that could become popular. I just have yet to see that happen in the health space. Plus, what I find interesting about her GPS example is that GPS has tried to become more and more invisible as well. I love that my phone now knows my calendar and the GPS to where I’m going and tells me that I’m late and gives me an easy link to get the navigation. So, even GPS is heading the direction of invisible as well.

Google Fit and Other Fitness Trackers

Posted on February 10, 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 always been intrigued by the various fitness trackers. I’ve never been that excited about their pure healthcare value, but I do believe that the amount we move (or don’t move) matters to our health. So, it makes since to track how much we move as one element of your health.

The problem I’ve had with all the fitness trackers I’ve used is that they end up in a drawer far too quick. In fact, I could never reliably wear one. My wife did better and made it a few weeks, but I just hated having a device attached to me. So, it never worked for me. (Side Note: HIMSS16 has a fitness challenge and they’re even accepting donations of fitness tracker devices you have gathering dust in your drawer.)

The closest I’ve come to a fitness tracker working for me is my cell phone. I was excited when my Samsung Galaxy S5 had the S Health app loaded on it and would track my steps and it could even do my heart rate. It was novel to see my step counts and see the trend over time. I was always excited when I’d go dancing and my step count would go through the roof and blow away all the goals that it had set for me.

I’ve since switched to the Google Nexus phone which has Google Fit built in. It has a similar step tracker and I definitely turned on Google Fit when I started with the phone. However, then I never heard or saw any notifications about it. I did’t really even realize it was on. Then, this week I got the notification from it that Google Fit was going to be disabled to save my battery since I hadn’t opened it in a long time (I can’t remember how many months they said).

What can I say? I totally forgot that it was even tracking me and it didn’t tell me that it was doing it. I do remember getting a notification or two that I’d had an active hour or something, but I’d just give myself a pat on the back and swipe off the notification. I guess that’s not considered using the app.

The other reason I probably didn’t care as much about the Google Fit tracking is that I knew that it was only tracking a small part of my movement since the cell phone is often with me, but not always. I work from home and so when I’m home I take my cell phone out of my pocket and it sits on my desk all day. That means it’s not tracking any of my movement during most days. I also play a lot of sports and I don’t want my cell phone in my pocket while I play. I guess that’s why all the Fitness trackers are these little devices that you could potentially wear while playing. Although, that feels like work and for what value?

Many have been dealing with this for years. What’s interesting is that I’ve been watching it for years as well and not much has changed. Is it nice that Google Fit is tracking my activity with almost no effort from me? Definitely, but with all the gaps in data it’s collecting, is that data really all that meaningful?

Would love to hear other people’s experiences with these trackers. Is there something new that’s changed your perspective on things?

The Fitness Wearable Nobody Knows About

Posted on January 27, 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 ran across a great article from Techcrunch that looked at the top 3 wearable vendors and they pointed out that most of us have probably never heard of the #3 wearable on that list. For those following along at home, the top 3 are Fitbit, Apple Watch, and Xiamoi Mi Band.

Everyone in the US has heard about Fitbit and the Apple Watch. However, my guess is that few in the US know about the Xiaomi Mi Band since 97% of its sales are in China. Here’s a look at the breakdown of wearable market share per the Techcrunch article linked above:

According to IDC, market leader Fitbit shipped 4.7 million wearable units in the third quarter, taking a 22.2 percent market share. Apple shipped 3.9 million units, for a 18.6 percent market share, while Xiaomi shipped 3.7 million units, or 17.4 percent of the market.

For all intents and purposes, the Xiaomi product line is very similar to the Fitbit product line. Some might even call it a knock off. The Mi Band originally started with steps, hours of sleep, and calories burned. Now the Mi Band Pulse also does heart rate. Have we heard this story before?

It’s really easy in our US centric minds to forget about what else is happening around the world. That’s particularly true of China which is one of the fastest growing wearable markets out there. I saw that first hand when I met all these Chinese digital health companies at CES. What will be interesting to watch is if and when some of these successful Chinese companies come to the US. We’ll see how they do.

Consumer Health Devices versus Medical Devices

Posted on January 20, 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 think there’s a major confusion in the current health app and device marketplace right now. The problem stems from consumers who draw conclusions even though claims aren’t really being made. I’ll use an example from my Healthcare Scene blog network.

I get asked all the time what I do for a job (like I’m sure most of you). I usually say that I’m a blogger and people then ask me what I blog about. I usually answer that I blog about healthcare IT. While people’s minds are blown by the fact that I’m a professional blogger, I can see in their eyes and often hear in their response that they didn’t really understand what it meant to blog about healthcare IT.

The most common interpretation is that I blog about health and wellness. I guess in some ways I tangentially blog about health and wellness, but no doubt in these people’s minds they’re picturing me writing about nutritional supplements, diet, fitness, and other health and wellness topics that they read in their magazines or favorite blogs online.

I never told them that I blogged about health and wellness, but they often interpret it that way since they don’t know the term healthcare IT to know what I really mean. When I try to clarify it for them, I often say that I write about how doctors use technology. That usually gets them closer.

I’ve found the same thing is happening with many consumer health devices. When you say that something is a consumer health devices they immediately draw their own conclusion that it must be a medical device that can be used by consumers. Unfortunately, the reality today is that consumer health devices are very different from medical devices.

As I’ve thought about the differences, I’ve come to realize that there’s one major difference that causes a lot of problems for those that misinterpret what they’re using. A medical device produces clinically relevant data that would be accepted and trusted by a medical professional. A consumer health device might or might not. We don’t know and therefore many medical professionals won’t use that data.

I don’t think it’s a problem that these consumer health devices don’t put out clinically relevant data. There seems to be a great business model for consumers to take a peak at their health data (regardless of how accurate it is). Plus, there are plenty of anecdotal stories about how this has helped individuals. That’s great.

The problem however comes in when we try to say that a consumer health device is something that it’s not. I think we’ll see this come into sharp focus over the next few years. Consumers will finally start to understand that not all devices are created equal. They’ll realize that some devices are clinically relevant (ie. their doctor will want and care about the data) and other devices are more for fun and intrigue than they are actually improving their health. Unfortunately, it’s just going to take us a while to get there.

Digital Health Video Blab from #CES2016

Posted on January 5, 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.

UPDATE: We had trouble finding a good internet connection at the event, so the blab didn’t work out well. However, on Friday of the event (from home), I took part in the MedHeads video chat about CES:

This week I’m excited to be attending the massive (170,000+ people) CES conference in Las Vegas. The amount of digital health at the conference is really astounding and exciting. You can check out some of our other CES Digital Health coverage on EMR and HIPAA.

On January 6th, 2016 at 2:30 PM PT (5:30 PM ET), I’m going to be a live video blab with Dr. Nick van Terheyden, CMO at Dell, from CES 2016. We’d love to have you join us and learn about what’s happening at CES and ask us anything you want. Just bookmark this page and the video blab will go live tomorrow.

I’ll also be taking part in the Digital Health Summit at CES. I’m told they’re doing a video recording of my session, so I’ll share that on Healthcare Scene in the future.

Fitbit for the Brain

Posted on August 26, 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.

Fitbit for Your Brain
The above wearable currently is pretty awkward. It reminds me of a wrestler or possibly one of those old swim caps. However, it’s a really interesting part of the evolution in wearables. The Barcelona based Neuroelectrics has put out this wearable to monitor your brain. Here’s an excerpt from the Guardian article on the product:

Dubbed a “Fitbit for the brain”, in a nod to the fitness monitoring device, the cap can diagnose medical conditions by examining brainwaves – small electronic pulses fired between the human brain’s nerve cells. It then treats the conditions by stimulating the brain with a low electrical current conveyed via a series of electrodes placed around the cap.

When in development, the devices initially monitored the small electrical impulses on the scalp emanating from neurons – the nerve cells – and recorded them using electroencephalography (EEG). Later advances allowed the cap to stimulate the brain as well in order to help with recovery.

“Our whole motivation is to understand better the brain and, to be honest, I think there is still a lot of work to do. Nobody really knows in depth how the brain works. We are looking at a very specific function of the brain which is the electric fields generated,” says Ana Maiques, co-founder and chief executive of Neuroelectrics.

“So in a way we are decoding the brain from an electrical perspective and also trying to influence the brain. It is still our motivation to understand, to see if processing data coming from an electroencephalogram we can understand what is going on inside the brain. And then in the last few years, we have been interested in trying to influence the dynamics of the brain.”

When you start digging into the science of the brain, you realize that we know a lot less about the brain than we know. It’s extremely complex and in many cases we really don’t know how it works. That’s why I think wearables like this one are so important. It’s trying to push forward some ideas so we can discover more about how the brain works. That’s a worthwhile goal even if it feels as daunting as Columbus trying to sail off the edge of the world. Hopefully what we discover in this search is just as dramatic as what Columbus found as well.