EHR and Health IT Consulting
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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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Health and Electronic Security

Health and Electronic Security | EHR and Health IT Consulting | Scoop.it

The rapid adoption of electronic health records (“EHR”) and other new technology in healthcare has resulted in the introduction of serious security threats. Numerous stories and reports have made it clear that hackers, criminals and others view the healthcare industry as a ripe target due to security vulnerabilities. This issue is exacerbated by the high value placed upon medical records in the black market.


The question that many are asking is was all of the money spent on acquiring EHRs misspent now that security flaws or issues are popping up with such frequency. Namely is healthcare throwing good money after bad. To some degree it may be a misplaced accusation. Any adoption of newer technologies will lead to issues, including exploitation of flaws that may not be expected. Unfortunately, it is also likely that bad actors will be ahead of the field when it comes to finding weaknesses or ways to get at data. Such a scenario should be viewed as an inherent risk in implementing technology. That being said, it is likely an unavoidable risk in this day and age. It is simply too difficult and against expectations to remain on the digital sidelines.


The increase in attacks against healthcare entities should appropriately raise alarm bells and spur action. Medical information is very sensitive on many levels and needs to be protected. One place to look for a solution is HIPAA. As is well-known, the HIPAA Security Rule sets standards for protecting health information. The technical, physical, and administrative safeguards define certain minimum standards to follow. In the current day and age though, the HIPAA standards by themselves are probably not enough. From this perspective, it is important to remember that HIPAA only sets a floor, not a ceiling. Best practices may well require actions beyond those proscribed by HIPAA. The healthcare industry needs to evolve and adapt to new realities.


The speed with which adaptation can occur will dictate how secure medical information remains. While much money was and is being spent in connection with new digital and technological solutions, the expense is not going to end as long as threats remain. Technology takes investment, time and attention, all of which are ongoing and recurring obligations.

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How cloud computing enables interoperability

How cloud computing enables interoperability | EHR and Health IT Consulting | Scoop.it

CMS has signaled a renewed focus on interoperability, a welcome development for healthcare professionals anxious to more easily exchange insightful data. But there’s still the matter of how well the people involved in various collaborative “Big Data in Healthcare” initiatives operate together.

At some point for most of us in our careers – usually early on – we’ve encountered a project that was initially heralded with a great deal of fanfare, only to ultimately fizzle out after failing to gain enough buy-in. For all the excitement surrounding Big Data projects, many are at similar risk of a premature end if stakeholder concerns aren’t addressed at the outset:

  • Who will host the data?
  • How will data privacy concerns be handled?
  • How have restrictions on data use been addressed?
  • Do existing consents allow for data sharing?
  • Will the data need to be de-identified? If so, using which methodology?
  • Who will be responsible for acquiring, maintaining and distributing it?
  • How will the data be protected as it’s routed to its new home?
  • How well will it be protected in its new home? Who will have access to it?

For this to work, a neutral ground is usually needed, offered by a trusted third party.

The cloud: breaking down barriers to data exchange
In healthcare, massive amounts of data are not stored in pre-defined, structured tables. Instead, they are often composed of text, notes, numbers, images, formulas, dates, and other facts that are inherently unstructured. In fact, certain kinds of data sources are being created so quickly that there is no time to store it before the need to analyze it.

Savvy healthcare executives see Big Data as an opportunity to break down the paradigm of siloed data. They know that isolated data can be inefficient. Yet even while supporting the vision of Big Data, many healthcare leaders are traditionally reluctant to share data outside their own firewalls. Due to competitive considerations and confidentiality risks, there must be a level of trust in the quality and security of the receiving organization’s health data management systems for the data owner to be willing to share it. No one wants to risk a HIPAA privacy or security violation at the hands of another entity.

'Dirty' data can yield hidden treasures
To make an effective Big Data play, data sharing arrangements must be made, data flows defined, data analytics engines and the underlying infrastructure created, and the proper data governance must be agreed upon by all relevant stakeholders. It is at this stage that a trusted third party data warehouse environment is critical for success.

Conventional wisdom leads many to believe that data must be scrubbed, normalized and aggregated into a standard format in order to gain key insights. In fact, for Big Data in Healthcare, the time-tested principle of “garbage in, garbage out” actually may not apply.

Using the right data analytics tools can reveal unexpected insights from unstructured or “dirty” data as some call it.

In addition to enabling insights from disparate data sources, storing and protecting data, data management services are now available that alleviate the need for healthcare organizations to hire additional experts in meaningful use or cloud technology, including:

  • Pulling data from different sources into a single cloud-based repository for collaborative use
  • De-identifying the data and stripping it of identifiable information
  • Data visualization with dashboards and reports
  • Audit trails of who accessed what, when and from where
  • Dynamically scaling the infrastructure as the data volume increases

Cloud for collaborative care
Entities that are members of an accountable care organization or other coordinated care programs also benefit from the neutrality of the cloud for a variety of functions, from the day-to-day, such as claims and billing, to more analytic reporting and collaboration. The cloud provider can host the data along with any other number of data management services that the healthcare organization can’t, or just doesn’t want to take on.

Can you blame them? Healthcare organizations need all of their IT staff on deck for analytics and other data projects. And as we move to a more coordinated and shared model for healthcare, all stakeholders need a neutral and trusted environment that fosters collaboration. And based on the potential for infinite computing power and storage on the cloud, the sky’s the limit for interoperability.


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Medical Data Exchange, Cloud Solutions Impact EHR Design

Medical Data Exchange, Cloud Solutions Impact EHR Design | EHR and Health IT Consulting | Scoop.it

Over the last two decades, the medical industry has changed drastically in terms of patient care and access to medical records. It was nearly impossible to obtain one’s own health record 20 years ago. Forbes reports that patients had little choice but to press legal action if they wished to access their own medical data.


In 1996, however, the Health Insurance Portability and Accountability Act (HIPAA) was passed, which did offer legal protections to patients who needed to see their health records. Nonetheless, there was still significant difficulty in accessing this information and most people never went through the challenging process.


Today, these problems are slowly disappearing, as patients have more ability to readily view their medical history and test results via patient portals and through other electronic means.


A study published earlier this year shows that after three hospital systems in separate states offered their patients the ability to view their health records and physician notes, nearly 70 percent of patients reported understanding their conditions better and taking better care of themselves including remaining vigilant about taking their medications on time. The results from the study also showed that providing patients with this ability did not majorly impact the physician workflow.


The design and evolution of certified EHR technology and health IT systems that held medical data are now changing toward a more cloud-based and mobile platform. This leads to more digitizing of medical records and providing more flexible solutions for healthcare professionals within the clinical setting.


Both mobile health and wearables are also impacting the design of certified EHR technology. The Apple watch, for instance, could potentially hold relevant medical data for physicians to view and patients to access. Additionally, mobile apps on smartphones or tablets could be used by patients to request drug refills and securely message doctors or nurse practitioners.


In a new report from market research firm IDC, Judy Hanover, Research Director at IDC, explains, “The new concept of flexible, mobile, cloud-based acute care EHR supports digitizing paper workflow and reengineering processes … There’s a huge appetite for getting better workflows into healthcare, looking at department specific and mobile apps. I would see an environment where hospitals and health systems would perhaps rip out and replace in some cases.”


According to the report, it is expected that over the next few years, providers will begin to replace their current certified EHR technology with cloud-based solutions instead. Greater investment will continue to be poured into the health IT industry as providers move onto meeting Stage 3 Meaningful Use requirements under the Medicare and Medicaid EHR Incentive Programs.


Additionally, the future of EHRs will continue to depend on EHR interoperability and the ready access of medical data across the healthcare industry. Forbes states that many within the medical sector believe EHR interoperability will be the “biggest game changer.” However, it may take longer than expected for interoperability and medical data exchange to expand across multiple healthcare settings, as this industry “moves slowly.”


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