Feature Articles

Corporate Resilience During A Pandemic

As humanity grapples with the spread of COVID-19 globally, the emotional response is to do something, anything, everything. But how do we take that energy and successfully adapt? Most prudent organizations have had on their radar more visible threats like hurricanes, earthquakes, power outages, terrorism, and war. The quiet pervasiveness of a pandemic seems to have caught us by surprise. But is adapting to a pandemic really that different? The good news is that proven principles still apply. Read More »

3 Metrics To Measure Your Open Source Community Health

Community building is table stakes in the success of any open source project. Even outside of open source, community is considered a competitive advantage for businesses in many industries—from retail, to gaming, to fitness. (For a deeper dive, see "When community becomes your competitive advantage" in the Harvard Business Review.) However, open source community building—especially offline activities—is notoriously hard to measure, track, and analyze. While we've all been to our fair share of meetups, conferences, and "summits" (and probably hosted a few of them ourselves), were they worth it? Did the community meaningfully grow? Was printing all those stickers and swags worth the money? Did we collect and track the right numbers to measure progress? To develop a better framework for measuring community, we can look to a different industry for guidance and fresh ideas: political campaigns.

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ONC Releases Final Rule on Interoperability: How Might it Affect Public Health?

On March 9, 2020 the Office of the National Coordinator for Health Information Technology (ONC) released its final rule on the 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program. Referred to by some people as the "Information Blocking Rule," since this is the primary topic, the document actually covers a host of other issues related to interoperability driven primarily by requirements of the 21st Century Cures Act. In addition to the final rule itself you can read the ONC press release, a comparison between the proposed and final rules, and lots of other resources.

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Telework Challenges in a Mobile Device World Facing a Pandemic

The coronavirus pandemic is affecting all walks of life. Hospitals and medical professionals are on high alert. Schools are closing. Professional sports teams are playing in empty stadiums and, in some cases, not at all. Companies and governments are reviewing how to reduce health risks while maintaining productivity. An obvious response is to expand their telework programs for employees. Telework or remote worker programs have their challenges, and the concern is genuine for the federal government. There is the need to re-work policies, stretch budgets, deal with security concerns, and a big part of the challenge is the changing workforce as smartphones – rather than PCs and landlines of yesteryear – are the tools of choice.

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How To Write Effective Documentation For Your Open Source Project

Unfortunately, good code won't speak for itself. Even the most elegantly designed and well-written codebase that solves the most pressing problem in the world won't just get adopted on its own. You, the open source creator, need to speak for your code and breathe life into your creation. That's where technical writing and documentation come in. A project's documentation gets the most amount of traffic, by far. It's the place where people decide whether to continue learning about your project or move on. Thus, spending time and energy on documentation and technical writing, focusing on the most important section, "Getting Started," will do wonders for your project's traction.

The Need for Speed - It's Time to Act!

As a society we also need to get moving on the population level as well - and the sooner the better! In his fascinating genomic epidemiology detective work Trevor Bedford conducted based on the COVID-19 research he and his team had done in the Bedford lab in Seattle WA, he concluded that the narrow testing that was done in the Seattle area in the early days of the Coronavirus spread allowed the virus to spread faster. In contrast, the Coronavirus testing-blitz in South Korea appears to keep the death rate lower than it could be. It's time to test! The FDA gave high-tech labs the green light to operate tests before receiving any agency review or authorization and both Quest Diagnostics and LabCorp already announced that they have test in the market. But according to CDC, as of March 8 there were only 1,707 tests performed in the US vs. 189,236 in South Korea.

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Coronavirus and the Recurring Mistake of Fighting the Wrong Wars

What do the coronavirus and Navy ships have in common? For that matter, what do our military spending and our healthcare spending have in common? More than you might think, and it boils down to this: we spend too much for too little, in large part because we tend to always be fighting the wrong wars.I started thinking about this a couple weeks ago due to a WSJ article about the U.S. Navy's "aging and fragmented technology." An internal Navy strategy memo warned that the Navy is "under cyber siege" by foreign adversaries, leaking information "like a sieve." It grimly pointed out...

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3 Steps For Product Marketing Your Open Source Project

Product marketing for COSS is materially different from product marketing for proprietary software and from general marketing practices like ads, lead generation, sponsorships, booths at conferences and trade shows, etc. Because the source code is open for all to see and the project's evolutionary history is completely transparent, you need to articulate—from a technical level to a technical audience—how and why your project works. Using the word "marketing" in this context is, in fact, misleading. It's really about product education. Your role is more like a coach, mentor, or teaching assistant in a computer science class or a code bootcamp than a "marketing person."

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VA Tackles Medical Device Vulnerabilities and Cyberthreats

VA recently signed partnerships with Massachusetts General Hospital and Shepherd University. This collaboration's research will address cybersecurity and compatibility measures needed in devices used for VA patient care. It will also refine existing and emerging cybersecurity standards and practices for network connectable medical devices, medical data systems and other related technology. Beyond VA, the agreements could have a broad impact in standardizing cybersecurity and safety requirements within the larger public health sector. VA is contributing to industry-wide awareness of both medical device vulnerabilities and threats, while applying further tests of the Underwriters Laboratories criteria and other emerging standards.

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Mortal Coils: Why We Must Stop Tolerating Failing Health Tech

Today, data are scattered across thousands of database tables within any single electronic medical record (EMR) system, but also across dozens of other systems that hold pharmacy data, imaging data, insurance data, laboratory data, etc. Pretty much none of it is available on demand in any given clinical setting. The inevitable result of this disconnected galaxy of data "black holes" is mistakes, or if not outright mistakes, well-intentioned missteps based on lack of background data within the acute-care setting.

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CMS Promoting Interoperability in 2021: All good things must come to an end?

We have spent years involved with the management of the Center for Medicare and Medicaid Services (CMS) Electronic Health Records (EHR) Incentive Programs which were created by the HITECH Act (2009). These programs were recently renamed Promoting Interoperability (PI) programs. In a nutshell, these programs were tied to the Medicare and Medicaid insurance programs and provided financial incentives over a number of years to ambulatory providers and hospitals to adopt and use EHRs. Vendors submitted their technology products for testing and certification that they performed specific functions and could exchange data using specified message formats...But the provisions of the HITECH Act are due to expire on September 30, 2021 (see CMS timeline). These are the programs affected...

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How The VA and UL Created an Orchestrated Approach to Healthcare Cybersecurity Assurance

In today's high-risk Internet of Medical Things (IoMT) and cyber-warfare environment, one tool or individual line of cybersecurity solutions would likely not be able to satisfy the requirements for security and safety put forth by an HDO; hence, the aggregation of solutions branded as MedFusion was derived. The VA UL CRADA discovered that healthcare is strengthened in terms of security and safety of connectable medical devices through in-depth cybersecurity defense...Learning from the VA and UL cybersecurity research results, with respect to product-level management of vulnerabilities and threats to medical devices and their associated software algorithms, we can impact the quality of adoption of electronic health records and other data collection systems connected to the IoMT and consumers...

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What Are We Prepared to Do in the United States to Save Primary Care?

I propose two significant changes to help make primary care relevant in the 21st century...I wrote a longer piece on [Virtual Care] earlier in the year. In short, it's a disgrace that we've put so many hurdles on telemedicine, and that it continues to be so underused. It is widely available in health plans, but rarely practiced by physicians nor by patients. Instead, we still mostly go to our doctors offices, to ERs, or perhaps now to drugstores.A televisit should be the first course of action for non-emergencies. We must remove regulatory and reimbursement barriers, and incent patients to take advantage of the speed and convenience of the option. Moreover, as AI options for diagnoses and advice quickly become more viable, we can use them to triage our needs, help assure continuity with physicians, and eventually reduce the need to talk to a human...

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The Current State of Blockchain and Where it's Going

In an earlier post, Blockchain evolution: A quick guide and why open source is at the heart of it, I discussed the first generations of blockchains: the public Bitcoin and cryptocurrency blockchains, followed by the Ethereum blockchain capable of executing programs ("smart contracts"), leading to permissioned versions of code-executing blockchains (e.g., Hyperledger Fabric, Quorum). Let's step back into the blockchain jungle and take a look at the current state of the ecosystem and the projects trying to solve some of the limitations of blockchain technology: speed and throughput, cross-blockchain information and value exchange, governance, and identity and account management.

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Let's Place Some Big Bets - Reinventing Medical Care

When we think about market research and Big Data, think about Henry Ford's (possibly apocryphal) quote: Most of our healthcare innovations and reforms take the existing healthcare system as a given and try to build upon it in some way. They add more on-ramps to the healthcare superhighway, widen its lanes, try to smooth the pavements, maybe even automate our driving on it. But sometimes we need to tear the highway down. Here, in brief, are some big bets I'd like to see someone take on...

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