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In the New England Journal of Medicine:
Letting the Air out of EHRs

Mandl and Kohane in the NEJM

Mandl and Kohane in the New England Journal of Medicine: Escaping the EHR Trap — The Future of Health IT [PDF]. 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.

EHR design: A mold in need of breaking

FierceEMR, June 13, 2012 — Marla Durben Hirsch
Editor’s Corner: Apparently I struck a nerve with last week’s commentary on making the transition to electronic health records. The editorial generated quite a few comments, and every one of them were against EHRs.  They’re expensive, become a crutch for the lazy or less-trained, and deter from direct patient-physician communication…
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Fierce Q&A: EHR vendors propagating a myth about their products

FierceEMR, June 13, 2012 — Marla Durben Hirsch
Electronic health record system vendors are “entrenched” in a legacy mindset that hampers innovation, preferring to propagate the myth that EHRs require specialized IT systems in order to protect their prices and block new entrants into the industry, according to an article published this week in the New England Journal of Medicine. EHRs can and should be redesigned and adopt modern…
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UK Collaborators Build SMART Proof of Concept at NHS Hack Day

The UK’s National Health Service held its first NHS Hack Day on May 26-27, a weekend marathon of disruptive innovation, largely inspired by the open source culture and hackathon trend in the US. One of the 14 teams to submit an app at the end of the session used SMART, implementing a portion of the SMART API to expose the HES dataset. The result was a modest data grid and radar chart for patient problems (image below). But the strategic ramifications, said co-developer Rob Tweed, are far-reaching. “The technology clearly works and is applicable to use in the UK just as in the US. This is a set of wheels that the NHS can avoid re-inventing.”

The demo app has also added momentum to a specific goal that Tweed and colleague George Lilly are helping us realize: to SMART-enable VistA, the open source EHR created at the US Dept. of Veterans Affairs. The two will be presenting on just that topic next Tuesday, June 5, at the 25th VistA Community Meeting in Fairfax, VA. Their talk will follow shortly after Lead Architect Josh Mandel presents an overview of the SMART architecture.

screenshot of SMART demo using patient problems from HES dataset

“CCD export” doesn’t solve interoperability

Meaningful Use mandates CCD export from EMRs. Here are some reasons why we’re still querying database tables and calling vendor-specific web services to extract the data we need to fuel apps.

At yesterday’s Health 2.0 conference, Farzad Mostashari asked why SMART isn’t using CCD export (as specified by Meaningful Use) to extract data from EMR systems. This is a great question, in part because it separates out two important aspects of SMART:

  1. Getting data out of today’s EHRs
  2. Presenting those data to apps in a natural, convenient, developer-friendly way.

—and focuses on #1. (I don’t think many would argue that CCD is fit for #2. And to be clear: for developers building a SMART app, the details of #1 are almost irrelevant. SMART app developers get one clear-cut API to work with, and consistent SMART data elements)

Continue reading ““CCD export” doesn’t solve interoperability”

National Coordinator Cites SMART as #1 Approach for Government Improving HIT

As reported in the Boston Globe, Farzad Mostashari, at the Health 2.o conference, observed that “The investments in research and development that are going on in the consumer technology space are now dwarfing the investment and innovation that are happening in, say, the military.” As an approach the government can take to promoting improvements in HIT, he cites the SMART project “where Zak Kohane and Ken Mandl are developing a system of “iPhone-like” medical apps designed so that they can be easily swapped out when better ones are developed but that allow for easy saving and transfer of data to a new program.”

Farzad Mostashari, National Coordinator for HIT, to keynote 2012 Indivo X Annual User’s Conference

Announcing the 2012 Indivo X Annual User’s Conference

Farzad Mostashari, MD, ScM, National Coordinator for Health Information Technology , will keynote the 2012 Indivo X Annual User’s Conference at Harvard Medical School June 18th-19th.

The 2012 Indivo X Annual User’s Conference to be held on June 18th-19th at Harvard Medical School’s Countway Library. Details and registration are available below. This meeting will have a technical focus, but will be of interest if you are:

  • Considering adopting Indivo for your health system
  • Integrating Indivo into your business offerings
  • Using Indivo for your research
  • Adding Patient Reported Outcomes to your registries or trials
  • Deeply in the Indivo X codebase
  • Interested in developing apps for Indivo X
  • Adopting the SMART platform and looking to add patient-facing apps

The Main Conference hours are Monday, June 18, from 1-5:30pm. Topics will include:

  • The Indivo X Release
  • Integration of Indivo X with www.SMARTPlatforms.org
  • Integration of Indivo X with www.i2b2.org
  • Indivo X iOS Framework
  • The upcoming Indivo Challenge
  • Lightning talks by Indivo implementers

On Tuesday, June 19th from 8am-3pm, we will run an all-day hackathon to design and begin implementing innovative patient-facing apps on top of Indivo. The morning will be spent brainstorming, connecting with teams around shared interests, and designing apps, and the afternoon will be devoted to implementation. This event is NOT limited to developers—health professionals, innovators from industry, or anyone with a good idea for an app will be invaluable for making the most of the hackathon. The Indivo team will be on hand to provide support and advice throughout the day.

Space is limited—please register here: Users’ Conference and Hackathon Registration Form

If you have any questions about the event or registration please contact skyler.kelemen@childrens.harvard.edu

Looking forward to seeing you there!

How SMART is your health IT system?

EHR Intelligence, March 27, 2012 — Kyle Murphy
Over the past few weeks, a debate has broken out between a team of researchers and the National Coordinator for Health Information Technology, Farzad Mostashari, over the former’s findings in a recently published study in Health Affairs. Dr. Mostashari used his government-hosted blog…
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SMART platform ‘promising’ for EHRs

FierceEMR, March 21, 2012 — Marla Durben Hirsch
The Substitutable Medical Applications, Reusable Technologies (SMART) platform appears to be a “promising approach” to improve electronic health records now that phase one of the project has been completed, according to its developers. The creators report this week in the Journal of American Medical Informatics Association that unlike current proprietary EHR systems, the SMART platform operates as a standard base platform to which users can add or subtract modular third-party applications, similar to the methodology used by iPhone or Android…
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How do You Promote Open App Development in Health IT?

Healthcare Informatics Magazine, March 20, 2012 — Jennifer Prestigiacomo
After attending a presentation at the HIMSS12 eCollaboration Forum, “Platform Innovation in an ‘Open’ Environment,” I got really excited for the upcoming SMART open app challenge. For those who are unfamiliar with the SMART Health App Challenge, it was started by a research team at Children’s Hospital of Boston and Harvard Medical School that launched a prize to encourage innovative app developers to build open platform apps that benefit patients and providers. The $5,000 prize was funded from the Office of the National Coordinator for Health IT….
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