This week I’ve taken vacation time to help my colleagues in Japan and New Zealand with national IT planning. As I often say, the healthcare IT challenges are the same all over the world, but the cultural context is different. In Japan, I spent 2 days in Tokyo and 1 day in Kyoto, lecturing, meeting, and listening to stakeholders. There is a great desire to share data for care coordination and clinical trials/clinical research. Telemedicine/telehealth is increasingly important in an aging Japanese society that has increasing healthcare needs but a limited number of caregivers and few opportunities to increase healthcare budgets. Here are a few of the current issues we discussed...
care coordination
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Fax Is Not a Machine, It Is a Technology
By John Nebergall | November 8, 2018
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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Fax Technology is the Cornerstone of Interoperability. Here's Why.
By John Nebergall | February 6, 2019
Fax is the dominant information exchange technology in U.S. healthcare, outpacing secure direct messaging 25-to-1. Most of that is exchanged using inefficient and unsecure machines. With the emergence of cloud-based fax technology to facilitate secure system-to-system document transfer, the use of cloud fax needs to be part of every CTO's/CIO's digital strategy...The evolution of fax from paper-based to cloud transmission and storage - Cloud Fax Technology (CFT) - is a key step that enables providers to comply with HIPAA and other regulations. Further strengthening CFT as a key component in Healthcare Information Systems (HIS) is its evolution into Direct Messaging platforms, enabling the seamless exchange of Patient Health Information (PHI) between the diverse data and document management systems used by labs, pharmacies, doctor's offices, hospitals, and billing providers. CFT supports and contributes to the goal of interoperability...
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Halamka Discusses Three Disruptive Care Coordination Innovations In Use at Beth Israel
By John D. Halamka, MD | July 20, 2016
Would you buy an iPhone if the only apps that ran on it were written by Apple? Maybe, but the functionality would not be very diverse. The same can be said of EHRs. Athena, Cerner, Epic, Meditech, and self developed EHRs such as BIDMC’s webOMR are purpose-built transaction engines for capturing data. However, it is impossible for any single vendor to provide all the innovation required by the marketplace to support new models of care I’m a strong believer in the concept of third party modules that layer on top of traditional EHRs in the same way that apps run in the iPhone ecosystem...
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Halamka Pays a Visit to Oscar Health
By John D. Halamka, MD | August 10, 2016
Today I’m in New York City visiting Oscar Health, on my continuing quest to determine how best to integrate digital platforms, patient-family engagement, and care coordination in preparation for MACRA/MIPS and the transformation from fee for service to alternative payment models. At the moment, there is no single magic bullet, but there are early innovations that hold promise. At BIDMC we’ve thought the best approach to care management is to identify a cohort with a disease, then enroll that cohort in a program which involves tracking progress against guidelines/protocols, deploying telemedicine/visiting nurses, and measuring data from home-based devices...
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Halamka Summarizes the CMS Meaningful Use Final Rule
By John D. Halamka, MD | October 20, 2015
I’ve been asked to summarize the 752 page CMS Meaningful Use Final Rule...Between the Notice of Proposed Rulemaking and the publication of the CMS Final Rule, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) passed to include sunsetting the Meaningful Use payment adjustment for professionals at the end of 2018. Also, MACRA requires the establishment of a Merit-Based Incentive Payment System (MIPS) which would incorporate Meaningful Use. The comment period will be used in an attempt to align the Meaningful Use program and the MIPS program...Stage 3 is more controversial and I will focus on that.
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Halamka's Health IT Observations from Japan and New Zealand
By John D. Halamka, MD | February 8, 2017
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Halamka's Next Steps for the National Healthcare IT agenda
By John D. Halamka, MD | March 1, 2017
At HIMSS, I listened carefully to payers, providers, patients, developers, and researchers. Below is a distillation of what I heard from thousands of stakeholders. It is not partisan and does not criticize the work of any person in industry, government or academia. It reflects the lessons learned from the past 20 years of healthcare IT implementation and policymaking. Knowing where we are now and where we want to be, here are 10 guiding principles.
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Halamka's Reflections on US Health IT Policy Trajectory
By John D. Halamka, MD | July 6, 2017
I’m in China this week, meeting with government, academia, and industry leaders in Guangzhou, Shenzhen, Beijing, Shanghai, and Suzhou. The twelve hour time difference means that I can work a day in China, followed by a day in Boston. For the next 7 days, I’ll truly be living on both sides of the planet. I recently delivered this policy update about the key developments in healthcare IT policy and sentiment over the past 90 days. I’ve not written a specific summary of the recently released Quality Patient Program proposed rule which provides the detailed regulatory guidance for implementation of MACRA/MIPS, but here’s the excellent 26 page synopsis created by CMS which provides an overview of the 1058 page rule...
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Health Care Data as a Public Utility: How Do We Get There?
Mohit Kaushal and Margaret Darling | Brookings | May 18, 2016
Despite the technological integration seen in banking and other industries, health care data has remained scattered and inaccessible. EHRs remain fragmented among 861 distinct ambulatory vendors and 277 inpatient vendors as of 2013.Similarly, insurance claims are stored in the databases of insurers, and information about public health is often kept in databases belonging to various governmental agencies. These silos wouldn’t necessarily be a problem, except for the lack of interoperability that has long plagued the health care industry. For this reason, many are reconsidering if health care data is a public good, provided to all members of the public without profit...
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Health Information Exchanges: More Innovation Needed
Ken Terry | InformationWeek Healthcare | August 2, 2013
HIEs have been slow to develop offerings that organizations can use to improve care coordination, says report. Read More »
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Health IT Interoperability Reimagined!
By John Nebergall | July 18, 2018
The evolution of fax from paper-based to cloud transmission and storage (CloudFax) is a key step that enables CloudFax providers to comply with HIPAA and other regulations. Further strengthening of CloudFax as a key component in Healthcare Information Systems (HIS) will be its evolution into a Direct Messaging platform that enables the seamless exchange of Patient Health Information (PHI) between the diverse data and document management systems used by labs, pharmacies, doctor's offices, hospitals, and billing providers. CloudFax will support and contribute to the goals of interoperability. Consider:
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HHS Awards $100 Million to Boost Community Health Center Quality
Bernie Monegain | Healthcare IT News | August 19, 2016
A total of 1,304 health centers across 50 states and the District of Columbia will divide $100 million to help boost healthcare quality, the U.S. Department of Health and Human Services announced. The funds are earmarked to expand quality improvement systems and infrastructure and to improve primary care service delivery...
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HHS Called on to Eliminate Health Information Blocking
Kate Monica | EHR Intelligence | August 31, 2017
A coalition of healthcare stakeholders convened by Health IT Now called HHS and its departments to eliminate information blocking so that providers can effectively aggregate patient EHRs and advance interoperability. The letter from organizations including the American Academy of Family Physicians (AAFP), AMIA, DirectTrust, and athenahealth requested HHS issue a proposed rule that takes existing laws, standardization, patient health data access, and other complicating factors into consideration...
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HIMSS13: Athenahealth Issues HIT Industry ‘Code Of Conduct’
Press Release |
athenahealth |
March 4, 2013
Code Lays Out Five Basic Principles to Move Industry Forward Read More »
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How A Simple New Tool Helps Doctors Care For Patients -- After They Leave The Office
Lisa Wirthman | Forbes | May 11, 2016
We live in an increasingly connected world, but patients who receive treatment from multiple doctors and healthcare systems still face a lack of coordination in their care, which can put their health outcomes at risk. PatientPing is working to help doctors collaborate and create a more consistent experience for patients with simple technology that connects healthcare providers across facilities, systems and geographies...
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