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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.

A 10 Year Old Child Shows Us Why A Direct Project Directory Is Unnecessary

Posted on December 15, 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.

I recently hosted a panel of direct project experts. During the panel, Greg Meyers (@greg_meyer93) talked about why the need for a Direct Address directory was overstated. He argued that doctors could collect the direct addresses for the network of providers they refer to on their own quite easily. A directory would be nice, but you could still easily get value from direct without one.

To prove this point, Greg sent over this great story about his niece.

This past weekend, my wife’s family held their Christmas dinner and gift exchange, and the actions from my 10 year old niece were the highlight of my day. She has been desperately wanting a iPod Touch for quite some time for simple tween workflows such as taking pictures/video, downloading apps, and emailing/video chatting with her friends. With me being the corruptive spoiler of my sister-in-law’s children, I got permission a few months back to get her daughter the prized iTouch as a Christmas present.

From the moment she opened it, her excitement almost exploded out of her face. She spent the first hour asking Siri silly little girl questions, but the next hour was a display of simple intuition and what appears to achieve what some in the Health IT domain describe as almost impossible.

The tasks was simple: setup her email and FaceTime so she could start communicating with her family and friend immediately. Keep in mind this a child whose only electronic presence is her GMail account mandated via her 5th grade class; no Facebook, no SnapChat, no Twitter, no WhatsApp, and no access to a repository of electronic endpoints other than what she could find with a google search.

We went down the path of getting FaceTime associated with an AppleId and configuring the email app with access to her GMail account. What happened next was my moment of the year. She went around asking all her family members for email addresses and entering them into her contacts list. Anybody that had an apple device, she asked if they were on FaceTime and tried to initiate a test video conversation. If she had issues connecting to them, she would ask them to initiate a conversation by giving them her address and added them into her contacts after terminating a test chat. She tried adding some her classmates via the email addresses she knew, but when she failed, she said she would just call them or ask when she went back to school on Monday. By the time the day was over, she had built a respectable network (with validated endpoints) with her closest contacts and formed solid plan of how to continue to build her network. Oh, and she did this without the assistance of a directory; just plain old simple leg work.

I’m kicking myself for not following her with a video camera, but I think this poetically demonstrated the ability to build useful networks via the trivial thought processes of a tween girl.

Thanks Greg for sharing the story. Sometimes we seem to forget that not all solutions have to be technical and we don’t have to be hand fed everything. Here’s the video interview with Greg Meyers, Julie Mass and Mark Hefner for those that want to learn more about Direct Project: