Tag Archives: Healthcare

Expert questions funds for interoperability challenges in healthcare

One expert says the $2 million in funding ONC is offering developers to address interoperability challenges in healthcare — although commendable — may not be enough.

“I applaud ONC for recognizing this challenge and making funds available for development of interoperability platforms and solutions,” said John McDaniel, senior vice president of innovation and technology for health IT consulting firm The HCI Group. “However, based on the work we have done with vendors that offer interoperability solutions, I don’t believe $2 million will address the issue.”

ONC funding offered in two areas

ONC will provide up to $2 million in funding to two recipients focused on developing innovative and breakthrough advances in two areas: expanding the scope of population-level data-focused application programming interfaces (APIs) and advancing clinical knowledge at the point of care, according to ONC.

For expanding the scale of APIs, ONC wants to see projects that reduce provider burdens associated with reporting through API technology, as well as assessing trade-offs associated with various big data formats and challenges to the scope of FHIR-based APIs.

As for advancing clinical knowledge at the point of care, ONC hopes to see “emerging innovations” in clinical medicine, as well as data-driven medicine infrastructure and legal and policy implications for innovative approaches, according to the ONC news release.

Additional funding may be available

ONC will fund up to $1 million per area of interest by 2019. After the funds are awarded, there will be a two-year project and budget period, but applicants are encouraged to submit responses based on a five-year project and budget period because additional funding for three to five years could be provided based on the availability of funds and “meaningful progress.”

Based on the work we have done with vendors that offer interoperability solutions, I don’t believe $2 million will address the issue.
John McDanielsenior vice president of innovation and technology, The HCI Group

The funding opportunity will be open for three years, allowing for the possibility that ONC will issue additional awards to other eligible applicants for future “priority areas of interest.”  

ONC expects the funding to “further a new generation of health IT development and inform the innovative implementation and refinement of standards, methods and techniques for overcoming major barriers and challenges as they are identified.” Though he questions whether $2 million will be enough to address interoperability challenges in healthcare, McDaniel said he has seen ONC be successful with similar initiatives in the past, such as establishing incentives to motivate healthcare organizations to implement EHRs, which enabled the digitization of patient care documentation.

The full scope of interoperability challenges in healthcare

Now, McDaniel said, the challenge is to enable full interoperability to not only digitize retrospective patient data, but to “capture and use real-time patient information coupled with cognitive computing to assist care providers with decision-making and best practices given the full view of all relevant patient data.”

“Developing interoperability between EHR’s is a good start, but since only a percentage of relevant retrospective patient data is maintained in those systems, we need to establish interoperability standards for dynamic exchange of data from all source systems, including IoT, EHR’s medical devices, personal health devices, etc., to enable precision and predictive care models,” McDaniel said.

Healthcare APIs get a new trial run for Medicare claims

In the ongoing battle to make healthcare data ubiquitous, the U.S. Digital Service for the Department of Health and Human Services has developed a new API, Blue Button 2.0, aimed at sharing Medicare claims information.

Blue Button 2.0 is part of an API-first strategy within HHS’ Centers for Medicare and Medicaid Services, and it comes at a time when a number of major companies, including Apple, have embraced the potential of healthcare APIs. APIs are the building blocks of applications and make it easier for developers to create software that can easily share information in a standardized way. Like Apple’s Health Records API, Blue Button 2.0 is based on a widely accepted healthcare API standard known as Fast Healthcare Interoperability Resources, or FHIR

Blue Button 2.0 is the API gateway to 53 million Medicare beneficiaries, including comprehensive part A, B and D data. “We’re starting to recognize that claims data has value in understanding the places a person has been in the healthcare ecosystem,” said Shannon Sartin, executive director of the U.S. Digital Service at HHS.

“But the problem is, how do you take a document that is mostly codes with very high-level information that’s not digestible and make it useful for a nonhealth-savvy individual? You want a third-party app to add value to that information,” Sartin said.

So, her team was asked to work on this problem. And out of their work, Blue Button 2.0 was born.

More than 500 developers have signed on

To date, over 500 developers are working with the new API to develop applications that bring claims data to consumers, providers, hospitals and, ultimately, into an EHR, Sartin said. But while there is a lot of interest, Sartin said this is just the first step when it comes to healthcare APIs.

“The government does not build products super well, and it does not do the marketing engagement necessary to get someone interested in using it,” she said. “We’re taking a different approach, acting as evangelists, and we’re spending time growing the community.”

And while a large number of developers are experimenting with Blue Button 2.0, Sartin’s group will be heavily vetting to eventually get to a much smaller number that will release applications due to privacy concerns around the claims data.

Looking for a user-friendly approach

We’re … acting as evangelists, and we’re spending time growing the community.
Shannon Sartinexecutive director of the U.S. Digital Service at HHS

In theory, the applications will make it easier for a Medicare consumer to let third parties access their claims information and then, in turn, make that data meaningful and actionable. But Arielle Trzcinski, senior analyst serving application development and delivery at Forrester Research, said she is concerned Blue Button 2.0 isn’t pushing the efforts around healthcare APIs far enough.

“Claims information is not the full picture,” she said. “If we’re truly making EHR records portable and something the consumer can own, you have to have beneficiaries download their medical information. That’s great, but how are they going to share it? What’s interesting about the Apple effort as a consumer is that you’re able to share that information with another provider. And it’s easy, because it’s all on your phone. I haven’t seen from Medicare yet how they might do it in the same user-friendly way.”

Sartin acknowledged Blue Button 2.0 takes aim at just a part of the bigger problem.

“My team is focused just on CMS and healthcare in a very narrow way. We recognize there are broader data and healthcare issues,” she said.

But when it comes to the world of healthcare APIs, it’s important to take that first step. And it’s also important to remember the complexity of the job ahead, something Sartin said her team — top-notch developers from private industry who chose government service to help — realized after they jumped in to the world of healthcare APIs. 

“We have engineers who’ve not worked in healthcare who thought the FHIR standard was overly complex,” she said. “But when you start to dig in to the complexity of health data, you recognize sharing health data with each doctor means something different. This is not as seamless as with banks that can standardize on numbers. There, a one is a one. But in health terminology, a one can mean 10 different things. You can’t normalize it. Having an outside perspective forces the health community to question it all.”

The power and promise of digital healthcare in the Middle East and Africa – Middle East & Africa News Center

Mirembe, 24, lives in a rural village in north-east Uganda, where access to healthcare is limited. Mirembe is pregnant and walks, cradling her swollen belly and fanning herself from the heat, 15 kilometres to the closest clinic to check on her unborn child.

Hundreds of expectant mothers, elderly men and women, and sickly children line the corridors of the clinic patiently awaiting medical attention. Midwives and nurses are few, and they wearily dart from patient to patient doing what they can to help. Mirembe will wait six hours to be attended to.

When she’s finally seen, she’s told the clinic doesn’t have an ultrasound machine. If she wants to have an ultrasound, she must travel to the Mulago Hospital in Kampala, Uganda’s largest public hospital, where she must pay 20,000 Ugandan shillings, equivalent to about US$5, for a prenatal visit. In this part of the world, that is a significant amount of money.

According to the World Health Organisation (WHO), about 830 women die from pregnancy or childbirth-related complications around the world every day. It’s estimated that in 2015, roughly 303 000 women died during and after pregnancy and childbirth. Many of these deaths were in low-resource locations like Uganda, and most could have been prevented.

However, technology is helping to eliminate some of the challenges of distance and lack of trained medical staff. Mirembe can now hear her unborn child’s heartbeat from the comfort of her own home through an innovative app call WinSenga, which reassures her that both she and her baby are healthy.

WinSenga is a mobile tool, supported by Microsoft technologies, which helps mothers with prenatal care. The idea was conceived when the Microsoft Imagine Cup competition inspired then-university students Okello and Aaron Tushabe to use their computer science skills to tackle some of Africa’s biggest problems. They were motivated by the plight of mothers like Mirembe who live outside the reach of modern medical care.

The handheld device scans the womb of a pregnant woman and reports foetal weight, position, breathing patterns, gestational age, and heart rate. The app makes use of a trumpet-shaped device and a microphone which transmits the data to a smart phone. The mobile application plays the part of the nurse’s ear and recommends a course of action. The analysis and recommendations are uploaded to the cloud and can be accessed by a doctor anywhere.

man touching a smart tablet

This is just one example of how Africa, a continent that bears one-quarter of the global disease burden but only has two percent of the world’s doctors, could outperform developed nations’ healthcare systems by leapfrogging over inefficiencies and legacy infrastructure.

In fact, digital healthcare in the Middle East and Africa (MEA) region is booming with the proliferation of disruptive solutions underpinned by 21st century innovations like cloud, mobile, Internet of Things (IoT) and Artificial Intelligence (AI).

Let’s talk telemedicine

One trend revolutionising the delivery of healthcare in MEA is telemedicine, which is the use of telecommunication and IT to provide clinical healthcare over long distances. Given the region’s high rate of mobile penetration, telemedicine is growing rapidly. In fact, the telemedicine market in MEA was estimated at $2.19 billion in 2015 and is projected to reach $3.67 billion in 2020.

Forward-thinking countries like Botswana are making swift progress when it comes to the implementation of sustainable telemedicine projects.  Microsoft and the Botswana Innovation Hub launched Africa’s first telemedicine service over TV white spaces in 2017. Through this initiative, clinics in outlying areas of Botswana can now access specialised care remotely using TV white spaces, which are unused broadcasting frequencies in the wireless spectrum.

The case for cloud storage as a service at Partners

Partners HealthCare relies on its enterprise research infrastructure and services group, or ERIS, to provide an essential service: storing, securing and enabling access to the data files that researchers need to do their work.

To do that, ERIS stood up a large network providing up to 50 TB of storage, so the research departments could consolidate their network drives, while also managing access to those files based on a permission system.

But researchers were contending with growing demands to better secure data and track access, said Brent Richter, director of ERIS at the nonprofit Boston-based healthcare system. Federal regulations and state laws, as well as standards and requirements imposed by the companies and institutions working with Partners, required increasing amounts of access controls, auditing capabilities and security layers.

That put pressure on ERIS to devise a system that could better meet those heightened healthcare privacy and security requirements.

“We were thinking about how do we get audit controls, full backup and high availability built into a file storage system that can be used at the endpoint and that still carries the nested permissions that can be shared across the workgroups within our firewall,” he explained.

Hybrid cloud storage as a service

At the time, ERIS was devising security plans based on the various requirements established by the different contracts and research projects, filling out paperwork to document those plans and performing time-intensive audits.

It was then that ERIS explored ClearSky Data. The cloud-storage-as-a-service provider was already being used by another IT unit within Partners for block storage; ERIS decided six months ago to pilot the ClearSky Data platform.

“They’re delivering a network service in our data center that’s relatively small; it has very fast storage inside of it that provides that cache, or staging area, for files that our users are mapping to their endpoints,” Richter explained.

From there, automation and software systems from ClearSky Data take those files and move them to its local data center, which is in Boston. “It replicates the data there, and it also keeps the server in our data center light. [ClearSky Data] has all the files on it, but not all the data in the files on it; it keeps what our users need when they’re using it.”

Essentially, ClearSky Data delivers on-demand primary storage, off-site backup and disaster recovery as a single service, he said.

All this, however, is invisible to the end users, he added. The researchers accessing data stored on the ClearSky Data platform, as well as the one built by ERIS, do not notice the differences in the technologies as they go about their usual work.

ClearSky benefits for Partners

ERIS’ decision to move to ClearSky Data’s fully managed service delivered several specific benefits, Richter said.

He said the new approach reduced the system’s on-premises storage footprint, while accelerating a hybrid cloud strategy. It delivered high performance, as well as more automated security and privacy controls. And it offered more data protection and disaster recovery capabilities, as well as more agility and elasticity.

Richter said buying the capabilities also helped ERIS to stay focused on its mission of delivering the technologies that enable the researchers.

“We could design and engineer something ourselves, but at the end of the day, we’re service providers. We want to provide our service with all the needed security so our users would just be able to leverage it, so they wouldn’t have to figure out whether it met the requirements on this contract or another,” Richter said.

He noted, too, that the decision to go with a hybrid cloud storage-as-a-service approach allowed ERIS to focus on activities that differentiate the Partners research community, such as supporting its data science efforts.

“It allows us to focus on our mission, which is providing IT products and services that enable discovery and research,” he added.

Pros and cons of IaaS platform

Partners’ storage-as-a-service strategy fits into the broader IaaS market, which has traditionally been broken into two parts: compute and storage, said Naveen Chhabra, a senior analyst serving infrastructure and operations professionals at Forrester Research Inc.

[Cloud storage as a service] allows us to focus on our mission, which is providing IT products and services that enable discovery and research.
Brent Richterdirector of ERIS at Partners HealthCare

In that light, ClearSky Data is one of many providers offering not just cloud storage, but the other infrastructure layers — and, indeed, the whole ecosystem — needed by enterprise IT departments, with AWS, IBM and Google being among the biggest vendors in the space, Chhabra said.

As for the cloud-storage-as-a-service approach adopted by Partners, Chhabra said it can offer enterprise IT departments flexibility, scalability and faster time to market — the benefits that traditionally come with cloud. Additionally, it can help enterprise IT move more of their workloads to the cloud.

There are potential drawbacks in a hybrid cloud storage-as-a-service setup, however, Chhabra said. Applying and enforcing access management policies in an environment where there are both on-premises and IaaS platforms can be challenging for IT, especially as deployment size grows. And while implementation of cloud-storage-as-a-service platforms, as well as IaaS in general, isn’t particularly challenging from a technology standpoint, the movement of applications on the new platform may not be as seamless or frictionless as promoted.

“The storage may not be as easily consumable by on-prem applications. [For example,] if you have an application running on-prem and it tries to consume the storage, there could be an integration challenge because of different standards,” he said.

IaaS may also be more expensive than keeping everything on premises, he said, adding that the higher costs aren’t usually significant enough to outweigh the benefits. “It may be fractionally costlier, and the customer may care about it, but not that much,” he said.

Competitive advantage

ERIS’ pilot phase with ClearSky Data involves standing up a Linux-based file service, as well as a Windows-based file service.

Because ERIS uses a chargeback system, Richter said the research groups his team serves can opt to use the older internal system — slightly less expensive — or they can opt to use ClearSky Data’s infrastructure.

“For those groups that have these contracts with much higher data and security controls than our system can provide, they now have an option that fulfills that need,” Richter said.

That itself provides Partners a boost in the competitive research market, he added.

“For our internal customers who have these contracts, they then won’t have to spend a month auditing their own systems to comply with an external auditor that these companies bring as part of the sponsored research before you even get the contract,” Richter said. “A lot of these departments are audited to make sure they have a base level [of security and compliance], which is quite high. So, if you have that in place already, that gives you a competitive advantage.”

Medicine Man: How AI is bringing humanity back into healthcare – Microsoft News Centre Europe

Oschner Health is one example of a company using AI to revolutionise healthcare. Its system is able to accurately track patients who are at risk of cardiac arrest, and can determine when there is a decline in their condition. This allows them to be admitted into intensive care hours earlier than they otherwise would have been. They are provided with potentially life-saving care, before their condition deteriorated to the point where medical care would have been less effective.

Project InnerEye, in use at Addenbrooke’s Hospital in Cambridge, is another solution which uses machine learning and computer vision for the analysis of radiological images. Designed to identify tumours, it improves the delivery of treatments such as radiotherapy, by precisely distinguishing between cancerous and healthy tissues. It can also better monitor disease progression during chemotherapy, so that treatment can be adjusted in line with how patients respond.

These AI solutions allow medical professionals to improve patient care and admittance time, thanks to their improved precision. This, in turn, reduces financial and manpower strain, improving the healthcare experience in the areas where this technology is being used.

This is supported by data from the World Health Organization (WHO), which shows that between 30 and 50 percent of cancer deaths could be avoided with prevention, early detection and treatment. With cancer costing the global economy an excess of an estimated $1.16 trillion a year, the impact of technology such as AI, is game-changing.

In the UK alone, for example, there are only 4.7 radiologists per 100,000 population, and this number will need to almost double by 2022 to meet demand. Because of this shortage, the NHS spent nearly £88 million in 2016 paying for backlogs of radiology scans to be reported – the same amount could have paid for over 1,000 full-time consultants.

“We are drowning in data in hospitals,” Kos states. “We don’t have enough human brainpower to deal with it all in a timely manner – which in healthcare, is vital.”

Using technology such as AI can therefore substantially decrease strain on healthcare systems, while simultaneously improving patient care and reducing costs, allowing doctors to spend their time on more complex medical diagnoses. Or, indeed, spending more time connecting with patients.

The human factor
Introducing AI to healthcare isn’t removing the humanity from medicine. On the contrary, it’s increasing it.

A study in the Annals of Internal Medicine found that doctors spend nearly twice as much time doing administrative work (49 percent) as they do with their patients (27 percent). In other words, doctors are spending more time crunching through data, sifting through and updating records, and analysing scans, than they are speaking to their patients.

In a profession where people are dealing with often traumatic, life-changing developments, this personal, human touch, is vital for the emotional well-being of patients and their loved ones. By using tools such as AI to free up more of their time, healthcare professionals can focus more on patient interaction, offering reassurance, providing guidance, and answering more questions.

Culture, and the challenges of change
Motivated by the lack of technology during his critical care period, Kos spent eight years crusading to introduce electronic medical record systems into hospitals. But nothing improved.

“We digitized, but we digitized all of the mistakes too. Then it dawned on me – digitization is important, but it’s not transformation.”

Without the supportive technology of cloud storage, or the data analysis powers of AI and machine learning, the full potential of these digitized records weren’t even close to being reached. Only years after, when cloud technology was accepted on a wider scale, and when collaborative tools such as Skype or real-time document editing in the cloud were established – could this initial digitization move on to the next level.

Research has shown that an organisation with the most advanced technology still won’t be as effective if it lacks the right company culture. Employees must be willing to embrace their new tools, while leaders must encourage a culture of learning. Only then, can the new tools be as effective as possible.

In the world of medicine, however, adopting the right culture for technological change can prove to be a challenge.

“Healthcare professionals are rather inward-looking,” says Kos. “Doctors listen to doctors. It’s a very top-down, hierarchical environment. You could have the best technology in the world, but if the culture isn’t ready to embrace it with a willingness to learn, it’s just not going to work.”

New team assembled to unlock the innovation potential in healthcare data – The Official Microsoft Blog

Peter Lee, Joshua Mandel and Jim Weinstein
From left, Peter Lee, Joshua Mandel and Jim Weinstein of Microsoft Healthcare. Photo: Dan DeLong for Microsoft

It’s an exciting time to be working shoulder-to-shoulder with our healthcare partners and customers, who represent some of the brightest minds in this important industry. We have been approaching the complexities of the healthcare industry with a growth mindset, and for the past two years our team has worked across Microsoft to accelerate healthcare innovation through artificial intelligence and cloud computing, with our initiative Healthcare NExT (New Experiences and Technologies). We shared some updates earlier this year on our work in cloud architectures, empowering clinicians and care teams, and precision medicine, and I’ve been thrilled to see the progress and reaction across the industry.

Today we are building on that progress. I’m very pleased to welcome two prominent experts in the science, technology and practice of value-based healthcare to the team. Jim Weinstein and Josh Mandel will be joining Microsoft Healthcare – which integrates Healthcare NExT and its research-driven efforts – with an added focus of creating strategic partnerships, and driving the cross-company strategy for healthcare and life sciences.

Jim Weinstein, Vice President, Microsoft Healthcare, Head of Innovation and Health Equity

Jim Weinstein will work closely with organizations on the front lines of healthcare delivery as we aim to support health systems, empower clinicians and enable the systems of care as they move to the cloud. He will be my partner in developing the strategic vision for Microsoft Healthcare, and will provide leadership that is grounded in decades of health industry experience. A widely respected visionary, author, surgeon and leader in the future of healthcare delivery who has advised three administrations on healthcare policy, Jim most recently served as CEO and president of Dartmouth-Hitchcock and the Dartmouth-Hitchcock Health system, and is the past director of the Dartmouth Institute, home of the Dartmouth Atlas of Health Care. Jim is also the co-founder and inaugural executive director of the national High Value Healthcare Collaborative, which brings together some of the nation’s top healthcare systems to share data, develop insights and advance the causes of better healthcare outcomes. He recently chaired the “Communities in Action, Pathways to Health Equity” report for the National Academy of Medicine. His book “Unraveled” looks at the broken healthcare system and how it might be repaired with patient-based clinical insights.

Joshua Mandel, Chief Architect, Microsoft Healthcare

Joshua Mandel will work closely with customers, partners and the open standards community to lay the groundwork for an open cloud architecture to unlock the value of healthcare for the entire health ecosystem. As a tireless evangelist for the importance of open standards, Josh will continue his work to help systems across the industry become more agile and interoperable. Josh’s impressive background as a physician and brilliant software architect has set him apart as a leader in the development of next-generation standards for healthcare data interoperability.  In his most recent role, Josh led the health IT ecosystem work at Verily (Google Life Sciences). He is a member of the research faculty at the Boston Children’s Hospital Computational Health Informatics Program where he served as lead architect for SMART Health IT, and is a visiting scientist at the Harvard Medical School Department of Biomedical Informatics. Josh earned his bachelor of science degree in electrical engineering and computer science from Massachusetts Institute of Technology, and his M.D. from Tufts University of Medicine.

Jim and Josh join us at an exciting time, as healthcare processes undergo a digital transformation. This transformation has created a wealth of healthcare data that has potential to help identify diseases earlier, create and improve treatments and improve the lives of patients across the globe. Unfortunately, even with advances in data protection and governance, healthcare data is not easily accessible by the researchers and doctors who need it to help us all realize the potential. And so, for a variety of regulatory, technological and political reasons, we see what is called the “health data funnel,” which holds back the case of scalable innovation in healthcare.

At Microsoft, we’re confident that many aspects of the IT foundations for healthcare will move from on-premise doctors’ offices and clinics to live in the cloud. We ask the questions: Can we take advantage of this huge sea change in healthcare to unlock the innovation potential in healthcare data? Can we work as a community to ensure that we don’t simply re-create the same data silos that we have today?

We think that together, we can solve these problems. We are taking concrete steps with an initial “blueprint” intended to standardize the process for the compliant, privacy-preserving movement of a patient’s personal health information to the cloud and the automated tracking of its exposure to machine learning and data science, for example to support external audit. This is a small first step, but progress toward an open architecture that ultimately will benefit doctors, nurses and clinicians in how they interact with patients, and also allow more time for patients to spend face-to-face with their care providers. It also opens up research opportunities for this data to be shared, and to be done under the same compliance and regulatory standards which protect your health data today; all with the goal of leading to advancements in medical science.

We have our work cut out for us but know that we have the right team in place. We’re looking forward to sharing more later this year about what we’re doing to help unlock the power of healthcare data and create opportunities for the entire health ecosystem.

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Why healthcare APIs will save lives, money and time

Stan Huff, M.D., chief medical informatics officer at Intermountain Healthcare, made a strong case for medical platform interoperability, healthcare APIs and an open source approach to health IT at an Object Management Group conference in Boston on Monday.

IT departments in most industries have long been enthusiastic users of APIs – standard software building blocks that make development and interoperability easier. They’ve also participated in the open source movement, where code is shared, reused and improved upon for the common good.

In the health IT space, however, these concepts have been slower to gain traction, and Apple just recently became the first company to open up its Health Record API to developers. Apple’s API is based on the Fast Healthcare Interoperability Resources (FHIR) standard, which was created in 2014 and is arguably the most talked about of the healthcare APIs today.

But being talked about is a long way from being implemented, and that, Huff was quick to stress, is the major problem. “FHIR is really easy to implement,” he told a room full of physicians. “It’s had unprecedented support from EHR companies. But it’s young still. We have a vision, but we just need to get there.”

What healthcare APIs can jump-start

The vision is a world where any electronic health record system could communicate with any other system; data could be gathered and mined; and, ultimately, decision engines could be built that could improve patient care, cut costs, reduce medical errors and even help with doctor burnout, Huff said.

To make his point, he shared some stark data. Citing a Johns Hopkins study, Huff said approximately 250,000 people die a year due to medical error, making errors the third-leading cause of death in the U.S. That is five times the amount of people who die in auto accidents, he said.

And then there is the issue of cost, because each EHR system at each hospital needs unique applications created for it. “That’s like saying we need 50 different versions of Yelp for each hospital,” he said. “Our architecture is wrong. It’s set up so that we can’t share what we’ve created. We’re paying an incredible price for software. Each useful app is created or re-created on each platform, and we pay for it.”

To be more specific, Huff said Intermountain, based in Murray, Utah, has developed 150 clinical decision support engines that offer best practices and advice on everything from diabetes to heart health.

“But that 150 really represents the low-hanging fruit,” he said. “We need 5,000 rules or modules, and there’s no scalable path to get there. And there’s no scalable path to pass that information on to community hospitals.”

If we do this right, we could save 100,000 lives a year.
Stan HuffM.D., chief medical informatics officer, Intermountain Healthcare

One large hospital was able to develop 13 of these decision engines in six months, but they’re specific to the EHR in use and would be “cost-prohibitive” to share with other hospitals.

To get started with healthcare APIs and down the path of interoperability, Huff said IT professionals need to ask themselves three questions:

  • What data should be collected?
  • How should the data be modeled?
  • And what does the data mean?

Asking, and then answering, those questions will kick-start the interoperability journey, help decide on the correct healthcare APIs and eventually will lead to sweeping changes in medicine.

“If we do this right, we could save 100,000 lives a year,” he said. “We could go from being right 50% of the time to 80% of the time. And we could get new EHR systems for millions, rather than billions.”

DRaaS solution: US Signal makes rounds in healthcare market

A managed service provider’s disaster-recovery-as-a-service offering is carving a niche among healthcare market customers, including Baystate Health System, a five-hospital medical enterprise in western Massachusetts.

The DRaaS solution from US Signal, an MSP based in Grand Rapids, Mich., is built on Zerto’s disaster recovery software, US Signal’s data center capability and the company’s managed services. The offering is designed to work in VMware vCenter Server and Microsoft System Center environments. One target market is healthcare.

“We have several healthcare facilities … all across the Midwest using this solution,” said Jerry Clark, director of cloud sales development at US Signal. The DRaaS solution meets HIPAA standards, according to the company.

Clark said many hospitals — and organizations in other industries, for that matter — are searching for ways to avoid the investment in duplicate hardware traditional DR approaches require. With DRaaS, hardware becomes the service provider’s issue. Instead of paying for hardware upfront, the customer pays a monthly management fee to the DRaaS provider. The approach has expanded the channel opportunity in DR.

“Enterprises … run into the same situation: ‘Do we spend all this Capex on disaster recovery hardware that may or may not ever get used?'” Clark noted. “A DRaaS solution makes it much more economical.”

Chart showing anticipated budget growth across various IT sectors
One-third of the respondents to TechTarget’s IT Priorities survey identified disaster recovery as an area for budget growth.

Baystate Health adopts DRaaS solution

US Signal found an East Coast customer, Baystate Health, based in Springfield, Mass., though VertitechIT, a US Signal consulting partner located in nearby Holyoke, Mass.

Jerry Clark, director of cloud sales development at US SignalJerry Clark

VertitechIT helped Baystate Health launch a software-defined data center initiative. The implementation uses the entire VMware stack across three active data centers. The three-node arrangement provides local data replication, but David Miller, senior IT director and CTO at Baystate Health, said an outage in 2016 knocked out all three sites — contrary to design assumptions — for 10 hours.

Miller said his organization had been looking into some form of remote replication and high availability but had yet to land a good solution. The downtime event, however, increased the urgency of finding one.

“We realized we had to do something now rather than later,” Miller said.

David Miller, CTO at Baystate Health SystemDavid Miller

VertitechIT introduced US Signal to Baystate Health. The companies met in VertitechIT’s corporate office and US Signal proposed its DRaaS solution. In its DRaaS solution, US Signal deploys Zerto’s IT Resilience Platform, specifically Zerto Virtual Manager and Virtual Replication Appliance. The software installed in the customer source environment replicates data writes for each protected virtual machine to the DR target site, in this case US Signal’s Grand Rapids data center. An MPLS link connects Baystate Health to the Michigan facility.

The remote replication service provides the benefit of geodiversity, according to the companies. Baystate Health’s data centers are all in the Springfield area.

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CIO of Christian Brothers Services discusses the
company’s infrastructure partnership with US Signal.

US Signal’s DRaaS solution also includes a playbook, which documents the steps Baystate Health IT personnel should take to failover to the disaster recovery site in the event of an outage. In addition, US Signal’s DRaaS package provides two annual DR tests. The DRaaS provider also tests failover before the DR plan goes into effect and documents that test in the playbook, Clark noted.

Miller said the DR service, which went live about a year ago, provides a recovery point objective (RPO) of “less than a couple of minutes” for Baystate Health’s PeopleSoft system, one of the healthcare provider’s tier-one applications. The recovery time objective (RTO) is less than two hours. RPO and RTO characteristics differ according to the application and its criticality.

Initially, the DRaaS solution covered a handful of apps, but the list of protected systems has expanded over the past 12 months, Miller said.

A DRaaS ‘showcase’

Myles Angell, executive project officer at VertitechIT, said the Baystate Health deployment has become “a showcase” when meeting with potential clients that have similar DR challenges.

Myles Angell, executive project officer at VertitechITMyles Angell

“We’re talking to other hospitals about it,” he said.

Other organizations interested in DRaaS should pay close attention to their application portfolios, however. Angell said businesses need to have a thorough understanding of applications before embarking on a DR strategy.

“To successfully build a disaster recovery option — and have confidence in the execution — relies on complete documentation of the application’s running state, dependencies and any necessary changes that would need to be executed at the time of a DR cut over,” he explained. “These pieces of information are vital to knowing how to adhere to the RTO/RPO objectives that have been defined.”

Angell said businesses may have a good understanding of their tier-one applications but may have less of a handle with regard to their tier-three or tier-four systems. The recovery of an application that isn’t well-documented or completely understood becomes a riskier endeavor when a disaster strikes.

“The DR option may miss the objectives and targets that the business is expecting and, therefore, the company may actually be worse off due to lost time trying to scramble for the little things that were not documented,” Angell said.

Four healthcare technology trends to watch in 2018

Industry experts are busy making their predictions for the top healthcare technology trends of 2018. The SearchHealthIT team looked into their respective crystal balls to make their own predictions about what trends the industry should be on the lookout for in the new year.

Blockchain finds its way back onto our 2018 list of healthcare technology trends after one health IT expert posited that the technology would move from theory to practice in 2017. Senior news and feature writer Shaun Sutner hypothesizes that the technology will start seeing its first real-world tests in healthcare this year.

EHR vendors will begin to find themselves more involved with providing analytics to healthcare providers, according to editorial director Scott Wallask.

Artificial intelligence will also continue to gain ground this year as healthcare organizations begin to apply the technology to medical diagnoses and image recognition, said news writer Kristen Lee.

Rounding out our predictions for the top healthcare technology trends of 2018 is digital health, which is becoming increasingly embraced by healthcare providers and patients alike. 

Let’s look at these predictions in more detail, as our editors and writers weigh in:

Blockchain moves from hope to practical use

It’s more than a fad and more than hype, but still, blockchain, and its healthcare incarnations, has yet to prove itself in the demanding crucible of health IT systems and clinical healthcare settings.

Shaun Sutner, senior news and features writerShaun Sutner

Sure, blockchain is one of the hottest healthcare technology trends during this window in time.

But this year in particular will be a major test for the fast-developing technology’s first major foray as people in the health IT community watch to see if and how providers start to use it to protect and more easily exchange health data.

There’s no question that in 2018, major vendors, many startups and independent software companies are moving quickly toward more fully realized blockchain in healthcare systems than most thought possible when blockchain burst out of the worlds of bitcoin and mainstream commerce little more than two years ago.

Now, IBM, Intel, Google, Microsoft  and others have units dedicated to development of blockchain products, including for healthcare. Federal health IT officials are promoting it in a big way.

Change Healthcare, made up of the former McKesson Corp.’s IT holdings, announced its own blockchain in healthcare product last year and is marketing it in 2018.

Yet, skeptics remain, and justifiably so.

Not only are there most likely distinct limitations to a technology that has not yet been realized in healthcare, but health IT has already seen other “solutions” to intractable problems like health data interoperability and cybersecurity fail.

But at least one thing is clear: The technology has much hope riding on it.

— Shaun Sutner, senior news and features writer

EHR vendors more involved in analytics

With electronic health record (EHR) systems in full force throughout the medical industry, 2018 will be the year when EHR vendors move more solidly into patient data analytics work. The advantages of doing so are clear, such as improving population health efforts and providing real-time reporting among various healthcare specialties.

Scott Wallask, editorial directorScott Wallask

Providers will respond favorably to this push. Most physician practices use at least some analytics capabilities already embedded in their EHR systems, according to a poll in 2017 conducted by MGMA, an association of medical practice professionals.

The potential for EHR giants like Epic Systems Corp. and Cerner Corp. to aggregate patient data within their products is a new business line that is blooming. Cerner has already planted its stake in population health management, which at its core requires number crunching to gauge patient outcomes. Company president Zane Burke told the Kansas City Business Journal that Cerner will expand its population health tools in 2018 based on the patient data it has amassed.

Cloud-based EHR seller AthenaHealth, a smaller competitor to Cerner and Epic, also pushes its population health analytics products, which ties in EHR data with patient insurance claims and lab results, for example.

— Scott Wallask, editorial director

AI in 2018

Artificial intelligence (AI) will no longer be a technology that healthcare professionals dream about one day impacting the industry and how patient care is delivered. For AI, 2018 is the year that this technology will move from simply being piloted at healthcare organizations to starting to make a real impact.

Kristen Lee, news and features writerKristen Lee

Although the most common uses of AI in healthcare today come in the form of natural language processing and robotic process automation — where AI is being used in a more basic form to pinpoint certain data in a sea of data, such as MedCPU, or automate repetitive administrative tasks, such as Blue Prism, for example — healthcare organizations are poised to do more with AI.

Some are already using AI for clinical decision support, population health, disease management, readmissions and claims processing, according to a survey conducted by the Center for Connected Medicine and the University of Pittsburgh Medical Center in Pennsylvania. But some experts believe that in 2018 AI will begin to provide value in areas such as cancer diagnostics, pathology, and image recognition — something Merge Healthcare, an IBM company that uses Watson, is capable of doing.

Expect AI to make practical inroads in 2018, Mark Michalski, executive director at Massachusetts General Hospital and Brigham and Women’s Hospital’s Center for Clinical Data Science in Boston, told Computer Business Review that, “By the end of next year, I think around half of leading healthcare systems will have adopted some form of AI within their diagnostic groups.”

— Kristen Lee, news and features writer

The digital health transformation will be mobilized

Mobile is becoming increasingly prevalent in healthcare, and with the proliferation of smartphones and tablets, the trend doesn’t appear to be slowing down any time soon. As far as healthcare technology trends go, digital health is one that is predicted to grow exponentially in 2018 and beyond. According to seed fund Rock Health, $3.5 billion was invested in 188 digital health companies in the first half of 2017 alone, and the number of wearables is projected to hit 34 million by 2022, according to Statista.

Tayla Holman, associate site editorTayla Holman

The Food and Drug Administration (FDA) also issued new guidance that loosened its regulations for certain mobile health technologies to reflect its “new, more modern approach to digital health products.” The agency said it was aware that healthcare providers and consumers were embracing digital health technology such as fitness trackers and mobile health apps, and that clinical evidence supported the fact that consumers can experience better outcomes when they are better informed about health. As such, the FDA felt it should encourage the development of technologies that can help people become more informed and “foster, not inhibit, innovation.” 

Digital health enables the elderly to age and live better in their own homes, using technology like fall-detection monitors. Telehealth and telemedicine will also be part of the digital health transformation as more states update their laws to expand access to those services. One area that is being expanded is telemental and telebehavioral health services. This is particularly beneficial since one in five adults in the U.S. suffers from mental illness, and often turn to their smartphone before they seek healthcare. Increasing mental health services allows more people to receive care when and where they need it.

Tayla Holman, associate site editor