With the Department of Justice announcement of the $155 million dollar eClinicalWorks settlement (including personal liability for the CEO, CMO and COO), many stakeholders are wondering what’s next for EHRs. Clearly the industry is in a state of transition. eCW will be distracted by its 5 year corporate integrity agreement. AthenaHealth will have to focus on the activist investors at Elliott Management who now own 10% of the company and have a track record of changing management/preparing companies for sale. As mergers and acquisitions result in more enterprise solutions, Epic (and to some extent Cerner) will displace other vendors in large healthcare systems. However, the ongoing operational cost of these enterprise solutions will cause many to re-examine alternatives such as Meditech...
Feature Articles
How to Create an Internet-in-a-Box on a Raspberry Pi
If you're a homeschool parent or a teacher with a limited budget, Internet-in-a-Box might be just what you've been looking for. Its hardware requirements are very modest—a Raspberry Pi 3, a 64GB microSD card, and a power supply—but it provides access to a wealth of educational resources, even to students without internet access in the most remote areas of the world. I recently had a chance to visit with developers Adam Holt and Tim Moody about the project. Adam said this wonderful initiative began with One Laptop per Child at MIT. From there it was forked in 2012 into the School Server Community Edition project, and now it is called Internet-in-a-Box. I learned of the project while attending LinuxConNA last summer in Toronto, where I first met Adam...
How OpenMRS is Used to Fight Malaria in Endemic Areas
Children receiving care at a health clinic using OpenMRS in rural Uganda. Statistics from the Ministry of Health show that malaria is still the leading cause of death in Uganda, accounting for over 27% of deaths. OpenMRS is an electronic medical record platform designed to be used in low-resource environments where malaria and many other deadly diseases are endemic such as Uganda, where malaria is the primary cause of death in children. OpenMRS is currently used in over 1,800 medical clinics in 64 countries, providing the health information technology infrastructure that is foundational to over 6.3 million patients...
Halamka on What's Next for Electronic Health Records
HHS Ventures Team Helps Detect Disease Outbreaks
It was a no brainer for the HHS Ventures Fund to include the Centers for Disease Control and Prevention’s (CDC) GHOST project in its latest round of funding. There are about 3.5 million Americans infected with Hepatitis C (HCV), which attacks the liver and can lead to cirrhosis and other serious health problems, according to the latest data collected by the CDC. This CDC Ventures team is developing a cloud-based, public health research tool to help state and local health departments more quickly detect and fight the spread of disease. The team calls their system GHOST – Global Hepatitis Outbreak Surveillance Technology...
A Major Lesson from Ebola: Pandemics Are Strongly Driven by Inequality
After more than a year since the Ebola pandemic appeared in West Africa, Liberia – one of the worst hit countries – has been declared free of the virus. However, the initial global response was not encouraging. Despite having the knowledge and technology needed to contain the outbreak, help was initially sluggish and poorly effective. This situation illustrates one of the major lessons from the history of pandemics: that they are strongly influenced by health inequalities. Pandemics are epidemics that spread widely and cross borders. In many respects, the world is a safer place for those concerned about these emerging infectious diseases – advances in science, particularly molecular biology, information technology, and epidemiology give us unprecedented tools for understanding, tracking and managing emerging threats...
When It Comes to Pharmaceuticals and Medical Devices, We Should Ask More and Listen Better
A new study in JAMA suggests that nearly one-in-three drugs approved by the FDA between 2001 and 2010 had post-market safety issues, which caused safety communications to physicians and consumers, "black-box" warnings on labels, and drug withdrawals. It is not clear how many patients may have died or otherwise harmed by these issues...Lead author Joseph Ross, M.D., noted: "No drug is completely safe, and during premarket evaluation, we are not going to pick up all the safety signals," and urged "that we have a strong system in place to continually evaluate drugs and to communicate new safety concerns quickly and effectively."
Are Open Source Clinical Decision Support (CDS) Services Subject to HIPAA Regulations?
Clinical Decision Support (CDS) services such as HLN’s Immunization Calculation Engine (ICE) are modular, loosely-coupled components of larger systems accessed via web services in a service-oriented architecture (SOA). Under HIPAA, services provided to Covered Entities (CE) which involve protected health information (PHI) as defined in the statute are subject to the regulation. But are CDS services such as ICE subject to this regulation?
OpenMRS Announces 2017 Google Summer of Code students
Congratulations to the 15 students selected by OpenMRS to participate in Google Summer of Code™ this year! A total of nearly 1,400 students were selected to participate with 201 different open-source projects. As the organization administrators for the program, we are thrilled to announce our 11th year of participation yet in the annual event graciously sponsored by Google. We’ve thoroughly enjoyed participating in this great program in the last 10 years and are even more excited about the students, projects and mentors that are participating this year. Coding for OpenMRS is a great way for university students to practice coding skills and at the same time help benefit people in developing countries who are on the front lines of the battle against HIV/AIDS, TB, Malaria, and other public health challenges. Read More »
The Right Way to Modernize VA's VistA EHR: Shift Development to the Private Sector and the Cloud
While changes to VistA are warranted and necessary, trashing the entire system because one component may be flawed makes little sense from technological or financial perspectives. The VA scheduling scandal was the product of an agency overwhelmed by veterans returning from two theaters of war. In that scenario, the scheduling system became a scapegoat for organizational and human resources challenges that were bound to manifest in one way or another.The VA should not heed calls to replace VistA for these key reasons...
The Next Big Challenge for Open Source: Rich Collaboration Software
The file sync and share movement started over a decade ago, led by the likes of Dropbox, Google Drive, and others, and became popular very fast. The killer feature was having all your files available on all your devices. No more forgetting to bring that important document to a meeting, emailing files, or handling multiple USB sticks. Files were always there when you needed them! That its growth happened with the start of the smartphone age made file sync and share even more useful. But its popularity wasn't just about having access to your own files on all your devices: it also made sharing easier, enabling a new level of working together. No longer emailing documents, no longer being unsure whether your colleague's feedback came on the latest version of your draft, no longer fixing errors that were already fixed...
Leveraging the "Learning Health Community" Concept in Education
This idea of an iterative engaged learning environment (we can call it a “Learning Health Community”) is not far-fetched. Such a system would require quality evidence-based data and information delivered in real-time based on the real-world experiences of millions of patients. As new verified information and data develop, these would be incorporated and then deployed. We would harness the power of existing and future knowledge in a form that is usable by both medical professionals and the patients they serve. The questioning fathers and others similarly situated could access the Internet for augmented and personalized health information.
Halamka on "The Dark Side of E-commerce"
As I mentioned in a recent post, Amazon has focused on the convenience of the customer instead of the convenience of their business. Yesterday’s New York Times highlighted the trend for the hotel industry to do the same. In my post, I lamented that some industries including old school industrial companies and healthcare have not widely adopted customer focused technologies. To their credit, Marvin Windows followed up with me and promised to accelerate their automation efforts. I was impressed. However, all is not completely rosy in the transformation from brick and mortar to e-commerce...
A New Android App for Teaching Kids How to Read
Have you been looking for software to help your child to read? Well, your quest may be over. Phoenicia is a new literacy application for Android developed by Michael Hall, an open source software developer, community manager, and technology evangelist currently working at Canonical, maker of Ubuntu. In this interview, he talks about the diagnosis of his oldest child with an Autism Spectrum Disorder, his learning curve of Android development, and why user testing matters more than you think...
Clicks-and-Mortar: Health Care's Future
The woes of the retail industry are well known, and are usually blamed on the impact of the Internet. Credit Suisse projects that 8,600 brick-and-mortar stores will close in 2017, which would beat the record set in 2008, at the height of the last recession. There are "zombie malls," full of empty stores but not yet shuttered. And then there's health care, where the retail business is booming. In a recent Wall Street Journal article, Christopher Mims set forth Three Hard Lessons the Internet is Teaching Traditional Stores. The lessons are: Data is King, Personalization + Automation = Profits, Legacy Tech Won't Cut It.
Europeana adds 470,000 images to Creative Commons Search
CC Search beta has added 470,000 images from the millions of materials contained in Europeana’s collection of Creative Commons images. Europeana is Europe’s digital platform for cultural heritage, collecting and providing online access to over 54 million of digitised items ranging from books, photos, and paintings to television broadcasts and 3D objects. As an important cultural partner to CC, Europeana’s platform strengthens the commons through its large, searchable collection of digital records from nearly 4,000 European libraries, archives, museums and audiovisual galleries...