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HPV Surveillance Project Reminds Us Why HIEs Still Matter

Posted on August 24, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

When healthcare organizations use EHR data to improve care or streamline processes, it seems like an obvious way to go. There are many benefits to doing so – certainly far more than I could cover in a single story—and odds of finding better ways to leverage such data further keep increasing over time.

Given the attention commercial EHR data use gets, it’s easy to forget the role of such data in improving public health. Yes, medical practices need to meet criteria that converge with public health objectives, such as managing diabetes and its side effects. And of course, population health management efforts directly mirror and sometimes overlap with public health goals. But it’s seldom the work of which rockstars are made.

However, given that the bulk of efforts have typically been spearheaded by government agencies or independent non-profits in the past, it’s a good idea to keep track of what they’re doing, especially if you’re wondering what else you can do with patient health data. It’s even more important to remember that even a cache of regional health data can be very valuable in supporting community health.

I was thinking about this recently when the following story turned up in my inbox.  On the surface, it’s not a big deal, but it’s the kind of cooperative effort that can improve community health in ways that work for everyone in healthcare.

This story looks at the kind of data harvesting exercise that flies under the radar of most providers. It describes an HPV surveillance effort, the HPV Vaccine Impact Monitoring Project (HPV-IMPACT), which is sponsored by the CDC and implemented by the Center for Community Health and Prevention at the University of Rochester.

The HPV-IMPACT project is relying in part on data by the Rochester RHIO, which is sharing anonymized patient health information collected between 2008 to 2014. The researchers are also using data from California, Connecticut, Oregon and Tennessee.

The goal of HPV-IMPACT is to identify trends such as changes in the percentage of women screened for HPV, the implications for different age groups and overall test outcomes. Once they complete this analysis, research will use it to determine whether HPV incidence rates can be attributed to vaccine use or alternatively, decreases in detection.

While this kind of project is bread-and-butter research, something that won’t ever make headlines in medical journals, it deserves some thought.

With things being as they are, it’s easy to dismiss HIEs as parts of a broken national interoperability effort. Hey, I’ve been as guilty of this as anyone. For many years, I waited for the HIE model today, in part because it just didn’t seem to be a sustainable business model, but at least some just kept on chuggin’.

As it turns out, regional HIEs aren’t abandonware — they just have their own niche. This kind of story reminds me that even limited health data collection efforts can make a difference. Keep up the good work, folks.

Mercy Shares De-Identified Data With Medtronic

Posted on October 20, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Medtronic has always performed controlled clinical trials to check out the safety and performance of its medical devices. But this time, it’s doing something more.

Dublin-based Medtronic has signed a data-sharing agreement with Mercy, the fifth largest Catholic health system in the U.S.  Under the terms of the agreement, the two are establishing a new data sharing and analysis network intended to help gather clinical evidence for medical device innovation, the company said.

Working with Mercy Technology Services, Medtronic will capture de-identified data from about 80,000 Mercy patients with heart failure. The device maker will use that data to explore real-world factors governing their response to Cardiac Resynchronization Therapy, a heart failure treatment option which helps some patients.

Medtronic believes that the de-identified patient data Mercy supplies could help improve device performance, according to Dr. Rick Kuntz, senior vice president of strategic scientific operations with Medtronic. “Having the ability to study patient care pathways and conditions before and after exposure to a medical device is crucial to understanding how those devices perform outside of controlled clinical trial setting,” said Kuntz in a prepared statement.

Mercy’s agreement with Medtronic is not unique. In fact, academic medical centers, pharmaceutical companies, health insurers and increasingly, broad-based technology giants are getting into the health data sharing game.

For example, earlier this year Google announced that it was expanding its partnerships with three high-profile academic medical centers under which they work to better analyze clinical data. According to Healthcare IT News, the partners will examine how machine learning can be used in clinical settings to sift through EMR data and find ways to improve outcomes.

“Advanced machine learning is mature enough to start accurately predicting medical events – such as whether patients will be hospitalized, how long they will stay, and whether the health is deteriorating despite treatment for conditions such as urinary tract infections, pneumonia, or heart failure,” said Google Brain Team researcher Katherine Chou in a blog post.

As with Mercy, the academic medical centers are sharing de-identified data. Chou says that offers plenty of information. “Machine learning can discover patterns in de-identified medical records to predict what is likely to happen next, and thus, anticipate the needs of the patients before they arise,” she wrote.

It’s worth pointing out that “de-identification” refers to a group of techniques for patient data protection which, according to NIST, include suppression of personal identifiers, replacing personal identifiers with an average value for the entire group of data, reporting personal identifiers as being within a given range, exchanging personal identifiers other information and swapping data between records.

It may someday become an issue when someone mixes up de-identification (which makes it quite difficult to define specific patients) and anonymization, a subcategory of de-identification whereby data can never be re-identified. Such confusion would, in short, be bad, as the difference between “de-identified” and “anonymized” matters.

In the meantime, though, de-identified data seems likely to help a wide variety of healthcare organizations do better work. As long as patient data stays private, much good can come of partnerships like the one underway at Mercy.

Health IT Security: What Can the Association for Computing Machinery (ACM) Contribute?

Posted on February 24, 2015 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

A dazed awareness of security risks in health IT has bubbled up from the shop floor administrators and conformance directors (who have always worried about them) to C-suite offices and the general public, thanks to a series of oversized data breaches that recentlh peaked in the Anthem Health Insurance break-in. Now the US Senate Health Committee is taking up security, explicitly referring to Anthem. The inquiry is extremely broad, though, promising to address “electronic health records, hospital networks, insurance records, and network-connected medical devices.”
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