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Thursday, September 22, 2016

On deck: the 10th Annual #health2con conference
It promises to be very interesting, as always. I'm staying onsite this year, going down Saturday so I can hit the ground running early Sunday. Mercifully, no NFL game across the street at Levi's Stadium this year.

In addition to the breadth of exquisitely-presented cutting edge health care and health tech topics, ten new companies will have their onstage debut.
  • Valeet Healthcares platform gives patients personalized health information while allowing providers to have a rounding tool and giving healthcare systems a dashboard to track metrics.
  • gripAble is an innovative mobile technology that bridges the gap between functional therapy and objective measurement of upper-limb function.
  • Cricket Health works with payor and provider customers to slow the progression of chronic kidney disease (CKD), manage the transition from CKD to End Stage Renal Disease, and improve ESRD care.
  • Qidza is a population health mobile platform that enables parents work with their physicians to track their children’s developmental milestones
  • Docent Health guides health systems to embrace a consumer-centric approach to healthcare by curating patient experiences.
  • Albeado builds Healthcare prediction and optimization solutions based on proprietary data science platform which combines clinical AI and Graph-Based Machine Learning.
  • Siren Care offers temperature-sensing smart socks which provide health data on foot ulcers, hot spots, and more to prevent future injuries.
  • MDwithME integrates soft and hardware components in a suitcase enabling full remote physical exams with an option of instant or delayed physician’s consult with quality of testing that equals or exceeds the current state of art.
  • DayTwo maintains health and prevent disease utilizing a microbiome platform, starting with personalized nutrition based on gut bacteria, aiming to normalize blood sugar levels and cultivate a healthy gut microbiome.
  • Regeneration Health is a health ecosystem powered by artificial intelligence that collects and monitors health in real time and curates free personalized health info and recommendations based on integrative medicine.
I recall my reflection on one of the 2015 launch presentations a year ago.

Among other things this year, Gerd Leonhard's "digital obesity" will be on my mind.

Along with that hardy perennial "interoperability." apropos,

Expand the deck to fullscreen for legibility.

I posted on HL7 "APIs" two years ago, here and here.

In related news, from the National Academy of Medicine:

As reported by FierceHealthCare:
National Academy of Medicine: HIT agenda must be reset

The U.S. has met only one of four federal health IT goals outlined by the White House in 2004, according to the National Academy of Medicine, which notes in a new discussion paper that the agenda for the next five years should be "reset."

The paper, part of NAM’s Vital Directions for Health and Health Care initiative, notes that while the national goal of electronic health record adoption has been reached, the three other goals outlined in 2004--interoperability, supporting consumers with information and public health, clinical trials and other data-intensive activities--have not. It identifies nine central themes in three focus areas that it suggests should be the major goals for health IT over the next five years, including:

Technical underpinnings:

  • Data standards and achieving interoperability at scale
  • Interoperability with consumer health technology
  • Improving patient identification matching to support interoperability
  • Service-oriented architectures and web-based services
...The paper outlines current problem areas, including Meaningful Use’s mixed success and inadequate EHR design. It also identifies opportunities and policy alternatives, such as authorizing the Department of Health and Human Services to adopt and promulgate standards through formal rule making for patient identification and matching.

The authors recommend three “vital directions” to take:

  1. End-to-end interoperability from devices to EHRs
  2. Aggressively address cybersecurity vulnerabilities
  3. Develop a data strategy that supports a learning health system...
Are we finally gonna cut through the persistent fog of "interoperababble"? Or will we see similar papers promulgated  five years out, all making the same recommendations we've been reading for years?

e.g., from the National Academy paper,
Data Standards and Achieving Interoperability at Scale
Many have concluded that the Meaningful Use goals of improved quality, safety, and efficiency cannot be reached until more data are shared for more purposes, with sharing integrated into the routine, health care–delivery work ow. As currently designed, HIT and the applicable regulations can slow the routine provision of health care. Enablers of efficiency—such as accurate, transparent, and actionable payer information available at the point of care; the ability to reuse structured health information for health care operations and administration; and documentation well suited for care in the 21st century—could help to achieve efficiency goals. Sharing data more broadly can enhance care coordination, ensuring that patients’ lifetime medical records travel among all providers. Redundant and unnecessary testing can be reduced. Physician orders for life-sustaining treatment can be communicated broadly. One estimate suggests that $80 billion could be saved annually if a comprehensive program of EHR data-sharing were widely implemented (Hillestad et al., 2005).
"2005"? I'm stuck in Groundhog Day. 2005 was the year I started working in the CMS Meaningful Use precursor DOQ-IT initiative at HealthInsight.

UPDATE: I printed the paper's pdf copy out and gave it the yellow marker / red pen treatment. Again, you could have pulled something up from a decade ago and made a few relatively minor edits to re-tread all of this. With respect to new stuff -- e.g., "precision medicine" and its foundational "omics" science underpinnings, this is all I find:
The Precision Medicine Initiative of the National Institutes of Health constitutes a bold step toward engaging individuals in helping to accelerate biomedical knowledge discovery through the use of electronic health information from EHRs and consumer health technology (NIH, 2016). [pg. 9]

In the era of "big data," the availability of more comprehensive, sensitive, and valuable — but less regulated — data emphasizes the ever present need for standards for encryption. Genomic (and "multi-omic") data used in personalized medicine lack policies and standards. [pg. 13]
That's all? I've ranted about these shortcomings in prior posts.
Got hooked up on Twitter with a company called "MI7" the other day.
Our software Q transforms every Electronic Health Record system into an API.
Sounds great. We'll see. Here's the question I want answered: "Does your app transform PHI metaphorically into the (iteratively, recursively lexically and semantically indestructible) "type-O blood" of health care? Y'know, that whole "data are the lifeblood of health care" thingy?

Interestingly another company, Redox,  -- host of a Sunday evening Health 2.0 Conference reception this year -- is also in this HIT "interop" fray:

Redox is the EHR integration platform for digital health solutions.
We empower healthcare applications to read, write, and query clinical data with any healthcare organization's electronic health record system. The bridge to interoperability is open.

I'm all eyes and ears.

In other news,

Chan Zuckerberg Initiative commits to investing $3 billion to cure diseases
An effort to cure all diseases within the lifetime of their daughter

The philanthropic initiative founded by Facebook founder Mark Zuckerberg and his wife, Priscilla Chan, will spend $3 billion over the next decade in an effort to cure and manage all human diseases. The Chan Zuckerberg's latest effort will begin with a $600 million investment in a project called Biohub, an independent research center located at the University of California at San Francisco that will work on developing new tools to measure and treat disease.

"Mark and I spent the past two years talking to scientists ranging form Nobel Prize laureates to graduate students," Chan said during an emotional talk at UCSF. "We believe that the future we all want for our children is possible. We set a goal: can we cure all diseases in our children's lifetime? That does't mean that no one will ever get sick. But it does mean that our children and their children should get sick a lot less. And that we should be able to detect and treat or at least manage it as an ongoing condition. Mark and I believe this is possible within our children's lifetime."...
Bears watching.


Day 9, no Jaco. It has been difficult to get motivated to do anything this week. Starting to despair that we'll never see him again.

"The benefit of being a Futurist is that you never have to change your slides."
LOL. Ian Morrison, Tuesday's Health 2.0 Keynote speaker, in an earlier interview with Matthew Holt. "I've got Powerpoint slides that are older than some of my clients."

More tech news...

Robot Nurses Will Make Shortages Obsolete
By 2022, one million nurse jobs will be unfilled—leaving patients with lower quality care and longer waits. But what if robots could do the job?

For years, the U.S. has experienced a shortage of registered nurses. The Bureau of Labor Statistics projects that while the number of nurses will increase by 19 percent by 2022, demand will grow faster than the supply, and that there will be over one million unfilled nursing jobs by then.

Those aged 65 or over comprise a bigger percentage of the U.S. population than ever, and by 2030, 20 percent of the U.S. population, or roughly 69 million people, will be senior citizens. While enrollment at nursing schools is up, these programs aren’t big enough to accept the number of applicants required to fill these positions.

So what’s the solution?

"Machines of Loving Grace"?


Saturday, Sept 24th, a young man found our Jaco this morning a couple of miles from our house, captured him, and turned him in to Animal Control. They scanned his chip and called us.

Apparently no worse for the wear. We are SO lucky. The kid didn't want to take the $100 reward I'd offered, but I insisted.

More to come...

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