The document summarizes a presentation given by Jeff Miller about the North Carolina Health Information Exchange (NC HIE). The NC HIE is a nonprofit organization established in 2010 to facilitate the secure exchange of health information across the state. It has a 25-member board of directors and four workgroups focused on clinical operations, governance, finance, and legal/policy issues. The goals of the NC HIE are to improve medical decision making, care coordination, health outcomes, and reduce costs by enabling the access and exchange of health data. The NC HIE provides various services like connectivity with participating systems, a clinical portal, secure messaging, and will expand offerings over time. Benefits of the NC HIE include better, safer, more
> Definition of RWD
> RWD - Big Data Characteristics
> Sources of RWD
> Important Stakeholders
> Benefits of RWD
> Why Data Sharing is Important?
> Benefits of Data Sharing
> Who Benefits?
> Ultimate Goals
> Case Studies
> Challenges
> Data Privacy Scenario
> Data Security in India
> Regulatory Perspectives Around RWD
> How to Encourage Data Sharing?
Patient Engagement Power Team Comments – Leslie Kelly Hall, ChairBrian Ahier
The Consumer/Patient Engagement Power Team will assess Standards and Certification Criteria NPRM and provide recommendations for strengthening consumer/patient engagement components. The Power Team will prioritize recommendations to enable patients to participate as partners in their care.
Precise Patient Registries for Clinical Research and Population ManagementDale Sanders
Patient registries have evolved from external, mandatory reporting databases to playing a critical role in internal clinical research, clinical quality, cost reduction, and population health management. This slide deck describes how to design those precise registries.
In search of a digital health compass: My data, my decision, our powerchronaki
Knowledge is power. Despite extensive investments in digital health technology, navigating the health system online is challenging for most citizens. Also for eHealth, the “Inverse Care Law” proposed by Hart in 1971, seems to apply. Availability of good medical or social care services and tools online, varies inversely with the need of the population. The low adoption of eHealth services, and persistent disparities in health triggers a call for multidisciplinary action.
Barriers and challenges are not to be underestimated. Culture, education, skills, costs, perceptions of power and role, are essential for multidisciplinary action. This comes together in digital health literacy, which ought to become an integral part to navigate any health system. Patients living with an implanted device or coping with persistent, chronic disease such as diabetes, as well as citizens engaged in self-care, caring for an elderly relative, a neighbor, or their child with illness or deteriorating health, need a digital health compass.
The panel will engage the audience to elaborate on a vision for this personal, digital health compass and drive advancement in health informatics and digital health standards. The transformative power of health data fueled by targeted digital health literacy interventions can be leveraged by open, massive, and individualized delivery. This way, digital health literate, confident patients and citizens join health professionals, researchers and policy makers to address age-related health and wellness changes to shape the emerging precision medicine and population health initiatives.
From a panel in the eHealthweek 2016. http://www.ehealthweek.org/ehome/128630/hl7-efmi-sessions/
> Definition of RWD
> RWD - Big Data Characteristics
> Sources of RWD
> Important Stakeholders
> Benefits of RWD
> Why Data Sharing is Important?
> Benefits of Data Sharing
> Who Benefits?
> Ultimate Goals
> Case Studies
> Challenges
> Data Privacy Scenario
> Data Security in India
> Regulatory Perspectives Around RWD
> How to Encourage Data Sharing?
Patient Engagement Power Team Comments – Leslie Kelly Hall, ChairBrian Ahier
The Consumer/Patient Engagement Power Team will assess Standards and Certification Criteria NPRM and provide recommendations for strengthening consumer/patient engagement components. The Power Team will prioritize recommendations to enable patients to participate as partners in their care.
Precise Patient Registries for Clinical Research and Population ManagementDale Sanders
Patient registries have evolved from external, mandatory reporting databases to playing a critical role in internal clinical research, clinical quality, cost reduction, and population health management. This slide deck describes how to design those precise registries.
In search of a digital health compass: My data, my decision, our powerchronaki
Knowledge is power. Despite extensive investments in digital health technology, navigating the health system online is challenging for most citizens. Also for eHealth, the “Inverse Care Law” proposed by Hart in 1971, seems to apply. Availability of good medical or social care services and tools online, varies inversely with the need of the population. The low adoption of eHealth services, and persistent disparities in health triggers a call for multidisciplinary action.
Barriers and challenges are not to be underestimated. Culture, education, skills, costs, perceptions of power and role, are essential for multidisciplinary action. This comes together in digital health literacy, which ought to become an integral part to navigate any health system. Patients living with an implanted device or coping with persistent, chronic disease such as diabetes, as well as citizens engaged in self-care, caring for an elderly relative, a neighbor, or their child with illness or deteriorating health, need a digital health compass.
The panel will engage the audience to elaborate on a vision for this personal, digital health compass and drive advancement in health informatics and digital health standards. The transformative power of health data fueled by targeted digital health literacy interventions can be leveraged by open, massive, and individualized delivery. This way, digital health literate, confident patients and citizens join health professionals, researchers and policy makers to address age-related health and wellness changes to shape the emerging precision medicine and population health initiatives.
From a panel in the eHealthweek 2016. http://www.ehealthweek.org/ehome/128630/hl7-efmi-sessions/
Best Practices for Enabling HIE and Incorporating Capabilities into EHR Workf...Justin Campbell
Health Information Exchange (HIE) allows health care providers to access and share a patient’s medical information securely and electronically, providing a unified view of patient data across health care organizations. HIE enhances clinicians’ workflow and their ability to connect, coordinate, and collaborate on patient care quickly and easily. However, health care organizations frequently struggle with last-mile connectivity from their clinical system of record to the receiving system and incorporating HIE capabilities into EHR workflows. This session will provide a framework for successful HIE onboarding including data access, conformance testing & validation, as well as share strategies for implementing HIE capabilities at the point of care. This session will also introduce the concept of Patient Centered Data Home and illustrate how the exchange of information utilizing the PCDH model is a cost-effective, scalable solution to assuring real-time clinical data is available whenever and wherever care occurs to improve the quality of care.
HIMSS15: Trust in Regional Exchange Supports Patient-Centered ResearchIBM Analytics
Thomas F. Check, MA, and Lorraine M. Fernandes, RHIA, gave this presentation at HIMSS15. Inside you will find info on a number of learning objectives including:
1.Explain how HIE patient-matching technology supports the innovative research infrastructure of NYC-CDRN.
2.Identify privacy issues addressed by HIE participants including how the NYC-CDRN infrastructure supports patient privacy.
3.Describe how consumer, patient consent and other concerns of community stakeholders are addressed.
4.Discuss the value of re-using data from Healthix and the Bronx RHIO including costs and technology infrastructure.
5.Illustrate the information data model’s use within NYC-CDRN and its connection to the PCORnet.
Follow @IBM Healthcare on Twitter: https://twitter.com/IBMHealthcare
Johan Vendrig
GM Information Services – healthAlliance
Andrew Terris
Programme Director, Patients First
Darrin Hackett
GM HIQ, Acting CIO Waikato DHB
Martin Wilson
GP, Sexual Health Physician, Clinical Leader
Pegasus, executive NICLG
Tony Cooke
Manager Health Systems Investment and
Planning, Information Group, NHB
(Thursday, 4.15, Panel)
Overview of Stage 2 Clinical Quality Measures for the Medicare and Medicaid E...Brian Ahier
Session provides in-depth overview of clinical quality measures included in the final rule for Stage 2 of Meaningful Use for the EHR Incentive Programs for eligible professionals. Details provided on the measures, the recommended core set for reporting purposes, and the upcoming release of the 2014 electronic specifications for the EHR Incentive Programs.
Best Practices for Enabling HIE and Incorporating Capabilities into EHR Workf...Justin Campbell
Health Information Exchange (HIE) allows health care providers to access and share a patient’s medical information securely and electronically, providing a unified view of patient data across health care organizations. HIE enhances clinicians’ workflow and their ability to connect, coordinate, and collaborate on patient care quickly and easily. However, health care organizations frequently struggle with last-mile connectivity from their clinical system of record to the receiving system and incorporating HIE capabilities into EHR workflows. This session will provide a framework for successful HIE onboarding including data access, conformance testing & validation, as well as share strategies for implementing HIE capabilities at the point of care. This session will also introduce the concept of Patient Centered Data Home and illustrate how the exchange of information utilizing the PCDH model is a cost-effective, scalable solution to assuring real-time clinical data is available whenever and wherever care occurs to improve the quality of care.
HIMSS15: Trust in Regional Exchange Supports Patient-Centered ResearchIBM Analytics
Thomas F. Check, MA, and Lorraine M. Fernandes, RHIA, gave this presentation at HIMSS15. Inside you will find info on a number of learning objectives including:
1.Explain how HIE patient-matching technology supports the innovative research infrastructure of NYC-CDRN.
2.Identify privacy issues addressed by HIE participants including how the NYC-CDRN infrastructure supports patient privacy.
3.Describe how consumer, patient consent and other concerns of community stakeholders are addressed.
4.Discuss the value of re-using data from Healthix and the Bronx RHIO including costs and technology infrastructure.
5.Illustrate the information data model’s use within NYC-CDRN and its connection to the PCORnet.
Follow @IBM Healthcare on Twitter: https://twitter.com/IBMHealthcare
Johan Vendrig
GM Information Services – healthAlliance
Andrew Terris
Programme Director, Patients First
Darrin Hackett
GM HIQ, Acting CIO Waikato DHB
Martin Wilson
GP, Sexual Health Physician, Clinical Leader
Pegasus, executive NICLG
Tony Cooke
Manager Health Systems Investment and
Planning, Information Group, NHB
(Thursday, 4.15, Panel)
Overview of Stage 2 Clinical Quality Measures for the Medicare and Medicaid E...Brian Ahier
Session provides in-depth overview of clinical quality measures included in the final rule for Stage 2 of Meaningful Use for the EHR Incentive Programs for eligible professionals. Details provided on the measures, the recommended core set for reporting purposes, and the upcoming release of the 2014 electronic specifications for the EHR Incentive Programs.
Quickly, easily, and precisly remove red eye from your photos using Photoshop. You don't need to use a red eye removal tool to make your photo's eyes look great
Presentation slides for Dave Whitlinger, Executive Director of the NY eHealth Collaborative, from the HIMSS'12 eCollaborationForum, February 23rd, 2012
> HTA and Real World Evidence (RWE)
> Why RWE? - Limitations with RCT
> RCT v/s RWE
> Definition of RWE
> Sources of RWE
> Advantages of RWE
> Application of Real World Data (RWD) in RWE
> Benefits of RWD in RWE
> Why Data Sharing is Important?
> Important Stakeholders
> How to Encourage Data Sharing?
> Benefits of Data Sharing
> Case Studies
> Data Privacy Scenario
> Data Security in India
> Regulatory Perspectives Around RWD/RWE
> Way Forward
EHRs, PHRs, EMRs: Making Sense of the Alphabet SoupCHI*Atlanta
CHI*Atlanta's October program tackles health records and the potential of user experience to improve their adoption. Panelists include CDC, Kaiser Permanente, and Greenway Technologies. Hosted at Philips Design to cover public, private, and vendor perspectives.
Information+Integration ? Innovation an HL7/EFMI/HIMSS @eHealthweek2015 in Rigachronaki
Join us to explore “Interoperability in action: information + integration = innovation?” and engage in lively debate on how rethinking interoperability standards and continuing education can bridge divides, change cultures, and open markets!
Perspectives from health management, industry, government, health education, and standardization exemplify challenges and opportunities for liberation of data that can drive desired social and technological innovation.
This is a call for action to explore how the partnership of HL7, EFMI and HIMSS can catalyze the equation “information + integration = innovation” to bridge divides, change culture and open markets.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
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3. NC HIE Overview and Governance
• Nonprofit organization established as a Statewide Designated Entity
(SDE) in April 2010
• Board of directors: 25 CEOs and health care leaders in the North
Carolina community
• Four workgroups: strategy and policy experts on
– Clinical and technical operations
– Governance
– Finance
– Legal and policy
4. Setting the Strategic Agenda – NC HIE Mission
NC HIE will provide a set of secure,
scalable information services that
• Promotes the access, exchange
and analysis of health care
information
• Enables participating organizations
to:
– Improve medical decision-making
and coordination of care
– Improve health outcomes
– Control health care costs
5. Why a NC Health Information Exchange?
Four focus areas for NC HIE initiatives:
7. NC HIE Services Overview
• HIE Connectivity Fabric
– Connectivity with participating systems: CCD,
HL7, SSO, Web Services (Rhapsody™).
– Storage of clinical information (CDR).
– EMPI.
– Data normalization.
– Privacy and consent
• Virtual Patient Record Network
– Web-based access to the longitudinal patient
record (Clinical Portal).
– User subscribed notifications
• Data Delivery Services
–Lab results
• Direct Secure Messaging
– Ability to send/receive secure messages with
other Direct providers
– Support for Direct-enabled EMR systems
8. Timeline
Core Services Phase IA
• EMPI/provider • Medication
directory management
• Security • Immunization registry
• Privacy and consent • Practice analytics
• Clinical messaging • Lab results
• VA Gateway
• DIRECT
• Web-based clinical
portal
• Notifications
• Virtual QO services
• Hosted EMR
Phase IB and Beyond
• Lab ordering • Referrals
• Procedural results • Senior care
• Pharmacy • Mobile gateway
• Consumer portal • Medical device gateway
• Payer gateway • Clinical decision support
• Medical imaging • Vital records
• Population health analytics • Advanced directives
• Syndromic surveillance • Home health
• Public health reporting • NwHIN trading partners
9. Benefits to the Health Ecosystem
Across all insurance types,
North Carolina has an EHR sites were associated
inbound move rate of 55.4%. with significantly higher
According to Forbes, Raleigh achievement of care and
and Charlotte remain two of outcome standards and
the most popular cities for greater improvement in
relocation. diabetes care.
There are almost 200,000
deaths a year from
preventable medical errors, American patients have seen
partly because this an average of 18.7 different
information is not readily doctors during their lives.
available to specialists and
emergency rooms.
By reducing their Only 6.3% of physicians use
dependence on paper a fully-functional electronic
records, a practice seeing health record system in their
3,000 patients annually could practice.
save $24,000.
At the highest level of health Emergency Departments with
IT adoption, only 0.001% of connectivity to an HIE have
prescriptions would require a improved productivity by
phone call between a more than 20%
pharmacist and physician.
10. What’s in it for everyone?
Providing NC with better, safer,
more affordable care
• Integration
• Communication
• Insight
• Agility
• Custom
11. Comparing NC and NL situation
North Carolina Netherlands
• Government actively supporting HIEs • Government in doubt how to support
• Patiënt consent: opt-in needed (for regional and national HIE
sharing, not collecting) • Patiënt consent: opt-in needed (for both
• Healthcare data also used for analysis collecting and sharing)
on population level • Healthcare data only used on patiënt
• Based on international standards (CCD level
/ HL7) • Based on international standards (CCD
• Almost 10 million inhabitants, 3,5 times / HL7)
the area of NL.
12. Prerequisites for successful implementation
• Changing the way of working of a multitude of organizations and
persons, is a tough job.
• Drivers for change are both quantitative and qualitative
– Higher quality of care and lower cost (or more income)
• Even if both are the projected outcome of a network-project, a couple
of objectives must be met to become successful:
– The will to exchange the patients data – and be serious about it
– A compelling business case for the total value chain
– A fair business model promoting the use for each of the participant in the network
– An HIE system that is integrated with the current IS of the caregivers
• Individual healthcare providers have little influence on development roadmap
of ISVs
14. Thank you, Jeff Miller !
• Thanks for sharing your thoughts and experiences with us today.
• "I'm Sure it's No Coincidence that
We're Sitting at this table Together.
Some things cannot be Mere Chance;
everybody has got an example of this.
On the other hand I think it's
Nonsense to Say Chance doesn't Exist.
I mean What's the Chance that
Nothing ever happens by chance"
Text and design by Nicole van Schouwenburg
for Royal Delft – Koninklijke Porceleyne Fles
15. Thank you, and have a great time at HIMSS 2012
Jeff Miller Toon van der Werf
• CEO NC HIE - Health Information • Consultant Vakgroep Zorg Capgemini
Exchange Netherlands
• jeff.miller@nchie.org • toon.vander.werf@capgemini.com
• +31(0)629 056 330
• Booth #13642-12
Editor's Notes
Core ServicesThe technologies that make up the NC HIE platform – the engine for everything elseParticipant ServicesThis is where NC HIE adds new services and value in addition to its coordinating role. Think of it like an “app store” for participating organizations, where they can find analytics, consultative help and other offerings that improve specific aspects of the health care ecosystems (i.e., Medication Management).Connectivity Services Clinician access to information from other State, Regional or Federal databases. This is where NC HIE lets participants talk outside their own communities.Qualified Organization Enablement and EnrichmentHelping to develop local programs and services
IntegrationInformation from multiple health care entities reduces medical errors and helps avoid duplication of servicesCommunicationBetter coordination during transitional care eventsInsightTurns information into insights, enabling rapid advancements and better decisionsAgilityStreamlining operations, accelerating the pace of innovation and ensuring complianceCustomUniquely designed for the NC health care system – not just an off-the-shelf solution