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!!

Execs Say Silicon Valley Has The Jump On Healthcare Innovation

Posted on September 12, 2018 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.

Lately, it’s begun to look as though the leading lights of Silicon Valley might bring the next wave of transformation to healthcare. But can they work big changes in the industry on their own, or are they more likely to succeed by throwing their extremely considerable muscle behind existing healthcare players? That’s one of the many questions at issue as companies like Google, Amazon (Yes, I know they’re in Seattle), and Facebook shoulder their way into the business.

According to a new survey by Reaction Data, many healthcare execs think Amazon, in particular, has the potential to change the game.  When asked which outside entrants were most likely to disrupt the healthcare industry, two-thirds of respondents said the that the online retailing giant topped the list. “Amazon is ahead of the game in many ways compared to the other companies,” a chief nursing officer told Reaction Data.

There’s little doubt that there’s an opening for a company like Amazon to solve some pressing problems. As an industry outsider – unless you count its recent big-ticket acquisition of PillPack, which happened about a minute ago – Amazon may be able to bring fresh eyes to some of healthcare’s biggest problems. For example, what health exec wouldn’t kill to benefit from the e-retailer’s immense logistics capabilities? The mind boggles.

Facebook and Google aren’t making as many healthcare headlines, but they too are moving carefully into the business. For example, consider Google’s partnership with Stanford aimed at creating digital scribes. The digital scribe initiative may not seem like much, but I wouldn’t underestimate what Google can learn from the effort and how effectively it can operationalize this knowledge. It isn’t 2010 anymore, and I think the search giant has come a long way since its Google Health PHR effort collapsed.

Facebook, too, has made some tentative steps toward building a healthcare business, such as its recent agreement to collaborate with the NYU School of Medicine on speeding up MRI scanning using AI. The social networking giant hasn’t shown itself capable of much diversification to date, but I wouldn’t count it out, if for no other reasons than the massive profits to be made. Even for Facebook, we’re talking about serious money here.

If you’re wondering what these companies hope to accomplish, it’s not surprising. There are so many possibilities. One place to start is rethinking the EHR. Maybe I’m a starry-eyed dreamer, but I agree with observers like Dale Sanders, an executive with HealthCatalyst, who argues that Silicon Valley disrupters might be poised to bring something new to the table. “I keep hoping that the Googles, Facebooks and Amazons of the world will quietly build a new generation EMR,” Sanders writes in a recent column.

EMR transformation is just one of many potential targets of opportunity for the Silicon Valley gang, though. There’s obviously a raft of other goals healthcare leaders might like to see realized, The truth is, though, that it matters less what the Silicon Valley giants do than the competitive scramble they kick off within the industry. Even if these behemoths never succeed in leading the charge, they’re likely to spur others to do so.

Does NLP Deserve To Be The New Hotness In Healthcare?

Posted on August 30, 2018 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.

Lately, I’ve been seeing a lot more talk about the benefits of using natural language processing technology in healthcare. In fact, when I Googled the topic, I turned up a number of articles on the subject published over the last several weeks. Clearly, something is afoot here.

What’s driving the happy talk? One case in point is a new report from health IT industry analyst firm Chilmark Research laying out 12 possible use cases for NLP in healthcare.

According to Chilmark, some of the most compelling options include speech recognition, clinical documentation improvement, data mining research, computer-assisted coding and automated registry reporting. Its researchers also seem to be fans of clinical trial matching, prior authorization, clinical decision support and risk adjustment and hierarchical condition categories, approaches it labels “emerging.”

From what I can see, the highest profile application of NLP in healthcare is using it to dig through unstructured data and text. For example, a recent article describes how Intermountain Healthcare has begun identifying heart failure patients by reading data from 25 different free text documents stored in the EHR. Clearly, exercises like these can have an immediate impact on patient health.

However, stories like the above are actually pretty unusual. Yes, healthcare organizations have been working to use NLP to mine text for some time, and it seems like a very logical way to filter out critical information. But is there a reason that NLP use even for this purpose isn’t as widespread as one might think? According to one critic, the answer is yes.

In a recent piece, Dale Sanders, president of technology at HealthCatalyst, goes after the use of comparative data, predictive analytics and NLP in healthcare, arguing that their benefits to healthcare organizations have been oversold.

Sanders, who says he came to healthcare with a deep understanding of NLP and predictive analytics, contends that NLP has had ”essentially no impact” on healthcare. ”We’ve made incremental progress, but there are fundamental gaps in our industry’s data ecosystem– missing pieces of the data puzzle– that inherently limit what we can achieve with NLP,” Sanders argues.

He doesn’t seem to see this changing in the near future either. Given how much money has already been sunk in the existing generation of EMRs, vendors have no incentive to improve their capacity for indexing information, Sanders says.

“In today’s EMRs, we have little more than expensive word processors,” he writes. “I keep hoping that the Googles, Facebooks and Amazons of the world will quietly build a new generation EMR.” He’s not the only one, though that’s a topic for another article.

I wish I could say that I side with researchers like Chilmark that see a bright near-term future for NLP in healthcare. After all, part of why I love doing what I do is exploring and getting excited about emerging technologies with high potential for improving healthcare, and I’d be happy to wave the NLP flag too.

Unfortunately, my guess is that Sanders is right about the obstacles that stand in the way of widespread NLP use in our industry. Until we have a more robust way of categorizing healthcare data and text, searching through it for value can only go so far. In other words, it may be a little too soon to pitch NLP’s benefits to providers.

Is Amazon Ready To Protect Patient Data?

Posted on July 6, 2018 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.

Late last month, a Connecticut woman found out that a third-party Amazon vendor she had done business with had exposed her personal medical data to the world, including her medical conditions, along with her name, birthdate and emergency contact information.

The story suggests that Amazon engaged in a bit of bureaucratic foot shuffling when called on the privacy lapse. According to the woman, an Amazon call center rep told her it would investigate the issue, but a further email told her they would not be able to release the outcome of this investigation. It’s little wonder she wasn’t satisfied.

Ultimately, it appears that she was only able to get immediate action once she contacted the third-party seller, which took the photos containing the information down promptly upon her request.

Though no small matter for the woman involved, the episode means little for the future of Amazon, in and of itself. However, it does suggest that the marriage of Amazon technology and healthcare data may pose unexpected problems.

For those who have been sleeping under a rock, in late June Amazon announced that it had acquired online pharmacy PillPack for what reports say was just under $1 billion. PillPack, which competes with services delivered by giants like CVS, lets users buy their meds in pre-made doses. News stories suggest that Amazon beat out fellow retail giant Walmart in making the buy, which should close the second half of this year.

Without a doubt, this was a banner day in the history of Amazon, which has officially stamped into healthcare in 10-ton boots. The deal could not only mark the beginning of new era for the retailer, but also the healthcare industry, which hasn’t yet seen a tech company take a lead in any consumer-facing healthcare business.

That being said, perhaps a more important question for readers of this publication is how it will manage data generated by PillPack, a store likely to grow exponentially as Amazon integrates the online pharmacy into its ecosystem.

While there are obviously many good things its staggering fulfillment and logistics capabilities can bring to PillPack, Amazon’s otherwise amazing systems weren’t built to protect patient health information.

When it comes to most any other company, I’d imagine these problems could be addressed by layering HIPAA-compliant technologies and policies over its existing infrastructure. However, given the widely distributed nature of its retail network, it’s not just a matter of rethinking some architecture. Sealing off health data could require completely transforming its approach to doing business. Just about every retail transaction could prove a chink in its armor.

Since it wasn’t itself required to meet HIPAA standards in this instance, Amazon won’t get any flack from regulators over the recent PHI exposure. Still, issues like this could undercut the trust it needs to integrate PillPack into its core business successfully.

If nothing else, Amazon had better put a strong PHI protection policy in place on its retail side. Otherwise, it could undermine the business it just spent almost $1 billion to buy.

Alexa Voice Assistant Centerpiece Of Amazon Health Effort

Posted on June 1, 2018 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.

I don’t know about you, but until recently I had thought of the Amazon Echo is something of a toy. From what I saw, it seemed too cute, too gimmicky and definitely too expensive for my taste. Then I had a chance to try out the Echo my mother kept in her kitchen.

It’s almost embarrassing to say how quickly I was hooked. I didn’t even use many of Alexa’s capabilities. All I had to do was command her to play some music, answer some questions and do a search on the Amazon.com site and I was convinced I needed to have one. Its $99 price suddenly seemed like a bargain.

Of course, being a health IT geek I immediately wondered how the Alexa voice assistant might play a part in applications like telemedicine, but I was spending too much time playing “Name That Song” (I’m an 80s champ) to think things through.

But I had the right instincts. It’s become increasingly clear that Amazon sees Alexa as a key channel for reaching healthcare decision-makers.

According to a story appearing on the CNBC website, Amazon has built a 12-person team within the Alexa voice-assisted division called “health & wellness” whose focus is to make Alexa more useful to healthcare patients and providers. Its first targets include diabetes management, care for mothers and infants and aging, according to people who spoke anonymously with CNBC.

Of course, this effort would involve working through HIPAA rules, but it’s hard to imagine that a company like Amazon couldn’t buy and/or cultivate that expertise.

In the piece, writers Eugene Kim and Christina Farr argue that the mere existence of the health & wellness group is a clear sign that Amazon plans to bring Alexa to healthcare. As long as the Echo can share and upload data in a secure, HIPAA-compliant fashion, the possibilities are almost endless. In addition to sharing data with patients and clinicians, this would make it possible to integrate the data with secure third-party apps.

Of course, a 12-person unit is microscopic in size within a company like Amazon, and from that standpoint, the group might seem like a one-off experiment. On the other hand, its work seems more important when you consider the steps Amazon has already taken in the healthcare space.

The most conspicuous move Amazon has made in healthcare came in early 2018, when it announced a joint initiative with Berkshire Hathaway and J.P. Morgan focused on improving healthcare services. To date, the partnership hasn’t said much about its plans, but it’s hard to argue that something huge could emerge from bringing together players of this size.

In another, less conspicuous move, Alexa took a step towards competing in the diabetes care market. In the summer of 2017, working with Merck, Amazon offered a prize to developers building Alexa “skills” which could help people with diabetes manage all aspects of their care. One might argue that this kind of project could be more important than something big and splashy.

It’s worth noting at this point that even a monster like Google still hasn’t made bold moves in healthcare (though it does have extraordinarily ambitious plans). Amazon may not find it easy to compete. Still, it will certainly do some interesting things, and I’m eager to see them play out. In fact, I’m on the edge of my seat – aren’t you?

Strong Showing from Non-healthcare Technology Vendors on #HIMSS18 Exhibit Floor

Posted on March 9, 2018 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

The #HIMSS18 exhibit hall was proof of the growing trend of non-traditional healthcare companies entering the market. Along every aisle there were booths from consumer and B2B brands that are familiar outside the context of healthcare. There were mega-brands like:

  • Amazon
  • Cisco
  • Google
  • Microsoft
  • Oracle
  • Verizon
  • Salesforce

But it wasn’t just tech giants that made an appearance at #HIMSS18. Sprinkled throughout the exhibit hall were other organizations who were taking their products and expertise, honed in other industries and applying them to healthcare:

  • Zebra Technologies
  • Windstream
  • Pegasystems
  • Liaison Technologies
  • Microstrategies
  • Panasonic
  • OpenText

I found this second group of companies fascinating.

In recent weeks we have seen big announcement from companies like Apple and Amazon about their new healthcare initiatives. On a #hcldr tweetchat early last month, we solicited opinions in collaboration with HIMSS on whether the arrival of these companies was ultimately going to be good or bad for healthcare. The community’s reaction was one of “cautious exuberance”.

On one hand, many were very excited about the potential for these companies to spur innovation and improve user (aka patient) experiences. On the other hand many people brought forward concerns about how viable these companies could scale their healthcare initiatives.

Consider Amazon and Apple’s recent announcements. Both are working toward creating a private network of clinics that are available to staff that bypasses the traditional provider-payer ecosystem. The goal is to drive down healthcare costs for employees while simultaneously improving workforce efficiency. But both these tech giants have highly-skilled, highly-educated workforces and they both operate in a hyper-competitive talent market where health benefits could be a deciding factor. I’m not sure how this might scale to companies where wages are lower and competition is not as fierce. Would there be the same incentive?

It will be interesting to see how these do-it-yourself approaches work out in the long term. But what has me more excited are the non-traditional healthcare companies that are bringing their products and expertise from other industries to healthcare. Companies like Zebra Technologies (retail & transportation), Windstream (infrastructure & communications) and Pegasystms (financial technology) are quietly using their non-healthcare solutions to improve healthcare TODAY. This practical approach is exciting to see because of the immediate benefit to healthcare and because the solutions are proven.

Their outside-in perspective coupled with their significant resources is something that I will be watching closely in the months following HIMSS18.

*Windstream Enterprises, Pegasystems and Liaison Technologies are sponsors of Healthcare Scene.

Despite Privacy Worries, Consumers Trust Apple With Their Health Data

Posted on August 14, 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.

These days, everyone seems to want access to consumer health data. We’re talking not just about healthcare companies, but also financial firms, insurance companies and technology giants like Apple, Google and Amazon.

Consumers have every reason to be concerned how their data is used, as companies outside of the healthcare realm, in particular, might use it in ways that make them uncomfortable. After all, these health-related companies may not have to follow HIPAA rules. Not only that, laws that govern data collection of any kind are still evolving on the state and federal level. It’s just not clear where privacy rules for health data are going.

Troubling ambiguities like these may be why 37% of the 1,000-plus people responding to a new Twitter poll said they wouldn’t share their data with anyone. Perhaps they’ve begun to realize that companies like Google could do a lot of harm if they act recklessly with the health data they’re accumulating.

Nonetheless, there’s at least one company they trust more than others with their PHI, according to the poll, which was conducted by a CNBC writer. That company is Apple, says columnist Christina Farr. When asked which companies they trust with the health data, 41% picked Apple. Meanwhile, Google and Amazon came in at 14% and 8% respectively. That’s a pretty big gap.

Why do consumers trust Apple more than other technology companies?  It’s far from clear. But Andrew Boyd, a professor of biomedical and health information sciences at the University of Illinois, suggests that it’s because Apple has taken steps to foster trust. “Apple has done a big push around health and privacy to breed familiarity and comfort,” Boyd told CNBC.

He noted that Apple has announced plans to make aggregated health information available on smartphones. Next, it plans to integrate other medical data, such as lab results, which usually aren’t part of an integrated health record, Farr points out. Apple has also promised users that it won’t sell health data to advertisers or third-party developers.

Ideally, other companies should be following in Apple’s footsteps, suggests health data privacy expert Lucia Savage, who responded to the Twitter poll.

Savage, who is currently serving as chief privacy and regulatory officer at Omada Health, believes that any company that collects health data should at least provide consumers with a summary of the data they collect on their users and promise not to sell it. (She didn’t say so directly, but we know most non-healthcare firms can’t be bothered with such niceties.)

I think we all look forward to the day when every company takes health data privacy seriously. But giants like Google, with effectively infinite resources, are still pushing the envelope, and we can only expect its competitors to do the same thing. Unless consumers mount a massive protest, or there’s a radical change in federal law, I suspect most non-healthcare firms will keep using health data however they please.

Amazon Offering Textbook Rental on the Kindle

Posted on July 20, 2011 I Written By

Unless you have exceptional athletic ability or wealthy parents, college is an extremely expensive adventure.  My large student loans that I will be paying on for the next decade or two can verify that if you have any doubt.  I can only imagine how bad it must be for medical students.

One of the most annoying expenses is the exorbitant price of textbooks.  I am pretty sure every college student has paid $100+ for a textbook that they didn’t even open, but were required to buy.  Then you go to sell the book back, and they offer you a whopping $10.  Well, at least you can buy lunch.

One of my greatest discoveries in college was the ability to buy, and sell, used textbooks on Amazon.  This saved me tons of money throughout my years, but I was still stuck with books that I would never use again that weren’t worth the postage to mail back.  They now have a new feature that makes life better on both ends.

Tens of thousands of textbooks are now available through the launch of Kindle Textbook Rental.  Through this program students can rent textbooks for anywhere from 30 to 360 days.  For shorter periods they can save 80% off the print list price. The rental period can be extended at anytime for a period as short as a day, or even buy the book at anytime.

Some of the cool features are that you can make margin notes and highlights that you can save even after your rental period ends.  Should you decide to rent the book again all of your notes will be retained through Whispersync technology on the Amazon Cloud.

Kindle textbooks are also available through the free Kindle apps available on PC, Mac, Apple devices, Windows phone, Android, and Blackberry devices.  That means that students can access their textbooks from pretty much anywhere.

For more information the press release can be found here, or you can go straight to their website at www.amazon.com/kindletextbooks