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Patient Directed Health Data Exchange on The Blockchain

Posted on September 7, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve long been friends with Dr. Tom Giannulli who most of you will probably have known as the CMO of Kareo. I first met Dr. Tom back when he created what I would call the first iPad optimized EHR interface back when Dr. Tom was at Epocrates and before they sold that EHR to Kareo. Needless to say, Dr. Tom is the kind of guy that likes to sit on the cutting edge of technology and how it applies to healthcare. So, it was no surprise to me when he came to me with his patient directed health data exchange called PatientDirected.io which is built on the blockchain.

While a lot of people talk about blockchain and theories about how blockchain could help healthcare, a lot of what people were doing was just talk. What I like about Dr. Tom and PatientDirected.io is that they just put out a video demo of a patient chart being requested from Kareo by the patient and then the patient sending that chart to Epic. Check it out to see what I mean:

Many of you that watch this demo might be asking. How is this on the blockchain? That’s one of the things that many people don’t understand about blockchain. If it’s done right, you won’t know anything about the blockchain. However, the blockchain can do things like creating smart contracts with providers which can create trusted connections. The blockchain is distributed, so your data isn’t stored on a central server that’s owned and controlled by PatientDirected.io. Basically, blockchain has a number of benefits, but it’s the “Intel Inside” and so it’s not something you should see as an end user, but it could provide some great benefits.

I also like that PatientDirected.io isn’t trying to reinvent the wheel. They’re using trusted third party applications like Verato to handle their master patient index and for verifying patients identity. There’s a lot more to explore when it comes to identity management, but it’s smart to work with companies that are doing this all across healthcare.

I was also impressed with the detailed sharing permissions that were available in PatientDirected.io. At first glance, a part of me wonders if it’s too complex for most patients. However, as long as the options are there, the interface can adapt to allow for specific patient preferences when it comes to data sharing. Of course, it’s nice that all of the sharing of this data will be tracked on the blockchain.

The key to all of this working for me is the integration with the EHR vendor. It looks like it’s using Direct to handle the messaging to the EHR vendor and back. This is good because I believe all certified EHR (which is pretty much all of them) have direct messaging built in. Some have integrated it better than others, but they all have this capability. My big concern with it though is whether what’s being shared by EHR vendors using Direct is enough data. And will that data that gets sent from one EHR to another appear in a format that’s useful to the receiving physician? If it’s not, then it doesn’t solve much of anything. Plus, I wonder what happens when a doctor gets a record request and doesn’t respond. This is especially true for EHR vendors who haven’t integrated Direct into the core EHR workflow. Will this take a culture change to not leave patients waiting for records that will never come?

As you could imagine, PatientDirected.io has an ICO offering on StartEngine.com. Looks like it just got started, but there’s an opportunity to buy their tokens if you’re interested and believe they’re on to something special.

I think there is a space for a patient directed health information exchange assuming we can make the exchange of information between disparate providers very simple. There are still some challenges for patients when it comes to getting access to their health information, but the law is clear that patients should have access to their health information. Now we just need the user interfaces to be as simple as clicking a button like is demonstrated in the video above and we’ll see much more patient directed health information exchange.

Nationwide Healthcare Interoperability Isn’t Happening

Posted on August 8, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve got interoperability on the mind today. I think it’s probably because of all the tweets that are coming out on the #InteropForum hashtag from the ONC Interoperability Forum in DC. I would have liked to attend, but I’m grateful that so many people are sharing what’s happening. That said, I must admit that I’m tired of a lot of the tweets that aren’t grounded in reality and that call for things that are never going to happen or tweets that propose goals that aren’t meaningful (yes, I had to use that word).

The first reality that’s become clear to me is that nationwide interoperability of healthcare data isn’t going to happen.

It’s just not going to happen and in most cases it shouldn’t happen when you consider the costs and benefits. Sure, we are all traveling a lot more, but there are 45 or so states in the US where no healthcare organization has need for my health information. If they do, then there are ways they can get it, but they are rare. Even if I have a crazy medical incident in an unusual state, those care providers know how to take care of me even without all my health records. Doctors are always treating patients with limited information. If I’m a chronic patient where certain information would be important for me if I’m treated out of state by a doctor that doesn’t know me, there are hundreds of options for me to carry that information on my phone.

My point here is that there aren’t any massive economic incentives for there to nationwide sharing of health data. Don’t be confused though. I’m not saying that sharing health data is not beneficial. What I’m saying is that we don’t need to build a national framework of health data sharing. When people suggest we should make that a reality, they’re essentially dooming interoperability. Talk about biting off more than you can chew. It’s become quite clear to me that Nationwide Interoperability of health data isn’t going to happen.

I love this excerpt from Brian Mack’s blog post on the Great Lakes Health Connect (an HIE) blog:

The Trusted Exchange Framework and Common Agreement (TEFCA) released by the Office of the National Coordinator last January, was (it was thought) intended to bring clarity and define a path forward for national interoperability, but has instead just added more uncertainty and the promise of additional layers of bureaucracy.

Discussions around national healthcare interoperability just bring more uncertainty and more layers of bureaucracy. It’s a failed approach.

With that said, it’s also very clear that smaller scale interoperability is not only possible but a valuable thing for most in healthcare. This was highlighted by interoperability expert, Greg Meyer, when he tweeted:

It’s really great that Greg is trying to figure out how we can generalize these point to point interoperability solutions. That’s a smart approach. However, buried in this tweet in a way that most will miss is the fact that there are a lot of unique scenarios and solutions where healthcare interoperability has been successful. Healthcare interoperability is possible and many organizations are doing it. Just not on a national scale.

To continue Greg’s analogy, we need more of these interoperability “snowflakes” and we need those creating the snowflakes to share their successes. A blizzard of snowflakes is a powerful thing even though the individual snowflakes are small. As it stands today, a national approach to interoperability is more like spending millions and billions of dollars on a snow making machine and then never turning it on. I’d rather have a million snowflakes than a billion dollar machine that doesn’t produce any snow. </ end snowflake analogy>

Another example of healthcare interoperability in action was shared at the Healthcare IT Expo this year. Don Lee offered a great summary of UPMC’s success with interoperability and the parts of interoperability they have solved. There’s always still more work to do, but if every hospital was able to accomplish what UPMC has accomplished in regards to healthcare interoperability, then we could have a very different discussion around healthcare data sharing.

The only solution I see to healthcare interoperability is for healthcare organizations to make it a priority. As I said back in 2013, Interoperability Needs Action, Not Talk. The more small interoperability connections we make, the more we’ll understand our data, how to connect, and build relationships between organizations. All of that will be key to even starting to thinking about nationwide healthcare interoperability. Until then, let’s table the nationwide healthcare interoperability discussions.

Healthcare Interoperability Tort Reform

Posted on November 12, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The more I learn about health care the more I think that health care would really benefit from tort reform. In many ways we’ve needed this for a while. I’ve never seen this study, but I’d love to see someone study how many health care costs are associated with unneeded tests and procedures that were ordered by doctors in order to help them avoid liability.

This happens all the time in health care and you can’t blame the doctors for doing it. Them ordering a likely unneeded extra test in order to avoid possible liability is a common practice. It only takes one time that they don’t order the test for the doctor to start over ordering tests and procedures. It’s unfortunately the lawsuit happy society that we live in and that’s why tort reform could help

Turns out that technology actually exacerbates this problem in many ways. A great example of this is in interoperability of health records. We all love the idea that everyone’s health information is pushed to the doctor so it’s available whenever the doctor needs it. I think we can all agree that the doctor having all of the information on a patient will lead to improved care for many patients. However, pushing all this new health information to the doctor raises a lot of questions.

From the doctor’s perspective they’re asking the question “Will I be held liable for health information that’s pushed to me?” “What if that health information shows suicidal tendencies for my patient and I don’t do anything about it because the information was pushed to me and I never actually saw it?” We could highlight a few hundred other scenarios where the doctor could be held liable if they don’t act on some information that’s forwarded to them. Any rational person could see how the doctor shouldn’t be responsible, but most lawsuits aren’t very rational.

Another example would be a doctor who has access to an HIE but doesn’t use it. Should the doctor be held liable for not using that information? What if the HIE had the allergies of a patient and could have prevented the doctor prescribing a drug to the patient because they were allergic? Should the doctor be held liable for information that was available in the HIE, but for whatever reason she chose not to access that information and ended up doing something bad?

I’m not a lawyer and I don’t play one on TV, but there are so many examples of potential liability that it’s quite scary. Is it any wonder why doctors are so frustrated with medicine? I think the right tort reforms could help. If we don’t, I think the cost of health care will continue to rise.

The Tower of EMR Babel

Posted on May 28, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s the sad state of interoperability. This week when I was teaching an EHR workshop I asked for those attending to define what an Electronic Health Record was in their own words. I’d say 90% of them said something about making the healthcare data available to be shared or some variation on that idea. This wasn’t surprising for me since I’ve heard hundreds and possibly thousands of doctors say the same thing. EHR is suppose to make it so we can share data.

While people pay lip service to this idea and just assume that somehow EHR would make data sharing possible, that’s far from the reality today. This is true even in some organizations where they own both the hospital and the ambulatory provider. How sad is this? Extremely sad in my book.

I’ve often wondered what would change the tide. I’ve been long hopeful that ACOs and value based care would help to push the data sharing forward, but that’s going to be a long process. The private HIEs are working the best of any HIEs I’ve seen, so maybe the trend of hospitals acquiring small practices and hospital systems acquiring hospital systems will get us to EHR data sharing nirvana. Although, I don’t think it’s going to make it there in most communities. Instead it’s just going to have a number of large organizations not wanting to share data as opposed to some large and some small ones.

Do people really have much hope for true EHR data sharing? Does FHIR give you this hope? I’m personally not all that optimistic. We all know it’s the right thing to do, but there are some powerful forces fighting against us.

Risk of Interoperability is Worse Data

Posted on July 17, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m a huge fan of healthcare interoperability. I think it needed to happen yesterday and that we could solve a number of our cost issues with healthcare data interoperability and we could save lives. Both of these are very worthy goals.

While I’m a huge fan of healthcare data interoperability, we also have to be careful that we do it right. While there are huge potential benefits of exchanging healthcare data, there are also huge risks involved in it as well. We have to address those risks so that interoperability doesn’t get a black eye because it was poorly implemented.

A great example of the potential risk of interoperability is making sure that we process and connect the data properly. Some might argue that this isn’t that big of an issue. Healthcare organizations have been doing this forever. They get a medical record faxed to their office and the HIM team lines up that medical record with the proper patient. I’m sure the medical records folks could tell us all sorts of stories about why matching a faxed medical record to a patient is a challenge and fraught with its own errors. However, for this discussion, let’s assume that the medical records folks are able to match the record to the patient. In reality, they’re certainly not perfect, but they do a really amazing job given the challenge.

Now let’s think about the process of matching records in an electronic world. Sure, we still have to align the incoming record with the right patient. That process is very similar to the faxed paper record world. For the most part, someone can take the record and attach it to the right patient like they did before. However, some EHR software are working to at least partially automate the process of attaching the records. In most cases this still involves some review and approval by a human and so it’s still very similar. At least it is similar until the human starts relying on the automated matching so much that they get lazy and don’t verify that it’s connecting the record to the correct patient. That’s the first challenge.

The other challenge in the electronic world is that EHR software is starting to import more than just a file attached to a patient record. With standards like CCDA, the EHR is going to import specific data elements into the patient record. There are plenty of ways these imported data elements could be screwed up. For example, what if it was a rule out diagnosis and it got imported as the actual diagnosis? What if the nurse providing care gets imported as a doctor? Considering the way these “standards” have been implemented, it’s not hard to see how an electronic exchange of health information runs the risk of bad health data in your system.

Some of you may remember my previous post highlighting how EMR perpetuates misinformation. If we import bad data into the EMR, the EMR will continue to perpetuate that misinformation for a long time. Now think about that in the context of a interoperable world. Not only will the bad data be perpetuated in one EMR system, but could be perpetuated across the healthcare system.

Posts like this remind me why we need to have the patient involved in their record. The best way to correct misinformation in your record is for the patient to be involved in their record. Although, they also need a way to update any misinformation as well.

I look forward to the day of healthcare data interoperability, but it definitely doesn’t come without its own risks.

FHA Supports Open Source Governance and Code Management of CONNECT

Posted on April 2, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The Federal Health Architecture (FHA) is working with Open Health Tools (OHT) to migrate the governance and code management of CONNECT, an open source software solution that enables secure health information exchange (HIE), to their open source community. OHT, a 501(c)(6) non-profit organization that governs open source communities and provides a framework for individuals, vendors, and government to collaborate on health IT projects, has selected CONNECT as one of their projects.

This is a key milestone for the CONNECT program that and the beginning of a fruitful collaboration with the open source community and FHA. FHA looks forward to supporting the community’s efforts, through OHT, to implement a governance structure that provides a mechanism for community participants– including health information exchanges, vendors, providers, and academia – to expand their contributions to the CONNECT program and have a meaningful voice in its future evolution. FHA will continue to contribute to the development of CONNECT to ensure that there are versions of this program that support the unique requirements of the federal health community.

FHA anticipates that CONNECT will continue to be a core component of the rapidly growing interoperability ecosystem, allowing organizations nationwide to support better, more cost effective care for all U.S. citizens.

CONNECT development began in 2007 as a federated program managed by FHA and its federal partners, including the Department of Health and Human Services, Department of Defense and Department of Veterans Affairs, and Social Security Administration. Over the following seven years, CONNECT grew and evolved to meet nationwide requirements to enable secure, efficient HIE among the federal partners, states and private organizations. FHA engaged with members of the public and private communities to develop CONNECT, with the existing codebase including contributions from 15+ organizations.

CONNECT is distributed under the BSD 3-Clause (Modified BSD) License. See opensource.org/licenses/BSD-3-Clause for further license details.

As an open source capability, CONNECT is available to anyone to download and tailor to their unique needs. FHA encourages industry to join in the development of the CONNECT community and contribute to the evolution of CONNECT.

For more information about FHA, visit www.healthit.gov/fha or contact federal.health@hhs.gov. For more information about CONNECT, visit the CONNECT Community Wiki at wiki.connectopensource.org.

One-Third of Chicago-Area Hospitals Come Together Into HIE

Posted on December 4, 2013 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.

Thirty-four Chicago hospitals have decided to come together into a health information exchange, with plans to begin exchanging data early next year, according to a story in Modern Healthcare.

The group, which calls itself MetroChicago HIE, considers itself to have critical mass, given that it embraces about a third of the region’s 89 hospitals.

To exchange data, the HIE is using Direct protocols permitting basic, encrypted clinical messaging, such as the transmission of referral letters between providers which have established authentication and business relationships, Modern Healthcare notes.

Even with Direct protocols in hand to streamline data sharing, the hospitals will face significant challenges in tightening communications between their various EMRs, which include a number of Epic and Cerner installations, as well as a few Meditech shops. Planners will also face issues when they set out to link the HIE to office-based physicians.

To address the problem of communicating between multiple interfaces, the HIE has hired technology firm SandLot Solutions, a company launched by North Texas Specialty Physicians.

To date, many hospitals have been reluctant to sink big bucks into HIE development. But participating hospitals in Chicago seem confident that there is a business case for spending on an HIE.

The truth is, this may just be a tipping point for hospital-run HIEs generally. For example, a recent study by HIMSS Analytics and ASG Software Solutions concluded that almost 70 percent of the 157 senior hospital IT execs surveyed were involved in HIE efforts.

Now, let’s see how these Chicago hospitals handle data exchange when they move beyond Direct into more advanced sharing. That will really be where the rubber hits the road.

Ideas, Insights and Predictions from Healthcare Social Media Thought Leaders

Posted on July 16, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I thought it would be fun to experiment with a new type of blog post. I came up with the idea during the recent #HITsm chat. I decided I’d ask 5 of the #HITsm participants to share an idea, prediction, insight, or thought that I could share in a blog post. I didn’t give them a topic, direction, or ask any questions. I just asked them to share something that thought would be useful or interesting. I found the results quite interesting.

I asked 5 people to tweet something. Only 4 of the 5 responded (probably a lost Twitter DM), but one of the people sent two tweets. So, the following are the 5 tweets with a little bit of commentary from me.


This is a really interesting insight. Chad has a really good point. I’m not sure I’ve seen a truly open HIE that just wanted to be the company sharing the data. I think a few have that goal in mind, but they haven’t gotten there yet. It will be a real game changer when an HIE just wants to be the pipes and not the faucet as well. I will say that most healthcare organizations aren’t quite ready to implement the faucet though either.


Thank you Dr. Nan for bringing some humor to the post. I love it! Although, maybe it’s not that funny since it rings far too close to the truth. I might also share this with my wife so she understands age appropriate behavior for our children.


This was the other tweet that Dr. Nan sent. You can tell it comes from a raw place. I’m actually surprised we don’t talk about doctor depression more. I read a lot of entrepreneur blogs and there’s been a real increase in discussion around entrepreneur depression. I expect that doctors could really benefit from this discussion as well. For some reason there’s a fear of discussing the real challenges and pressures of the job.


Would we expect anything other than workflow from Dr. Webster? I’m not sure I like his prediction. I hope he’s wrong. I don’t want a workaround for EHR workflow. I want something drastically different.


I love this concept and refer to it as treating healthy patients. Although, I love Ryan’s approach of patients taking responsibility for their own health and engaging with those they love in health-generating behaviors. Sure, doctors are miracle workers, but we as patients should be much more involved in our health as well.

That’s all she wrote. If you like this idea, let me know. If you’d like to participate in a future post, be sure to tweet me @ehrandhit.

A Private HIE is a Vendor Neutral Archive Applied to EHR

Posted on June 17, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been really fascinated by the work many hospital systems are doing to create a private HIE in their organization. As I wrote, I think that private HIE could lead to a nationwide HIE. It’s still a bit of a long shot, but I think it has more promise than the other HIE initiatives I’ve seen in action.

Along with my interest in private HIEs, I’ve also been fascinated by the switch to Vendor Neutral Archives (VNA) in the radiology space. In a VNA, you can store any medical image in the archive and it doesn’t matter what device you use to capture or view the image. Think about the flexibility that this provides. You’re no longer locked into a certain piece of imaging equipment or to a certain viewing application. Instead, you can switch as needed.

As I consider these two areas, it seems that a private HIE is the first step to having a vendor neutral archive. In fact, I’m not sure why more people haven’t applied the principles of vendor neutral archives to the EHR world. I imagine the challenge is in the complexity of the data. Sure, DICOM isn’t a simple piece of data either, but at least there are some DICOM standards that most medical imaging companies follow. The same can’t be said in the EHR world.

The problem now is that the term HIE has so much failure associated with it. I imagine that’s why we moved from RHIO to HIE as well. However, I think that the change from creating an HIE to a vendor neutral archive for EHR data would be a dramatic shift in thinking. This could be an important decision for a large hospital system. Instead of just trying to share data from EHR to EHR, what if they created a vendor neutral archive of all their EHR data such that your future EHR was built around that VNA instead of around a specific piece of software. I’m not sure there are many hospital CIOs brave enough to look this far out.

What do you think of the VNA concept applied to EHR? Is a private HIE the start of a VNA for EHR?

EMRs Help Identify High-Risk Pregnancies

Posted on June 7, 2013 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.

A group of researchers have begun a project in which they use EMRs to identify pregnant mothers who may be at high risk for medical complications.

The researchers, who are being supported by Johns Hopkins University’s Center for Population Health IT (CPHIT), are conducting a pilot using predictive modeling and natural language processing to find indicators of possible risk in the text of records for pregnant Medicaid beneficiaries, according to an article in iHealthBeat.

Maryland, where the pilot is taking place, has had a statewide HIE in place since 2009. The HIE data is useful for spotting trends in the medical histories of individual patients, as it ensures that doctors have the whole story, but obviously, the data doesn’t analyze itself.

That’s where CPHIT comes in. Its job is to find ways to improve public health using existing sources of data.

To find high-risk moms, the researchers are working with CPHIT to find such hints such as whether the mother smokes or lives in an abusive environment. Historically, those beneficiaries don’t receive regular follow-up care, the story notes.

The team of researchers and CPHIT learned which beneficiaries should be considered a risk, in part, by taking a trip to a Johns Hopkins campus in East Baltimore, where a nurse shared warning signs for complicated pregnancies and along the way, shared different phrases which could confuse the search (such as ‘former tobacco user’ or ‘this patient is not a tobacco user’ or ‘this patient lives with a tobacco user.’)

Now armed with this information — and a difficult-to-obtain link between OB, primary care charts and insurance files — the pilot is slowly moving forward. When researchers find mothers who could be at risk for complicated pregnancy, they contact those mothers about receiving care needed to increase the odds of their having a safe, normal pregnancy and delivery.