New Age in Healthcare

Taken from http://blogs.computerworld.com/20046/glitz_glam_and_the_glimmer_of_a_new_age_in_health_care:

Many wonder how information technology can shape the future of health care. There is no better place to find that answer than at the 2012 Healthcare Information and Management Systems Society (HIMSS) in Las Vegas. HIMSS is an annual gathering of 38,000 mobile-device-wielding doctors, nurses, IT evangelists, exhibitors, state and federal government officials, all attempting to answer that very question.

It's not an idle query, either. The U.S. spent nearly $2.6 trillion on health care in 2010. It's clear that IT has a significant opportunity to help increase the effectiveness and efficiency of the healthcare industry.

EHR growth trajectory
A couple of trends caught my eye at HIMSS, beginning with the increasing number of electronic health record (EHR) solutions available. The health care industry has been trying to move to electronic health records for years, but it can be a complicated and expensive process. Recent changes in federal regulations and incentives are intended to effectively mandate EHRs, turning the status quo upside down.

An EHR provides the necessary foundation to expand and exchange health data across organizational boundaries. For instance, by 2020, I envision being able to seamlessly receive health care services from anybody I choose, just like using my Visa card to shop at stores that cater to my interests.

For IT pros, dramatic growth in EHR systems will bring more intense demands on computing, storage, and imaging resources. These are familiar challenges, but what some may not realize is that EHR systems are not ordinary-the data supports life-critical applications, which means that these systems must be continuously available. If an organization wants to be part of the integrated health data exchange, it could be looking at billions of transactions in a single year.

Also, increased variety in EHR solutions also makes it more difficult to figure out how to accept data from other organizations. Data standards like ICD-10 can help. But there are many types of critical data that remain a challenge, including encounter information. And frankly, that's the low-hanging fruit. As health care organizations move toward a more preventative approach to health maintenance, the types and volume of health data will expand. After all, wouldn't you want information like your preventative health alerts and record of healthy activities to travel with you?

Volume, velocity and variety of medical data
Another game changer in healthcare is the personalization of medicine based on the analysis of large cohorts of historical data. A presenter at HIMSS mentioned, studies suggest that it takes an average of 17 years for research evidence to reach clinical practice. Instead, imagine the ability to bring evidence from thousands of cases over decades directly to the point of care in every patient encounter, providing treatment options contextualized to the individual patient.

Big data technologies and their ability to digest structured and unstructured data are key to making this vision a reality. For example, health care organizations have been storing images (e.g. X-ray, MRI, CAT) electronically for quite some time; however, the resolution of the images has been increasing, while more and more organizations are using software for analysis, in addition to storage and retrieval. Continuously analyzing large numbers of high resolution images will require the ability to handle data at the scale of companies like Google or Yahoo. Fortunately, if the number of HIMSS exhibitors is any indication, this message has been received loud and clear by the industry. That's a good thing, because this is an area where we need to move quickly.

From the perspective of IT, health care has been relatively quiet industry for decades. That has changed. There is immense opportunity to innovate and make a difference. The pieces exist to make health care better; we just need to put those pieces together. The black box is open.

 I couldn't agree more with the last paragraph of this article.  I have worked in the healthcare IT field for just over 4 years now and there has been so many changes to our environment.  When I first began, there was sort of a mixed-bag of technologies.  Most systems, however, were old archaic ones based off of Unix and even MS-DOS (and yes, I know this is not shocking to a lot of companies out there who still work off these systems).  As I began to move forward in my career, I had seen systems that hadn't been touched in years become replaced with newer systems that offered bleeding edge technology solutions.  That means tremendous growth within the healthcare IT industry and new radical ways to look at healthcare.

EMR is quickly growing and physicians are embracing it now than ever before.  This is mostly due to an EMR stimulus plan implemented by President Obama in 2009.  This plan basically offered potentially $44,000 in incentives to physicians who go electronic.  In just one year, the amount of St. Francis affiliated physicians who have adopted an EMR solution is more than tripled.  In 2011, a New York-based research firm estimated the U.S. EHR market at nearly $15.8 billion and predicts it will rise to $31.9 billion in 2015.  The goal is to have a system which integrates all EHR so that it may be available anywhere in the U.S.  What this means is basically if you need to be hospitalized for any reason while being on vacation at, let's say, Honolulu, your medical records can be accessed at the hospital where you are receiving treatment.  Although we are getting a step closer to that ultimate goal, we are ways away from that coming to fruition.  The biggest challenge I see is integrating the many varieties of EHR into a system that would allow them to talk to each other.

Never Stop Innovating

 I thought this article was perfect for this week because it sort of incorporates into this weeks assignment on disruptive technologies.  It gives some good pointers on how to come up innovative ideas and how to get them into the mainstream.  Taken from http://blogs.computerworld.com/20169/innovate_consistently_yes_you_can:

It's 2020. The at-home, telemedicine robot reminds me it's time for the doctor to check how well the burn on my arm is healing. The specialist is in a clinic located more than 45 miles away, but she thoroughly examines my arm through a wound assessment device built into the robot. After the consultation, my smart band reminds me that the mobile health vehicle will be at my workplace, and I should stop by to get my flu shot. I quickly acknowledge my medication reminder alert, take my meds, and then hop into my driverless smart car. On my way to work, I voice-tweet to share my symptom and treatment information with other patients like me in my social health group.
Science fiction? No. This is what digitally-driven healthcare might look like in 2020. All of these technologies and more are being evaluated by health care organizations, and have a solid chance of becoming reality over the next decade.
But getting there will take a lot of work. In addition to proving that an emerging technology can solve a real problem better than the existing solution, we must ensure that innovative ideas/technologies don't fall into the Operationalization Gap or "O-Gap" -- the abyss between an idea and its fruition.
Here are a few of the lessons that we've learned about effectively managing innovation and successfully introducing new technology to an organization.

• Be purposeful. We all welcome flashes of inspiration, but sustained innovation doesn't happen by accident. Establish an end-to-end innovation technology management process. Systematically plan for and manage: innovation initiation, ideation, funding, rapid prototyping, transfer of knowledge, piloting, operationalization, and intellectual property management. Create and manage a balanced emerging technology portfolio (including existing technologies that can be used innovatively to solve problems, as well as emerging and transformative technologies that need to be further evaluated). Provide a comprehensive view of the technology landscape -- tracking both internal and external technology innovation activities from both vendors and competitors. This process discipline will help in several ways. It will help ensure a consistent flow of fresh ideas and help quickly identify the ones best suited to an organization. Defining a process also provides tangible gateways that you can attach metrics to, making it possible to measure how well you're doing and identify areas for improvement.

• Foster a culture of innovation. Ideas come from everywhere: bottom-up, top-down, and sideways, so find ways to let thousands of ideas bloom. Social collaborative and learning networks can help incubate, crowd-source, and foster knowledge sharing. Explore the use of code-a-thons and innovation capital (seed investments) to fund, incentivize, and jumpstart innovative ideas. Nominate and recognize local or portfolio innovation technology champions who disseminate learning and innovate through the use of new and existing technologies.

• Test real things, not ideas. When you find a promising innovation or technology, find a way to test its essential elements as quickly as possible. With fast, light prototypes or mock-ups, you can quickly involve contributors and sponsors from a range of disciplines and detect deficiencies in early design, coding and requirement analysis. Also, make sure that you always think, "People first." Human-centered thinking and methods such as field observations in hospitals or patients' homes can help IT better understand the needs of end-users (patients or clinicians) and their environments.

• Embrace and learn from successful failures. For an innovative technology to spread across an organization, it often requires significant changes in workflow, process, training, culture, and infrastructure. Not all great ideas will succeed. What often looks good under controlled pilots can easily fail in the production environment. David Garvin, a Harvard Business School professor, wrote in "Building a Learning Organization" that "the knowledge gained from failures (is) often instrumental in achieving subsequent successes... In the simplest terms, failure is the ultimate teacher." The history of innovation is a long list of failures that eventually led to bigger successes. Thomas Edison said, "Every wrong attempt discarded is often a step forward." Steve Jobs was fired by Apple in 1985 only to come back a decade later to reinvent the company.

As health innovation and technology evolve, understanding how and when to invest in or adopt them is critically important. I'm looking forward to learning about your best practices.

New SSD Technology

Taken from http://www.pcworld.com/businesscenter/article/254765/hgst_announces_12gbps_sas_ssds_for_use_in_enterprise_data_centers.html:

Western Digital company HGST on Tuesday announced what it claimed to be the first 12 gigabits-per-second (Gbps) SAS solid state drive for use in enterprise storage servers, delivering twice the throughput compared to current 6Gbps SAS technology.

The new SSDs with the Serial Attached SCSI (SAS) interface technology are meant to be used in enterprise server parks, and are equipped with a second interface port. With 12Gbps SAS on each of these ports, the drive can transmit and receive data at a rate of 12Gbps, resulting in a total available interface bandwidth of 4.8GB per second per drive, HGST said.

Though announcing a technology demonstration of the new product, the company did not comment on the likely availability of the drives.

HGST said it is expecting the industry to transition to the use of 12Gbps SAS technology by 2013.

It said in a statement that its 12Gbps SAS drives were interoperable with 12Gbps SAS HBAs (host bus adapters) and expanders from both LSI and PMC-Sierra. Assuring interoperability is critical for the adoption of a new interface standard, the company added.

PMC-Sierra announced the availability of 12Gbps SAS protocol controllers at the end of January this year and said it has been working closely with HGST on interoperability testing. The new high-performance SSDs can deliver up to 100 times more Input/Output Operations Per Second (IOPS) than traditional hard disk drives (HDDs) creating a demand for these controllers, the company said at the time. Its 12Gbps connections delivers 40 percent more drive connectivity, ensuring a scalable tiered storage for corporate and cloud data centers, it added.

LSI demonstrated its 12Gbps SAS expander and Input/Output (I/O) controller last November. The company said at the time that with the adoption of SSDs on the rise within the enterprise, 12Gbps SAS connectivity will be essential to unleash the full performance potential of next-generation server platforms.

HGST said on Tuesday that its new SSDs are backwards compatible with 6Gbps SAS so investments in current SAS infrastructures are protected. The company will demonstrate its 12Gbps SAS technology at the SCSI Trade Association Technology Showcase on May 9.

With the widespread popularity of virtualized apps and desktops, speed has never been more critical.  Citrix and VMware enable you to open up a remote session on a server and work as if you were working on your own workstation.  With the many benefits of virtualized apps and desktops, including centralized management, comes the problem of speed.  When you have dozens of users creating sessions on the server, the server gets taxed heavily and speed degradation becomes apparent.  This is really where SSD technology can help the most.

Security Breach in Boston Children's Hospital

Taken from http://www.esecurityplanet.com/network-security/boston-childrens-hospital-acknowledges-security-breach.html:

Boston Children's Hospital recently notified patients that a hospital laptop had been stolen, resulting in a possible security breach.

"The laptop computer was in the possession of a Boston Children’s staff member attending a conference in Buenos Aires, Argentina," writes Dark Reading's Brian Prince. "The laptop was password-protected but not encrypted. A file containing patient information had been sent to the laptop as an email attachment. It was determined that although the file was not saved to the laptop's hard drive, it was still on the laptop as an email attachment at the time of the theft."

Patient information in the file included the names, medical record numbers, dates of birth, diagnoses, procedures, and dates of surgery for 2,159 patients. The hospital says no patient financial data or Social Security numbers were involved.

"The hospital notified patients and their families of the breach by e-mail," writes The Boston Globe's Chelsea Conaboy. "Hospitals are required to notify the media when there is a breach of patient information affecting more than 500 people in one state."

"Boston Children’s takes this incident and the protection of protected health and personal information extremely seriously," Daniel J. Nigrin, MD, MS, Boston Children's Hospital's senior vice president for information services and chief information officer, said in a statement. "We take great measures to ensure that Protected Health Information is never inadvertently released, and we are undertaking additional steps to prevent breaches such as this in the future. We deeply regret and apologize for any concern or inconvenience this situation may cause our patients and families."

"The state is no stranger to healthcare data breaches," notes FierceHealthCare's Alicia Caramenico. "In fact, more than 200 healthcare data breaches have affected almost 980,000 people in Massachusetts over the past four years, according to a report [PDF file] last month from the state's Office of Consumer Affairs and Business Regulation."

IT security is one of the most difficult facets in IT, especially when it comes to healthcare.  As the industry relies more heavily on technology, the more difficult it is to secure patient data.  Technology can be our number one ally and it can also be our worst enemy.  IT seems to focus a lot on security in terms of a hacker getting in from the outside and comprising systems with sensitive data, but in this case, it was as simple as someone leaving a laptop unattended.  Working in the healthcare field, I realize what a hectic environment it is and things like this can happen.  This is where strong passwords and data encryption come into play.  Now depending how tech savvy this thief is, this data may or may not be in harm's way.  Cracking the password is probably not the thief's main concern and most likely they will just reformat the hard drive and use the laptop for personal entertainment.  Still, if the intent was to gain access to confidential medical records, cracking a password won't be too difficult.  Had the data been encrypted, it would have added an extra measure of security and avoided the embarrassment of this article.  At least the article could've went something along the lines of "The laptop was password-protected AND encrypted".

Frequencies To Be Set Aside Specifically For Medical Devices

Taken from http://thehill.com/blogs/hillicon-valley/technology/229413-fcc-sets-aside-frequencies-for-medical-devices:

The Federal Communications Commission (FCC) voted on Thursday to set aside radio frequency spectrum for wireless medical devices that can monitor a patient's body.

The vote makes the United States the first country in the world to set aside spectrum specifically for the medical devices, known as Medical Area Body Networks (MBANs).

The low-powered sensors allow doctors to remotely monitor a patients' medical data, such as temperature, respiratory function or blood glucose levels, in real time. The technology could allow more patients to receive medial care at home.

FCC Chairman Julius Genachowski said the technology has "tremendous potential to untether patients from tubes and wires, and improve the quality of healthcare and ensure better outcomes for patients."

He cited a study that found an unmonitored patient has just a six percent chance of surviving a cardiac arrest, but monitored patients have a 48 percent chance of surviving. He also claimed the medical devices could reduce healthcare costs by as much as $12,000 per patient by reducing the risk of infections.

All five commissioners voted for the proposal. In statements, Jessica Rosenworcel and Ajit Pai, who were appearing in their first meeting as commissioners, both predicted that the order will save lives and reduce healthcare costs.

The spectrum that the FCC set aside for the devices is now being used by commercial test pilots. The rule will allow different users to share the spectrum band.

I think this is actually a cool advancement in medical technology.  When you see patients in a hospital, they are hooked up to a number of different machines and depending on the ailment, they could have dozens of sensors taped all over their bodies.  Doesn't sound comfortable does it?  Not only does this serve to eliminate that but also provide a way for doctors to monitor patients remotely.  I, for one, would love to see how this get put into action.  I would presume that these body sensors would communicate with some type of router device in the patients home that would either be able to transmit data through the air over great distances or tie into an existing broadband connection.  One concern I do have is the effect of these radio waves on the human body.  There's already concern about how potentially dangerous cell phones could be, surely the FCC would designate a "safe" radio frequency that would not cause adverse effects on the body.  Overall, this technology is very promising and has the potential of detecting dangerous readings before it's too late.

Making Cloud Storage Possible for Healthcare

Cloud storage is a hot topic for many companies because of its many advantages. Basically cloud storage allows companies to have access to larger storage networks, free up real estate used by traditional storage devices, and eliminate the need for an in-house server team.  Cloud storage is also paid in increments instead of all at once so when everything is said and done a company can see immense cost savings.  All that sounds great, but now let's talk about healthcare.  The main concern with cloud storage in a healthcare environment is that sensitive patient data is not secure.  Another is concern is that we know this data going into the "cloud", but where exactly is that?  At my job, we even block any type of online storage, including iCloud, GoogleDocs, and Evernote for fear of patient data being compromised.

In this article, Cloud Storage Encryption and Healthcare,  a security approach called Split-key Encryption is introduced.  Taken from the article:

It allows healthcare providers for the first time to manage encryption keys in the cloud, yet at the same time to split the encryption key, so customers (for example a hospital using medical applications hosted in the cloud) are the only ones who control their “half key”, and therefore patient data is never visible to the cloud provider, or healthcare software vendor.

It looks like the healthcare industry will be able to reap the benefits of cloud storage in the near future.  Does this sound like a promising solution?

Introduction

Hey guys... welcome to my blog!!!  This blog will be dedicated to IT in the healthcare industry.  Hospitals, medical offices, and other healthcare facilities use IT in a number of different ways and are usually home to the latest technological advances known to mankind.  This is why IT is critical in this type of setting because it is required that data is fast, reliable, and secure.  In a healthcare setting, it is imparative that the availability of the network is near 100%, therefore, downtime just isn't an option.  In this blog, I will not only introduce the latest and greatest but also explore the challenges we face in healthcare IT everyday, from meeting the demands of bandwidth intensive medical applications to ensuring that the security of data abides by HIPPA regulations.  Thanks for coming and enjoy my blog!!