tag:blogger.com,1999:blog-4384692836709903146.post8471379934765915125..comments2024-03-27T09:55:23.143-07:00Comments on Dispatch from the Digital Health Frontier: 21st Century Cures ActJohn Halamkahttp://www.blogger.com/profile/04550236129132159307noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-4384692836709903146.post-24910359981046000432015-05-20T19:22:24.596-07:002015-05-20T19:22:24.596-07:00Great post, John!
Responding to #4, regarding sec...Great post, John!<br /><br />Responding to #4, regarding security, I don’t think we’re at all likely to be successful in “clean[ing] up privacy/security heterogeneity.” Healthcare privacy and security law is Constitutionally the purview of the states, and likely to remain that way. What we need are solutions for dealing with that heterogeneity so that critical health information can be shared efficiently across state and jurisdictional boundaries. The cloud services providers have somehow managed to offer their services worldwide, despite jurisdictional laws restricting where bits may be deposited. Technology providers are equally capable of developing solutions for dealing with the heterogeneity of state privacy laws. In fact, I know of solutions that already exist, one of which was mentioned in Adrian Gropper’s comment – turning over control to consumers. <br /><br />Re patient identity, I agree with you that we need to remove barriers to patient identity management. Not only that, we need to remove barriers to publicly funded research efforts aimed at developing solutions to patient identity management. I continually marvel at the schizophrenic nature of privacy these days – half of the time I spend worrying about the fact that today’s “big data” technologies make it impossible for an individual to be “anonymous,” and the other half worrying about how providers can possibly figure out an individual’s identity.Dixie Bakerhttps://www.blogger.com/profile/03486516651040409665noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-51705743564154982692015-05-20T17:34:23.668-07:002015-05-20T17:34:23.668-07:00When I read about the Lock Ness Monster of Informa...When I read about the Lock Ness Monster of Information Blocking I had to laugh as I too have called it "bunk" and just another perception from someone who is not a technologist and made it up to marketing something. We all know who's marketing what but geez how embarrassing for DeSalvo that has spoken about it, she got duped and taken in and she's not alone.<br /><br />De-certification another good point too as we are obsessed with "scoring" people everywhere today as it makes money selling these scores, and de-certification, well one step closer to a caste system if you will. The problem is that government folks and consumers don't seem to have a clue on how complex everything is today and how insurers built it that way as it means money. <br /><br />Again you wonder what's going on over there as we don't have people in the government who are in healthcare but rather one leading HHS that's a former admin for former Citi Exect/US Treasuury Head Robert Rubin and the head of Medicare is a former Goldman Sachs banker, not to mention a Untied Healthcare executive. I don't think they really are capable of being the correct folks in charge. <br /><br />Great job on nailing the Aesop's Fable on "Information Blocking". Time to be a skeptic when you need to be. I feel better now not being a lone data logician. Medical Quackhttps://www.blogger.com/profile/12443589277651479846noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-87270448742090179642015-05-20T11:33:41.877-07:002015-05-20T11:33:41.877-07:00The failure of HITECH Meaningful Use to produce in...The failure of HITECH Meaningful Use to produce interoperability justifies additional legislation but we need need to be careful to diagnose appropriately before treating. Over-regulation of technology is what got us here. Certification has proved to be a race to the bottom for innovation and an incentive for vendor and provider consolidation. The problem we have today is due to a strategy that makes certified EHR vendors and their customers responsible for both the control of personal data and its value-added processing. Control of personal data needs to be with the patient and data processing needs to be valued and paid-for.<br /><br />Legislation needs to treat patients as first-class citizens in health information exchange with the ability to direct access to private health data to anyone anywhere without redaction or delay. Security issues are important, but they are not to be used as an excuse for lack of transparency, lack of access, and the patient's inability to delegate access. Legislation can build trust and scalability by shutting off the hidden data flows under "HIPAA Treatment, Payment, and Operations" because they have not worked. It's time to take the spirit of the JASON reports to heart and legislate interoperability based on a patient-controlled Public API.Adrian Gropperhttps://www.blogger.com/profile/14435645301228523460noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-34953825531523246232015-05-20T11:00:47.619-07:002015-05-20T11:00:47.619-07:00Well put, John. Sensible, doable, focused.
Al...Well put, John. Sensible, doable, focused.<br /> Alas, the ONC is still focused on promoting sales of HIT and, most recently, on promoting itself. Yesterday it issued a set of "comments" on its interoperability proposals. But they were NOT comments. Rather they were a compendium of puff pieces saying how wise and great was the ONC. Period. In fact, on the actual document (if one clicked to see them) they were called something like "letters of support." Nothing wrong with that but how do we make progress if we confine ourselves to "yes" men and sycophants? Where are the thousands of comments the ONC says its received? Comments that would perhaps mirror some of what you (John) are saying. Anonymousnoreply@blogger.com