Covid has highlighted these systemic craters in the US medical landscape, showing them up for what we have always known them to be. A major impediment to the delivery of effective healthcare across America. We can now contemplate a manned mission to Mars in the next decade but can’t match data between two hospitals separated by less than a mile.

As Covid developed and spread across the US, it became glaringly obvious there were massive constraints in terms of the free sharing of data based on any industry standards. There are none. No standardization exists. An excellent example provided by a colleague highlights this.

A pre-term birth in Texas, at 20 weeks, results in the death of the infant. Our lungs only develop at 23 weeks. The death certificate issued in Texas will list asphyxiation as the cause of death. Arguably, the baby was doing perfectly well until the mother unexpectedly went into labor. So shouldn’t the real cause of death be exactly that, premature labor? Other states think so and may use that as the cause of death.

Researchers delving into preterm deliveries and mortalities associated with it have to manually sift through data from 50 states, account for variances in the way the data is collected and interpreted, and then reformat the data into a system that accounts for all these variables. It is an impossible task. The end result is that the benefits of the actual data collected are lost, permanently.

Identifying disease trends and prevalence, treatment outcomes, drug efficacy, spikes in notifiable diseases and any other use you care to attach to the data become all but impossible. This results in two very distinct outcomes. Poor response times and poor delivery of care based on evidence, the cornerstone of effective medicine. We are drowning our patients and caregivers in a worthless sea of uninterpretable data. It is unsustainable and patently stupid.

Again, in Texas, a doctor friend’s office has one electronic health record. He works with various hospitals in the area. One hospital uses its own proprietary system. The other two hospitals both use Epic. None of them can communicate Covid results to each other without someone manually inputting the result from one system to the other. The duplication, the loss of man-hours, and the lack of transparency simply beggar belief.

When you are forced to resort to Facebook and Twitter to share information about potentially beneficial results in treating your pandemic patients, we know the system is broken. When you cannot medically assess your population at glance, you lose the ability to respond in a timely fashion to threats. You lose the ability to assess the efficacy of treatments across a population. All of which boils down to one simple thing. Poorly managed and mismatched data aggregation resulting from fragmented systems. No standardization.

Towards Standards

Medicine understands and obeys protocols. The practical implementation of treatments functions more effectively within a predetermined set of parameters, created by the industry, for the industry and that evolve along with the industry. The same needs to hold true of the software that endeavors to understand, collect and sort the data the industry produces. Its primary purpose must be to serve the industry.

America’s IT health issues stem directly from its political system and the autonomy enjoyed by states over their own healthcare and health software. It simply promotes fragmented solutions. Add insurance companies, federal systems, and pharma to the mix and the complexity of a “one system for all” solution becomes apparent.

Hospitals who wish to protect their financial models, income streams and other data are loathe to share. Financial motives outweigh the overriding need for open transparency. These are issues that occur within the confines of the same city, and when distances move these treasure troves of data into different states, any hope of meaningful data sharing is all but lost.

To formalize or standardize this turbulent sea of data, the industry must develop a clear and medically relevant set of healthcare data standards. Guidelines that allow national and state-wide access to data for caregivers, patients, stakeholders, and regulatory authorities. It is an insanely simple task, complicated to impossibility by the interference of influences from outside the sphere of healthcare.

Politics, law, legislation, profits, and privacy issues notwithstanding, the ever-increasing fragmentation needs to be addressed now. Not by outside parties, but by those who intimately understand the inner workings of the industry. We may be divided geographically and politically, but our physiology and susceptibility to illness remain a global shared constant.

This is the foundation we need to build from, never losing sight of the end goal. The effective and timely delivery of meaningful care for patients. They are, after all, the reason the industry exists.

Past Failures and Present Day Winners

Remember Google Health and Microsoft’s brave version. They were going to conquer health and change the world. It’s been a decade. Neither has achieved much, not even a perceptible dent or scratch on the surface of healthcare in the US, and this failure is telling.

Change cannot be driven by agents outside of the industry. Patients can also not impact this eco-system in a meaningful way. It is the caregivers that matter most, the individuals who use the systems, day in and day out, in the pursuit of their noble cause. These are the individuals who can and must demand standardization, who must enforce conformity for the data they produce to enable the amazing benefits we currently blithely ignore.

Oklahoma has done things right. Their medical system functions incredibly efficiently. Built by doctors for doctors, it has served the state well and this system, along with others can provide hugely valuable insights into a real-world working model for efficient medical data sharing.

In much the same way Android and Apple can both access the internet and the data it contains, despite their glaringly different operating systems, healthcare needs to set about creating its own intranet. Call it Mednet or Healthnet, it really doesn’t matter. Just build it. It is medicines “Field of Dreams” moment. Build it and they will come.

Tomorrow

Ask me what I see for medicine, ten years from now and you better have a chair handy. Essentially it is this.

Medicine is a trailblazer when it comes to embracing new technologies, often an early adopter and equally often, an innovator. In ten years and possibly far sooner, your smartwatch will save your life. Data it collects will be fed back via a secure network to your healthcare provider. Automated triggers will be enacted allowing your doctor to schedule medical interventions, adjust medication dosages and monitor your overall health.

This streamlining of services will only become possible once the healthcare industry develops those standards we were discussing. That way Apple and Android will know exactly how to connect to healthcare’s internet. Standardized protocols matter. They enable the rapid development of supporting software, products, and services.

Imagine in 2020, if we’d been able to pick up by location, spikes in body temperature for covid infected Americans. Arguably, millions of infectious people could have been isolated or quarantined within hours. Time matters, responses matter. Both require standardized data. We need to use the impetus covid has provided to make work of this.

Trust

That elusive commodity we have come to take for granted. Any system is only as good as the data it can collect and without widescale adoption, the system fails. Trust plays an integral part in the delivery of effective healthcare. Compromise the ability of the public to trust and you are lost, Again, covid has provided a rude wake-up call, vaccines being the casualty in this instance.

Wide-scale abuse of patient data is prevalent in the industry, accompanied by unethical practices, including the illegal harvesting of patient DNA. These practices need to be vigorously outlawed and policed to restore public faith. To restore trust.

Take Facebook and Apple as an excellent analogy. Facebook enjoys almost no trust in the public mind relating to its data collection and use. It’s one of the reasons I don’t use the Facebook platform, but I happily let Apple intrude on my life. The difference. Trust.

[This article was written by Founding Medika Editor Robert Tuner, PhD., one year ago. It’s an insightful piece and as we look toward HIMSS 2022, consider what – if anything – has changed.]

The post How Fragmentation in U.S. Health Care Disrupts Standardized Medical Data appeared first on Medika Life.

The average American is blissfully unaware of this world, even though it directly affects them, often in hugely personal ways. Your most intimate details, like medical records, may be available for sale online and there’s nothing you can do to prevent it.

When the hack, referred to as a Ransomware Attack, hits closer to home, it becomes public knowledge. Take for instance the attack in early May on American gasoline supplier Colonial Pipeline, which crippled many cities. Americans were soon queuing for gas, hoarding supplies, as gas stations across the US closed or ran out of gas. 

The hackers had taken control of the systems operating the supply of gasoline via pipelines that criss-cross America. This was personal and the American public felt the effects first hand. Ransomeware was all over the news.

What most Americans don’t realize, however, is just how common these attacks are. It’s the perfect digital crime. Take over some company’s system, shut it down remotely from a place of safety, and then demand payment from the company. Once the company pays — the ransom — their systems are unlocked and they can resume business.

Bizarrely, the hacker’s “code of ethics” for want of a better term, seems to hold true. Once payment is made, the systems are released. Payment is a simple matter, digital currencies like Bitcoin make tracking the money all but impossible. 

It could be argued that without access to digital currencies, these hackers would be unable to extort money from their victims without leaving a clear trail for authorities to pursue.

Aside from the obvious inconvenience and potential dangers to essential energy supplies and other critical systems, there is another hugely unreported consequence of these hacks. The bleeding of personally identifying data. That’s your info and mine, all of it fair game. Don’t forget, these hackers are inside the systems they compromise, they have sufficient access to lock down the system.

It would be hugely naive to imagine they simply leave it there. While companies run around trying to secure loans to pay off ransom demands, the hackers are merrily downloading every shred of data they can strip from the systems.

That’s where the real value lies. Your information or data, which is spread throughout numerous systems across the US. This data is worth real hard cash on the dark web, especially certain types of personal data, like your healthcare information. From recent reports, it would appear no systems within the US are immune.

Your Data, Healthcare, and the silent war

Most ransomware attacks never see the public light of day. They’re kept quiet and settled away from the prying eyes of the media and the public. For very good reasons. Investors don’t like companies that appear vulnerable and companies would rather not spend the next six months explaining to their customers that their data was compromised.

Healthcare is particularly vulnerable. It’s a sector favored by hackers. Easy access to poorly protected systems, rich data pickings, and a culture of “keeping it on the QT’ among medical institutions, hospitals, and healthcare systems make this sector almost irresistible. 1 in 3 companies or institutions within healthcare get hit, according to a recent whitepaper from IT Security firm Sophos. Here are the key takeaways from the paper. 

• 34% of healthcare organizations were hit by ransomware in the last year.
• 65% that were hit by ransomware in the last year said the cybercriminals succeeded in encrypting their data in the most significant attack. 
• 44% of those whose data was encrypted used backups to restore data. 
• 34% of those whose data was encrypted paid the ransom to get their data back in the most significant ransomware attack. 
• However, on average, only 69% of the encrypted data was restored after the ransom was paid. 
• 89% of healthcare organizations have a malware incident recovery plan. 
• The average bill for rectifying a ransomware attack, considering downtime, people time, device cost, network cost, lost opportunity, ransom paid etc. was US$1.27 million. While this is a huge sum, it’s also the lowest among all sectors surveyed.

Scripps is an excellent example in case. Scripps began notifying more than 147,000 individuals in early June this year that their protected health information was exposed during a malware attack. They now face 4 class-action lawsuits.

For certain patients, exposed information included names, addresses, birthdates, health insurance data, medical record numbers, patient account numbers, and treatment details. Less than 2.5 percent of individuals’ Social Security numbers and/or driver’s license numbers were involved, according to the health system.

The list of attacks is growing exponentially.

• 500,000 patient files were potentially stolen in a ransomware attack on Iowa clinics.
• 334,000 Ohio Medicaid providers’ data were breached in a vendor hack

Keep in mind that only a small percentage of these attacks are ever made public and the data above should serve as a fair warning to all healthcare organizations. No one is immune and even smaller organizations are targeted.

Protecting yourself

Clearly, we cannot exist in a modern society without sharing our most private details with companies on a daily basis. There is a huge amount of trust involved, and where many Americans now simply take this relationship for granted, assuming companies will protect their information, ransomware exploits have exposed clear flaws in companies’ approaches to protecting our privacy.

We cannot affect or restrict the data we share without compromising, for instance in a healthcare setting, our quality of care and service. In these instances, the onus falls squarely on the shoulders of the service providers to protect our data and they are failing. 

Our only recourse in this instance is to lobby our congressmen and women. Changes need to be urgently brought to bear on the holders of personal data, fines imposed for lack of proper security, and audited processes put in place to ensure our data is safe.

This is going to prove challenging, particularly when not even the federal government’s systems appear immune to attack. Perhaps it is time to apply Bitcoin-style encryption to our data and fight fire with fire.

The post Held for Ransom. A New Pandemic is Sweeping American Healthcare appeared first on Medika Life.

We’ve got vaccines. Getting vaccinated is another matter.

It is amazing how one aspect of our response to COVID-19 appears fueled by light-speed technology, while another seems to be powered by a spinning hamster wheel. It’s curious that we can do great things in the lab to save lives, but we can’t effectively or efficiently coordinate the delivery of information, care, or medicines to consumers.

It’s part of a pattern that shows not enough thought has been given to the most basic coordination of information. After almost 11 months of dealing with the virus, we are still scrambling. At the outset of the pandemic, it was a mad dash to secure personal protective equipment for our frontline healthcare providers, essential workers, and households. Then we saw a run on toilet paper and other supermarket supplies, with the images of empty store shelves a stark reminder of how demand could quickly outstrip the capacity of our supply chains. Now, we are confounded by the frustration of scheduling COVID-19 vaccine appointments or having them canceled when there isn’t enough vaccine to administer.

Bottom line: our health information and delivery systems are not structured to prioritize consumers. Trying to secure a vaccine appointment is like swimming upstream, a tension-generating reminder of the fact that the health system isn’t set up to cater to patients.

Health system communications aren’t even modern. “It’s no secret that many providers and payers relied heavily on the use of fax machines and printed documentation,” said Paul Joiner, chief operating officer of health information network Availity, in a recent interview with Healthcare IT News. As the pandemic “disrupted operations for payers and providers, with many employees and staff members working from home, the willingness to collaborate advanced significantly,” Joiner added. “The old way of sending transactions, clinical documentation, and policy changes transformed overnight.”

And yet, many doctors continue to defend the use of the fax machine, citing HIPAA regulations and concerns of malware or ransomware. This continues to act as a stumbling block in an ailing system, where information needs to be put to active use directing and supporting action as part of an interventional medical care movement that people with health risks desperately need. People are at risk of dying, yet fax machines putt-putt along, alive and well.

What keeps consumers and patients from life-extending essentials is a failure of coordinating and communicating information; in a sense, weaponizing it against disease. Effectively sharing information helped power the innovation that resulted in novel vaccines. However, failing to coordinate how information is inputted, accessed, and applied fuels the anxiety we’re all feeling right now as people who should be protected from Covid-19 — those with life-threatening medical conditions, schoolteachers, people 65 and older, and others — struggle to get vaccinated.

Driving innovation is not the underlying problem; it is organizing information.

Most product shortages are created by poor planning colliding with public need, or worse, people panicking. Forget about moving pills, ampules, or devices on massive pallets from around the world to patients’ hospital bedsides. We have to reimagine how we move people’s medical information off paper charts and onto cloud-based systems so that health professionals — from providers to epidemiologists — can better serve patients with the needed level of coordination and urgency.

Now, as we rebuild our economic system, we have the opportunity to revisit how we coordinate the organization and delivery of healthcare that comprises 18 percent of the United States gross domestic product (GDP).

If we rally our information, tech muscle, and energies toward this one public health challenge alone, it will translate into billions in savings from reduced hospital costs, physician visits, and insurance bills, lifting the burden on taxpayers — both employers and families. It will also save people’s lives.

Remove the Information Sword of Damocles From Patient Care

To incentivize overhauling our health information systems, we need to make medical information available to consumers. That means upping the ante on cybersecurity to protect consumers and advance their health needs. It does not mean using data against them by denying consumers long-term care and coverage.

Many people shy away from confronting health challenges or sharing their personal data for fear their medical records will be held over them like the sword of Damocles. Is penalizing people for being unhealthy at one stage in their life journey worth punishing them in the future? Isn’t helping them to get healthy the ultimate win-win-win, reducing costs and waste and keeping them alive longer?

Information cannot be a vehicle for medical exclusion but should be a means to create healthier people and provide them with better, well-coordinated care.

Let us look at COVID-19 as a wake-up call. At some point, employers and insurers will find that encouraging self-care and disease intervention is a savvy, responsible business model. Digital health tools are readily available to support this. Telemedicine, health apps, remote monitoring tools, and other AI-based technologies contribute to healthier people who can access targeted medicines and individualized dosing.

It may be anathema to the holders of the system’s information keys to place consumers in the driver’s seat of wellness and self-care by giving them access to their own information. That’s got to change. “You cannot deliver on the promise of digital transformation with traditional IT,” reminds Edward W. Marx, chief digital officer, Tech Mahindra Health & Life Sciences, who also served as the chief information officer at Cleveland Clinic.

While we remember our supermarket runs for toilet paper, continue to stockpile masks and gloves, and struggle to set up our appointments for vaccination, we need to look beyond these snafus at what drives the system — information. COVID-19 reinforces that information technology is the foundation for countless public health solutions. It’s time we acted on that realization.

The post Reimagining the Healthcare Economy Through Information appeared first on Medika Life.