At Health:Refactored (San Francisco) I presented a practical and technical look at why current health IT systems integrate poorly and how we can fix it.
Building safety-critical medical device platforms and Meaningful Use EHR gate...Shahid Shah
This is an in depth technical presentation delivered at OSCon 2012 on how to define, design, and build modern safety-critical medical device platforms and Meaningful Use compliant EHR gateways. The talk starts with a quick background on comparative effective research (CER) and patient-centered outcomes research (PCOR) and the kinds of data the government is looking to leverage in the future to help reduce healthcare costs and improve health outcomes. After defining why data is important, the workshop will cover the different techniques for collecting medical data – such as directly from a patient, through healthcare professionals, through labs, and finally through medical devices; the presentation will cover which kinds of data are easy to collect and what are more difficult and how technical challenges to collection can be overcome.
After covering the data collection area the workshop will dive deep into a modern medical device platform architecture which the speaker calls “The Ultimate Medical Device Connectivity Architecture” – providing an in-depth overview and answering questions around architecture, specifications, and design or modern (connected) medical devices.
Presentations of open source software and other inexpensive design techniques for implementing connected architectures will be covered. Finally, the talk will cover details about medical device gateways, what new Meaningful Use rules might require when connecting EHRs to gateways, and how to design and architect gateways that can stand the test of time and be interoperable over the long haul.
HxRefactored: Stop dreaming about fluid data interoperability and start focus...Shahid Shah
This was presented at Health 2.0's HxRefactored 2014 Conference in Brooklyn.
Background:
* Many enterprise apps are being built these days, but most are designed to work as a stand alone system similar to consumer apps
* Healthcare-specific software engineering and integration tools are going to do more harm than good (industry-neutral is better).
Key Takeaways:
* Any enterprise app which acts like a consumer app that doesn’t integrate well into hospital or ambulatory systems and workflows is doomed
* There’s nothing unique about health IT data that justifies complex, expensive, or special technology.
* There’s a lot unique about healthcare workflows that require common technologies to be adapted properly.
OSEHRA Summit 2012 Lunch Keynote: Current health IT systems integrate poorly ...Shahid Shah
OSEHRA Summit 2012 Lunch Keynote - The Myth of Health Data Integration Complexity. This is an opinionated look at why current health IT systems integrate poorly and how it’s a big opportunity for the OSEHRA Community.
Background:
* A deluge of healthcare data is being created as we digitize biology, chemistry, and physics.
* Data changes the questions we ask and it can actually democratize and improve the science of medicine, if we let it.
* While cures are the only real miracles of medicine, big data can help solve intractable problems and lead to more cures.
* Healthcare-focused software engineering is going to do more harm than good (industry-neutral is better).
Key takeaways:
* Major opportunity for systems integrators
* Applications come and go, data lives forever. He who owns, integrates, and uses data wins in the end.
* Never leave your data in the hands of an application/system vendor.
* There’s nothing special about health IT data that justifies complex, expensive, or special technology.
* Spend freely on multiple systems and integration-friendly solutions.
Architecting, designing and building medical devices in an outcomes focused B...Shahid Shah
Keeping your medical device designs relevant in an era of value based and outcome driven care is not easy. In this talk, I cover the following topics:
* “Connected EHRs”, device interoperability, and “Accountable Tech” are the future of med devices
* Hardware, sensors, and software are transient businesses but data lives forever. He who owns, integrates, and uses data wins in the end.
* Data from devices is too important and specialized to be left to software vendors, managed service providers, and system integrators.
Reasons Why Health Data is Poorly Integrated Today and What We Can Do About ItShahid Shah
Presented at the 3rd Annual Open Source EHR Summit - Key takeaways:
* Any enterprise app which acts like a consumer app that doesn’t integrate well into hospital or ambulatory systems and workflows is doomed
* There’s nothing unique about health IT data that justifies complex, expensive, or special technology.
* There’s a lot unique about healthcare workflows that require common technologies to be adapted properly.
How to Use Open Source Technologies in Safety-critical Digital Health Applica...Shahid Shah
Presented at 3rd Annual Open Source EHR Summit - Key Takeaways:
* Outcomes driven care (vs. fees for service or volume driven care) is in our future
* Because outcomes now matter more than ever, open source digital health solutions are even more important
* There are new realities of patient populations driving open source even faster
* How to use open source reliably and and securely in a safety-critical environment like medical devices
How medical devices help fill EHRs with clinically useful data for comparative effectiveness research and data interoperability. This talk was given at the IEEE Baltimore Section EMB Society
Building safety-critical medical device platforms and Meaningful Use EHR gate...Shahid Shah
This is an in depth technical presentation delivered at OSCon 2012 on how to define, design, and build modern safety-critical medical device platforms and Meaningful Use compliant EHR gateways. The talk starts with a quick background on comparative effective research (CER) and patient-centered outcomes research (PCOR) and the kinds of data the government is looking to leverage in the future to help reduce healthcare costs and improve health outcomes. After defining why data is important, the workshop will cover the different techniques for collecting medical data – such as directly from a patient, through healthcare professionals, through labs, and finally through medical devices; the presentation will cover which kinds of data are easy to collect and what are more difficult and how technical challenges to collection can be overcome.
After covering the data collection area the workshop will dive deep into a modern medical device platform architecture which the speaker calls “The Ultimate Medical Device Connectivity Architecture” – providing an in-depth overview and answering questions around architecture, specifications, and design or modern (connected) medical devices.
Presentations of open source software and other inexpensive design techniques for implementing connected architectures will be covered. Finally, the talk will cover details about medical device gateways, what new Meaningful Use rules might require when connecting EHRs to gateways, and how to design and architect gateways that can stand the test of time and be interoperable over the long haul.
HxRefactored: Stop dreaming about fluid data interoperability and start focus...Shahid Shah
This was presented at Health 2.0's HxRefactored 2014 Conference in Brooklyn.
Background:
* Many enterprise apps are being built these days, but most are designed to work as a stand alone system similar to consumer apps
* Healthcare-specific software engineering and integration tools are going to do more harm than good (industry-neutral is better).
Key Takeaways:
* Any enterprise app which acts like a consumer app that doesn’t integrate well into hospital or ambulatory systems and workflows is doomed
* There’s nothing unique about health IT data that justifies complex, expensive, or special technology.
* There’s a lot unique about healthcare workflows that require common technologies to be adapted properly.
OSEHRA Summit 2012 Lunch Keynote: Current health IT systems integrate poorly ...Shahid Shah
OSEHRA Summit 2012 Lunch Keynote - The Myth of Health Data Integration Complexity. This is an opinionated look at why current health IT systems integrate poorly and how it’s a big opportunity for the OSEHRA Community.
Background:
* A deluge of healthcare data is being created as we digitize biology, chemistry, and physics.
* Data changes the questions we ask and it can actually democratize and improve the science of medicine, if we let it.
* While cures are the only real miracles of medicine, big data can help solve intractable problems and lead to more cures.
* Healthcare-focused software engineering is going to do more harm than good (industry-neutral is better).
Key takeaways:
* Major opportunity for systems integrators
* Applications come and go, data lives forever. He who owns, integrates, and uses data wins in the end.
* Never leave your data in the hands of an application/system vendor.
* There’s nothing special about health IT data that justifies complex, expensive, or special technology.
* Spend freely on multiple systems and integration-friendly solutions.
Architecting, designing and building medical devices in an outcomes focused B...Shahid Shah
Keeping your medical device designs relevant in an era of value based and outcome driven care is not easy. In this talk, I cover the following topics:
* “Connected EHRs”, device interoperability, and “Accountable Tech” are the future of med devices
* Hardware, sensors, and software are transient businesses but data lives forever. He who owns, integrates, and uses data wins in the end.
* Data from devices is too important and specialized to be left to software vendors, managed service providers, and system integrators.
Reasons Why Health Data is Poorly Integrated Today and What We Can Do About ItShahid Shah
Presented at the 3rd Annual Open Source EHR Summit - Key takeaways:
* Any enterprise app which acts like a consumer app that doesn’t integrate well into hospital or ambulatory systems and workflows is doomed
* There’s nothing unique about health IT data that justifies complex, expensive, or special technology.
* There’s a lot unique about healthcare workflows that require common technologies to be adapted properly.
How to Use Open Source Technologies in Safety-critical Digital Health Applica...Shahid Shah
Presented at 3rd Annual Open Source EHR Summit - Key Takeaways:
* Outcomes driven care (vs. fees for service or volume driven care) is in our future
* Because outcomes now matter more than ever, open source digital health solutions are even more important
* There are new realities of patient populations driving open source even faster
* How to use open source reliably and and securely in a safety-critical environment like medical devices
How medical devices help fill EHRs with clinically useful data for comparative effectiveness research and data interoperability. This talk was given at the IEEE Baltimore Section EMB Society
How to emrace risk-based Security management in a compliance-driven cultureShahid Shah
This lecture was presented at the IEEE ITPC at the Trenton Computer Festival on March 16.
Security and Regulatory Compliance aren’t the same thing – but they’re often confused. When you’re working in a government, healthcare, or financial environment there’s a tendency to think that if you’re FISMA-compliant or HIPAA-compliant or any other X-compliant that you must have good security.
However, sophisticated risk management and real security don’t have much to do with compliance and you can actually great security and be non-compliant with regulatory requirements as well be fully compliant but not secure. This talk, led by Security guru Shahid Shah, will talk about how make sure risk-based security management is properly incorporate into compliance-driven cultures.
Reasons why health data is poorly integrated today and what we can do about itShahid Shah
Presented at StrataRX 2012: http://strataconf.com/rx2012/public/schedule/detail/25953
While the entire healthcare community, for decades, has been clamoring for, cajoling, and demanding integration of its IT systems, we’re actually in a pretty elementary stage when it comes to useful, practical, health IT systems integration beyond on-premise and in-building hospital software. Our problem in the industry is not that engineers don’t know how to create the right technology solutions or that somehow we have a big governance problem; while those are certainly issues in certain settings, the real cross-industry issue is much bigger – our approach to integration is decades old, opaque, and rewards closed systems.
For decades, starting in the 50’s through the mid 90’s before the web / Internet came along, systems integration meant that every system had to know about each other in advance, decide on what data they would share, engage in governance meetings, have memoranda of understanding or contracts in place, etc. After the web came along, most of that was thrown out the window because the approach changed to one that said the owner of the data provides whatever they decide (e.g. through a web server) and whoever wants it will be provided secure access and they can come get it (e.g. through a browser or HTTP client). This kind of revolutionary approach in systems integration is what the health IT and medical device sectors are sorely lacking and something that ONC can help promote.
Specifically, the following things are holding us back when it comes to poor integration in healthcare and what future EHRs can do about it:
• We don’t support shared identities, single sign on (SSO), and industry-neutral authentication and authorization. Most health IT systems create their own custom logins and identities for its users including roles, permissions, access controls, etc. stored in an opaque part of their own proprietary database. ONC should mandate that all future EHRs use industry-neutral and well supported identity management technologies so that each system has a least the ability to share identities. Without identity sharing and exchange there can be no easy and secure application integration capabilities no matter how good the formats are. I’m continually surprised how little attention is paid to this cornerstone of application integration. There are very nice open identity exchange protocols, such as SAML, OpenID, and oAuth as well as open roles and permissions management protocols such as XACML that make identity and permission sharing possible. Free open source tools such as OpenAM, Apache Directory, OpenLDAP, Shibboleth, and many commercial vendors have drop-in tools to make it almost trivial to do identity sharing, SSO, and RBAC.
Life expectancy is increasing and what used to kill humans 100 years ago is very different than what kills humans today and that patients need to be empowered more to improve their own health. This talk was given at the IEEE Baltimore Section EMB Society
How to Use Open Source Technologies in Safety-critical Medical Device PlatformsShahid Shah
There is a great deal of fear and angst in the medical device vendor community about the use open source in safety-critical products. This presentation provides advice on why the fear is misplaced and how to proceed with using open source in safety-critical medical devices.
Healthcare Analytics Summit Keynote Fall 2017Dale Sanders
The Data Operating System. Changing the Digital Trajectory of Healthcare. Why do we need to change the current digital trajectory? What’s the business case for a Data Operating System? What is a Data Operating System and how did we get here? What difference will DOS make? What should we do with it and what should we expect?
OSEHRA is a Great Business Opportunity for Systems IntegratorsShahid Shah
This is an opinionated look at why current health IT systems integrate poorly and how it’s a big opportunity for the systems integrators to profit from supporting the OSEHRA Community.
Background:
* EHRs are not the center of the healthcare data ecosystem.
* Applications come and go, data lives forever. He who owns, integrates, and uses data wins in the end.
* Never leave data in the hands of the application only.
Key takeaways:
* OSEHRA is major business opportunity for ISVs and systems integrators
* There’s nothing special about health IT data that justifies complex, expensive, or special technology.
The Hive Data Virtualization Introduction - Sanjay Krishnamurti, Chief Archit...The Hive
Talk by Sanjay Krishnamurthi, Chief Architect of Informatica at The Hive Panel Discussion "Data Virtualization: Beyond Traditional Data Integration" on May 28, 2013.
Data-Driven is Passé: Transform Into An Insights-Driven EnterpriseDenodo
Watch the full webinar: http://goo.gl/c5rlCM
Speakers: Holger Kisker, Ph.D., Vice President and Research Director at Forrester Research Inc.
Listen to Holger Kisker, Vice President and Research Director at Forrester Research Inc., describe the three step plan for organizations to become insights-driven rather than data-driven enterprises. Adopting systems of insight and embedding them into your organization’s systems of engagement, record, and automation allows you to turn data into action. As a final step, data virtualization can help keep all systems in synch, being a key enabler for systems of insight.
BDW Chicago 2016 - Ramu Kalvakuntla, Sr. Principal - Technical - Big Data Pra...Big Data Week
We all are aware of the challenges enterprises are having with growing data and silo’d data stores. Business is not able to make reliable decisions with un-trusted data and on top of that, they don’t have access to all data within and outside their enterprise to stay ahead of the competition and make key decisions in their business
This session will take a deep dive into current challenges business are having today and how to build a Modern Data Architecture using emerging technologies such as Hadoop, Spark, NoSQL data stores, MPP Data stores and scalable and cost effective cloud solutions such as AWS, Azure and Bigstep.
20 Years in Healthcare Analytics & Data Warehousing: What did we learn? What'...Health Catalyst
The enterprise data warehouse (EDW) at Intermountain Healthcare went live in 1998. The EDW at Northwestern Medicine went live in 2006. Dale Sanders was the chief architect and strategist for both. The business inspiration behind Health Catalyst was, in essence, to create the commercial availability of the technology, analytics, and data utilization skills associated with these systems at Intermountain and Northwestern. Lee Pierce assumed leadership of the Intermountain EDW in 2008. Andrew Winter assumed leadership of the Northwestern EDW in 2009, and transitioned leadership of the EDW to Shakeeb Akhter in 2016. This webinar is a fireside chat among friends and colleagues as they look back across their healthcare IT decisions to answer these questions:
What did we do right and what did we do wrong?
What advice do we have for others in this emerging era of Big Data?
What does the future of analytics and Big Data look like in healthcare?
Using Case-based Methods for Evaluating Complexity in the Health SectorJSI
Anne LaFond presented as part of a panel at the 2015 Evaluation Conference on using case-based methods for evaluating complexity in the health sector, sharing insights from various JSI case studies.
How to emrace risk-based Security management in a compliance-driven cultureShahid Shah
This lecture was presented at the IEEE ITPC at the Trenton Computer Festival on March 16.
Security and Regulatory Compliance aren’t the same thing – but they’re often confused. When you’re working in a government, healthcare, or financial environment there’s a tendency to think that if you’re FISMA-compliant or HIPAA-compliant or any other X-compliant that you must have good security.
However, sophisticated risk management and real security don’t have much to do with compliance and you can actually great security and be non-compliant with regulatory requirements as well be fully compliant but not secure. This talk, led by Security guru Shahid Shah, will talk about how make sure risk-based security management is properly incorporate into compliance-driven cultures.
Reasons why health data is poorly integrated today and what we can do about itShahid Shah
Presented at StrataRX 2012: http://strataconf.com/rx2012/public/schedule/detail/25953
While the entire healthcare community, for decades, has been clamoring for, cajoling, and demanding integration of its IT systems, we’re actually in a pretty elementary stage when it comes to useful, practical, health IT systems integration beyond on-premise and in-building hospital software. Our problem in the industry is not that engineers don’t know how to create the right technology solutions or that somehow we have a big governance problem; while those are certainly issues in certain settings, the real cross-industry issue is much bigger – our approach to integration is decades old, opaque, and rewards closed systems.
For decades, starting in the 50’s through the mid 90’s before the web / Internet came along, systems integration meant that every system had to know about each other in advance, decide on what data they would share, engage in governance meetings, have memoranda of understanding or contracts in place, etc. After the web came along, most of that was thrown out the window because the approach changed to one that said the owner of the data provides whatever they decide (e.g. through a web server) and whoever wants it will be provided secure access and they can come get it (e.g. through a browser or HTTP client). This kind of revolutionary approach in systems integration is what the health IT and medical device sectors are sorely lacking and something that ONC can help promote.
Specifically, the following things are holding us back when it comes to poor integration in healthcare and what future EHRs can do about it:
• We don’t support shared identities, single sign on (SSO), and industry-neutral authentication and authorization. Most health IT systems create their own custom logins and identities for its users including roles, permissions, access controls, etc. stored in an opaque part of their own proprietary database. ONC should mandate that all future EHRs use industry-neutral and well supported identity management technologies so that each system has a least the ability to share identities. Without identity sharing and exchange there can be no easy and secure application integration capabilities no matter how good the formats are. I’m continually surprised how little attention is paid to this cornerstone of application integration. There are very nice open identity exchange protocols, such as SAML, OpenID, and oAuth as well as open roles and permissions management protocols such as XACML that make identity and permission sharing possible. Free open source tools such as OpenAM, Apache Directory, OpenLDAP, Shibboleth, and many commercial vendors have drop-in tools to make it almost trivial to do identity sharing, SSO, and RBAC.
Life expectancy is increasing and what used to kill humans 100 years ago is very different than what kills humans today and that patients need to be empowered more to improve their own health. This talk was given at the IEEE Baltimore Section EMB Society
How to Use Open Source Technologies in Safety-critical Medical Device PlatformsShahid Shah
There is a great deal of fear and angst in the medical device vendor community about the use open source in safety-critical products. This presentation provides advice on why the fear is misplaced and how to proceed with using open source in safety-critical medical devices.
Healthcare Analytics Summit Keynote Fall 2017Dale Sanders
The Data Operating System. Changing the Digital Trajectory of Healthcare. Why do we need to change the current digital trajectory? What’s the business case for a Data Operating System? What is a Data Operating System and how did we get here? What difference will DOS make? What should we do with it and what should we expect?
OSEHRA is a Great Business Opportunity for Systems IntegratorsShahid Shah
This is an opinionated look at why current health IT systems integrate poorly and how it’s a big opportunity for the systems integrators to profit from supporting the OSEHRA Community.
Background:
* EHRs are not the center of the healthcare data ecosystem.
* Applications come and go, data lives forever. He who owns, integrates, and uses data wins in the end.
* Never leave data in the hands of the application only.
Key takeaways:
* OSEHRA is major business opportunity for ISVs and systems integrators
* There’s nothing special about health IT data that justifies complex, expensive, or special technology.
The Hive Data Virtualization Introduction - Sanjay Krishnamurti, Chief Archit...The Hive
Talk by Sanjay Krishnamurthi, Chief Architect of Informatica at The Hive Panel Discussion "Data Virtualization: Beyond Traditional Data Integration" on May 28, 2013.
Data-Driven is Passé: Transform Into An Insights-Driven EnterpriseDenodo
Watch the full webinar: http://goo.gl/c5rlCM
Speakers: Holger Kisker, Ph.D., Vice President and Research Director at Forrester Research Inc.
Listen to Holger Kisker, Vice President and Research Director at Forrester Research Inc., describe the three step plan for organizations to become insights-driven rather than data-driven enterprises. Adopting systems of insight and embedding them into your organization’s systems of engagement, record, and automation allows you to turn data into action. As a final step, data virtualization can help keep all systems in synch, being a key enabler for systems of insight.
BDW Chicago 2016 - Ramu Kalvakuntla, Sr. Principal - Technical - Big Data Pra...Big Data Week
We all are aware of the challenges enterprises are having with growing data and silo’d data stores. Business is not able to make reliable decisions with un-trusted data and on top of that, they don’t have access to all data within and outside their enterprise to stay ahead of the competition and make key decisions in their business
This session will take a deep dive into current challenges business are having today and how to build a Modern Data Architecture using emerging technologies such as Hadoop, Spark, NoSQL data stores, MPP Data stores and scalable and cost effective cloud solutions such as AWS, Azure and Bigstep.
20 Years in Healthcare Analytics & Data Warehousing: What did we learn? What'...Health Catalyst
The enterprise data warehouse (EDW) at Intermountain Healthcare went live in 1998. The EDW at Northwestern Medicine went live in 2006. Dale Sanders was the chief architect and strategist for both. The business inspiration behind Health Catalyst was, in essence, to create the commercial availability of the technology, analytics, and data utilization skills associated with these systems at Intermountain and Northwestern. Lee Pierce assumed leadership of the Intermountain EDW in 2008. Andrew Winter assumed leadership of the Northwestern EDW in 2009, and transitioned leadership of the EDW to Shakeeb Akhter in 2016. This webinar is a fireside chat among friends and colleagues as they look back across their healthcare IT decisions to answer these questions:
What did we do right and what did we do wrong?
What advice do we have for others in this emerging era of Big Data?
What does the future of analytics and Big Data look like in healthcare?
Using Case-based Methods for Evaluating Complexity in the Health SectorJSI
Anne LaFond presented as part of a panel at the 2015 Evaluation Conference on using case-based methods for evaluating complexity in the health sector, sharing insights from various JSI case studies.
Non Invasive Health Monitoring with mHealthBart Collet
mHealth Trends and examples of non invasive mobile health devices, organisations and services.
Made as preparation for MoMoAMS #14 about mHealth, Jan 25th 2010, Amsterdam
Revenue opportunities in the management of healthcare data delugeShahid Shah
Healthcare data is hard to deal with and getting even harder and more expensive. In this presentation, Shahid Shah covers why:
* Healthcare data is going from hard to nearly impossible to manage.
* Applications come and go, data lives forever.
* Data integration is notoriously difficult, even in the best of circumstances, and requires sophisticated tools and attention to detail.
And, then talks about how new techniques are needed to store and manage healthcare data.
Service oriented architecture (SOA) deserves service oriented dataShahid Shah
Centralized, monolithic databases primarily built using relational approaches have ruled for decades; they’ve given us tremendous advances such as vertically scaled business-critical transactional systems and web applications. The next generation of microapps, microservices, and web widgets demand a scale that vertical scale application-centric relational databases are having difficulty with so we need to move to a more service-oriented database approach in which even small services like those that service patients in a patient portal or specific modules of EHRs can and should have their own databases.
This talk encourages the idea of service-focused databases and how they differ from application-centric databases; using this new approach allows faster delivery of applications, less coupling, and better scalability. Healthcare and biomedical databases are notoriously complex and no single database technology can serve its needs so we need a more service-oriented approach to database design.
You’ll learn how to choose the right database technology for each service, how to model service-oriented databases differently than application-oriented ones, and how to keep service databases running smoothly.
The Data Operating System: Changing the Digital Trajectory of HealthcareDale Sanders
This is the next evolution in health information exchanges and data warehouses, specifically designed to support analytics, transaction processing, and third party application development, in one platform, the Data Operating System.
The Data Operating System: Changing the Digital Trajectory of HealthcareHealth Catalyst
In 1989, John Reed, the CEO of Citibank and the early pioneer for ATMs, said, “I can see a future in which the data and information that is exchanged in our transactions are worth more than the transactions themselves.” We are at an interesting digital nexus in healthcare. Few of us would argue against the notion that data and digital health will play a bigger and bigger role in the future. But, are we on the right track to deliver on that future? It required $30B in federal incentive money to subsidize the uptake of Electronic Health Records (EHRs). You could argue that the federal incentives stimulated the first major step towards the digitization of health, but few physicians would celebrate its value in comparison to its expense. As the healthcare market consolidates through mergers and acquisitions (M&A), patching disparate EHRs and other information systems together becomes even more important, and challenging. An organization is not integrated until its data is integrated, but costly forklift replacements of these transaction information systems and consolidating them with a single EHR solution is not a viable financial solution.
Med Device Vendors Have Big Opportunities in Health IT Software, Services, an...Shahid Shah
If you’re in the medical device manufacturing or hardware sales business your revenue growth (CAGR) is under pressure like never before. You’re being asked to do more with less but you’re probably going to find that hard to accomplish because of one or more of the following challenges:
* Longer product development timelines caused by more FDA and other government regulations
* Increased demand by customers to have your devices deliver user experiences that are more like “consumer” devices such as cell phones and tablets
* Lower margins as a reaction to commodity competition (your sensor hardware business will be commoditized faster and faster over time)
* More complex and longer sales cycles because devices are now being approved for sale not by facilities and clinical executives alone but increasingly by CIOs and IT teams
* Increased cost of risk management and compliance caused by connectivity requirements
Any one of these challenges is difficult to meet but these days you’re probably being asked to meet more than one simultaneously. The solutions are not simple but the good news is that medical device manufacturers have many revenue generation opportunities today that can fund the new strategic imperatives you’ll need to put into place to meet the challenges listed above.
This briefing, presented by Netspective CEO Shahid Shah, describes some of the opportunities and how device vendors can take advantage of them.
The Health Catalyst Data Operating System (DOS™): Lessons Learned and Plans ...Health Catalyst
Just over three years ago, Health Catalyst publicly announced the development of the Data Operating System (DOSTM). Conceptually, DOS goes back more than 20 years as a single platform that could support what Dale Sanders calls the “Three Missions of Data”—analytics, data-first application development, and interoperability.
“Data platforms are the next evolution of the technology stack,” Sanders says. While the Cloud made infrastructure an easy and scalable platform, modern operating systems and programming languages made software platforms scalable and easy to build. He cautions, however, “Data wrangling, especially in healthcare, is still a giant challenge.” Sanders explains that DOS is therefore an essential strategy for Health Catalyst, as well as an important new concept in the world of platforms.
“DOS and its concept is a data platform that makes analytics, app development, and interoperability easy and scalable,” Sanders says.
In this webinar, Sanders and Bryan Hinton will review the concept of a data operating system and the vision behind it. Hinton, who leads the DOS team for Health Catalyst, will reflect on lessons learned over the past three years and what he has planned for the future.
Mergers, acquisitions, and partnerships dramatically reducing it consolidati...Health Catalyst
Please join Dale Sanders, President of Health Catalyst Technology, in this webinar as he explains his experiences, observations, and advice about the use of an EDW or DOS to reduce the costs of IT integration in healthcare M&A and rapidly increase the value proposition of the new organization. Dale has a diverse background in complex data environments and decision support, spanning three decades in the US Air Force, National Security Agency, and as a CIO in healthcare.
Big data is generating a lot of hype in every industry including healthcare. As my colleagues and I talk to leaders at health systems, we’ve learned that they’re looking for answers about big data. They’ve heard that it’s something important and that they need to be thinking about it. But they don’t really know what they’re supposed to do with it.
Healthcare Analytics Platform: DOS Delivers the 7 Essential ComponentsHealth Catalyst
The Data Operating System (DOS™) is a vast data and analytics ecosystem whose laser focus is to rapidly and efficiently improve outcomes across every healthcare domain. DOS is a cornerstone in the foundation for building the future of healthcare analytics. This white paper from Imran Qureshi details the seven capabilities of DOS that combine to unlock data for healthcare improvement:
1. Acquire
2. Organize
3. Standardize
4. Analyze
5. Deliver
6. Orchestrate
7. Extend
These seven components will reveal how DOS is a data-first system that can extract value from healthcare data and allow leadership and analytics teams to fully develop the insights necessary for health system transformation.
Health IT has a Big Data opportunity with HL7 analytics. Learn about what is possible from Wes Wright, CIO at Seattle Children's Hospital, and Erik Giesa, SVP of Marketing and Business Development at ExtraHop.
The third webcast in this series focuses on ways to meet your health system’s specific needs and achieve a 360-degree view of your patients, processes, physicians, and costs without purchasing multiple, disparate solutions, and creating information silos.
Our speakers discuss their collective experience in working with organizations to create tailored platforms that provide convenient access to data collected by, and stored in, disparate clinical information systems and enabling that data to be securely used by users throughout the broader healthcare community. Actionable data – available to all users when they need it – serves as a foundation for analysis and decision-making aimed at improving how care is delivered.
You can find it online at http://www.informationbuilders.com/webevents/online/24637#sthash.RnwoH27x.dpuf
Open Insights Harvard DBMI - Personal Health Train - Kees van Bochove - The HyveKees van Bochove
In this talk, the Personal Health Train concept will be introduced, which enables running personalized medicine workflows as trains visiting data stations (e.g. hospital records, primary care records, clinical studies and registries, patient-held data from e.g. wearable sensors etc.) The Personal Health Train is a very powerful concept, which is however dependent on source medical data to be coded with appropriate metadata on consent, license, scope etc. of the data, and the data itself to be encoded using biomedical data standards, which is an ever growing field in biomedical informatics. In order to realize the Personal Health Train biomedical data will need to be FAIR, i.e. adopt the FAIR Guiding Principles. This talk will cover the emerging GO-FAIR international movement, and provide examples of how several European health data networks currently are adopting open standards based stacks, to enable routine health care data to be come accessible for research.
CHC Briefing: OSEHRA is a great business opportunity for healthcare IT ISVs a...Shahid Shah
An opinionated look at why current health IT systems integrate poorly and how it’s a big opportunity for the OSEHRA Community
Topics Covered:
* An overview of VA, VHA, VistA, and OSEHRA
* The macro healthcare environment and why OSEHRA is am important participant
* What’s needed by the industry that OSEHRA can provide
Key takeaways:
* OSEHRA is major business opportunity for ISVs and systems integrators
* There’s nothing special about health IT data that justifies complex, expensive, or special technology
Similar to The Myth of Health Data Integration Complexity (20)
The biggest opportunities in digital health for Turkey's Medical Sector Shahid Shah
This was presented at the Digital Health Summit Turkey 2014 in Istanbul. It is an American healthcare expert's viewpoint on what should matter to Turkey based on lessons from the USA. Designed for a mixed audience of providers, pharma, and bio entrepreneurs and executives.
Open Source is a great opportunity for EHR, Digital Health, and Health IT Int...Shahid Shah
Presented at the OSEHRA Summit 2014, this talk focused on:
* OSEHRA is major business opportunity for ISVs and systems integrators
* Open source software and associated business models can satisfy most needs.
* There’s nothing special about health IT data that justifies complex, expensive, or special technology.
The shift from Fee for Service to Outcomes-Driven care means huge opportuniti...Shahid Shah
I presented this opinionated look at why the Medicare Shared Savings plans, ACOs and other outcomes-driven payment models are being promoted over fee for service (FFS) models and what that means for service providers and integrators. Evidence driven healthcare is required to help reduce costs and data drives evidence – the problem is that institutions are having trouble pulling together all the data they need. Current health IT systems integrate poorly and anyone that can improve that data integration to help with pricing transparency, cost transparency, care coordination, and population health management will have work for years.
Healthcare New Media Marketing Conference KeynoteShahid Shah
Keynote presentation by Shahid Shah and Joel Selzer delivered at the Healthcare New Media Conference in Chicago, June 14th 2010. This deck looks back on the impact social media has made across the patient and provider landscape, examining specific examples over the past year, and offers a vision of what the future may hold.
We walk through how hospitals, patient communities, physician networks, pharmaceutical manufacturers, the federal government and private innovators have managed the opportunities and challenges social media provides.
What do Secure, HIPAA Compliant, Clouds Mean to SOA in Healthcare?Shahid Shah
Technical discussion about service oriented architecture (SOA) and HIPAA compliant clouds. This talk was presented at the Object Management Group's (OMG) SOA in Healthcare working group in the Summer of 2011. It covered the following major topics:
* What does HIPAA mean in the cloud?
* Are cloud providers covered by HIPAA?
* Cloud safeguards that can meet HIPAA requirements
* Healthcare SOA In the cloud
The EMR/EHR and Health IT Landscape for Sales ProfessionalsShahid Shah
This presentation was made to multiple national sale force teams who are selling EHRs and other health IT products.
Topics covered:
* Where do EMRs / EHRs fit and why?
* What are the most important considerations for customers?
* What are their top problems?
* How to approach customers with marketing messages that matter.
* How to cut through sales clutter.
What’s next for healthcare information technology innovation?Shahid Shah
This is a summary of a talk I gave at the Vanderbilt Healthcare Conference 2012 in Nashville.
It focused on answering a couple of key questions:
* What does innovation in healthcare mean?
* Where are the major areas in healthcare where innovation is required?
And had a few key takeaways:
* Understand health tech buy fallacies
* Understand PBU: Payer vs. Benefiter vs. User
* Understand why healthcare businesses buy stuff so you can build the right thing
Do’s and Don’ts of Risk-based Security management in a Compliance-driven CultureShahid Shah
Security and Regulatory Compliance aren’t the same thing – but they’re often confused. When you’re working in a government, healthcare, or financial environment there’s a tendency to think that if you’re FISMA-compliant or HIPAA-compliant or any other X-compliant that you must have good security.
However, sophisticated risk management and real security don’t have much to do with compliance and you can actually great security and be non-compliant with regulatory requirements as well be fully compliant but not secure. This talk, led by Security guru Shahid Shah, will talk about how make sure risk-based security management is properly incorporate into compliance-driven cultures.
A recording of this presentation is available at: https://www.brighttalk.com/webcast/288/62133
Differentiating your products and services at the HIMSS 2013 ConferenceShahid Shah
Provide actionable advice on how to make the HIMSS Conference experience more effective and learn how to have your marketing and sales messages rise above all the noise. We covered the following major subjects:
* Describe the expectations of attendees and why they attend
* Provide suggestions for how to clearly differentiate your products and services
* Explain some of the common mistakes exhibitors make
* Plan what to do before, during, and after the conference
If you'd like to hear it with audio, please visit www.influentialnetworks.com/himss-2013-conference-services/
GCC-HIMSS Webinar "What’s next for healthcare information technology innovati...Shahid Shah
My Greater Chicago Chapter of HIMSS webinar on “What’s Next for Healthcare Information Technology Innovation?” The screencast with audio is available here: https://www4.gotomeeting.com/register
Getting Beyond the Hype of “Disrupting Healthcare” and Focusing on Actionable...Shahid Shah
This was a Keynote Address I gave at Healthcare Unbound 2013 and focused on what’s needed for healthcare technology innovation in a value- and outcomes-driven model.
There’s a ton of hype surrounding disruptive technology innovation in healthcare but nothing is truly making a dent in the healthcare sector the same way as disruptions have occurred in other major segments of our economy. The slow but sure march from Fee For Service Based Care to Outcomes Driven Care has certainly started but it’s neither fast enough nor substantial enough to bend the cost curve or improve value to patients in the short term.
This presentation discusses how we can get beyond the hype by focusing on actionable innovation. Specifically, I answered the following questions:
* What does innovation in healthcare mean?
* Where are the major areas in healthcare where innovation is required?
Important takeaways this session included:
* Understand PBU: Payer vs. Benefiter vs. User
* Understand why healthcare businesses buy stuff so you can build the right thing
The future of empowered patients is in wireless capable medical devices with ...Shahid Shah
This presentation was given at the Tenth Annual Healthcare Unbound Conference in Denver. It covers the following topics:
* Things that kill and harm human beings today are very different than just 100 years ago
* Health policy and payments are shifting to deal with new realities
* Marketplace and industry challenges for device vendors
* Why wireless connectivity is good business
* Why wireless connectivity is a disruptive innovation
Key takeaways include:
* Wireless is a business enabler but there’s a lot to consider.
* Hardware, sensors, and software are transient businesses but data lives forever. * He who owns, integrates, and uses data wins in the end.
* Data from devices is too important and specialized to be left to software vendors, managed service providers, and system integrators.
Smart TV Buyer Insights Survey 2024 by 91mobiles.pdf91mobiles
91mobiles recently conducted a Smart TV Buyer Insights Survey in which we asked over 3,000 respondents about the TV they own, aspects they look at on a new TV, and their TV buying preferences.
Software Delivery At the Speed of AI: Inflectra Invests In AI-Powered QualityInflectra
In this insightful webinar, Inflectra explores how artificial intelligence (AI) is transforming software development and testing. Discover how AI-powered tools are revolutionizing every stage of the software development lifecycle (SDLC), from design and prototyping to testing, deployment, and monitoring.
Learn about:
• The Future of Testing: How AI is shifting testing towards verification, analysis, and higher-level skills, while reducing repetitive tasks.
• Test Automation: How AI-powered test case generation, optimization, and self-healing tests are making testing more efficient and effective.
• Visual Testing: Explore the emerging capabilities of AI in visual testing and how it's set to revolutionize UI verification.
• Inflectra's AI Solutions: See demonstrations of Inflectra's cutting-edge AI tools like the ChatGPT plugin and Azure Open AI platform, designed to streamline your testing process.
Whether you're a developer, tester, or QA professional, this webinar will give you valuable insights into how AI is shaping the future of software delivery.
Slack (or Teams) Automation for Bonterra Impact Management (fka Social Soluti...Jeffrey Haguewood
Sidekick Solutions uses Bonterra Impact Management (fka Social Solutions Apricot) and automation solutions to integrate data for business workflows.
We believe integration and automation are essential to user experience and the promise of efficient work through technology. Automation is the critical ingredient to realizing that full vision. We develop integration products and services for Bonterra Case Management software to support the deployment of automations for a variety of use cases.
This video focuses on the notifications, alerts, and approval requests using Slack for Bonterra Impact Management. The solutions covered in this webinar can also be deployed for Microsoft Teams.
Interested in deploying notification automations for Bonterra Impact Management? Contact us at sales@sidekicksolutionsllc.com to discuss next steps.
"Impact of front-end architecture on development cost", Viktor TurskyiFwdays
I have heard many times that architecture is not important for the front-end. Also, many times I have seen how developers implement features on the front-end just following the standard rules for a framework and think that this is enough to successfully launch the project, and then the project fails. How to prevent this and what approach to choose? I have launched dozens of complex projects and during the talk we will analyze which approaches have worked for me and which have not.
GDG Cloud Southlake #33: Boule & Rebala: Effective AppSec in SDLC using Deplo...James Anderson
Effective Application Security in Software Delivery lifecycle using Deployment Firewall and DBOM
The modern software delivery process (or the CI/CD process) includes many tools, distributed teams, open-source code, and cloud platforms. Constant focus on speed to release software to market, along with the traditional slow and manual security checks has caused gaps in continuous security as an important piece in the software supply chain. Today organizations feel more susceptible to external and internal cyber threats due to the vast attack surface in their applications supply chain and the lack of end-to-end governance and risk management.
The software team must secure its software delivery process to avoid vulnerability and security breaches. This needs to be achieved with existing tool chains and without extensive rework of the delivery processes. This talk will present strategies and techniques for providing visibility into the true risk of the existing vulnerabilities, preventing the introduction of security issues in the software, resolving vulnerabilities in production environments quickly, and capturing the deployment bill of materials (DBOM).
Speakers:
Bob Boule
Robert Boule is a technology enthusiast with PASSION for technology and making things work along with a knack for helping others understand how things work. He comes with around 20 years of solution engineering experience in application security, software continuous delivery, and SaaS platforms. He is known for his dynamic presentations in CI/CD and application security integrated in software delivery lifecycle.
Gopinath Rebala
Gopinath Rebala is the CTO of OpsMx, where he has overall responsibility for the machine learning and data processing architectures for Secure Software Delivery. Gopi also has a strong connection with our customers, leading design and architecture for strategic implementations. Gopi is a frequent speaker and well-known leader in continuous delivery and integrating security into software delivery.
UiPath Test Automation using UiPath Test Suite series, part 3DianaGray10
Welcome to UiPath Test Automation using UiPath Test Suite series part 3. In this session, we will cover desktop automation along with UI automation.
Topics covered:
UI automation Introduction,
UI automation Sample
Desktop automation flow
Pradeep Chinnala, Senior Consultant Automation Developer @WonderBotz and UiPath MVP
Deepak Rai, Automation Practice Lead, Boundaryless Group and UiPath MVP
JMeter webinar - integration with InfluxDB and GrafanaRTTS
Watch this recorded webinar about real-time monitoring of application performance. See how to integrate Apache JMeter, the open-source leader in performance testing, with InfluxDB, the open-source time-series database, and Grafana, the open-source analytics and visualization application.
In this webinar, we will review the benefits of leveraging InfluxDB and Grafana when executing load tests and demonstrate how these tools are used to visualize performance metrics.
Length: 30 minutes
Session Overview
-------------------------------------------
During this webinar, we will cover the following topics while demonstrating the integrations of JMeter, InfluxDB and Grafana:
- What out-of-the-box solutions are available for real-time monitoring JMeter tests?
- What are the benefits of integrating InfluxDB and Grafana into the load testing stack?
- Which features are provided by Grafana?
- Demonstration of InfluxDB and Grafana using a practice web application
To view the webinar recording, go to:
https://www.rttsweb.com/jmeter-integration-webinar
State of ICS and IoT Cyber Threat Landscape Report 2024 previewPrayukth K V
The IoT and OT threat landscape report has been prepared by the Threat Research Team at Sectrio using data from Sectrio, cyber threat intelligence farming facilities spread across over 85 cities around the world. In addition, Sectrio also runs AI-based advanced threat and payload engagement facilities that serve as sinks to attract and engage sophisticated threat actors, and newer malware including new variants and latent threats that are at an earlier stage of development.
The latest edition of the OT/ICS and IoT security Threat Landscape Report 2024 also covers:
State of global ICS asset and network exposure
Sectoral targets and attacks as well as the cost of ransom
Global APT activity, AI usage, actor and tactic profiles, and implications
Rise in volumes of AI-powered cyberattacks
Major cyber events in 2024
Malware and malicious payload trends
Cyberattack types and targets
Vulnerability exploit attempts on CVEs
Attacks on counties – USA
Expansion of bot farms – how, where, and why
In-depth analysis of the cyber threat landscape across North America, South America, Europe, APAC, and the Middle East
Why are attacks on smart factories rising?
Cyber risk predictions
Axis of attacks – Europe
Systemic attacks in the Middle East
Download the full report from here:
https://sectrio.com/resources/ot-threat-landscape-reports/sectrio-releases-ot-ics-and-iot-security-threat-landscape-report-2024/
Connector Corner: Automate dynamic content and events by pushing a buttonDianaGray10
Here is something new! In our next Connector Corner webinar, we will demonstrate how you can use a single workflow to:
Create a campaign using Mailchimp with merge tags/fields
Send an interactive Slack channel message (using buttons)
Have the message received by managers and peers along with a test email for review
But there’s more:
In a second workflow supporting the same use case, you’ll see:
Your campaign sent to target colleagues for approval
If the “Approve” button is clicked, a Jira/Zendesk ticket is created for the marketing design team
But—if the “Reject” button is pushed, colleagues will be alerted via Slack message
Join us to learn more about this new, human-in-the-loop capability, brought to you by Integration Service connectors.
And...
Speakers:
Akshay Agnihotri, Product Manager
Charlie Greenberg, Host
Key Trends Shaping the Future of Infrastructure.pdfCheryl Hung
Keynote at DIGIT West Expo, Glasgow on 29 May 2024.
Cheryl Hung, ochery.com
Sr Director, Infrastructure Ecosystem, Arm.
The key trends across hardware, cloud and open-source; exploring how these areas are likely to mature and develop over the short and long-term, and then considering how organisations can position themselves to adapt and thrive.
The Art of the Pitch: WordPress Relationships and SalesLaura Byrne
Clients don’t know what they don’t know. What web solutions are right for them? How does WordPress come into the picture? How do you make sure you understand scope and timeline? What do you do if sometime changes?
All these questions and more will be explored as we talk about matching clients’ needs with what your agency offers without pulling teeth or pulling your hair out. Practical tips, and strategies for successful relationship building that leads to closing the deal.
GraphRAG is All You need? LLM & Knowledge GraphGuy Korland
Guy Korland, CEO and Co-founder of FalkorDB, will review two articles on the integration of language models with knowledge graphs.
1. Unifying Large Language Models and Knowledge Graphs: A Roadmap.
https://arxiv.org/abs/2306.08302
2. Microsoft Research's GraphRAG paper and a review paper on various uses of knowledge graphs:
https://www.microsoft.com/en-us/research/blog/graphrag-unlocking-llm-discovery-on-narrative-private-data/
FIDO Alliance Osaka Seminar: Passkeys at Amazon.pdf
The Myth of Health Data Integration Complexity
1. The Myth of Health Data
Integration Complexity
There’s nothing special about health IT data that
justifies complex, expensive, or special technology
By Shahid N. Shah, CEO
2. NETSPECTIVE
Who is Shahid?
•
•
•
•
20+ years of software engineering and multidiscipline complex IT implementations (Gov.,
defense, health, finance, insurance)
12+ years of healthcare IT and medical
devices experience (blog at
http://healthcareguy.com)
15+ years of technology management
experience (government, non-profit,
commercial)
10+ years as architect, engineer, and
implementation manager on various EMR
and EHR initiatives (commercial and nonprofit)
www.netspective.com
Author of Chapter 13, “You’re
the CIO of your Own Office”
2
3. NETSPECTIVE
What’s this talk about?
Background
•
•
•
•
A deluge of healthcare data is being
created as we digitize biology,
chemistry, and physics.
Data changes the questions we ask
and it can actually democratize and
improve the science of medicine, if we
let it.
While cures are the only real miracles
of medicine, data can help solve
intractable problems and lead to more
cures.
Healthcare-focused software
engineering is going to do more harm
than good (industry-neutral is better).
www.netspective.com
Key takeaways
•
•
•
•
Applications come and go, data lives
forever. He who owns, integrates,
and uses data wins in the end.
Never leave your data in the hands
of an application/system vendor.
There’s nothing special about
health IT data that justifies
complex, expensive, or special
technology.
Spend freely on multiple systems
and integration-friendly solutions.
3
4. NETSPECTIVE
NEJM believes doctors are trapped
It is a widely accepted myth that medicine requires
complex, highly specialized information-technology (IT)
systems.
This myth continues to justify soaring IT costs,
burdensome physician workloads, and stagnation in
innovation — while doctors become increasingly bound
to documentation and communication products that are
functionally decades behind those they use in their
“civilian” life.
New England Journal of Medicine “Escaping the EHR Trap - The Future of Health IT”, June 2012
www.netspective.com
4
5. NETSPECTIVE
Data changes the questions we ask
Simple visual facts
www.netspective.com
Complex visual facts
Complex computable
facts
5
6. NETSPECTIVE
Implications for scientific discovery
The old way
Identify problem
Identify data
Ask questions
Generate questions
Collect data
Mine data
Answer questions
www.netspective.com
The new way
Answer questions
6
7. NETSPECTIVE
Application focus is biggest mistake
Application-focused IT instead of Data-focused IT is causing business problems.
Silos of information exist across
groups (duplication, little sharing)
Clinical
Apps
Billing
Apps
Lab
Apps
Other
Apps
Healthcare Provider Systems
Patient
Apps
Partner Systems
Poor data integration across
application bases
www.netspective.com
7
8. NETSPECTIVE
The Strategy: Modernize Integration
Need to get existing applications to share data through modern integration
techniques
Clinical
Apps
NCI
App
Billing
Apps
Lab
Other
Apps
Apps
NEI
App
Healthcare Provider Systems
Patient
Apps
NHLBI
App
Partner Systems
Master Data Management, Entity Resolution, and Data Integration
Improved integration by services
that can communicate between applications
www.netspective.com
8
9. NETSPECTIVE
Confronting Data Integration Myths
My EHR will handle
everything I need
and push data
where required
Without semantic
mapping the
aggregated data is
not useful
www.netspective.com
I can’t possibly store
everything
I don’t have to
worry about storing
certain types of data
I only need to store
data for a period of
time
If I don’t understand
how to synthesize
data now, I’d rather
not store it
9
10. NETSPECTIVE
Why health IT system integrate poorly
•
•
•
•
Permissions-oriented culture
prevents tinkering and “hacking”
We don't support shared identities,
single sign on (SSO), and industryneutral authentication and
authorization
We're too focused on "structured
data integration" instead of "practical
app integration" in our early project
phases
We focus more on "pushing" versus
"pulling" data than is warranted
early in projects
www.netspective.com
•
•
•
•
We have “Inside out” architecture,
not “Outside in”
We're too focused on heavyweight
industry-specific formats instead of
lightweight or micro formats
Data emitted is not tagged using
semantic markup, so it's not
securable or searchable by default
When health IT systems produce
HTML, CSS, JavaScript, JSON, and
other common outputs, it's not done
in a security- and integrationfriendly manner
10
12. NETSPECTIVE
Encourage clinical “tinkering” and “hacking”
• Clinicians usually go
into medicine because
they’re problem solvers
• Today’s permissionsoriented culture now
prevents “playing” with
data and discovering
solutions
www.netspective.com
12
13. NETSPECTIVE
Promote “Outside-in” architecture
Think about clinical and
hospital operations and
processes as a collection
of business capabilities or
services that can be
delivered across
organizations.
www.netspective.com
13
14. NETSPECTIVE
Implement industry-neutral ICAM
Implement shared identities, single sign on (SSO), neutral authentication and authorization
Proprietary identity is hurting us
•
•
Most health IT systems create their own
custom identity, credentialing, and access
management (ICAM) in an opaque part of
a proprietary database.
We’re waiting for solutions from health IT
vendors but free or commercial industryneutral solutions are much better and
future proof.
www.netspective.com
Identity exchange is possible
• Follow National Strategy for Trusted Identities
in Cyberspace (NSTIC)
• Use open identity exchange protocols such as
SAML, OpenID, and Oauth
• Use open roles and permissions-management
protocols, such as XACML
• Consider open source tools such as OpenAM,
Apache Directory, OpenLDAP Shibboleth, or
,
commercial vendors.
• Externalize attribute-based access control
(ABAC) and role-based access control (RBAC)
from clinical systems into enterprise systems
like Active Directory or LDAP
.
14
15. NETSPECTIVE
App-focused integration is better than nothing
Structured data dogma gets in the way of faster decision support real solutions
Dogma is preventing integration
App-centric sharing is possible
Many think that we shouldn’t integrate
until structured data at detailed machinecomputable levels is available.
The thinking is that because mistakes can
be made with semi-structured or hard to
map data, we should rely on paper, make
users live with missing data, or just make
educated guesses instead.
Instead of waiting for HL7 or other structured
data about patients, we can use simple
techniques like HTML widgets to share
"snippets" of our apps.
• Allow applications immediate access to
portions of data they don't already manage.
• Widgets are portions of apps that can be
embedded or "mashed up" in other apps
without tight coupling.
• Blue Button has demonstrated the power of
app integration versus structured data
integration. It provides immediate benefit to
users while the data geeks figure out what
they need for analytics, computations, etc.
www.netspective.com
15
16. NETSPECTIVE
Pushing data is more expensive than pulling it
We focus more on "pushing" versus "pulling" data than is warranted early in projects
Old way to architect:
“What data can you send me?” (push)
Better way to architect:
“What data can I publish safely?” (pull)
The "push" model, where the system that
contains the data is responsible for sending the
data to all those that are interested (or to some
central provider, such as a health information
exchange or HL7 router) shouldn’t be the only
model used for data integration.
• Implement syndicated Atom-like feeds (which
could contain HL7 or other formats).
• Data holders should allow secure
authenticated subscriptions to their data and
not worry about direct coupling with other
apps.
• Consider the Open Data Protocol (oData).
• Enable auditing of protected health
information by logging data transfers through
use of syslog and other reliable methods.
• Enable proper access control rules expressed
in standards like XACML.
www.netspective.com
16
17. NETSPECTIVE
Industry-specific formats aren’t always necessary
Reliance on heavyweight industry-specific formats instead of lightweight micro formats is bad
HL7 and X.12 aren’t the only formats
Consider industry-neutral protocols
The general assumption is that
formats like HL7, CCD, and X.12 are
the only ways to do data integration
in healthcare but of course that’s
not quite true.
•
•
•
•
www.netspective.com
Consider identity exchange
protocols like SAML for integration
of user profile data and even for
exchange of patient demographics
and related profile information.
Consider iCalendar/ICS publishing
and subscribing for schedule data.
Consider microformats like FOAF
and similar formats from
schema.org.
Consider semantic data formats
like RDF, RDFa, and related family.
17
18. NETSPECTIVE
Tag all app data using semantic markup
When data is not tagged using semantic markup, it's not securable or shareable by default
Legacy systems trap valuable data
Semantic markup and tagging is easy
In many existing contracts, the
vendors of systems that house the
data also ‘own’ the data and it can’t
be easily liberated because the
vendors of the systems actively
prevent it from being shared or are
just too busy to liberate the data.
• One easy way to create semantically
meaningful and easier to share and
secure patient data is to have all
HTML tags be generated with
companion RDFa or HTML5 Data
Attributes using industry-neutral
schemas and microformats similar to
the ones defined at Schema.org.
• Google's recent implementation of
its Knowledge Graph is a great
example of the utility of this
semantic mapping approach.
www.netspective.com
18
19. NETSPECTIVE
Produce data in search-friendly manner
Produce HTML, JavaScript and other data in a security- and integration-friendly approach
Proprietary data formats limit findability
Search engines are great integrators
• Legacy applications only present
through text or windowed
interfaces that can be “scraped”.
• Web-based applications present
HTML, JavaScript, images, and
other assets but aren’t search
engine friendly.
• Most users need access to
information trapped in existing
applications but sometimes they
don’t need must more than access
that a search engine could easily
provide.
• Assume that all pages in an
application, especial web
applications, will be “ingested” by
a securable, protectable, search
engine that can act as the first
method of integration.
www.netspective.com
19
20. NETSPECTIVE
Rely first on open source, then proprietary
“Free” is not as important as open source, you should pay for software but require openness
Healthcare fears open source
Open source can save health IT
• Only the government spends more per
user on antiquated software than we do
in healthcare.
• There is a general fear that open source
means unsupported software or lower
quality solutions or unwanted security
breaches.
• Other industries save billions by using
open source.
• Commercial vendors give better pricing,
service, and support when they know
they are competing with open source.
• Open source is sometimes more secure,
higher quality, and better supported
than commercial equivalents.
• Don’t dismiss open source, consider it
the default choice and select commercial
alternatives when they are known to be
better.
www.netspective.com
20