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
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/
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
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
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
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.
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.
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.
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
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/
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
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
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
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.
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.
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.
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.
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 Barriers to Military Healthcare Technology Innovation and What We Can Do ...Shahid Shah
This briefing was presented at the Military Electronic Healthcare Records Symposium in Washington DC. It answers the following questions:
* Is disruptive innovation in military healthcare technology possible?
* What does innovation in military healthcare mean?
* Where are the major areas in military healthcare where innovation is required?
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
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.
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.
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.
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.
Achieve Internet VP of Operations Marc Hermsmeyer and Dexcom Inc., Senior Marketing Manager Tom Hall speak about technology solutions for the Healthcare Industry using Open Source software, such as Drupal.
The Government is forcing technology innovation within the Healthcare industry yet there are very few solutions out there that are tailored for the specific requirements and needs of the Healthcare market. In past experiences with Dexcom and other Healthcare clients Achieve has leveraged the power of Drupal to create powerful solutions that drive patient outcomes, improve workflows, and remain compliant with rigorous regulatory requirements.
This presentation shines a light on the technology needs of the Healthcare market and how Drupal can meet those needs.
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.
The Myth of Health Data Integration ComplexityShahid Shah
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.
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.
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.
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.
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.
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.
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 Barriers to Military Healthcare Technology Innovation and What We Can Do ...Shahid Shah
This briefing was presented at the Military Electronic Healthcare Records Symposium in Washington DC. It answers the following questions:
* Is disruptive innovation in military healthcare technology possible?
* What does innovation in military healthcare mean?
* Where are the major areas in military healthcare where innovation is required?
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
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.
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.
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.
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.
Achieve Internet VP of Operations Marc Hermsmeyer and Dexcom Inc., Senior Marketing Manager Tom Hall speak about technology solutions for the Healthcare Industry using Open Source software, such as Drupal.
The Government is forcing technology innovation within the Healthcare industry yet there are very few solutions out there that are tailored for the specific requirements and needs of the Healthcare market. In past experiences with Dexcom and other Healthcare clients Achieve has leveraged the power of Drupal to create powerful solutions that drive patient outcomes, improve workflows, and remain compliant with rigorous regulatory requirements.
This presentation shines a light on the technology needs of the Healthcare market and how Drupal can meet those needs.
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.
The Myth of Health Data Integration ComplexityShahid Shah
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.
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.
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.
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.
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.
Driving Business Agility & Innovation with Enterprise ArchitectureCorso
How can Enterprise Architecture take the driving seat to deliver increased business agility and uncover new opportunities for innovation? This presentation, first given at the Gartner Enterprise Architecture Summit 2015 in Grapevine, Texas, explains how it can be done.
Civic tech the future of civic engagement and technology innovationAlberto Gomez Isassi
Conference imparted on October Monday 5, 2015 at the Civic Engagement Summit. University of Texas San Antonio (UTSA).
Civic Tech international landscape - what is being done to advance the smart cities agenda, citizen engagement in the digital age, the advent of ubiquitous technologies, and the impact of technology innovation in democracy
Mark Szulc provided the keynote address for the India sessions, highlighting the market as well as his favorite highlights of the AEM6.2 release. To see the on-demand IMMERSE Session please go to http://bit.ly/Immerse16
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.
Creating Interoperable Medical Devices that fit into Hospital Enterprise IT E...Shahid Shah
Creating connected medical devices is challenging but doing so in an interoperable manner that can easily and flexibly fit into modern hospital IT environments is even more difficult. This presentation provides sage advice on how to design connected life-critical medical devices so that they work well within modern hospital environments.
Wireless capable medical devices with significant software and data integrati...Shahid Shah
OSEHRA's position in the open source and EHR ecosystems is special because of its size, breadth, and scope. It's deployed in so many institutions with so many clinical users that whatever we can learn from it can affect the healthcare industry at large. Wireless technologies are disrupting many industries and healthcare is next.
This talk covers:
* The state of mHealth and wireless in OSEHRA
* Marketplace and industry challenges for device vendors connecting to VistA
* Why wireless connectivity to OSEHRA is good business
* Why wireless connectivity to OSEHRA is a potentially disruptive innovation
Key takeaways are:
* 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.
Why should we care about integrating data? What should we be trying to achieve? Population Health. The Softer, Human Side of Being “Data Driven” not “Driven By Data." The New Era of Decision Support in Healthcare. Top 10 Challenges To Integrating External Data.
Gain insights from data analytics and take action! Learn why everyone is making a big deal about big data in healthcare and how data analytics creates action.
How COVID-19 is Accelerating Digital Transformation in Health and Social Care?NUS-ISS
Without a doubt, COVID-19 has become the unexpected driver for digital transformation. It is accelerating the transformation, especially in the health and social care space, as we are forced to adapt to the new norm brought about by the crisis. Join us as we discuss the trends and what might be the new health and social care landscape in Singapore after 2020.
Big data in the real world opportunities and challenges facing healthcare -...Leo Barella
The Healthcare system will be target of major disruption more than any other industry in the next 10 years.
The Digital economics and increasing demand by consumers for more real time information in order to make better decisions on who they want to "hire" to perform services for them or in their behalf will be the driver of this disruption. Analytics, Big Data and Machine Learning will lay the foundation for the next generation of healthcare yet there are still many challenges to truly revolutionize the healthcare system end to end (Providers, Pharma, Payers)
Leveraging the Internet of Things to Improve Patient OutcomesAlex Taser
This public thought leader dialogue reinforced that we are in midst of a technology-enabled revolution in healthcare. A world of IoT sensors and the Big Data it enables has the power to personalize and improve care, predict conditions, and enable access and affordable service to previously under-reached communities.
Rather than a sci-fi fantasty, the future of IoT healthcare is already here. While fractured, the technology exists and its capabilities are growing exponentially. The success in ensuring patient health and empowerment hinges on our ability to shift the culture of care, rethink incentives, collaborate across systems, and put the patient voice at the center of it all.
An Introduction to the Health Information Technology for Economic and Clinical Health Act -- HITECH and electronic medical records -- part of the economic stimulus package.
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.
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
Similar to Reasons why health data is poorly integrated today and what we can do about it (20)
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
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
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.
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
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
Generating a custom Ruby SDK for your web service or Rails API using Smithyg2nightmarescribd
Have you ever wanted a Ruby client API to communicate with your web service? Smithy is a protocol-agnostic language for defining services and SDKs. Smithy Ruby is an implementation of Smithy that generates a Ruby SDK using a Smithy model. In this talk, we will explore Smithy and Smithy Ruby to learn how to generate custom feature-rich SDKs that can communicate with any web service, such as a Rails JSON API.
DevOps and Testing slides at DASA ConnectKari Kakkonen
My and Rik Marselis slides at 30.5.2024 DASA Connect conference. We discuss about what is testing, then what is agile testing and finally what is Testing in DevOps. Finally we had lovely workshop with the participants trying to find out different ways to think about quality and testing in different parts of the DevOps infinity loop.
Accelerate your Kubernetes clusters with Varnish CachingThijs Feryn
A presentation about the usage and availability of Varnish on Kubernetes. This talk explores the capabilities of Varnish caching and shows how to use the Varnish Helm chart to deploy it to Kubernetes.
This presentation was delivered at K8SUG Singapore. See https://feryn.eu/presentations/accelerate-your-kubernetes-clusters-with-varnish-caching-k8sug-singapore-28-2024 for more details.
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
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.
UiPath Test Automation using UiPath Test Suite series, part 4DianaGray10
Welcome to UiPath Test Automation using UiPath Test Suite series part 4. In this session, we will cover Test Manager overview along with SAP heatmap.
The UiPath Test Manager overview with SAP heatmap webinar offers a concise yet comprehensive exploration of the role of a Test Manager within SAP environments, coupled with the utilization of heatmaps for effective testing strategies.
Participants will gain insights into the responsibilities, challenges, and best practices associated with test management in SAP projects. Additionally, the webinar delves into the significance of heatmaps as a visual aid for identifying testing priorities, areas of risk, and resource allocation within SAP landscapes. Through this session, attendees can expect to enhance their understanding of test management principles while learning practical approaches to optimize testing processes in SAP environments using heatmap visualization techniques
What will you get from this session?
1. Insights into SAP testing best practices
2. Heatmap utilization for testing
3. Optimization of testing processes
4. Demo
Topics covered:
Execution from the test manager
Orchestrator execution result
Defect reporting
SAP heatmap example with demo
Speaker:
Deepak Rai, Automation Practice Lead, Boundaryless Group and UiPath MVP
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/
Transcript: Selling digital books in 2024: Insights from industry leaders - T...BookNet Canada
The publishing industry has been selling digital audiobooks and ebooks for over a decade and has found its groove. What’s changed? What has stayed the same? Where do we go from here? Join a group of leading sales peers from across the industry for a conversation about the lessons learned since the popularization of digital books, best practices, digital book supply chain management, and more.
Link to video recording: https://bnctechforum.ca/sessions/selling-digital-books-in-2024-insights-from-industry-leaders/
Presented by BookNet Canada on May 28, 2024, with support from the Department of Canadian Heritage.
Encryption in Microsoft 365 - ExpertsLive Netherlands 2024Albert Hoitingh
In this session I delve into the encryption technology used in Microsoft 365 and Microsoft Purview. Including the concepts of Customer Key and Double Key Encryption.
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/
State of ICS and IoT Cyber Threat Landscape Report 2024 preview
Reasons why health data is poorly integrated today and what we can do about it
1. The Myth of Health Data
Integration Complexity
An opinionated look at why current health IT systems
integrate poorly and what we can do about it
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 you’ll learn today
Let’s stop the hand waving and relying on the government to take care of integration
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).
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
6. NETSPECTIVE
We’re digitizing biology
Last and past decades
Digitize
mathematics
Digitize
literature
Digitize social
behavior
Predict human
behavior
Gigabytes and petabytes
www.netspective.com
This and future decades
Digitize biology
Digitize
chemistry
Digitize physics
Predict
fundamental
behaviors
Petabytes and exabytes
6
7. NETSPECTIVE
What’s creating “data deluge”?
Social Interactions
Biosensors
Economics
Phenotypics
Since 1970,
pennies per
patient
Since 1980s,
pennies per
patient
• Business focused data
• Retrospective
• Built on fee for service models
• Inward looking and not focused
on clinical benefits
www.netspective.com
• Must be continuously collected
• Mostly Retrospective
• Useful for population health
• Part digital, mostly analog
• Family History is hard
Genomics
Since 2000s,
started at $100k
per patient, <$1k
soon
• Can be collected infrequently
• Personalized
• Prospective
• Potentially predictive
• Digital
• Family history is easy
Proteomics
Emerging
• Must be continuously collected
• Difficult today, easier tomorrow
• Super-personalized
• Prospective
• Predictive
7
8. NETSPECTIVE
Data changes the questions we ask
Simple visual facts
www.netspective.com
Complex visual facts
Complex computable
facts
8
9. 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
9
10. NETSPECTIVE
We’re in the integration age
We’re not in an
app-driven
future but an
integrationdriven future.
He who
integrates the
best, wins.
Source: Geoffrey Raines, MITRE
www.netspective.com
10
11. Where is all the data coming from?
Recognizable Data Sources
12. NETSPECTIVE
Data is hidden everywhere
Clinical trials data
(failed or successful)
Secure Social Patient
Relationship
Management (PRM)
Patient
Communications,
SMS, IM, E-mail,
Voice, and Telehealth
Patient Education,
Calculators, Widgets,
Content
Management
Blue Button, HL7,
X.12, HIEs, EHR, and
HealthVault
Integration
E-commerce, Ads,
Subscriptions, and
Activity-based Billing
Accountable Care,
Patient Care
Continuity and
Coordination
Patient Family and
Community
Engagement
Patient Consent,
Permissions, and
Disclosure
Management
www.netspective.com
12
13. NETSPECTIVE
More hidden sources of data
Clinical systems
Consumer and
patient health
systems
Core transaction
systems
Decision
support systems
(DSS and CPOE)
Electronic
medical record
(EMR)
Managed care
systems
Medical
management
systems
Materials
management
systems
Clinical data
repository
Patient
relationship
management
Imaging
Integrated
medical devices
Clinical trials
systems
Telemedicine
systems
Workflow
technologies
Work force
enabling
technologies
www.netspective.com
13
14. NETSPECTIVE
Unstructured patient data sources
Patient
Source
Self reported by
patient
Health
Professional
Observations by
HCP
Labs &
Diagnostics
Computed from
specimens
Errors
High
Medium
Slow
Slow
Low
Medium
Megabytes
Megabytes
Megabytes
Data type
PDFs, images
PDFs, images
PDFs, images
Availability
Common
Common
Common
Computed from
specimens
High
Data size
Computed realtime from patient
Medium
Reliability
Biomarkers /
Genetics
Low
Time
Medical Devices
www.netspective.com
Uncommon
Uncommon
14
15. NETSPECTIVE
Structured patient data sources
Patient
Source
Self reported by
patient
Health
Professional
Observations by
HCP
Labs &
Diagnostics
Specimens
Medical Devices
Real-time from
patient
Biomarkers /
Genetics
Specimens
Errors
High
Medium
Low
Low
Low
Time
Slow
Slow
Medium
Fast
Slow
Reliability
Low
Medium
High
High
High
Kilobytes
Kilobytes
Kilobytes
Megabytes
Gigabytes
Gigabytes
Gigabytes
Uncommon
Uncommon
Discrete size
Streaming size
Availability
www.netspective.com
Uncommon
Common
Somewhat
Common
15
17. NETSPECTIVE
Why you can’t just “buy interoperability”
Interoperability of data is an emergent property of your IT environment
Myth
Truth
• I only have a few systems
to integrate
• I know all my data formats
• I know where all my data is
and most of it is valid
• My vendor already knows
how all this works and will
solve my problems
• There are actually hundreds
of systems
• There are dozens of formats
you’re not aware of
• Lots of data is missing and
data quality is poor
• Tons of undocumented
databases and sources
• Vendors aren’t incentivized to
integrate data
www.netspective.com
17
18. 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
18
19. 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
19
21. NETSPECTIVE
Why health IT systems integrate poorly
Technology “Culture”
•
•
•
•
•
Permissions-oriented culture prevents
tinkering and “hacking”
We don’t let patients drive data
decisions.
No scripting or customizing EHRs, lab
systems, etc.
Interoperability isn’t required for
transactions to be completed (ecommerce)
We have “Inside out” architecture, not
“Outside in”
www.netspective.com
Actual Technology
•
•
•
•
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“
We focus more on "pushing" versus
"pulling" data than is warranted early
in projects
We're too focused on heavyweight
industry-specific formats instead of
lightweight or micro formats
21
22. NETSPECTIVE
Promote “Outside-in” architecture
The IT department inside your organization cannot possibly do everything you’d like
Process and people consolidation won’t work in
the future
Defining and coordinating interactions across a
multitude of organizations is the new way
“For decades, businesses typically have been
rewarded for consolidation around standard
processes and stockpiling assets through
people, technology and goods.
Companies are discovering they need a new
kind of leverage – capability leverage – to
mobilize third parties that can add value.”
• Outside-in architecture asks you to think
about your operations and processes as
a collection of business capabilities or
services.
• Each individual service must be analyzed
and packaged to see who can deliver
them best. According to Deloitte, “this
architectural transition requires new skills
from the CIO and the IT organization.
CIOs who anticipate and understand the
opportunity are likely to become much
more effective business partners with
other executive leaders.”
Source: Deloitte “Outside-in Architecture”
www.netspective.com
22
23. 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
.
23
24. 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
24
25. 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
25
26. 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.
Microsoft Excel & Access, Google
Docs, etc. don’t have live access to
our data in transactional systems
such as EHRs.
•
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.
26
27. 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
27
28. 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
28
29. 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
29
30. NETSPECTIVE
Primary challenges
• Tooling strategy must be comprehensive. What hardware and
software tools are available to non-technical personnel to encourage
sharing?
• Formats matter. Are you using entity resolution, master data and
metadata schemas, documenting your data formats, and access
protocols?
• Incentivize data sharing. What are the rewards for sharing or penalties
for not sharing healthcare data?
• Distribute costs. How are you going to allow data users to contribute
to the storage, archiving, analysis, and management costs?
• Determine utilization. What metrics will you use determine what’s
working and what’s not?
www.netspective.com
30