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Voice Technology: A Disruptive Force in Healthcare

Posted on November 19, 2018 I Written By

The following is a guest blog post by Adam Sabloff, CEO of VirtualHealth.

Voice technology is a disruptive force across many industries, and healthcare is no exception. In sync with tools like Amazon Alexa and Echo, voice-user interfaces (VUI) have the potential to take care management to the next level, and the advantages extend far beyond simple conveniences for patients. 

The world of healthcare lives in siloes: patients, family members, doctors, care managers, and health aides, just to name a few. All are inputting valuable health information from disparate systems, devices, and other sources—resulting in a fragmented view of the patient’s health.

A growing number of healthcare innovators, myself included, believe that voice technology is one solution that can help bring all the pieces together.

I joked during a presentation at Amazon’s VOICE Summit, where I addressed the use of voice technology as a patient engagement tool, that I had received a late-night text from my sister-in-law that four flavors of Goldfish crackers – which she knows I love – were being recalled due to salmonella. Imagine if Alexa knew my ordering behavior, understood what I had in my pantry and alerted me immediately to the recall. Now imagine if Alexa also automatically sent me a box to return the bags in question or merely alerted me to throw out my Goldfish stash and arranged for my refund.

When you apply those “what ifs” to healthcare, they take on new, more significant meaning.

Transforming Care Delivery with Greater Insights

Driven by the massive popularity of Alexa and Google Home, VUI is transforming care delivery by empowering providers with greater insights like these and better engaging patients in behavior change that leads to overall better health and outcomes. Implementation of VUI can enhance process across a variety of use cases such as:

  • Prompting patients to schedule appointments and follow through with care plans
  • Reminding patients about medications
  • Guiding patients through procedure preparations
  • Standardizing care information provided before or after treatment.
  • Enable interaction to complete assessments

The sky is the limit when it comes to implementing VUI, but the immediate goal is identifying medium-risk individuals before they become high-risk. What if Jane just had knee surgery but lives in a 4th floor walk-up? Her care team knows that compliance with her discharge plan may prove difficult. Voice technology can be the intuitive, patient-friendly layer that allows data to flow into healthcare systems faster.

Aging at Home

One of the biggest topics being addressed these days is Medicare’s unprecedented push into the home—a shift driven by an aging population that is outgrowing the amount of available senior living beds.

By weaving VUI-based smart home products like Amazon Alexa and Google Home into the fabric of healthcare technology, we can provide a better quality of life to seniors while allowing them to age gracefully in the comfort of their own homes.

Last month,, an Amazon spokesperson told a reporter that the company frequently receives positive feedback from “aging-in-place” customers who use Alexa’s smart-home features as an alternative to going up and down stairs. Amazon’s Echo Show is another product that offers users Tap to Alexa, a screen interface that lets users who are deaf and hard of hearing tap common commands. Microsoft, for its part, recently launched an A.I. for an accessibility program to create inclusive, affordable technology.

While a number of aging in place-focused technologies like these are already available, more still are being explored. We are seeing seniors embrace today’s connected devices to stay safely independent. Everything from blood pressure and glucose monitors to motion sensors are making seniors’ homes safer and smarter. Furthermore, voice devices can serve as the central data hub for all the connected devices in a person’s home. 10 years from now, I anticipate that most seniors who live independently will do so in smart homes equipped with passive devices that continuously monitor vital signs and activities of daily living. I also foresee the use of other monitoring devices, such as food trackers that monitor inventories and replenish when needed.

Addressing Social Determinants

Social factors such as lower income, education level, or high-crime area have been shown to significantly affect health outcomes. Subsequently, social determinants can cause care gaps such as difficulties with transportation, proper nutrition, understanding educational materials on a specific condition, or lack of a support network to help ensure compliance.

According to Lyft, 3.6 million Americans have transportation issues that prevent them from getting to or from doctors’ appointments, and 25% of lower-income patients have missed or rescheduled their appointments due to lack of transportation.

That’s where voice technology can help.

If John Smith needs to go to the doctor and Medicaid will pay for the appointment, John can say, “Alexa, I need to go to the doctor next week.” Alexa might respond, “Your doctor is available at 10 am on Tuesday. I’ll arrange for a Lyft to pick you up.”

It’s the same with nutritional needs. If John says, “I need meals,” Alexa might say, “You’re on a low sodium diet. Your choices for this shipment include asparagus or carrots.” By making solutions easier to reach, VUI can close the care gaps more efficiently and effectively than a care manager reaching out via email or phone.

To be sure, there are a lot of lofty ideas out there when it comes to VUI and healthcare, but it’s not practical to boil the ocean; instead, it’s important to hone in on those aspects of healthcare where it can have the greatest impact in the shortest amount of time.  By engaging patients in their homes – particularly those who make up the most high-risk, complex populations – VUI applications can keep patients out of the doctor’s office or hospital, while still providing strong outcomes.

About Adam Sabloff
Adam Sabloff, CEO and Founder of VirtualHealth, is a nationally recognized leader and executive in the healthcare industry. Adam’s impact in the field can be traced back to the mid-2000s, when he co-created the Ritz-Carlton Residences in Baltimore and discovered a significant gap leaving seniors and the chronically ill without access to essential care delivery and technology.

That insight, coupled with the loss of a loved one to a late-stage diagnosis, led Adam to develop VirtualHealth, the first comprehensive care management solution purpose-built for integrated value-based care. Designed for use by payers and providers, the platform aggregates and normalizes patient data from multiple sources effectively providing healthcare organizations with the tools to provide proactive, quality care.

Adam is a frequent speaker at healthcare and technology events, including the annual J.P. Morgan Healthcare Conference, Parks Associates’ Connected Health Summit, and the Amazon Voice Summit where he discusses topics including the need for advanced health IT solutions to achieve a true “whole-person” view of the patient.

Stanford Offers 10-Year Vision For EHRs

Posted on October 12, 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 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.

Despite many efforts to improve EHRs, few physicians see them as adding value to the practice. Sadly, it’s little surprise given that many vendors don’t worry much about what physicians want, focusing instead on selling features to CIOs.

As a result, they still don’t like their EHRs that much. In fact, a recent survey conducted by Stanford Medicine and the Harris Poll found that 44% of physicians said that the top value of the EHR was to serve as digital storage, which isn’t a ringing endorsement. Just eight percent saw the EHR as having clinical value, with three percent citing disease prevention, 2% clinical decision support and 3% patient engagement as top benefits.

Is it possible to create a new EHR model that physicians love? According to Stanford, we could build out an ideal EHR by the year 2028.

In Stanford’s vision, clinicians and other healthcare professionals simply take care of the patients without having to think about health records. Once examinations are complete, information would flow seamlessly to all parties involved, including payers, hospitals, physicians and the patient.

Meanwhile, it would be possible to populate the EHR with little or no effort. For example, an automated physician’s assistant would “listen” to interactions between the doctor and the patient and analyze what was said. Depending on what is said in the room, along with verbal cues of the clinicians, it would record all relevant information in the physical exam.

What’s more, the automated physician’s assistant would have AI capabilities, allowing it to synthesize medical literature, the patient’s history and relevant histories of other patients available in anonymized, aggregated form.

Having reviewed these factors, the system would then populate different possible diagnoses for the clinician to address. The analysis would take patient characteristics into account, including lifestyle, medication history, and genetic makeup.

In addition to its vision, the survey report offered some short-term recommendations on how medical practices can support physician EHR use. They included:

  • Training physicians well on how to use the EHR when they’re coming on board, as well as when there are incremental changes to the system
  • Involving physicians in the development of clinical workflows that take advantage of EHR capabilities
  • Delivering EHR development projects as quickly as possible once physicians request them
  • Making data analytics abilities available to physicians in a manner that can be used intuitively at the point of care
  • Considering automated solutions to eliminate manual EHR documentation

Technologists, for their part, can take also take immediate steps to support physician EHR use, including:

  • Developing systems and product updates in partnership with physicians
  • Limiting the use of manual EHR documentation by using AI, natural language processing and other emerging technologies
  • Using AI to perform several other functions, including synthesizing and summarizing relevant information in the EHR for each patient encounter and offering current and contextualized information to each member of the patient care team

In addition, to boost the value of EHRs over the long-term, 67% of physicians said making interoperability work was important, followed by improving predictive analytics capabilities (43%), and integrating financial information into the EHR to help patients understand care costs (32%).

Marginalized Populations Continue to Struggle for Access to Healthcare

Posted on May 23, 2018 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

I recently had the privilege of attending the annual #Cinderblocks5 event in Grantsville MD. Organized by the incredible Regina Holliday, this event is a blend of art school, community town-hall, healthcare update, and patient rally. It is definitely not your typical healthcare conference. This was my third year attending and every year I get more out of the event.

The only thing I can compare #Cinderblocks5 to is summer camp. Remember going to camp in the middle of nowhere – seeing old friends and meeting new ones while doing things you don’t normally do? That’s kind of what #Cinderblocks5 is like. It’s the only event on my calendar where I will hear a plea from an HIV-positive patient about the need for better access, followed by an update from a local community leader about the latest in affordable housing, followed by a walking tour with a park ranger.

Set in the idyllic hills of Northwestern Maryland, Grantsville is a tiny little community that is a stone’s throw from Interstate 68. It was historically a stop on the National Road (US Route 40) which once carried thousands of pioneers. The town of 800 is now home to a budding artisan community and has one of the best hidden gems of a restaurant I have ever eaten at – The Cornucopia Café.

Of course the town is now the home of my good friend Regina Holliday: speaker, tireless advocate and community leader. She is the force of nature who created the #TheWalkingGallery which I am honored to be a member of.

Although there is never a planned theme to #Cinderblocks5 events, one always emerges. For me, the theme of this year’s event was marginalized populations and their access (or lack of access) to healthcare. The first speaker was none other than Amy Edgar APRN, CRNP, FNP-C @ProfAmyE who spoke about her work pioneering mental health work at Children’s Integrated Center for Success @CICSuccess. Access to mental health services remains a challenge – especially for those who need it most: marginalized people.

We later heard from Heather Hanline, Executive Director of the Dove Center @dovecenter_gc –  which provides safety, advocacy and counseling to survivors of domestic violence and sexual assault. There is such a need (unfortunately) for these types of services in rural communities, a point made by Hanline several times in her impassioned presentation. Without the Dove Center, trauma survivors would have to drive miles into the big cities to get help.

We also heard from Robb Fulks @TheIncredibleF. Fulks is an incredible human being. For almost his entire life the odds have been stacked against him. He has numerous comorbidities including HIV. As if that is not enough he is coping on a shoestring budget. In the past Fulks has spoken out against the rising cost of life-sustaining medications that used to be <$20 and against exclusionary tactics by insurance companies. This year Fulks said the most powerful line at #Cinderblocks5:

Other speakers at #Cinderblocks5 included:

  • Ashley Elliott a recovering addict (sober since 2012) who talked about how she battles the stigma in her small town and how there is a lack of recovery programs in rural communities
  • Michael Mittelman @mike_mitt who highlighted how poorly living organ donors are treated by the healthcare system after their life-saving gift is given
  • Jade Kenney and Kendra Brill who spoke about their struggle to build a safe haven (Rainbow Bridge Home – for the LGBTQIA community in a rural setting and how they were/are both marginalized by “polite society”

Being at #Cinderblocks5 was a poignant reminder that: (a) art, music and reflection are as much a part of healthcare as IT, workflows and treatment regiments; (b) there is no substitute for in-person meetings; and (c) that we still have a lot of work to do when it comes to people at the margins of healthcare. Whether it’s because of economics, social norms, mental health issues or belief systems, there are many people who do not have access to healthcare that need our help. We cannot forget about these people when designing the health systems of the future and the Health IT solutions that will power them.

#HIMSS18 First Day:  A Haze Of Uncertainty

Posted on March 7, 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 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.

Entering the HIMSS exhibit area always feels like walking straight into a hurricane. But if you know how to navigate the show, things usually start to come into focus.

There’s a bunch of young, scrappy and hungry startups clustered in a hive, a second tier of more-established but still emerging ventures and a scattering of non-healthcare contenders hoping to crack the market. And of course, there are the dream places put in place by usual suspects like Accenture, SAP and Citrix. (I also stumbled across a large data analytics company, the curiously-named splunk> — I kid you not – whose pillars of data-like moving color squares might have been the most spectacular display on the floor.)

The point I’m trying to make here is that as immense and overwhelming as a show like HIMSS can be, there’s a certain order amongst the chaos. And I usually leave with an idea of which technologies are on the ascendance, and which seem the closest to practical deployment. This time, not so much.

I may have missed something, but my sense on first glance that I was surrounded by solutions that were immature, off-target or backed by companies trying to be all things to all people. Also, surprisingly few even spoke the word “doctor” when describing their product.

For example, a smallish HIT company probably can’t address IoT, population health, social determinants data and care coordination in one swell foop, but I ran into more than one that was trying to do something like this.

All told, I came away with a feeling that many vendors are trapped in a haze of uncertainty right now. To be fair, I understand why. Most are trying to build solutions without knowing the answers to some important questions.

What are the best uses of blockchain, if any? What role should AI play in data analytics, care management and patient interaction? How do we best define population health management? How should much-needed care coordination technologies be architected, and how will they fit into physician workflow?

Yes, I know that vendors’ job is to sort these things like these out and solve the problems effectively. But this year, many seem to be struggling far more than usual.

Meanwhile, I should note that there seems to be a mismatch between what vendors showed up and what providers say that they want. Why so few vendors focused on RCM or cybersecurity, for example? I know that to some extent, HIMSS is about emerging tech rather than existing solutions, but the gap between practical and emerging solutions seemed larger than usual.

Don’t get me wrong – I’m learning a lot here. The wonderful buzz of excited conversations in the hall is as intense as always. And the show is epic and entertaining as always. Let’s hope that next year, the fog has cleared.

Most Health Organizations Now Integrating SDOH Into Pop Health Management Programs

Posted on February 20, 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 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 new survey has found that healthcare organizations have begun to actively integrate social determinants of health into the population health management strategies.

The research, conducted by Change Healthcare and the HealthCare Executive Group, found that 80% of organizations had begun to track and use data on social determinants. This is a huge step up from just a few years ago, when discussions around SDOH and their use in population health management were more speculative than practical.

Perhaps the most interesting technique organizations are using is enlisting doctors in this effort. About 21% are training doctors to identify social determinants, a step which, in my opinion, is long overdue. Given how taxing this might be for physicians at first, it’s good to see that just a hair under 21% have also rolled out point-of-care checklists designed to help clinicians identify potential social determinants.

Other strategies respondents are using to leverage SDOH info include integrating community programs and resources into their population health management programs (42%), integrating medical data with financial, census and geographic data (34%), offering social assessment tools with health risk assessments (33%), incorporating social determinants into the clinical workflow (27 percent) and using third-party software, data and/or services (19%).

On a side note, the research data also suggests that another set of tools in PHM — mobile and digital health technologies — haven’t found their footing. When asked what’s limiting widespread consumer adoption of these tools, top reasons respondents cited included security and privacy concerns (49%), limited functionality (35%), a duplicative, redundant and confusing app environment (34%), problems with system interoperability (33%), a lack of healthcare literacy (33%) and poor user interface design (32%).

The latter data pointing to low mobile/digital health adoption came as a surprise to me. I like to think I can see through health IT industry hype, but maybe I’ve been fooled somehow. The data I’ve seen to date (some of it, admittedly, collected by vendors) has suggested for years that mobile healthcare adoption was climbing dramatically and that more recently, other digital health tools have begun to follow suit. I guess I missed something.

Given this lag, I’m glad to see that healthcare organizations are enlisting physicians, point-of-care checklists, clinical integration and other tactics to make use of SDOH data. We all know on a gut level that if the patient can’t get to the doctor, lacks social support or lives in a “food desert” where finding unprocessed foods and healthy produce may be quite difficult, preaching at them about their health concerns isn’t going to help. It’s high time we help physicians collect this information and find ways to close some of these gaps.

Everything Old is New Again at Lenovo #HIThinkTank Event

Posted on June 28, 2017 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

Last week in Durham NC, 35 healthcare innovators gathered at the Lenovo offices to discuss three trendy topics: Value-base care, connected health and virtual care. Dubbed the Health Innovation Think Tank #HIThinkTank, it was the first summit-style event hosted by Lenovo Health.

#HIThinkTank was designed to be an opportunity for audience members to learn about the latest innovations from leading academics, technology companies and healthcare organizations. I went into the event expecting to hear about the latest in artificial intelligence, big data, predictive analytics and genomic medicine. It did not turn out to be that kind of event…and it was all the better for it.

I would say that the overall theme of #HIThinkTank was innovation through the application of old ideas in new ways. In other words, everything old is new again in healthcare.

The day started with Rasu Shrestha MD, Chief Innovation Officer at UMPC Enterprises, emphatically stating that we are “in a time of tremendous opportunity in healthcare” and that it was “time for us to move from ‘doing digital’ to truly ‘being digital’”. Shrestha went on to explain that our challenge now was to reimagine clinical processes/workflows in light of modern technologies and methodologies. Like the re-engineering wave that swept through manufacturing in the 1980s, Shrestha believes it’s time to engage all stakeholders and collaborate on reworking healthcare.

Shrestha was followed by Juliet Silver of Perficient who gave us all a dose of reality by telling her personal healthcare story. The day Silver’s husband was diagnosed with cancer was the day she became an advocate – “Google searching and academic research quickly became my constant companions as we struggled to make sense of his disease.” Silver made specific mention of how she had to manually obtain paper copies of her husband’s medical records in order to share them with members of his care team and what a difference that made in his care. She hinted that patients may be the key to truly solving healthcare’s interoperability problem as they are the one stakeholder with the most to lose/gain.

After Silver, several speakers made their case for a return to a more community-based approach to healthcare – one that harkens back to the days of early pioneers when physicians, nurses and members of the community worked together to keep each other healthy.

Holly Miller MD of MedAllies presented the results of a local implementation of CMS’s Comprehensive Primary Care Plus (CPC+) program – a program that stressed simple post-discharge follow-up as a way to reduce readmissions and keep overall healthcare spending to a minimum. Miller specifically mentioned how community doctors do this all the time.

This was echoed by Marty Fattig, CEO of Nemaha County Hospital, a 16-bed facility 60 miles south of Omaha NE. Fattig spoke at length about the successful EHR, HIE data sharing and population health initiatives by his staff. Particularly noteworthy was his repeated statement: “We may not have the financial or technical resources of the large networks, but we get stuff done because we are all driven to improve the health of our community peers. It makes a big difference that we see our patients at church, at the grocery store and at the post office.” Ironically this old fashioned community approach to delivering healthcare is now the goal of many healthcare organizations.

In the afternoon Steve Aylward of Change Healthcare and Dr Sylvan Waller led the discussion on virtual care by first reminding the audience that over 90% of virtual visits still happen via the phone. Video consults is the fastest growing area of virtual care, but it has a long way to go to catch up to the telephone. Dr Waller said it best “In 30 years #telehealth will finally become the overnight success everyone expects it to be”. Both Aylward and Waller stressed that we cannot lose sight of these “older technologies” that work for patients when we think about innovation.

For me, what drove home this theme of old-is-new-again was the afternoon tour of the Lenovo model data center. This new highly efficient and “green” room prominently featured Lenovo’s latest innovation – direct water-cooled servers. The new NeXtScale WCT server series boasts high pressure water lines that physically run through the server and draw heat directly away from the quad CPUs. Back in the early 90’s I remember getting a tour of an IBM facility (not far from Lenovo’s facility in Durham) that still had a functioning 308X mainframe that featured…you guessed it…water cooling technology.

All in all, I walked away from #HIThinkTank feeling encouraged about the future of healthcare. It was refreshing to be at an innovation event and hear about actual successful implementations rather than pie-in-the-sky promises. The event reaffirmed my belief that technology alone is insufficient to fix healthcare. Those of us in HealthIT need to do more than just create cool products, we need to help clients re-engineer their internal processes to better utilize those products to improve community health.

As Dr Shrestha said – It’s time for us to stop doing digital and truly be digital.

The Sexiest Data in Health IT: Datapalooza 2017

Posted on May 15, 2017 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor. Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare. twitter: @coherencemed

The data at this conference was the Best Data. The Biggest Data. No one has better data than this conference.

The sexiest data in all of healthIT was highlighted in Washington DC at Datapalooza April 27-28, 2017.  One of the main themes was how to deal with social determinants of health and the value of that data.  Sachin H. Jain, MD of Caremore Health reminded us that “If a patient doesn’t have food at home waiting for them they won’t get better” social data needs to be in the equation. Some of the chatter on the subject of healthcare reform has been criticism that providing mandatory coverage hasn’t always been paired with knowledge of the area. If a patient qualifies for Medicaid and has a lower paying job how can they afford to miss work and get care for their health issues?
Rural areas also have access issues. Patient “Charles” works full time during the week and qualifies for Medicaid. He can’t afford to miss a lot of work but needs a half a day to get treatments which affect his ability to work. There is no public transportation in his town to the hospital in a city an hour and a half away. Charles can’t afford the gas or unpaid time off work for his treatment.

Urban patient “Haley” returns to her local ER department more than once a week with Asthma attacks.  Her treatments are failing because she lives in an apartment with mold in the walls. As Craig Kartchner from the Intermountain Healthcare team responded to the #datapalooza  hashtag online- These can be the most difficult things to change.

The 2016 report to Congress addresses the difficulty of the intersection between social factors and providing quality healthcare in terms of Social Determinants of Health:

“If beneficiaries with social risk factors have worse health outcomes because the providers they see provide low quality care, value based purchasing could be a powerful tool to drive improvements in care and reduce health disparities. However, if beneficiaries with social risk factors have worse health outcomes because of elements beyond the quality of care provided, such as the social risk factors themselves, value based payment models could do just the opposite. If providers have limited ability to influence health outcomes for beneficiaries with social risk factors, they may become reluctant to care for beneficiaries with social risk factors, out of fear of incurring penalties due to factors they have limited ability to influence.”

Innovaccer just launched a free tool to help care teams track and monitor Medicare advantage plans. I went to their website and looked at my county and found data about the strengths in Salt Lake where I’m located. They included:

  • Low prevalence of smoking
  • Low Unemployed Percentage
  • Low prevalence of physically inactive adults

Challenges for my area?

  • Low graduation rate
  • High average of daily Air pollution
  • High income inequality
  • High Violent crime rate per 100,000 population

Salt Lake actually has some really bad inversion problems during the winter months and some days the particulate matter in the air creates problems for respiratory problems. During the 2016-2017 winter there were 18 days of red air quality and 28 days of yellow air quality. A smart solution for addressing social determinants of health that negatively impact patients in this area could be addressing decreasing air pollution through increased public transportation. Healthcare systems will see an increase in cost of care during those times and long term population health challenges can emerge. You can look at your county after you enter your email address on their site. This kind of social data visualization can give high level insights into the social factors your population faces.

One of the themes of HealthDataPalooza was how to use system change to navigate the intersection between taking care of patients and not finding way to exclude groups. During his panel discussion of predictive analytics, Craig Monson the medical director for analytics and reporting discussed how “data analytics is the shiny new toy of healthcare.”    In addition to winning the unofficial datapalooza award for the most quotes and one liners – Craig presented the Clinical Risk Prediction Initiative (CRISPI).  This is a multi variable logistic regression model with data from the Atrius health data warehouse. His questions for systems to remember in their data analysis selection are “Who is the population you are serving? What is the outcome you need? What is the intervention you should implement?”

Warning- Craig reminds us that in a world of increasing sexy artificial intelligence coding a lot of the value analysis can be done with regression. Based on that statement alone I think he can be trusted. I still need to see his data.

CRISPI analyzed the relative utility of certain types of data, and didn’t have a large jump in utility when adding Social Determinant Data. This data was one of the most popular data sets during Datapalooza discussions but the reality of making actionable insights into system improvement? Craig’s analysis said it was lacking. Does this mean social determinant data isn’t significant or that it needs to be handled with a combination of traditional modeling and other methods?  Craig’s assertion seemed to fly in the face of the hot new trend of Social Determinants of Health data from the surface.

Do we have too much data or the wrong use of the data? Most of the companies investing into this space used data sources outside the traditional definition to help create solutions with social determinate of health and Patient outcomes. They differed in how they analyzed social determinant data. Traditional data sources for the social determinants of health are well defined within the public health research.  The conditions in which you work and live impact your health.

Datapalooza had some of the greatest minds in data analytics and speakers addressed gaps in data usefulness. Knowing that a certain large county wide population has a problem with air quality might not be enough to improve patient outcomes. There is need for analysis of traditional data sources in this realm and how they can get meaningful impact for patients and communities. Healthcare innovators need to look at different data sources.  Nick Dawson, Executive director of Johns-Hopkins Sibley Innovation Hub responded to the conversation about food at home with the data about Washington DC.  “DC like many cities has open public data on food scarcity. But it’s not part of a clinical record. The two datasets never touch.” Data about food scarcity can help hospital systems collaborate with SNAP and Government as well as local food programs. Dawson leads an innovation lab at Johns Hopkins Sibley where managers, directors, VPs and C Suite leaders are responsible for working with 4 innovation projects each year.

Audun Utengen, the Co Founder of Symplur said “There’s so much gold in the social media data if you choose to see it.” Social data available online helps providers meet patients where they are and collect valuable data.  Social media data is another source to collect data about patient preferences and interactions for reaching healthcare populations providers are trying to serve. With so much data available sorting through relevant and helpful data provides a new challenge for healthcare systems and providers.

New Data sources can be paired with a consultative model for improving the intersection of accountable care and lack of access due to social factors. We have more sophisticated analytic tools than ever for providing high value care in the intersection between provider responsibility and social collaboration. This proactive collaboration needs to occur on local and national levels.  “It’s the social determinants of health and the behavioral aspects that we need to fund and will change healthcare” we were reminded. Finding local community programs that have success and helping develop a strategy for approaching Social Determinants of Health is on the mind of healthIT professionals.

A number of companies examine data from sources such as social media and internet usage or behavioral data to design improvements for social determinants of health outcomes.   They seek to bridge the gaps mentioned by Dawson. Data sets exist that could help build programs for social determinants of health.  Mandi Bishop started Lifely Insights centered around building custom community plans with behavioral insights into social determinant data. Health in all Policies is a government initiative supporting increased structure and guidelines in these areas. They support local and State initiatives with a focus on prevention.

I’m looking forward to seeing how the data landscape evolves this year. Government Challenges such as the Healthy Behavior Data Challenge launched at Datapalooza will help fund great improvements. All the data people will get together and determine meaningful data sets for building programs addressing the social determinants of health. They will have visualization tools with Tableau. They will find ways to get food to patients at home so those patients will get better. Programs will find a way to get care to rural patients with financial difficulty and build safe housing.

From a healthcare delivery perspective the idea of collaborating about data models can help improve community health and decrease provider and payer cost. The social determinants of health can cost healthcare organizations more money than data modeling and proactive community collaboration.

Great regressions, saving money and improving outcomes?

That is Datapalooza.

Social Determinants of Health (SDOH) Chart

Posted on June 28, 2016 I Written By

John Lynn is the Founder of the 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 and 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 seems like my latest kick is talking about Social Determinants of Health (SDOH) and their impact on our health and the health system (Note: I blame Mandi Bishop for this). Many of you might remember that I recently asked if doctors ever cared about SDOH. The topic also came up in the recent Health Disruptors chat where I asked pointed questions about SDOH from a practicing doctor. Dr. Vanagon’s responses were quite insightful.

During that chat, I started listing off some of the possible social determinants of health. I knew my list was lacking and I figured someone else had created a much better list. As fate would have it, this list popped up on my social news feed:

Social Determinants of Health (SDOH) Chart

Does anyone else get a bit overwhelmed when you see a full list like this? However, it also displays huge opportunities since our current health system is working on such a small portion of this chart. We’re going to have to expand what we’re doing if we truly want to lower the cost of healthcare as we know it. Although, it’s also important to note that doctors can only influence so much of what impacts our health.

Which SDOH factors do you think it would be best for our health system to work on first?

When Did A Doctor Last Worry About Social Determinants of Health (SDOH)?

Posted on June 16, 2016 I Written By

John Lynn is the Founder of the 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 and 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 heard over and over the importance of social determinants of health (SDOH) and their impact on healthcare costs. The concept is fascinating and challenging. There are thousands of examples. A simple one to illustrate the challenge is the patient who arrives at the emergency room with a fever. The doctor treats the fever and then sends them back to their home where they have no heat and are likely to get sick again.

I ask all the doctors that read this blog, when was the last time you worried about these various social determinants of health (SDOH) in the care you provided a patient?

I’ll be interested to hear people’s responses to this question. I’m sure it would create some incredible stories from doctors who really care about their patients and go above and beyond their job duties. In fact, it would be amazing to hear and share some of these stories. We could learn a lot from them. However, I’m also quite sure that almost all of those stories would end with the doctor saying “I wasn’t paid to help the patient this way but it was the right thing to do.”

Let me be clear. I’m not blaming doctors for not doing more for their patients. If I were a doctor, I’m sure I’d have made similar decisions to most of the doctors out there. They do what they’re paid to do.

As I’ve been sitting through the AHIP Institute conference, I’m pondering on if this will change. Will value based reimbursement force doctors to understand SDOH or will they just leave that to their health system or their various software systems to figure it out for them?

I’m torn on the answer to that question. A part of me thinks that most doctors won’t want to dive into that area of health. Their training wasn’t designed for that type of thinking and it would be a tough transition of mindset for many. On the other hand, I think there’s a really important human component that’s going to be required in SDOH. Doctors have an inherent level of trust that is extremely valuable with patients.

What do you think of SDOH? Will doctors need to learn about it? Will the systems just take care of it for them?

Healthcare IT Twitter Roundup

Posted on March 17, 2016 I Written By

John Lynn is the Founder of the 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 and 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 sucking the nectar out of Twitter and providing me own commentary on what people are sharing.

This would be a good step forward. Machine to machine communication can be a lot more accurate.

When you see some of the amazing things they’re starting to discover in genetics, you can see why many are focusing on genetics. However, Pat’s point is a good one that we should focus on other social determinants of health (SDOH) also since they can have a lot of impact.

This is where the cloud is so powerful. Cloud computing is going to be the solution to this problem.

I see more and more efforts to include the patient voice. Love this!