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CLOUD Health

The power of CLOUD comes not only from its ability to bring together ME across your various life domains from health to education to finance and beyond but its ability to put you back in the center of your health decisions. In the midst of the national debate over healthcare, we can not lose sight of the fact that health is about you. ME 1.0 can help both you and the healthcare system achieve that goal.

Digital Debacle for EHRs in Britain: The Challenge of Using 19th Century Thinking to Solve 21st Century Problems

Last week’s Daily Telegraph in the UK reveals the challenges we will face with EHRs in the United States if we do not change our perspective on the solution before cementing 19th century approaches into rules at HHS. “Patient’s Medical Records Go Online Without Consent,” by Kate Develin does an excellent job of looking at the implications of seeing this as a records problem rather than a patients problem.  EHRs divorced from the patients to whom they belong is at the heart of the digital debacle in Britain.

The following quote is at the very heart of the privacy issue:

The “summary” records contain basic medical information including illnesses, vaccination history, and could include medication patients have been given. Ages and addresses are also included. (emphasis added)

The issue with privacy on the Internet today is that the data silos into which our records are poured not only include What I Am™ but Who I Am™.  The combination of critical health information Read the rest of this entry »

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eHealth Initiative: Health IT’s Role in Care and Reform

In a world where many of us as consumers are accustomed to accessing their bank accounts online, checking their location on a GPS or smartphone and booking travel online, it is not surprising that 57% expect their physicians to use electronic health records — EHRs.  This statistic, from John Rother of AARP, seems appropriate in a world of advanced technology.  Actually, one might expect this number to be higher.  What is surprising is that 83% of physicians do not use HIT in their practices to support technology-enabled changes to the supply chain of information.

However, talking about technology and transforming an enterprise through the use of technology are two different things. eHealth Initiative is one organization, like Health 2.0 and many others, that are providing important forums for evolving discussions on this vital topic.  Aneesh Chopra, CTO of the United States, gave the opening keynote at both the Health 2.0 conference in San Francisco this fall and at eHI’s 2010 Annual Conference, occurring now in Washington, DC.  His enthusiasm for the potential of technology was unmuted at both events.  And, of course, in the months between October and January, the initial suite of proposed standards for meaningful use have been promulgated.

Perhaps most striking about the new proposed final rule on “electronic” health records is the myriad of regular mail, overnight mail and courier instructions preceding the actual proposed rule, a rule that seeks to outline the exchange of electronic information!   Read the rest of this entry »

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2000 Pages: Too Many or Too Few? (Update)

On October 29, 2009, the Speaker of the House of the 1st Session of the 111th Congress revealed the results of a tangled legislative process and unveiled a bill “to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.”  That legislation is now being taken up actively by the U.S. Senate.

Many are debating whether 2000 pages is too long… CLOUD asks if it is too few…

Read the rest of this entry »

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Express Scripts data breach: Isolated Incident or Endemic Problem?

Express Scripts data breach may have hit 700,000 victims

SC Magazine | Chuck Miller | October 1, 2009

Last year’s data breach of St. Louis-based Express Scripts may be more serious than initially believed.

In November 2008, the major pharmacy benefit management firm said it received an anonymous letter that included the names, Social Security numbers, birth dates and, in some cases, prescription information of 75 members. The writer or writers threatened to release millions of more records if the business failed to pay an unspecified sum of money.

In the last two months, based on new information from the extortionists, Express Scripts began notifying more than 700,000 victims of their personal information may have been compromised.

CLOUD Take: It is interesting that a data breach that affected 700,000 people is perceived as a breach of Express Scripts.  Although the point of loss may have been systems at Express Scripts, there were 700,000 breaches, not one. Read the rest of this entry »

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XBRL: Can It Make a Difference in the World of Healthcare?

I just made the following post to the XBRL Matters LinkedIn group, which has a discussion thread on the impact of XBRL (successfully promulgated and mandated by the SEC) in healthcare.  I post it here to share with the broader CLOUD Health community:

There is no “there there on the Internet”. This simple thought is an important point by which to consider some recent innovative thinking going on on opposite sides of the globe. Read the rest of this entry »

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Tim Brown, CEO of IDEO, Speaks on “Change By Design” on NPR

NPR’s Rene Montagne interviewed Tim Brown this morning on the issue of healthcare and design.  Tim said that he would love to create “the electronic medical record of the future” and that many new solutions have to be designed around people.  Interview is here.

CLOUD could not agree more with Tim and were thrilled to take part in a dialogue on this topic with frog design yesterday in a Twitter forum on #futureofhealthcare.  Transcript will be posted here soon.  The frog design sponsored forum was on their recent article, “Is the Future of Healthcare Social?” in Fast Company.

Not only is Tim right that the EMR of the future must be controlled by people Read the rest of this entry »

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Reflections on Health 2.0 Conference: Day 2 (Aggregation & Interoperability)

Day Two of Health 2.0 was a whirlwind of demos, tools, websites and a sizzling array of the latest concepts and some intriguing innovations.  Amidst the flurry of panels, presenters and ideas, there were two themes that emerged by the end of the day:  aggregation and interoperability.

The aggregation theme evolved quickly and was the title of one of the morning’s panels.  From my perspective, the notion of aggregation falls into three big buckets:  aggregation of content, aggregation of patients and aggregations of physicians/provider.   Read the rest of this entry »

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Reflections on Health 2.0 Conference: Day 1

Payments. Meaningful use. Populations. Communities. For as many interesting ideas that were presented on day one at Health 2.0, these points of friction in the health value chain appear to be the barriers to change.

Much like HL7 and CDISC have only 15% adoption due to privacy concerns, these topics, payments especially, appear to be the elephants in the room at Health 2.0. Read the rest of this entry »

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Conversations @ Health 2.0 Conference: “We’ll have a PHR for each person in state of Minnesota.”

Nathan Moracco, State of Minnesota Management & Budget, just made this really powerful quote on the Payers and Health 2.0 panel at the Health 2.0 Conference.  This quote reflects an interesting theme that has developed over the course of the morning’s agenda… where is the point of aggregation and who owns ME in healthcare?

There have been a number of demonstrations of excellent platforms and powerful tools, but they are all disconnected.  One of the questions posed to panelists was this, “who is going to go to five different portals and engage each one of them?”   Read the rest of this entry »

Conversations @ Health 2.0 Conference: Day 1

San Francisco… 55 degrees… a vibrant morning for Health 2.0, and I’ve already had some interesting conversations about CLOUD before the program even starts.

On the way over from the hotel on the bus to the San Francisco Concourse and home of Health 2.0, I engaged in an interesting conversation with someone that has worked in health systems as a major contractor, Read the rest of this entry »