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Healthcare Identity and Interoperability – #HITsm Chat Topic

Posted on March 21, 2018 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 3/23 at Noon ET (9 AM PT). This week’s chat will be hosted by Julie Maas (@JulieWMaas) from EMR Direct on the topic of “Healthcare Identity and Interoperability”.

There is a lot of discussion about healthcare identity in the industry recently, since:

  • Patient data is now available via public APIs from Health IT vendors that are moving into production with 2015 Edition compliant software
  • Patient matching problems persist, with no national identifier on the horizon
  • New NIST 800-63-3 identity proofing requirements and GDPR are coming onto the scene
  • Now even Jared Kushner is demanding patient access to data
  • Apple and Google are starting to take healthcare data seriously and a new class of third party “Client App” developers, managing health data, is emerging
  • TEFCA

All health data managed by healthcare providers carries legal (both federal and state) restrictions about who can access it. Data holders want to be sure they are making health data available to the right patients (who have rights to that data or have been made an authorized patient representative) and to the right providers and payers (certain assertions simplify this).  Initiatives like TEFCA and consumer-mediated exchange and the underlying technologies they typically reference are helping to clarify and expand the ways that better use of health data can improve health care delivery. What this translates to is a huge ask on the part of technologists to dramatically expand the volume of digital data that can be shared as well as the entities with whom it can be shared, while maintaining patient privacy and data security.

Important considerations that need to be addressed in the immediate short term to handle these developments are:

  • How to manage the identity and associated credentials of a querying entity (patient, provider, or payer) that is accessing their own personal health data or large volumes of data and what minimum bar is necessary to authorize such a transaction?
  • Similar question but for a patient app developer
  • Similar question for the patient who either through an in-person visit ONLY or alternatively via an entirely online interaction, obtains a credential for access to their own data
  • How do all of the above change, if at all, when 800-63-3 is brought under the lens? Can the above credentials still be generated through an online-only process considering the hefty restrictions of 800-63-3?

Please join us for this week’s #HITsm chat as we talk about the following questions:

T1: What does interoperability mean to you? Big asks/personal stories? #HITsm

T2: Ever heard (from a friend) of health data leaving 1 health system and being utilized in a different EMR? How did this help the patient? What personal information would patients be willing to make shareable between orgs in order to help providers “make sure you’re you”? #HITsm

T3: Does every provider already have the exact interoperability they want? Why or why not? If not, what is the biggest gap? #HITsm

T4: What do patients need to know about a patient facing application before allowing it to access their health data through an open API? #HITsm
(Want to really get into the weeds? See this and this)

T5: Is it a useful first pass for a patient to be able to share all health data from a given provider, or are special “valet keys” to limit sharing to certain data categories needed? #HITsm

Bonus: Do you have any ideas to improve measure reporting in order to reduce the burden on providers? #HITsm
(See this)

Upcoming #HITsm Chat Schedule
3/30 – What is Patient – Centric Care?
Hosted by Linda Stotsky (@EMRAnswers)

4/6 – TBD
Hosted by TBD

4/13 – TBD
Hosted by TBD

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Inching Toward Health IT Interoperability – #HITsm Chat Topic

Posted on August 1, 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 8/4 at Noon ET (9 AM PT). This week’s chat will be hosted by Alan Portela (@AlanWPortela) from Airstrip on the topic of “Inching Toward Health IT Interoperability.”

To some it may seem as though ‘interoperability’ is a stale health IT buzzword, but nothing could be further from the truth. Why? Because interoperability still isn’t a reality.

Data is digital, but not readily available; data exists in EHRs, but isn’t aggregated and shared in a way that makes sense for clinicians. In addition, precision medicine relies upon the ability to collect real time data from medical devices at the moment of care – physiologic phenotypes, genomic data, and the like. Precision medicine fundamentally depends on data to make unique diagnosis/care plans for individuals or populations. That cannot happen easily or effectively without interoperability.

Health IT could play a significant role in addressing more serious health issues, but a lack of interoperability and access holds us back. If we want precision medicine, then we need to recognize that interoperability is a must.

Questions we will explore in this week’s #HITsm chat include:
T1: Where have you seen the most success in health IT interoperability? #HITsm

T2: What have been your largest barriers to health IT interoperability? #HITsm

T3: What is vital to making health IT interoperability a reality? #HITsm

T4: Which industry stakeholder has the biggest responsibility to push health IT interoperability forward? #HITsm

T5: How should governing bodies – national and/or industry specific – support health IT interoperability? #HITsm

Bonus: How can we, as health IT leaders and innovators, drive the change the industry needs? #HITsm

Upcoming #HITsm Chat Schedule
8/11 – TBD
Hosted by TBD

8/18 – Diversity in HIT
Hosted by Jeanmarie Loria (@JeanmarieLoria) from @advizehealth

8/25 – Consumer Data Liquidity – The Road So Far, The Road Ahead
Hosted by Greg Meyer (@Greg_Meyer93)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Health Data Sharing and Patient Centered Care with DataMotion Health

Posted on April 13, 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.

Now that the HIMSS Haze has worn off, we thought we’d start sharing some of the great video interviews we did at HIMSS 2016. In this case, we did a 3 pack of interviews at the DataMotion Health booth where we got some amazing insights into health data sharing, engaging patients, and providing patient centered care.

First up is our chat with Dr. Peter Tippett, CEO of Healthcelerate and Co-Chairman of DataMotion Health, about the evolution of healthcare data sharing. Dr. Tippett offers some great insights into the challenge of structured vs unstructured data. He also talks about some of the subtleties of medicine that are often lost when trying to share data. Plus, you can’t talk with Dr. Tippett without some discussion of ensuring the privacy and security of health data.

Next up, we talked with Dennis Robbins, PHD, MPH, National Thought Leader and member of DataMotion Health’s Advisory Board, about the patient perspective on all this technology. He provides some great insights into patients’ interest in healthcare and how we need to treat them more like people than like patients. Dr. Robbins was a strong voice for the patient at HIMSS.

Finally we talked with Bob Janacek, Co-Founder and CTO of DataMotion Health, about the challenges associated with coordinating the entire care team in healthcare. The concept of the care team is becoming much more important in healthcare and making sure the care team is sharing the most accurate data is crucial to their success. Learn from Bob about the role Direct plays in this data sharing.

Thanks DataMotion Health for having us to your booth and having your experts share their insights with the healthcare IT community. I look forward to seeing you progress in your continued work to make health data sharing accessible, secure, and easy for healthcare organizations.

The Real HIPAA Blog Series on Health IT Buzz

Posted on April 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.

If you’re not familiar with the Health IT Buzz blog, it’s the Health IT blog that’s done by ONC (Office of the National Coordinator). I always love to see the government organizations blogging. No doubt they’re careful about what they post on their blog, but it still provides some great insights into ONC’s perspective on health IT and where they might take future regulations and government rules.

A great example of this is the Real HIPAA series of blog posts that they posted back in February. Yes, I realize I’m behind, but I’ll blame it on HIMSS.

Here’s an overview of the series:

It’s a common misconception that the Health Insurance Portability and Accountability Act (HIPAA) makes it difficult, if not impossible, to move electronic health data when and where it is needed for patient care and health. This blog series and accompanying fact sheets aim to correct this misunderstanding so that health information is available when and where it is needed.

The blog series dives into the weeds a bit and so it won’t likely be read by the average doctor or nurse. However, it’s a great resource for HIPAA privacy officers, CIOs, CSOs, and others interested in healthcare interoperability. I can already see these blog posts being past around management teams as they discuss what data they’re allowed to share, with whom, and when.

What’s clear in the series is that ONC wants to communicate that HIPAA is meant to enable health data sharing and not discourage it. We all know people who have used HIPAA to stop sharing. We’ll see if we start seeing more people use it as a reason to share it with the right people at the right time and the right place.

The Easiest Form of Healthcare Information Blocking – Charge for It

Posted on March 23, 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 watched the discussion around information blocking in healthcare with a lot of interest. I’ve seen many people (including the government) talk about how information blocking is a major issue in healthcare and that we need to do something to solve the problem of information blocking. I’ve read other organizations who have searched for information blocking and say they can’t find it and that people are overstating the issue of information blocking.

I do think that some people overstate how big of an issue information blocking is, but I know that it’s a problem. Sometimes the information blocking is done purposefully, but other times it’s happening without much thought as to why they should or shouldn’t take part in information sharing.

As I’ve watched this discussion evolve and the drive towards interoperability I’ve realized that what’s happening in interoperability today could very well be the easiest and most legal form of information blocking that exists: charge for the information.

When I look into the future of information sharing, I can see EHR vendors salivating at these new found revenue streams associated with data sharing. Sure, it will only be pennies or fractions of a penny to share each record. However, when you spread that across millions and millions of records those fractions of a penny really start to add up.

When I look at the interoperability options that are being built today, these options are going to be able to charge for access to this data in a very granular way. All the data sharing is easily tracked and if it’s being tracked it can easily be charged for. I expect large healthcare organizations are going to have to start creating entire budgets dedicated to the cost of interoperability.

Once this happens smaller healthcare organizations are going to be blocked out of accessing the data. However, they won’t be literally blocked out of accessing the data like they are now. Instead, they’ll have access to the data, but the cost to access the data will be so much that they’ll be unable to access the data due to the high costs.

If you’re someone who’s a fan of information blocking, this is the perfect solution. No one can tell you that they couldn’t get access to the data, because they could get access to the data. All they had to do was pay for it. The fact that they couldn’t afford to access the data is a different issue. I expect this day will come sooner than we think.

EHR Vendor Commitments to Make Data Work at #HIMSS16

Posted on March 2, 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.

As I think back on the first day and a half of HIMSS, I think that this might be the biggest news of the conference so far:

It seems that most people see this as a hollow commitment. Some might argue that we’re jaded by past history and they’d be right. However I’d make a different argument. Interoperability is hard and there are plenty of incentives not to do it. I don’t see this changing because EHR vendors commit to being interoperable.

Let’s be honest. Saying that they’ve “committed” doesn’t matter if they have no skin in the game. There’s no payment for successfully creating a product that’s interoperable. There’s no penalty for not being interoperable. That’s not ONC and HHS’ fault. They only have the levers that the government provides them. There are just so many easy ways for EHR vendors to feign interest in a real commitment to interoperability without actually executing on that vision.

While this type of announcement at HIMSS doesn’t really make me think that the dynamics around healthcare interoperability will change, I do like HHS’ decision to have EHR vendors work out the interoperability problem. If the government couldn’t solve interoperability with $36 billion in incentive money and penalties to boot, do we really think they can do anything to change the equation? At least on their own. This has to be an industry focused effort or it won’t happen.

While I must admit that I’m slowly becoming a skeptic of ever achieving true interoperability of health data, I think we will see point examples where data is being shared. I’m always intrigued by great companies who realize that they can’t be everything, but they can be something. I think we’ll see more of more companies like this.

Expecting Evolutionary, Not Revolutionary at #HIMSS16

Posted on February 26, 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.

As most of you know, I’m deep in the weeds of planning for the HIMSS 2016 Annual conference. Actually, at this point on the Friday before HIMSS, I’m more or less planned. Now I’m just sitting here and wondering what things I might have missed. With that said, I’ve been preparing for this live video interview with the Samsung CMO which starts in 30 minutes (it’s recorded in case you miss the live discussion) and so I’ve been thinking about what I’m going to see at HIMSS. As someone who follows the changes in healthcare technology every day, I’m expecting lots of evolutionary changes and very little revolutionary.

As I think about it, I’m trying to imagine what someone could announce that would be revolutionary. That includes thinking back to past HIMSS to what announcements really revolutionized the industry. I can only think of two announcements that come close. The first announcement was when the meaningful use regulations were dropped right before the ONC session at HIMSS. Few people would argue that meaningful use has not revolutionized healthcare IT. Certainly many people would argue that it’s been a revolution that’s damaged the industry. Regardless of whether you see meaningful use as positive or negative, it’s changed so many things about healthcare IT.

The second announcement that stands out in my mind was the CommonWell health alliance. I’m a little careful to suggest that it was a revolutionary announcement because years later interoperability is still something that happens for a few days at the HIMSS Interoperability showcase and then a few point implementations, but isn’t really a reality for most. However, CommonWell was a pretty interesting step forward to have so many competing EHR companies on stage together to talk about working together. Of course, it was also notable that Epic wasn’t on stage with them. This year I’ve seen a number of other EHR vendors join CommonWell (still no Epic yet), so we’ll see if years later it finally bears the fruits of what they were talking about when they announced the effort.

The other problem with the idea that we’ll see something revolutionary at HIMSS 2016 is that revolutions take time. Revolutionary technology or approaches don’t just happen based on an announcement at a conference. That’s true even if the conference is the largest healthcare IT conference in the world. Maybe you could see the inkling of the start of the revolution, but then you’re gazing into a crystal ball.

The second problem for me personally is that I see and communicate with so many of these companies throughout the year. In just the last 6 months I’ve seen a lot of the HIMSS 2016 companies at various events like CES, RSNA, MGMA, AHIMA, etc. With that familiarity everything starts to settle into an evolution of visions and not something revolutionary.

Of course, I always love to be surprised. Maybe someone will come out with something revolutionary that changes my perspective. However, given the culture of healthcare and it’s ability to suppress revolutionary ideas, I’ll be happy to see all the amazing evolution in technology at HIMSS. Plus, the very best revolutionary ideas are often just multiple evolutionary ideas combined together in a nice package.

What’s Next in the World of Healthcare IT and EHR?

Posted on February 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.

In the following video, Healthcare Scene sits down with Dana Sellers, CEO of Encore, a Quintiles Company. Dana is an expert in the world of healthcare IT and EHR and provides some amazing expertise on what’s happening in the industry. We talk about where healthcare IT is headed now that meaningful use has matured and healthcare CIOs are starting to look towards new areas of opportunity along with how they can make the most out of their previous EHR investments.

As we usually do with all of our Healthcare Scene interviews, we held an “After Party” session with a little more informal discussion about what’s happening in the healthcare IT industry. If you don’t watch anything else, skip to this section of the video when Dana tells a story about a CIO who showed the leadership needed to make healthcare interoperability a reality.

Video Interview with Helen Waters, VP at MEDITECH

Posted on January 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.

Healthcare Scene was lucky to sit down with Helen Waters, VP at MEDITECH, to talk about the EHR market and MEDITECH’s place in that market. Plus, we dive into the culture and history of MEDITECH and how it’s changed. We also explore MEDITECH’s plans around innovation, integration, and value along with MEDITECH’s efforts to deploy cloud and mobile solutions. Finally, we had to talk about healthcare interoperability. We hope you’ll enjoy this wide ranging interview with Helen Waters:

After the formal interview we did above, we allow people watching live to be able to ask questions and even hop on camera to offer their insights or ask questions of Helen in what we call the “after party.” In this “after party” discussion we talk to Helen about her thoughts on the changing healthcare reimbursement landscape and what MEDITECH is doing to prepare for it. We also talk about integrating telemedicine into MEDITECH. I also ask Helen about MEDITECH’s views on EHR APIs.

We hope you’ll enjoy this look into EHR vendor, MEDITECH.

We Share Health Data with Marketing Companies, Why Not with Healthcare Providers? Answer: $$

Posted on November 20, 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.

For those who don’t realize it, your health data is being shared all over the place. Yes, we like to think that our health care data is being stored and protected and that laws like HIPAA keep them safe, but there are plenty of ways to legally share health care data today. In fact, many EHR vendors sell your health care data for a pretty penny.

Of course, many would argue that it’s shared in a way that complies with all the laws and that it’s done in a way that your health record isn’t individually identified. They’re only sharing your health data in a de-identified manner. Others would argue that you can’t deidentify the health data and that there are ways to reidentify the data. I’ll leave those arguments for another post. We’ll also leave the argument over whether all this sharing of health data (usually to marketing, pharma and insurance companies) is safe or not for a future post as well.

What’s undeniable is that health data for pretty much all of us is being bought and sold all over health care. If you don’t believe it’s so, take a minute to look at the work of Deborah Peel from Patient Privacy Rights and learn about her project theDataMap. She’ll be happy to inform you of all the ways data is currently being bought and sold. It’s a really big business.

Here’s where the irony comes in. We have no trouble sharing health data (Yes, even EHR vendors have no problem sharing data and lets be clear that not all EHR vendors share data with these outside companies but mare are sharing data) with marketing companies, payers and pharma companies that are willing to pay for access to that data. Yet, when we ask EHR vendors to share health data with other EHR vendors or with an HIE, they balk at the idea as if it’s impossible. They follow that up with a bunch of lame excuses about HIPAA privacy or the complexity of health care data.

Let’s call a spade a spade. We could pretty easily be interoperable in health care if we wanted to be interoperable. We know that’s true because when the money is there from these third party companies, EHR vendors can share data with them. The problem has been that the money has never been there before for EHR vendors to be motivated enough to make interoperability between EHR vendors possible. In fact, you could easily argue that the money was instructing EHR vendors not to be interoperable.

However, times are changing. Certainly the government pressure to be interoperable is out there, but that doesn’t really motivate the industry if there’s not some financial teeth behind it. Luckily the financial teeth are starting to appear in the form of value based reimbursement and the move away from fee for service. That and other trends are pushing healthcare providers to want interoperable health records as an important part of their business. That’s a far cry from where interoperability was seen as bad for their business.

I heard about this shift first hand recently when I was talking with Micky Tripathi, President & CEO of the Massachusetts eHealth Collaborative. Micky told me that his organization had recently run a few RFPs for healthcare organizations searching for an EHR. As part of the EHR selection process Micky recounted that interoperability of health records was not only included in the RFP, but was one of the deciding factors in the healthcare organizations’ EHR selections. The same thing would have never been said even 3-5 years ago.

No doubt interoperability of health records has a long way to go, but there are signs that times are changing. The economics are starting to make sense for organizations to embrace interoperablity. That’s a great thing since we know they can do it once the right economic motivations are present.