Archive for Healthcare Data Mining

HHS opens innovators program to public voting

For the first time, the public can vote on their favorite innovation from among the finalists of the HHSinnovates Program, Health and Human Services Secretary Kathleen Sebelius announced this past Friday.

Launched in the spring of 2010 as part of HHS’s open government efforts, HHSinnovates is meant to recognize innovative projects from HHS employees aimed at helping solve thorny healthcare challenges.

“The HHSinnovates Program recognizes and rewards good ideas and facilitates the exchange of innovations throughout the Department and beyond,” said Secretary Sebelius. “Innovative ideas and practices aren’t restricted to the private sector: government workers are developing new ideas and facilitating connections to improve the way government works and improve the health of all Americans.”

[See also: HHS aims to cut medical errors.]

Twice a year, HHS employees are invited to submit their innovations, and the top picks are posted for secure, online voting by the entire HHS community. Six finalists are chosen and publicly announced. The Secretary then selects her top picks.

Now, for the first time, the public will pick the “People’s Choice” winner. In the program’s fifth round, the public is invited to choose from among six finalists. They come from 60 total submissions from across HHS, officials say, noting that each embodies an innovative spirit, and is scalable and replicable:

The 100K Pathogen Genome Project. This collaborative project, originating from the Food and Drug Administration, academia, and industry partners, aims to sequence the genetic codes (genome) of 100,000 strains of important food pathogens (tiny organisms that cause food-borne illnesses – bacteria, viruses and others) and make them available in a free and public database at the National Institute of Health’s (NIH) National Center for Biotechnology Information.  Open access to sequences allows researchers to develop tests that can identify bacteria present in a food within a matter of hours or days, significantly faster than the two weeks it now takes to grow and analyze bacterial cultures conventionallyNational Institute of Allergy and Infectious Diseases (NIAID) Exchange. NIH’s NIAID developed an internal supply exchange for their institute called “NIAID Exchange” to help increase the speed and efficiency of government.  They developed a user-friendly Web resource where staff can advertise existing government-owned scientific and office equipment and supplies they no longer need and search for available items advertised by other staff members.  The NIAID program has saved over $30,000 since its release to the institute last January.Online Food Handler Training Project. The Albuquerque Area Indian Health Service (IHS) led the development of an online food handler certification program that trains an average of 3,500 food handlers a year in class room food handler trainings, while compensating for a 20 percent reduction in staff.  This novel training program, which was developed in collaboration with local partners, incorporates the principles of adult learning and story-telling in a way that is culturally sensitive and resonates with tribal customers.  The training is available to the public on the IHS website, and numerous people from across the country has registered and initiated the training.Development and Use of Coal Dust Explosibility Meter. The Centers for Disease Control and Prevention’s National Institute of Occupational Safety and Health in association with industry and commercial partners developed a coal dust meter that gives users real-time feedback on environmental conditions – a significant improvement over the lengthy measurement procedure currently employed.  This tool, which gives immediate results, represents an improved means for underground coal miners and coal mine operators to assess the relative hazard of dust accumulations in their mines.  To date, more than 200 of these devices have been sold and are being deployed in mines across the United States.National Health Service Corps Jobs Center. Many underserved communities remain underserved because it is very difficult to recruit physicians to high-need areas; in some instances it can take up to two years and $60,000.  To help improve this process, the Health Resources and Services Administration’s National Health Service Corps established the NHSC Jobs Center, an online employment site connecting thousands of job-seeking medical professionals, doctors, nurses, dentists, and mental health providers in primary care disciplines to thousands of employers in underserved communities throughout the United States and U.S. territories.National Institute of Health Research Portfolio Online Reporting Tools. The National Institute of Health developed a Research Health Portfolio Online Reporting Tool (RePORT) that serves as a one-stop shop to provide the public with an interactive suite of tools to search NIH-funded research and the work of its investigators.  By providing the scientific community with better tools to explore the portfolio of NIH-funded research, RePORT furthers progress to foster fundamental creative discoveries, innovative research strategies, and their applications.

[See also: HHS aims to spur software apps development.]

Public voting is open until Sept. 14, 2012. Winners will be announced on Sept. 24. To learn more, visit the HHSinnovates website.

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ONC drops pursuit of NwHIN governance

The Office of the National Coordinator for Health IT has dropped pursuit of a regulation for establishing “rules of the road” for the nationwide health information network (NwHIN) based on feedback it has received.

Commenters from industry and the public made it clear that federal regulation could slow development of health information exchange just as those activities are starting to emerge and pick up steam, “perhaps more than is widely appreciated,” according to Dr. Farzad Mostashari, national coordinator for health IT.

ONC issued a request for information (RFI) in May to collect public comment on a possible approach for rulemaking to spell out “conditions of trusted exchange,” including safeguards and technical and business practices. ONC wanted to receive broad input before issuing a proposed rule, he said.

ONC also considered establishing a voluntary accreditation and certification process through which to approve organizations as being legitimate participants in NwHIN, somewhat similar to the procedures for certifying electronic health records for meaningful use functions.

“Based on what we heard and our analysis of alternatives, we’ve decided not to continue with the formal rulemaking process at this time, and instead implement an approach that provides a means for defining and implementing nationwide trusted exchange with higher agility, and lower likelihood of regret,” he wrote in a Sept. 7 blog.

NwHIN is a set of comprehensive standards, services and policies that enable healthcare organizations to share information securely through the Internet.

ONC’s goal is that information follows the patient where and when it is needed, across organizational, vendor, and geographic boundaries.

But the current state of information exchange and care coordination is far from this ideal. In addition to technical challenges with interoperability, “the absence of common ‘rules of the road’ may be hindering the development of a trusted marketplace for information exchange services,” Mostashari said.

However, voluntary governance bodies are now forming both for directed and query-based exchange. ONC wants to encourage the exchange activities that are gaining steam, “and not to hobble them,” he said, especially with the expectations for standards-based exchange in stage 2 of meaningful use.

“And let me assure you that if systemic problems or market break-downs emerge that might require regulatory action, we will again seek input from the public and our stakeholders, including the Health IT Policy and Standards committees,” Mostashari warned.

Participation in the NwHIN Exchange previously was limited to federal health agencies and primarily large healthcare organizations that contract with them or are federal grantees. Agreement on how to assure conditions for trusted exchange will enable many more organizations to participate.

Among the actions that ONC will press for to promote trusted exchange are:

• Identify and shine a light on good practices that support secure and interoperable exchange and provide a guide for evolving governance models

• Learn from and engage with groups in governance and oversight roles for exchange partners in order to foster models within and across communities

• Continue to use existing authorities and convening powers to create consensus and provide guidance and tools around specific barriers to interoperability and exchange

• Evaluate how and what consumer protections can be appropriately applied to health information exchange through existing regulations

• Monitor and learn from the wide range of activities that are occurring.

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What the platforms tell us about parties’ stance on health IT

It’s a joke without a punch line: Both Republican and Democratic national party platforms make sparse mention of health IT.

To be certain, there’s plenty of focus on the broader healthcare issues. The GOP platform, in fact, dedicates its first two sections to ‘Saving Medicare for future generations’ and ‘Strengthening Medicaid in the states’, while the Democrats also address the issue early on with a section about healthcare as part of ‘The middle class bargain’ and another on ‘Social Security and Medicaid.’

[Survey analysis: Romneycare vs. Obamacare, do Americans care?]

As for any particulars of health IT, well, that’s another matter. Quite literally, each party offers up a single sentence on its intentions for health IT.

From page 33 of the 2012 Republican Platform PDF:
We support technology enhancements for health records and data systems while affirming patient privacy and ownership of health information.

Now, should that strike you as oddly vague, just wait.

“If anyone was disappointed in the scant attention given to health IT in the Republican Party Platform, then the Democratic Party Platform should give them pause,” said Brian Ahier, health IT evangelist at Mid-Columbia Medical Center, author of the Healthcare, Technology, and Government 2.0 blog, and city councilor in The Dalles, Ore. “Health IT is barely mentioned at all, and only in the context of broader technology initiatives.”

Indeed, in the 2012 Democratic National Party Platform health IT is on page 41 of the PDF:
We will ensure that America has a 21st century digital infrastructure – robust wired and wireless broadband capability, a smarter electrical grid, and upgraded information technology infrastructure in key sectors such as health care and education.

Reactions to the perhaps pithy stances of both parties stance have been mixed.

“I regret that the platforms are largely silent on HIT,” former four-term Vermont Governor Jim Douglas wrote in an email exchange with Government Health IT. Douglas is now a member of the Bipartisan Policy Center’s Governor’s Council and executive-in-residence at Middlebury College. “Perhaps it’s not a sexy topic, but it’s essential to our efforts to improve the quality of care and contain costs.”

So, why such vague references to health IT? Shouldn’t the national party platforms include a greater vision of and intent for the technologies forging the underpinnings of next-gen healthcare in America? Or is what the parties outlined enough for the majority of American voters?

“At this point in time I think maybe it is enough,” said Iowa State Representative Linda Upmeyer (R), a career nurse practitioner who has proposed health IT legislation since being elected 10 years ago. “I hope what it means is that this is really in an early state, but there’s a commitment to move health IT forward, that they’re listening and trying to continually improve so that the government doesn’t get this wrong.”

While some will argue that the November elections might test the bipartisan nature of health IT, at least for now Ahier, Douglas and Upmeyer view the party platforms as evidence that bipartisanship remains intact.

“It would seem that both parties agree that when health IT is used effectively it can help address the challenges confronting our healthcare system,” Ahier said. Douglas added that “the current administration continues to move the ball down the field through grants to the states, incentives to providers and implementation of the meaningful use standards,” he said. “I’m confident that the bipartisan support will continue because both parties understand the value of HIT.”

Which leads back to the beginning, where both parties support health IT, but are short on detail about exactly how – which may be because neither party can say for sure precisely what committing to health IT will really mean for the future.

[See also: Political strategists on how candidates should shape healthcare messages in election.]

“It’s always important to have something that keeps policymakers pushing health IT to the forefront, but we policymakers, be it inside the beltway or inside the golden dome in Iowa, don’t have the solutions or all the answers. So we can commit to investing in health IT and rely on the people really doing it to help determine what the next steps are,” Upmeyer, the Iowa rep said. “I don’t really want congressmen or senators or legislators deciding for them.”

Neither does Steven Waldren, MD, director of the Center for Health IT at the American Academy of Family Physicians.

“I’d much rather health IT not be a political football and remain behind the scenes a little because there’s no political urgency such that either side is going to try to politicize it and move forward. Instead, they recognize it’s an important issue,” Waldren said. “The two platforms have different philosophies but at least it’s not being debated at the level of lies, made up truths, or spinning things out of context.”

Although, there might be a solid punch line or two to emerge from that manner of rhetoric.

For more of our politics coverage, visit Political Malpractice: Healthcare in the 2012 Election.

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The political healthcare week that was on Twitter

In a new Twitter record for politics, President Barack Obama’s Democratic National Convention speech spurred people around the world to Tweet at a rate of 52,757 per minute, tech blog Mashable reported.

In related news, Mashable noted, the $100,000-each Twitter trends Republicans and Democrats have been promoting — #RomneyRyan2012, #AreYouBetterOff, #16TrillionFail and #Forward2012 — haven’t really worked out for either of them. A lot of people using the hashtags have done so making arguments and commentary counter to their sponsored intent.

Editorial skepticism: It is somewhat hard to believe there are a lot of undecided voters on Twitter anyway.

In any event, on Twitter this week there was the usual partisan chest-thumping and also some interesting anecdotes from individuals about their company’s rising premiums and people day-tripping from Oklahoma to Mexico for prescriptions:

James Wolcott ?@JamesWolcott
“We’re building an America in which Walter White won’t have to become a meth cook because he lacks proper health care coverage.” #DNC2012

BikeWalkLee ?@BikeWalkLee
This bicycle bus at both conventions was the initiative of a health care company, with a goal of encouraging…

James JP Hawkins ?@jphawkins2009
Graph showing the dispicable lies told by obama & his minions regarding the future of healthcare under obamanocare:

Robert Faulhaber ?@rfaulhaber
CBO Fact Checks Clinton Claim Obama Controlled HealthcareCosts http://zite.to/RHltKx via @zite

Fred Pollack ?@FredPollack
If laughter is the best medicine, I’m surprised healthcare companies haven’t yet figured out a way to charge us a copay.

Kernel Wars ?@Kernelwars
Fox News Debunks Years Of Its Own Commentary By Accurately Reporting That Health Care Reform Reduces Deficit

Luke Russert ?@LukeRussert
Also significant: Very lite mention of healthcare reform and nothing on stimulus. 2 HUGE Obama legislative accomplishments avoided

David Limbaugh ?@DavidLimbaugh
No, the people most certainly did not endorse your health care plan — don’t try to foist that off on the American people.

David Swerdlick ?@Swerdlick
If you want healthcare passed, call Obama. If you want healthcare explained, call Clinton.

?@RANDCorporation
One public dollar invested in contraception saves $4 in Medicaid expenditures.http://bit.ly/OZgzb6

Lis Smith ?@Lis_Smith
The last time @MittRomney was on “Meet the Press”, he endorsed a federal individual health care mandatehttp://www.youtube.com/watch?v=2M9gGwW2gCs #flipflop

Brad Thor ?@BradThor
#Obama pledged that healthcare reform wouldn’t add a cent to the deficit, but #Obamacare will actlly have net cost of approx $1.2 trillion

Tabitha Hale ?@TabithaHale
“Freedom means keeping gov’t out of our most private affairs” unless we’re regulating your health care or forcing you to perform abortions.

Scott Rasmussen ?@RasmussenPoll
50% Favor Repeal of Health Care Law, 41% Opposed…http://tinyurl.com/33lscbm #healthcare

Chris Ward ?@christopherward
In other completely unrelated news, Murdoch has started up a new health care company. #reshuffle

Michael Graham ?@MGraham969
Remember as you listen to Rubio that next week you’ll hear US politicians PRAISING the Cuban health care system. #NaturalTruth#DNC

Mark Cherrington ?@MarkCherrington
Have no doubt if it wasn’t for Quebec, we’d have the death penalty and no universal health care system. Quebec the social conscience of CDN

Arthur Brooks ?@arthurbrooks
If we’re serious about health care reform, that means getting serious about health care cronyism.

Matt Yglesias ?@mattyglesias
The best thing Bill Clinton did last night was try to bring Medicaid into the policy debate:

Drew Armstrong ?@ArmstrongDrew
Bill taking some liberties with that health care cost inflation statistic. (Bad) economy was a large part of that.

James Young ?@welcomebrand
Bike highways in Denmark. Will pay for themselves in healthcaresavings in less than a year. Take note UK govt!

John S ?@gottahavej
Obama isn’t making sure YOU GET HEALTHCARE! He is selling HC insurance that DOESN’T PAY enough of the bill for doctors to accept. #rnc #dnc

Old Man Potter ?@HenryFPotter
Turned out empty chair did not raise my taxes. Well, of course not. It’s a chair. But when I wasn’t looking, it socialized health care.

Rebel Leader ?@UntiLimInCharge
#DNC: You guys r gonna decide health care for 300 million yet can’t decide if God should be in your platform? … #tcot #tlot #glbt #p2#gop

Buckley Brinkman ?@PBuckley
Healthcare is 18% of GNP. Up from 7.2% in 1970. Projected to be 40% in 2050. WOW! 40%!?! @WMEP_News

GS Elevator Gossip ?@GSElevator
Would Bill Clinton’s cosmetic surgery be covered under Obamacare?

The Hill Healthwatch ?@hillhealthwatch
Fact-checkers find few flaws in Clinton’s healthcare claims

cole thomas ?@coletrickle0
I love how they zoom in on the diseased looking people whenever they talk about healthcare. #DNC

Nicholas Halcomb ?@NHalcomb
#DNC you think Healthcare should be free? Ok, you go to school for 10-12 yrs and see what it’s like to not get paid for your service.

Amy ?@inspiredzone
Half my monthly take home pay goes to student loans. If I gethealthcare through my job, I lose another 1/4 of what’s left #DNC#Clinton

Bec ?@Brocklesnitch
My gf’s grandparents who live in Oklahoma make a fun day trip over the border to Mexico to get their prescriptions #dnc #healthcare

Domenick Cilea ?@dcilea
I question Clinton’s stats on healthcare costs; my company’s premiums went up 57 and 25 percent in the last two years. #dnc

jasonscottjones ?@jasonscottjones                                                                          Speaking of #healthcare #BillClinton is running a #clinic @ #DNC

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In Arkansas, building an HIE from scratch

Ray Scott was pretty much ready to retire when Arkansas Governor Mike Beebe asked to him to work as a consultant in the state’s health IT office. With Arkansas lagging in electronic health record use and also ranking as one of the poorest, sickest and most obesity-plagued states, Beebe, a Democrat, was trying to improve and modernize the state’s health system, and wanted Scott to help craft an application for the ONC’s HITECH Act grant to build a statewide health information exchange.

“He said, ‘We only need you for 90 days,’” recalled Scott, a veteran Arkansas politico and bureaucrat who’s worked for seven governors, including Bill Clinton and Mike Huckabee, and most recently was head of the state’s health agency. “I tried to convince him that I wasn’t the guy.”

[Related: Delaware HIE wants to be ‘another pillar’ of health information.]

Scott then became Arkansas health IT coordinator in 2010, and has led the construction of Arkansas’ statewide HIE, the State Health Alliance for Records Exchange or SHARE. SHARE, its infrastructure and policy, has basically been built from scratch. A few community health systems, hospitals and Blue Cross Blue Shield Arkansas had internal HIEs, but there wasn’t much regional exchange, and at one large hospital, Scott said, more than half of the patients have been coming from outside its network. In a state where a lot of areas still lack broadband Internet, small practices are just starting to use, or consider using, digital health records.

“I knew we were way behind in terms of how health information is used, compared to how IT is used in finance,” Scott said.
SHARE has been built as a public utility, a model that in other states, like Kansas, has been controversial and not panned out as intended. Although the details about data ownership and financing haven’t been worked out, leaving some stakeholders, like the Arkansas Hospital Association, with lingering concerns, SHARE seems to have mostly broad support.

“He’s gone out of his way to be inclusive of all parties,” Paul Cunningham, vice president of Arkansas Hospital Association, said of Scott.

Experience with public policy — where politics, business and science intersect — is probably why Scott was chosen for the job. He recalls Governor Beebe saying to him: ‘’I need you to do this because you know the players and this ain’t your first rodeo.”

“We weren’t trying to build a new large bureaucracy that would control and run everything,” Scott said. “I tried to disarm any notion that folks had of ‘Here goes Ray building an empire.’”

The public utility model evolved out of stakeholder talks, Scott said. He focused on what functions the HIE would have and how to build it, rather than the more controversial question of who owns the data, who’d be running the HIE and how it would be financed.

“If we started there,” Scott said, “we would never get anywhere.”

Those are central questions, of course, and they haven’t been answered yet. Now doing direct messaging with 2,000 providers (and about as many signing up currently) and with query functionality set to go live in a year, SHARE, its IT built by the vendor OptumInsight, is operating on the original $8 million ONC grant and set to start financing itself with provider fees in the future, their nature still to be decided.

Those issues aside, the progress with SHARE is palpable, said Joe Thompson, the state’s surgeon general and director of Arkansas Center for Healthcare Improvement.
“I think we’re in a transition period, we’ve got to find the balance between how do we keep the IT nimble enough and secure,” Thompson said. “We’re really trying to transform the whole system,” referring to Arkansas plan to shift private and public healthcare away from a fee-for-service system to a pay-for-quality model, as recently noted in The New York Times Opinionator blog.

Both Thompson and Cunningham, from the Arkansas Hospital Association, note that there is always the option to turn SHARE into a private nonprofit or create private HIEs.

“Whichever route you take, there’s going to be a cost for it,” Cunningham said.

[Q&A: Taking a radiology practice from no IT to HIE — with ROI.]

And whichever route SHARE ultimately takes, the ONC is pretty impressed.

“One state that seems to truly have embodied the goals of the State Health Information Exchange (SHIE) Cooperative Agreement program is Arkansas,” ONC spokesperson Peter Ashkenaz said. “They look towards the overall bigger picture of the quality and efficiency of health care, and are always seeking ways to increase meaningful exchange, including collaboration with other programs such as payment reform initiatives.”

And Scott, who is also a noted nature photographer and is retiring at the end of the year, has much praise for the ONC and federal government: “I think the wisdom by those visionaries who wrote the HITECH Act is that you’re not going to transform the healthcare system in this country if you don’t build a comprehensive communications network.”

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