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Consortium for Local Ownership and Use of Data, Inc.
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HIPAA is the Health Insurance Portability and Accountability Act. It supports neither portability, accountability, nor privacy. CLOUD does, by letting you decide when and if you'll let others know that your health history belongs to you -- and keeping your identity and your information private until you decide to let someone see it.

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Posts Tagged Health 2.0

Health 2.0 Show: Joshua Seidman, ONC on “Meaningful Use”

May 5

Posted by Gary in CLOUD Health | No Comments

Earlier this week, 51 healthcare groups wrote to the Centers for Medicare and Medicaid Services asking for the current federal EHR adoption goals to be done “in a manner that will remove barriers to and promote the widespread adoption of health information technology.” This letter, sent on May 3, is an interesting backdrop for Wil Yu and Joshua Seidman’s participation in the Health 2.0 Show’s webinar on meaningful use today. It appears from the letter to CMS that the concern is not simply the adoption rules for EHRs but how these groups’ advanced HIT systems might or might not meet those requirements by 2011 and most importantly whether hospitals are eligible for the associated incentives.  (The debate over ‘pushing’ adoption through institutions, as opposed to ‘pulling’ adoption through patient-centered approaches will be taken up in another post.)

Dr. Seidman started his Health 2.0 Show webinar with a similar comment to his other addresses to eHealth groups, “it is not about technology but about transforming healthcare.”  He is right, and this is the heart of the meaningful use discussion.  It is also a perspective that should inform our reaction to the letter to CMS from earlier this week.  Slowing things down until 2017 or speeding them up will not matter unless we are approaching the problem in the right way.  With over $200M in beacon grants announced this week, we must ask ourselves:

Are EHRs a data-source or a presentation layer? If we are simply replicating paper-based medical documents in electronic form, are we really advancing the state of the art?  What parts of these data challenges should be handled in federal rules and which parts should be tackled by new open standards to re-architect the very plumbing of the Internet?

CLOUD is a non-profit technology standards consortia advocating, promoting and developing a language for people on the Internet.  This language, like HTML, is not focused on any particular domain, health or otherwise.  As a result, we are not advocating a specific approach to EHRs or final rules from ONC at HHS.   Read the rest of this entry »

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Health 2.0 Europe: A Personal Health Record (PHR) By Another Name…

Apr 7

Posted by Gary in CLOUD Health | 3 Comments

As I sit here at the start of Day 2 at Health 2.0 Europe, I can’t help having a sense of deja vu.  Not just the deja vu that comes from being at a previous Health 2.0 conference in San Francisco, but the deja vu that comes from the feeling that the field of Health 2.0, not the conference, is just passing the old threshold of electronic data interchange (EDI).  As Matthew Holt set the stage for this portion of the Health 2.0 Tools session, he commented that “it is becoming a data utility layer rather than a personal health record.”

Unfortunately, watching Roni Zeigler show off Google Health, it is clear that there is not even a real data utility layer for health.  This is not to say that Google Health is not breaking important new ground, but the idea that I have to import information from the Cleveland Clinic or any other source is what gives me that feeling of deja vu.  For all the prowess of Google, this is just a Web 2.0 version of the old EDI approach to moving information.   Read the rest of this entry »

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Health 2.0 Europe: Do We Need an EU for Online Communities?

Apr 6

Posted by Gary in CLOUD Health | 4 Comments

Over the past two hours at Health 2.0 in Paris, the attendees of this excellent conference (almost 500 folks) have been treated to a large variety of both online patient and physician communities from both Europe and the United States.  From PatientsLikeMe to IWantGreatCare to Imedo, we’ve seen excellent examples of web communities from the US, UK and Germany.  On the physician side, we’ve been treated to resources like santé log in France, Sermo in the US, and Medting in Spain.

One of the questions that was raised by the moderators and by the audience is can these communities translate across geographies?  This question was not raised in the context of language translation but instead from the perspective of broader community engagement.  That same question was also tweeted by @andrewspong in the context of the intersection of these communities between physicians and patients.  That tweet is an excellent one and got me to thinking about how a CLOUD-enabled Internet might change some of the context around how communities are formed and engaged. Read the rest of this entry »

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Health 2.0 Europe: Tagging… From Monet to the Internet

Apr 6

Posted by Gary in CLOUD Health | No Comments

It is such a joy to be in Paris in the springtime!  The weather here is almost as beautiful as the weather at Health 2.0 in San Francisco last October.  The air is fresh, the flowers are blooming, and speakers from over 13 countries will be presenting at Health 2.0 in Paris.  The program is being hosted at the Cité Internationale Universitaire of Paris.

With the program commencing at 1pm today, I decided to join my wife on a walk of the Seine this morning and a visit to the Musée d’Orsay.  With a limited time at the Musée d’Orsay, I felt compelled to visit the impressionist and postimpressionist works.  They are my favorites.  As we looked at some Monets, I noticed something very intriguing about each of his works and for that matter all of the painted works in the Orsay’s collection. As important as the works themselves, it was equally important to the artist to put their WHO and WHEN tag on their works.   Read the rest of this entry »

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

Oct 12

Posted by Gary in CLOUD Health | 3 Comments

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

Oct 9

Posted by Gary in CLOUD Health | 1 Comment

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)

Oct 7

Posted by Gary in CLOUD Health | No Comments

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

Oct 7

Posted by Gary in CLOUD Health | No Comments

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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Health 2.0 Conference: Health 2.0 Meet ME 1.0

Oct 2

Posted by Gary in CLOUD Health | No Comments

The Design Center concourse in San Francisco could not be a better venue for the upcoming Health 2.0 Conference.  For all of the debate that is raging about health care, reform, insurance companies and the rest, the issue at hand is really one of design.  The theme, User-Generated Healthcare, is itself a design issue.

Places of the Soul, by Christopher Day, makes the point that architecture must begin based on where the designed structure is to be placed.  As he notes in the book, studies have shown that there is strong correlation between recovery time at the hospital and patient view, with every leaf being ‘worth its weight in gold.’  Design matters.  The Health 2.0 team has architected an excellent agenda that looks at the design issue of the healthcare system from the perspective of the patient.  I am excited to be attending and look forward to the possibility of CLOUD presenting its new vision and language during the Human Centered Design Contest.

CLOUD believes that the Internet needs a new design, too, an architecture based on starting from a new place, the individual.  ME 1.0 looks forward to meeting Health 2.0 and engaging in a new blueprint for the future!

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EHRs: There is no There There on the Internet

Sep 29

Posted by Gary in CLOUD Health | No Comments

Just over a year ago at the Personal Democracy Forum in NYC, I posted an item to my personal blog at theendoflinearity.com on this topic, the idea that there are no destinations on the Internet.   Having wrestled with this topic for many months, it became clear that the challenge of ‘destination thinking’ from the real world was complicating solutions to topics like health care because it was focusing us on areas other than patients by which to find solutions.

The quest for the holy grail of the electronic health record is particularly difficult because of fundamental disagreements about matters as general as the scope of the “health” domain. What are the proper relationships between records made by examining physicians, diagnostic experts, health insurance companies, parties paying for health insurance, patients themselves, and others? What about schools that require particular vaccination records or physical examinations for athletic participation? Or financial service providers pricing annuities based on actuarial estimates?

This piece by Tevi Troy at the Washington Post highlights key issues that CLOUD can help address as we seek to solve this electronic health record challenge through new vectors and a change in your horizon.

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