Tag Archives: BlueButtonOnFHIR

OAuth Trust Whitelist API Specification

I recently published a post on the HHS IDEA Lab blog as part of my role as Entrepreneur-In-Residence. That post referred to a WhiteList API I have proposed. That linked to a document on Google Drive. Some people have issues reaching Google Docs/Drive so I am posting the specification here too.

OAuth Trust Whitelist API

Document Information

Author: Mark Scrimshire (mark@ekivemark.com)

Google Drive Link for comments: https://docs.google.com/document/d/1-LHUL-2iy8Y4duZGN_7Z7mCKjSMBCdo9rdOWgurQ4Zk/edit?usp=sharing

Version: 1.0

Background

The Centers for Medicare and Medicaid Services is building a next generation BlueButton service. This will be a REST API that will present HL7 FHIR structured data resources.

The service will enable Medicare beneficiaries to connect their data to the applications, services and research programs they trust.

CMS needs to be able to perform some basic validation of the third party application before issuing an application key.

The purpose of this specification is to create a whitelist API that reaches out to direct messaging trust bundle providers to confirm that an entity is a valid member of a legitimate trust bundle.

The whitelist API will validate the data provided and return either a 404 Not found or a 200 Ok with a datetime entry that identify when the certificate for the entity expires.

Security

The whitelist API is intended for organizations, such as CMS, that want to validate requests for third party application access against existing healthcare industry validation services such as DirectTrust or NATE (National Association for Trusted Exchange).

The API will use OAuth2 to control authorization and the API will be offered over a secure HTTPS/SSL connection.

API Payload

The call to the Whitelist API endpoint will be a PUT request with a JSON payload as follows:

{

“requested_by”: requester_email,

“bundle”: bundle_id,

“domain”: domain,

“owner”: owner_email,

“shared_secret”: shared_secret,

}

requested_by: this is the email address of the person making the application for, the originating site. This is typically a developers really administrator in the third party application development organization.

bundle_id: this is an id to allow the whitelist API to recognize which trust bundle the entity is registered in. This allows a trust organization to accommodate multiple trust bundles.

domain: the is the domain that is registered in the trust bundle for the entity.

owner: this is the email of the organization representative that controls the entity account within the trust bundle. This is typically the email address of the person who applied for their organization to join the given trust bundle.

shared_secret: this is a key that is maintained for the entity outside of the trust bundle certificate. It is a key that is known only to the administrative owner of an entity in the trust bundle.

API Actions

The Whitelist API will assess the content of the JSON payload.

If the submitter provides incorrect information the API will return a 404 “Not found” http response.

If all of the fields are supplied correctly the API will identify the trust certificate for the entity and return the expiry date in a JSON response as follows:

{

“expires”: “YYYYMMDD.HHMM”

}

 

The #BlueButton on #FHIR Tour: from #HIE to #ONC to #HL7 to @Health2con

Bluebutton on FHIR from 35,000 feet

NATE/HIE Conference: Deer Valley, UT

This week has been a crazy travel week. I have been across the country talking BlueButton on FHIR at different events. The first leg was a trip to Deer Valley Utah to the National Association for Trusted Exchange (NATE) and Health Information Exchange User Group (HIE HUG) Conference.

At the conference there were some great discussions about what I will call “Traceability” for health record information. The question is how best to capture information about where health information came from and whether it was altered along the way. This will become increasingly important as Patients become more involved with their Health Information. They are set to become both creators (from wearable devices) and aggregators (assimilating information from their journey across the health care system). Traceability gives the recipients the ability to apply a level of confidence to the information they receive.

As Health Care evolves the Fast Health Interoperability Resource (FHIR) framework we need to consider how this traceability AND an individual’s privacy and sharing preferences are passed with different data profiles and in the structured document formats (CCDA) that flow across Health information Exchanges and other networks in health care.

Later in the Conference I presented two workshops that built on my “Baptism of FHIR” presentation. One workshop was an overview of FHIR and how we are looking at FHIR as part of the next generation of BlueButton for Medicare beneficiaries. Rather than build yet another API we are looking to leverage FHIR as a standard format and transport. The second workshop, presented with Aaron Seib, from NATE, looked at a proposed use case for a “Virtual Clipboard” and how this could be mapped to FHIR profiles to allow patient information to be gathered and communicated as part of any appointment setup where coverage and eligibility needs to be checked. This is an area of great interest to a number of Payer organizations.

You can see the deck from workshop on Slideshare here: http://www.slideshare.net/ekivemark/b-bon-fhirworkshop

ONC Consumer Summit: Washington, DC

I left the NATE/HIE Conference on Wednesday to take a late flight to get back to Washington DC for the ONC Consumer Summit. There I was privileged to share the stage with some of my predecessors who have worked inside the Federal Government on BlueButton. Claudia Williams, from the White House, chaired the panel with Erin Siminerio, from the ONC and prior Presidential Innovation Fellow Ryan Panchadsaram and Gajen Sunthara. It was a chance to reflect back on the great things that have been achieved in the past five years with BlueButton and to gaze forward at what the future looks like for BlueButton as it moves in to the world of Health APIs.

After Thursday’s ONC Summit I met with folks who are interested in the President’s Precision Medicine Initiative which has patient consent and privacy preferences front and center. This was followed with additional meetings to talk about Privacy Preferences. It seems that the stars are aligning to make some real progress in this area. This will ultimately help consumers gain better control over their health data and how it is shared.

HL7 FHIR Connectathon: Atlanta, GA

Friday meant a trip to Atlanta to join in Saturday’s HL7 FHIR Connectathon. The event was a packed house with over 100 participants. It was great to meet Grahame Grieve, the father of FHIR, James Agnew, the prime mover behind the java-based HAPI Server and Josh Mandel, the chief architect behind Project Argonaut and FHIR-based S/MART Apps. These guys are brilliant. Just a few minutes with them can be incredibly enlightening. One of the things that was impressive in the few short hours i was able to spend at the Connectathon is the diversity of people and organizations involved in FHIR. This is truly an international movement. Even within the USA FHIR is gathering not just interest, but action, from organizations across the health care spectrum. Payers were strongly represented, as well as EMR vendors, Health Information Exchanges and developers from organizations that support these sectors. Experimentation is going on but the core of FHIR is being developed rapidly for real world adoption.

FHIR is not perfect but it has a real ability to help address some of the challenges with the current practice of shipping large structured documents between entities. FHIR can be more granular, can be pulled on demand and can help to support privacy because less information needs to be disclosed than a comparable CCDA document.

Health 2.0 – Developer Challenge: San Francisco, CA

My short time at the Connectathon was packed with networking with people who are interested in the BlueButton on FHIR work being carried out at CMS. It would have been great to stay longer but I am writing this blog post from a plane at 35,000 feet heading to Santa Clara, CA to get to day 2 of the Health 2.0 Hackathon and then joining the Health 2.0 Conference until Wednesday.

At the Health 2.0 Hackathon, aka the Developer Challenge there is a track that is looking at FHIR resources. This is an opportunity to bring FHIR to the wider health care developer and entrepreneurial community. I am looking forward to working with friends and colleagues to continue fleshing out the BlueButton on FHIR prototype I have been working on. The code for the protoype BlueButton API front-end is available on github here: https://github.com/ekivemark/bbofuser

The backend HAPI Server, built in Java, is also available on Github here: https://github.com/ekivemark/FHIR-Server
This is a version that uses a back-end PostgreSQL Server to store the FHIR data.

Health 2.0 Fall Conference: Santa Clara, CA

I am also looking forward to connecting with people during Health 2.0. There has already been a request from a European country to learn more about the BlueButton API we are developing. They see it as useful for distributing health information to citizens.

All in all this has been (and continues to be) a crazy two weeks of travel but it has been incredibly worthwhile meeting so many thought leaders who are pushing to improve the state of Health Care for consumers and patients everywhere.

More to come: Watch out for a blizzard of blog posts

I will also give you this warning. When I am at conferences I often produce real time notes from sessions, warts and all 🙂 and publish these to this blog. So watch out for a series of posts appearing from the Health 2.0 Conference over the course of the next week.

[category News, Health]
[tag health cloud, bluebutton]

Mark Scrimshire

IT and Health Data Ninja

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://blog.ekivemark.com
email: mark@ekivemark.com
Stay up-to-date: Twitter @ekivemark

Disclosure:
I am currently HHS Entrepreneur-in-Residence working at CMS on an assignment to update BlueButton for Medicare Beneficiaries. This involves creating a Data API. Watch out for more about BlueButton on FHIR.

The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.

Medyear: Less Hassle, Better Care.

#ConsumerSummit15 – Engaging Underserved and Minority Communities with Health IT

Engaging Underserved and Minority Communities with Health IT

Realtime notes from the ONC Consumer Summit aththe Hilton in Washington DC.

Moderator: Elizabeth Cohn, Ph.D RN (@ElizabethCohn)

Angela Diop – Unity System Health Care (@AngelaDiop)

Suzanne Bakken, Columbia University (@CU_Nursing)

Kelly Brititain, Michigan State University

How do we explode the myths that the underserved are not interested in access to their health information

With minority and underserved populations look at Mobile First solutions.

How much do we really understand the social determinants of Health?

What has been seen:
– Not everyone has smartphones
– adoption in using a portal is growing.
– Women are more engaged

  • Designing FOR and WITH the target audience yields better adoption
  • How do you engage the consumer to get them where THEY WANT to be.

Whether patient or Provider you have to engage them in design. When you do this adoption and culture change happens faster than you expect.

Visualization – less is not always more. Often people want more information.

[category News, Health]

[tag health cloud, bluebutton]

MaMrk Scrimshire

IT and Health Data Ninja

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://blog.ekivemark.com
email: mark@ekivemark.com
Stay up-to-date: Twitter @ekivemark

Disclosure:

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries. This involves creating a Data API. Watch out for more about BlueButton on FHIR.

The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.

Medyear: Less Hassle, Better Care.

#ConsumerSummit15 Healthfinder.gov and other tools

ONC Consumer Summit

Realtime notes from the ONC Consumer Summit aththe Hilton in Washington DC.

Healthfinder.gov – Ellen Langhans

Now provide Content Syndication and a Content API.

Healthfinder is embedded in to CVS Minute Clinic.

CVS drives around 400,000 views per month.

CDC -Shannon Stockley

MyIR – Immunization Registry trial across 5 states.

38% of users called their doctors to schedule a visit
18% called their doctor to see if a vaccine is needed.

US Postal Service – Digital integration – Kelley Sullivan

600,000 employees.
Establishing secure communications for health transactions.

USPS Health Connect Pilot – Offers a dashboard with configurable tiles.

All employees will have a Direct Address.

Cryptographic Hash security service to allow chain of custody to be confirmed for each record in their PHR.

Messages use Direct Messages.
USPS will be one of the largest Direct Messaging implementation.

[category News, Health]

[tag health cloud, bluebutton]

MaMrk Scrimshire

IT and Health Data Ninja

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://blog.ekivemark.com
email: mark@ekivemark.com
Stay up-to-date: Twitter @ekivemark

Disclosure:

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries. This involves creating a Data API. Watch out for more about BlueButton on FHIR.

The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.

Medyear: Less Hassle, Better Care.

#ConsumerSummit15 Making Patient Engagement the Fabric of an Organization

Moderator: Leslie Kelly Hall

Melissa Phipps – Novant Health

Major change is tied to culture. Don’t focus on just tools and tasks.

Addressing the culture by engaging Physicians. Advocacy can be seen as criticism.

Removing official Patient Advocates. We should all be patient advocates in the system. it is a philosophy.

Choices and Champions (addresses end of life care)
Novant Reads – invited team members to read recommended books. (8,000 of 26,000 have stepped forward).

Making the Translator part of the care team. Moving from Transactional to Relational.

Gerri Lynn Baumblatt, Emmi Solutions (@GeriLynn)

How does technology help people prepare for visits?

Meet people where they are.

  • Decision aids and treatment options.
  • Ask people about their goals.
  • Collect the information and share with their physician so there can be a more valuable conversation about care options.

Helping to improve the conversation around End of Life Care. Finding ways to make information available to give insight and informed decisions that is sensitive to cultural backgrounds.

Andrea Ippolito, VA Center for Innovation

The VA was in crisis in 2014. The new head of VA came from P&G. Formed the MyVA team. Looking at providing the best experience for veterans.
Human Centered Design is being rolled out across the VA.

Improve the Veteran experience by empowering employees.

Patient Self-Service: Massive roll-out of kiosks. Helping to reduce wait times. VA is trying to shift the care model from a paternal to shared-decision model.

Prosthetics and Assistive Technologies. Bringing engineers in to the sessions with veterans. 3D Printing extensions using the maker movement to design custom assistive technologies.

The VA has an iPhone app that allows Vets to adjust their hearing aids instead of traveling to a VA Clinic for a two minute appointment.

@onc_healthit #consumersummit15 @susannahfox @n_brennan @healthprivacy health data panel

I am at the ONC consumer summit. These are my real time notes…

Susannah Fox moderates a panel on health data.
On the panel:

Niall Breenan
Deven McGraw
Theresa Hancock
Cora Han
Col. John Scott

What does it look like 5 years out?

Deven: easy access to data at no cost for the consumer

Theresa: during Katrina vets gave their username and password to care team so they had access to their medical record.

The patient needs to be at the center but the provider needs to be engaged.

Don’t aim for all or nothing. Work incrementally.

Revisit and reinvent and identify what works.

Niall: what is the next step for Bluebutton?

Proud of what has been accomplished but it needs to be better.

Col. Scott: what is current state of Bluebutton in the DoD?

DoD leverages data in bi-directional data exchange and makes it available to patients.

Immunization
Medications
Problem list

Problem list has proven most valuable.

Cora: what does the FTC have to do with health?

They protect privacy and security of consumers health information:

  • enforcement
  • policy workshops
  • outreach

Doing outreach to health app developers to inform them on what rules apply and how they need to comply.

Deven: privacy is important for trust.
We need to give consumers control over their data.

What action can people take:

Theresa: barriers : so many technologies cause confusion for consumers. Providers do need access to patient generated data.

Cora: barriers: how do you provide effective notice? But there is innovation in consumer interaction.

Business and consumers need incentives to engage.

Col. Scott: we are on verge of s revolution. There is a convergence happening. The patient is also willing to trust online services.

Many barriers but one is that patient information needs to be trusted.

Provider liability over data they don’t control is a real issue

Niall: barrier: persistent and ongoing fear over privacy and security.

Action: visionary leaders in the privacy space to create a pathway to trust of new technologies

Deven: 5 year vision:

Ease of data access (VDT) in 5 years complaints about patient access dwindle.

[category News, Health]

[tag health cloud, bluebutton]

MaMrk Scrimshire

IT and Health Data Ninja

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://blog.ekivemark.com
email: mark
Stay up-to-date: Twitter @ekivemark

Disclosure:

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries. This involves creating a Data API. Watch out for more about BlueButton on FHIR.

The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.

Medyear: Less Hassle, Better Care.

#NATE/HIE Sid Thornton Intro to #HL7 #FHIR

I am at the NATE/HIE Conference in Deer Valley, UT.

#Intro to HL7 FHIR

Sid Thornton at InterMountain Healthcare.

Connectivity was always a challenge.
Data Aggregation with semantic interoperability was impossible
Unable to understand a specific patient in context of a transaction amongst a care team.

Care Coordination was stymied.

InterMountain looked to better interoperability standards. This caused them to look at FHIR.

Aren’t today’s standards good enough? Do we need another standard.

Can FHIR solve the challenge of Health Information Exchange?.

Data Movement has been a problem.
Data needs to move in anticipation of its necessary use.

Check out http://hl7.org/fhir

FHIR – Next Generation standards Framework

FHIR maintains information context as it travels between systems.

FHIR is open source.
FHIR is a “Public API” for healthcare.

FHIR Resources are snippets of data. They get compiled in to profiles.

FHIR Resources are modular components that can be combined.

The goal of FHIR is to enable connections to be built in a day rather than months.

FHIR Resources:

Resource: Observation
Profiles could include: :Lab Obs, PAtient Obs, Family Hx Obs. etc…

FHIR Advantages:

  • Focus on implementation
  • Implementation Libraries
  • Specification is Free.
  • Evolves from HL7 V2 and CDA
  • Strongly based on Web standards that operate at scale
  • Human Readable component goes with the machine readable content.
  • Concise and well documented

In the real world of care coordination:
– We don’t know what data will be needed
– We don’t know where it needs to go and be consumed

This drives the need for PULL on Open but secure networks.

FHIR Adaptation in Utah

Utah is known for it’s high birth rate.

Intermountain delivers 35,000 new borns each year.

Newborn data bundle challenges:
– Linked results from state lab screenings
– Demographic changes
– Relevant data from prenatal and delivery care.
– Relevant Family History
– New Pediatrician
– High admission and readmission rates

Newborn FHIR APIs

  • Person disambiguation, record link
  • Demographic Update
  • Data GET for Prenatal and Delivery Care
  • Data GET for Family History
  • Provider Schedule Link
  • Provider attestation link thorough search

Hardest issue is a listener to detect provider attestation – looking at scheduling links.

Using HL7 V2 Interfaces would result in a 12-13 year project.

Poison Control Center Use Case and FHIR APIs

  • Demographic ambiguities (“I have a friend….”) record Link
  • Referral Uncertainties
  • Lab Result consultation (Push/Subscribe)
  • Case Resolution – Administrative Closure

HIE-Assisted Care Coordination

  • HIE Demographic Sync
  • HIE Activity Listener
  • HIE Privacy advocate
  • HIE Forwarding Delivery Service

UHIN has had a decade long experience/discovery of the challenges in acquiring consent.

Privacy model needs to be applied at the atomic data level. Traceability is required to the Privacy declarations as data flows around the system.

Care Coordination Broker

  • Logical processes and message handling workflows are required at the center.

  • Need backward compatibility to allow prior standard formats to be used.

The FHIR Opportunity

  • FHIR may be efficient and precise
  • Document-based HIE Care Coordination requires substantial processing overhead
  • Document-based HIE Care Coordination discloses more than minimum clinical data.

There is a significant effort to model data upfront.

  • Clinical Element Models:

http://www.clincialelement.com

CIMI – International Standard modeling effort

SMART on FHIR App Gallery

SMART APPs include SMART Neonatal Bilirubin Alerts.

Monitoring happens outside the Delivery system.

There is a concept of a Care Plan delivered as a SMART App.
This is portable across organization publishing FHIR data.

SMART Apps do NOT have to be aimed at Medical Professionals.
Consumers can use SMART Apps.

Next up I am presenting “Direct on FHIR” with Aaron Seib of NATE.

[category News, Health]

[tag health cloud, bluebutton]

MaMrk Scrimshire

IT and Health Data Ninja

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://blog.ekivemark.com
email: mark@ekivemark.com
Stay up-to-date: Twitter @ekivemark

Disclosure:

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries. This involves creating a Data API. Watch out for more about BlueButton on FHIR.

The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.

Medyear: Less Hassle, Better Care.

#NATE/HIE Conference – Charles Kennedy #PopHealth at Healthagen/@Aetna

I am at the NATE/HIE Conference in the Population Health session.

Charles Kennedy of Healthagen gave a very insightful presentation on:

Population Health Management

60% of Providers say value-based care is part of their Strategic Plan.

We are in the very early stages of ACO evolution.

Provider risk-taking: 70% are only taking upside risks. Yet 23% see themselves as leaders in taking risk.

Leading providers (23%) have common factors:
– Plan and Provider assets, at least 1 arrangement with full risk and over 70,000 covered lives.

  • Providers are beginning to develop full-risk capabilities beginning with their employee populations. (Dog fooding)

Public Policy is driving change in the ACO world.

Infrastructure and vendors were not in place to meet the legislative objective – to give every american an electronic medical record.

Fee for Service is moving to fee for service with incentives for efficiency and quality (MIPS)
Risk Managed Care is moving to include quality objectives. (APMs)

These two approaches both meet at Population Health.

MIPS program has real teeth to impact reimbursement based on quality outcomes. By 2022 there could be a Plus or minus 9% impact to reimbursement.

As a zero sum payment model the competitive nature of Physicians can really drive change.

50% of Medicare reimbursement will be in Category 2 or better by 2018.
90% of all Fee For Service payments will be linked to service.

Value-based care requires management of disease and the progression of disease.

Population Health Management is a critical evolving capability.

“Everything begins with Data”

Claims data is price and not cost.

Value-based care needs a real-time navigation system. Timely indicators that enable changes to care in real-time at the time care is delivered.

Lowest Value Care in Fee For Service = ~$800B/Year

  • Prevention Failures: $56B
  • Fraud: $80B
  • Unnecessary Services: $216B
  • Inflated Prices: $112B
  • Inefficient Care Delivery: $136B
  • Administration Costs: $200B

Address with:
– Transparency
– Health IT
– Administrative Platforms
– Care Management and Clinical Re-engineering

Aetna/Humana merger is about reducing administrative costs.

ACO Care Systems – Building a Virtual Care System. A contract between Payer, Physician Network and Hospital System.

All parties need a single view of the patient.

Keys to success:
– Population Health Management
– Care Coordination
– Patient Engagement
– Data Exchange and Analytics

Pop Health Management:
– Wellness
– Prevention
– Care Management
– Reduce Waste / Improve Efficiency
– Clinical Teams

Analytics needs to be at least as good as the doctors assessment. It needs to be contextual.

Today systems focus on:

  • Transitions of Care
  • Ambulatory Care Management
  • Utilization Management

Improved performance will translate to lower cost for consumers or higher payments for medical professionals.

Aetna owns Medicity. Looking to link with ActiveHealth (another acquisition). Looking to develop Analytics Algorithms.

Insurance Exchanges are helping to direct consumers to better solutions.

Look at Delivery Systems intent. Is Value or Market Dominance the driver?

How is the Patient engaged?
You need a fundamental understanding of the patient.

Chronic disease drives cost so patient engagement is a critical component.

Medical knowledge needs to be distilled to a point that it is actionable by the patient and their caregiving team.

[category News, Health]

[tag health cloud, bluebutton]

MaMrk Scrimshire

IT and Health Data Ninja

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://blog.ekivemark.com
email: mark@ekivemark.com
Stay up-to-date: Twitter @ekivemark

Disclosure:

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries. This involves creating a Data API. Watch out for more about BlueButton on FHIR.

The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.

Medyear: Less Hassle, Better Care.

#NATE/HIE Conference – MyHealth Access Network

From the NATE/HIE Conference:

MyHealth Access Network talking about access to information.

There is an EMR Gap due to fragmented data and Information Blocking

Seven categories of Data Blocking:

  1. EMR Fees
  2. HIE Fees
  3. Hotel California
    4.Inexplicable
  4. GIGO
  5. EHR-Universe
  6. Hidden Switch:

Biggest problems:
EMR Fees and GIGO.

Meaningful Use certification happens in a vacuum.

Certified systems have custom adaptations before being put in to production for a customer.

MyHealth’s OK market:

  • 650+ locations
  • Data feeds in real time

Meaningful Use Certification (77 FR 54193) for Data Portability and CHPL Compliance
Portability: 77 FR 54289

The Surveillance System enforces the viability of the certification process.

Complaints can go to ONC.Certification

MyHealth had issues with eCW.

Ask for the Data Portability Function.

eCW would prefer you to purchase their eCW Hub where they charge per provider connected per month.

It turns that eCW has a hidden switch that allows a CCDA to be dropped to a folder. This can then be used by the provider.

Within 24 hours MyHealth was using eCW CCDAs. But this only appears to work on Locally Hosted eClinical Works implementations. It does not appear to work in a hosted/cloud environment.

The CCDA looked great but the structured data format was severely lacking.

MyHealth is using PopHealth to calculate Patient Population metrics.

Clinical and claims data in isolation can’t answer the value question. You need both aggregated.

Bulk Export is a requirement for Meaningful Use Certification in 2014.

This session generated a lot of discussion on Information Blocking.

Great presentation by Mike Noshay and Joe Walker of MyHealth Access Netowrk.

[category News, Health]

[tag health cloud, bluebutton]

MaMrk Scrimshire

IT and Health Data Ninja

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://blog.ekivemark.com
email: mark@ekivemark.com
Stay up-to-date: Twitter @ekivemark

Disclosure:

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries. This involves creating a Data API. Watch out for more about BlueButton on FHIR.

The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.

Medyear: Less Hassle, Better Care.

#NATE/HIE Conference – Communication Medication Management (HealthLINC

At the NATE/HIE Conference:

Community Medication Management

Chronic Disease is a growing National Crisis. By 2030 Half of the population will have one or more chronic conditions.

Drug-related problems are real problems. We spend more on the problems with taking medicines than we spend on the meds themselves.

The Average is 13 prescriptions.
Increasing use of expensive specialty medications

Issues:

  • Medication List Discrepancy (80% of Drug Therapy Problems – DTP)

Drug Therapy Problems:
– Cardio Vascular
– Pysch

These are the top two categories with DTPs.

Coordinated Medication Management can significantly reduce hospitalizations by performing a risk scoring of patients to identify the high risk patients.