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Using LibreHealth EHR for Education in Academic Settings
Traditionally, access to EHRs has been viewed as important only for software training, particularly order entry. What seems to be overlooked is the potential for education, analytics and research. Additionally, one could argue that there should be an open-source “EHR Sandbox” so multiple external EHR integrations could be studied and reported. Furthermore, many EHR users view the software as a means to enter or extract data on one patient at a time and fail to see the benefit in analyzing their entire clinic population (population health). The following diagram displays how an EHR could be used for education, training, analytics and research.
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How Cyber Hardening Can Protect Patient Privacy And Treatment
The abundance of internet-connected devices that collect and share patient data has greatly increased the “attack surface” (where an attacker inserts or extracts data) and number of possible vulnerabilities within a system. Now that medical devices can connect to home-based routers, public Wi-Fi or cellular networks to relay data to hospitals, specialists, and care providers. In addition, the software in those devices lacks cybersecurity and can be updated and reprogrammed remotely. Thus, sensitive patient information is even more prone to data breaches, and the safety of the devices can be compromised. Recent supply chain compromises, and the migration of health applications and platforms to the cloud, also add to the threat equation. This article looks at why the medical community is so vulnerable and suggests how it can better protect life-saving equipment and sensitive data from unprecedented cyberattacks.
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CDC Issues RFI for Real-world Testing of Health Information Technology
In October the Centers for Disease Control and Prevention (CDC) issued a Request for Information (RFI) for a Natural Test Collaborative (NTC). Through a series of questions, the RFI seeks opinions and information about "The development of a national testbed (notionally called the National Test Collaborative (NTC)) for real-world testing of health information technology (IT)" and "Approaches for creating a sustainable infrastructure" to achieve it. The scope of the questions is somewhat confusing and quite broad, starting with Clinical Decision Support (CDS) and electronic Clinical Quality Measures (eCQMs) but quickly expanding to Electronic Health Records (EHR) and interoperability (not precisely defined).
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Get Smart, Integrate Artificial Intelligence into Your Business, Sooner
We've moved from the Computer Information Age to the "Digital Data Artificial Intelligence Age." It's the 4th Industrial Revolution. Just as computers transformed business processes and created the need for an "Information Technology Strategy." Today an integrated enterprise "Business - IT - Big Data - AI Strategy" is essential to lower costs and expand markets through differentiated products and services. The Artificial Intelligence strategy is not an add-on. It needs to be a core element of your enterprise strategic plan in 2019 and beyond!
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The Big Get Bigger, Until They Don't
You may have missed it, but the Open Markets Institute released a report on what it calls "America's Concentration Crisis." The report begins bluntly: "Monopoly power is all around us: as consumers, business owners, employees, entrepreneurs, and citizens." As David Leonhardt wrote in his op-ed about the report, "The federal government, under presidents of both parties, has largely surrendered to monopoly power." Their associated data set details market concentration within 32 industries, several of which are health related. For example, in electronic health record systems, the top 3 firms account for 58% of the market, whereas in pharmacies/drugstores, the top 3 control 67% (and the top 2 alone have 61% share).
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Is the US Finally Ready to Get Serious About Biodefense?
Biological and other disaster threats - whether accidental, driven by forces of nature, or intentional - pose fairly grave risks to the United States and the world. Situational awareness has been a conspicuous topic ever since the 9/11 attacks and the anthrax scare that followed shortly thereafter. Since then we have experienced numerous disasters: health impacts of major weather events such as hurricanes and earthquakes, new virus outbreaks like Ebola in Africa, raging wildfires on the West Coast (I live in California), and the ever-present threat of pandemic flu which a hundred years ago infected some 500 million people across the globe and killed an estimated 50 million people worldwide, according to the Center for Disease Control and Preparedness (CDC). But since the initial flurry of public health preparedness funds in the ensuing several years after the 9/11 attacks, this topic has not had a high priority at CDC nor the funding necessary to implement it successfully.
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Fax Is Not a Machine, It Is a Technology
Once more I am listening to a presentation on interoperability. These always get a little uncomfortable - especially in the early going - because I can almost predict where the presenter will go horribly wrong and do a complete disservice to the audience (generally somewhere between slides 3 and 8). This time it was slide 6 where the speaker inserts stock picture of a decrepit old fax machine with paper cascading off a desk and onto the floor. This comes along with the typical lecture on everything that is wrong with "fax". With the lemmings in the audience nodding/snickering along, the speaker proceeds to misinform and mislead the group. Cringe-worthy really. What's misleading? Pretty much everything he says.
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The Business of Healthcare Is Business
Hmm, that headline doesn't seem right, does it? I mean, shouldn't the business of healthcare be, well, health? Or, at least, caring? Actually, shouldn't the business of healthcare be patients? After all, everyone in healthcare says it's all about patients. Everyone says they're patient-centered, whatever that means. But think about this: who in healthcare gets paid for you to be healthy? Or, conversely, who in healthcare doesn't get paid when you get sick, or when you don't improve under their care? Whether we planned it or not, whether we admit it or not, or whether we like it or not, our healthcare system is a business that has become about making money.
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How Open Source Hardware Increases Cybersecurity
Hardware hacks are particularly scary because they trump any software security safeguards-for example, they can render all accounts on a server password-less. Fortunately, we can benefit from what the software industry has learned from decades of fighting prolific software hackers: Using open source techniques can, perhaps counterintuitively, make a system more secure. Open source hardware and distributed manufacturing can provide protection from future attacks...security is one of the core benefits of open source. While open source is not inherently more secure, it allows you to verify security yourself (or pay someone more qualified to do so). With closed source programs, you must trust, without verification, that a program works properly.
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Open Source Goes Corporate: Can Open Healthcare Be Far Behind?
If you aren't in IT, you may have missed the news that IBM is acquiring Red Hat, a leader in the open source Linux movement, or that, a couple days prior, Microsoft closed on its acquisition of GitHub, a leader in open source software development. Earlier this year Salesforce acquired Mulesoft, and Cloudera and Hortonworks merged; all were other open source leaders. I must confess, I had never heard of some of these companies, but I'm starting to believe what MarketWatch said following the IBM announcement: "open source has truly arrived." What exactly that means, especially for healthcare, I'm not sure, but it's worth exploring. IBM is paying $34b for Red Hat.
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