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Healthcare Informatics Recognized with ASHPE Award for 2017 Top Ten Tech Trends Report

May 1, 2018
by the editors of Healthcare Informatics
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Healthcare Informatics has once again been recognized by the American Society for Healthcare Publication Editors (ASHPE) for demonstrating writing excellence in the society’s Best Special Report editorial category for 2017.

Healthcare Informatics’ Editor-in-Chief Mark Hagland, Managing Editor Rajiv Leventhal, Associate Editor Heather Landi and Contributing Editor David Raths won the Bronze award for the Top Ten Tech Trends 2017 Report, which was published in Healthcare Informatics’ March 2017 issue. ASHPE’s 2018 Awards Competition honors writing excellence and insightful reporting among U.S. healthcare publications.

For the fifth consecutive year, Healthcare Informatics won an award for its signature “Top Ten Tech Trends” special report—last year, editors took home the Gold Award in the Best Special Report/Section category; in 2016 and 2015, the Top Ten Tech Trends won Silver awards and in 2014, that special report was recognized with a Bronze award. It is the sixth straight year the publication has been recognized by ASHPE. In 2013, it won the Gold Award for Online News Coverage.

Healthcare Informatics’ Top Ten Tech Trends report comes out every year in the spring and gives readers insight into how their worlds could be shaped in the next several years as it relates to health IT. It is a widely quoted issue, and one of the best-read every year. The 2017 report covered an extensive array of health IT’s most pressing issues: from value-based care delivery and purchasing; to iterative learning around big data; to FHIR and interoperability; to blockchain; and much more. All of the 2017 Top Ten Tech Trend stories can be read in full right here.

On receiving notification of the award, Healthcare Informatics Editor-in-Chief Mark Hagland said, “All of us on the editorial team at Healthcare Informatics are deeply gratified to receive recognition again this year for our ‘Top Ten Tech Trends’ package of articles, one of the most anticipated and well-read sets of articles of its kind in the healthcare IT industry. Receiving five awards in a row for ‘Top Ten Tech Trends’ is a much-appreciated external validation of our work, which is focused as always on giving our readers the vital information and insights they need, as they work to help their organizations succeed in a rapidly changing healthcare industry. We are deeply appreciative of the contribution of ASHPE to recognizing good work across the healthcare publishing world, and we congratulate our colleagues on our sister publications at the Vendome Group for their awards, as well.”

The full list of 2017 ASHPE winners can be seen here. Three of Healthcare Informatics’ sister-publications in the Vendome Group family also won awards: Behavioral Health Executive, a Bronze Award for Best Blog; i Advance Senior Care, a Gold award for Best Human Interest Article; and Addiction Professional, a Gold award for Best Feature Article and a Silver award for Best Original Research.

 

2018 Seattle Health IT Summit

Renowned leaders in U.S. and North American healthcare gather throughout the year to present important information and share insights at the Healthcare Informatics Health IT Summits.

October 22 - 23, 2018 | Seattle


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Will IBM Watson Repeat History?

August 15, 2018
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Recently, there have been some articles about IBM Watson and healthcare.  In particular, a blog by John Lynn speculates on the “health” of IBM Watson in healthcare.

I’ve had my own personal experiences with IBM in healthcare.  While with GE, we did a joint venture with IBM in the early days of PACS and RIS, and I was an original IBM MedSpeak/Radiology reseller in the early days of speech recognition.  In both cases, IBM did not have the financial wherewithal to play the long game in terms of the technology and exited both.

Interestingly enough, MedSpeak/Radiology was not the first foray into digital dictation for IBM, so they exited that business multiple times.  I also have to say, MedSpeak/Radiology was a pioneering technology that was very competitive.  It just wasn’t the business case the IBM management was looking for.  Similarly, IBM’s effort with GE toward RIS and PACS was naively predicated on employing IBM’s RIS product, and not on interoperability with other RIS vendors.

There are countless business examples of companies launching products based on great expectations, only to have them fail to achieve those expectations.  There are also countless examples of companies getting into products that have no relevance to existing businesses because the think they have a “better mousetrap.”  One that comes to mind is GE.  Years ago, GE developed in their research center an electric garden tractor which was very innovative for the 1970’s.  Unfortunately, when GE attempted to bring the product to market, they discovered they did not have a single market channel that addressed lawn-care equipment!  GE ended up selling it to Bolens for a fraction of the development cost.  And, in retrospect, it was premature given the current fascination with electric vehicles!

I am not implying that IBM hasn’t done its homework on IBM Watson.  I suspect it may be more of two other factors at play.  One, it’s a question of chicken and egg.  Is the advancement of Artificial Intelligence more about the application or the platform?  Secondly, does IBM have the infrastructure to succeed?  In the case of the first factor, IBM is more about the platform than the application.  In the second case, the same could be said for the platform versus the application, as IBM does not have a significantly parallel channel that would address AI applications.

I think this is why IBM initially acquired Merge Technologies, as they saw it as both a “sandbox” to learn imaging, but they may have also seen it as a potential distribution channel.  With further understanding, they were quick to learn that attempting to develop and market applications through Merge would make them a competitor to other viable players such as GE, Philips, and Siemens.  That resulted in a move to create “consortiums” that could develop applications on the IBM Watson platform, thus broadening the appeal of IBM Watson across a broader distribution channel.

The question going forward is – has IBM learned from its history of past healthcare ventures?  If IBM can make a business case for addressing Watson as the platform for AI, it might be a stronger case than trying to be the end point for AI.  This would be consistent with its strength in computational platforms in business, which have classically been a better business model than applications (OS2 or Lotus vs. Microsoft Windows and Office anybody?!). 

I recall the OS2 days versus Microsoft Windows.  As a fan of OS2, I had hoped it would succeed.  Unfortunately, as I learned, there were very few applications for OS2, which is ultimately why people purchased personal computers in the first place.  If IBM had been smart, they would have given OS2 software licenses away in an attempt to build consumer demand for the development of applications.  Unfortunately, that didn’t happen, and I doubt there are any OS2 users out there today.

If IBM can take stock of its history, there is a fighting chance for IBM Watson to be a significant factor in healthcare.  But, the company will need to learn how best to foster the development of AI applications.  In his blog, John Lynn relates the experience of Lukas Wartman of the McDonnell Genome Institute at the Washington University School of Medicine in St. Louis, who laments on how much faith one can put in the results (of using Watson).  As with past technologies, we are at the tip of the iceberg in terms of applying the technology.  Here’s hoping that IBM can figure this one out, be in it for the long game, and live up to the hype of IBM Watson!

 

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Analyzing Blockchain’s Evolution in Healthcare: Two Experts Dive into the Details

August 15, 2018
by Rajiv Leventhal, Managing Editor
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Two healthcare leaders at KPMG believe that blockchain activity in healthcare will ramp up in the next 12 to 24 months

Earlier this year, five prominent healthcare organizations—Humana, MultiPlan, Quest Diagnostics, and UnitedHealth Group’s Optum and UnitedHealthcare—announced they would be launching a blockchain-based pilot program with the aim to improve healthcare data quality and reduce administrative costs. The organizations said they would be specifically examining how the technology could help ensure that the most current healthcare provider information is available in health plan provider directories.

While many more details of this initiative are not yet known, this announcement has opened the eyes of other healthcare IT leaders who have become increasingly curious about this emerging technology. For instance, at the Nashville Health IT Summit earlier this summer, a senior executive from MultiPlan, which is part of this pilot project, was asked about his perspectives on the research and development work done on blockchain in healthcare in the past few years.

To this point, two leaders at KPMG—Arun Ghosh, the firm's U.S. blockchain leader; and Michael B. Yetter, director, healthcare management consulting—recently spoke with Healthcare Informatics about the impact of this new initiative, what the greatest use cases are for blockchain in healthcare today, and how quickly providers and payers might start moving into full-scale projects. Below are excerpts from that discussion.

What are you hearing about blockchain right now as it relates to its greatest use cases in healthcare? What are people most bullish about?

Yetter: From a client perspective, things are a bit on the early side. But [we often see that] as many emerging technologies gain momentum in some other sectors, you will see the pathway through pharma and then into healthcare with payers and providers. We are seeing that same pattern here. On the ground in the healthcare space, especially amongst payers and providers, we’re starting to see more interest in meaningful pilots. We have had some earlier adopters doing proof of concepts and pilots—many around claims or aspects of claims management, and some around the regulatory impacts of the supply chain.

Michael B. Yetter

We are starting to see the nature of conversations around what those use cases could be become increasingly sophisticated around things such as consortiums on provider data, and making sure the historical challenges around getting provider data to agree across multiple entities—who are either submitting or processing claims—that those specific data elements or attributes or shared or reconciled in a better way. So that’s one good example for where you are starting to see collaboration.

Ghosh: The additional capability that blockchain provides, versus traditional EHR (electronic health record) systems, and other enterprise technology that exists today, is that from the time of an encounter to the time of discharge, we see blockchain being piloted around records and interactions with the patient, but also interactions with the pharmaceutical ecosystem—from drug provisioning or procurement to drug administration. Even with the Obama administration saying that we need EHRs across the board, it’s still nascent in terms of who has access to what kind of record and what kind of electronification exists.

Arun Ghosh

So blockchain is coming as the next level of granularity: if we can provide immutable records that are now at the time of pre-diagnosis all the way to wellness, we can track getting better, but also not returning to the hospital. Now, we have a story. Between payers, providers, pharmaceuticals, and distributors, we are seeing varying levels of interest and adoption. They are saying, “let’s pilot a certain part of this,” but there is still no end-to-end view yet, from what we have seen.

What are your thoughts on the MultiPlan/Humana/Optum/Quest/United initiative? Would you classify this as a meaningful pilot?

Yetter: From an outside view, and we haven’t been directly involved, it’s my understanding that this collaboration is focused on provider data sharing. I would classify that as more meaningful because they are bringing multiple parties together to solve for a specific use case and problem. So it goes beyond the earliest conversations, going back a year or more, that were more about learning and understanding the technology. Now they are saying that they get the technology, so let me apply this to a problem we have and something that we can enhance in the industry. And seeing multiple big players involved is encouraging.

Some have said that the greatest use of blockchain in healthcare could be improving on how HIEs (health information exchanges) operate today. Do you agree?

Yetter: I don’t think this is achievable in the short term, and there is the bigger picture of truly getting to a complete HIE—and when I say complete, I mean the truly clinical data that is shared between entities, and ideally something that is more accessible to the patient. The ingredients are there for blockchain to make that significantly more usable, and something that can be potentially controlled and accessed by the actual patient or member. And the patient or member can then have the ability to access the information, and also to permission through some of the mechanisms through blockchain, the sharing of that data or specific parts of the data to others who need it in the healthcare environment. There is a lot of good capabilities there that will evolve in this direction to have blockchain enabling more advanced HIEs, but it will be several steps along the pathway before we truly get to that transformation.

Ghosh: Part of this [potential] disruptive model is that it’s the true democratization of healthcare data—if my data is now being “streamed” into a blockchain, I have ownership of it. So the hypothesis of value here is that if the individual can control his or her data, and then can choose who to share it with—the plan, provider, or someone like Nike or Under Armour—the concept is that there are rewards, such as avoiding rehospitalizations.

How can healthcare organizations better prepare their infrastructures now to implement blockchain in the future?

Yetter: I think the blockchain [implementation] would be more of an add-on, especially in the near term. And I think you will see some of the major vendors out there, be it EHR or adjudication systems, start to consider and build in aspects of blockchain into their own platforms. So there will be a broader enablement that will naturally flow into the infrastructure as it moves forward. But in the near term, there is a good opportunity to add blockchain capabilities to what they already have, and then leverage it for specific cases of pilots or at-scale activities.

Ghosh: The big thing to recognize is that the way enterprise blockchain is evolving, from an infrastructure perspective, it is becoming augmentative rather than disruptive. So you can take an EHR and then you can augment the whole EHR workflow, from encounter to discharge, on the blockchain, [while maintaining] what the traditional EHR looks like. You don’t have to transmit all the data, like you would do in a data warehouse, into another ecosystem. You can leave it as source and hash parts of it on the blockchain as you build the blocks along the workflow. The enterprise blockchain vendors are making this easy to adopt.

There has been plenty of back-and-forth about just how much security blockchain can provide. What are your thoughts on this?

Ghosh: Anytime you encrypt data, it can always be decrypted. A blockchain is nothing but a distributed database at the end of the day. If you have access to that database that doesn’t have a consensus mechanism attached to it, then it is a little insecure. Looking at the T.J. Maxx breach a few years ago, people were swiping their credit cards and the transmission from the point of fail system to the storage system was being intercepted; that was the hack. In the same way, from the time that the traditional system would write to the blockchain, you can intercept that data, and that’s when the insecurity could come into play. And those standards are still evolving. There is no vendor out there that can not only encrypt the transmission protocols between source and blockchain, but also ensure that the blockchain itself is secure.  

What predictions could you offer for blockchain’s continued evolution in healthcare?

Yetter: In 12 to 24 months, you will see a lot of fast-moving activity, and with the changing nature of conversations and the work being done now, there is a clear signal that we are at a bit of an inflection point. But I think we will accelerate the meaningful work in this space and bring the technology in. Going back to the idea of acceptance and use of emerging technologies in other sectors first, we are seeing blockchain in place in financial institutions in meaningful ways. So in the next year or two, I think we will see the same thing in healthcare, whether it’s aspects around provider data, or getting into exposing things to the patient or member so they have greater control. We’ll see a lot of energy and investment in that space.

Ghosh: I think that beyond the pilots that you see today, the voice of the customer will be increasingly automated with enterprise blockchain. Within healthcare, the issue is, how do you provide greater autonomy, depending on who has the data and where? It’s not one or two companies that are trying to do something; it’s five or 10 that want to get together before someone else beats them to it.

 

 


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AHRQ Launches App Challenge for PRO Data Standardization

August 15, 2018
by Rajiv Leventhal, Managing Editor
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The Agency for Healthcare Research and Quality (AHRQ) has launched a competition to address the need for greater use of standardized patient-reported outcomes (PRO) data in clinical care and research.

The total prize pool for the challenge, called the AHRQ Step Up App Challenge, and which will be spread out over three phases, is $250,000. PRO data, according to AHRQ, are defined as any report on the status of a patient’s health condition that comes directly from the patient, without interpretation of the patient’s response by a clinician or other medical expert.

But a key challenge for providers and patients is that PRO data are not routinely collected and used in practice. One reason is that there is no standardized way to collect and integrate PRO data into health IT systems, thereby limiting the ability for clinicians to use the data or easily share these data across health systems for research or other purposes, including quality improvement, according to AHRQ officials.

As such, the AHRQ Step Up App Challenge seeks innovative technologists who can develop and present user-friendly apps capable of collecting standardized PRO data in various ambulatory settings, including primary and specialty care. The winning app will be tested in nine practice settings affiliated with MedStar Health in Washington, D.C., Maryland, and Virginia.

The challenge has three specific phases:

  • Phase 1: Participants will submit a five-page business proposal, demonstrating the originality and feasibility of their app idea.  Up to 10 winners will be selected with a prize of up to $12,000 each.
  • Phase 2: Phase one winners will develop and present an app capable of collecting standardized PRO data in various ambulatory care settings, including primary and specialty care.  First prize in this phase is up to $35,000, second prize is up to $30,000, and third prize is $25,000.
  • Phase 3: The grand prize winner in phase two will collaborate with MedStar Health to test the app in nine practices.  Upon completion of a successful pilot test, the grand prize winner will be awarded up to $40,000, bringing the winning prize to as much as $87,000.

The AHRQ Step Up App Challenge seeks innovative technologists who can develop and present user-friendly apps capable of collecting standardized PRO data in various ambulatory settings, including primary and specialty care. The winning app will be tested in nine practice settings affiliated with MedStar Health in Washington, D.C., Maryland, and Virginia.

“While some digital tools exist to collect these data, they are not in wide use due to problems with integrating them in practice workflow, as well as patients’ discomfort with using such tools,” AHRQ Director Gopal Khanna, said in a statement. “This competition will address this issue and result in a user-friendly app that can enhance healthcare data collection and thereby improve the quality of care for all Americans.”

In partnership with AHRQ, the Office of the Secretary is providing financial support from the Patient-Centered Outcomes Trust Fund, and the Office of the National Coordinator for Health IT (ONC) is leading stakeholder efforts to develop the technical specifications for the Step Up App Challenge.

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