Dispatch From The Digital Health Frontier: The Spirit Of PCAST

When this step has been completed (by November 2010), we will work on a rule-based mapping between the SNOMED CT CORE Problem list subset and ICD-10-CM. Harvard has retained an expert consultant and is moving forward on an aggressive schedule (60 days) to analyze all the potential sustainable business models (direct grant funding, indirect overhead, chargebacks, school operating budgets, transaction fees, subscription fees) that will support growth in infrastructure and staff over time. Harvard High Performance Computing Summit and updated the attendees on the latest research computing and novel applications at Harvard Medical School. The school funds the power/cooling/hosting/basic infrastructure as well as an expert staff to serve the faculty. It mines the literature, Harvard directories, and the connections among all Harvard faculty to identify the right people to ask the right questions. Clinical Documentation (including ICD-10 and Medication Management) – 2013 is right around the corner and we need full compliance with 5010 and ICD-10 standards in our clinical and financial systems. 4. Building collaborations with Profiles – The path to wisdom requires that researchers ask the right questions. Researchers use their grants to add computing power and storage to the community utility instead of building small clusters under desks and in local mini-data centers.

While the use of mHealth devices and apps is already widespread in clinical trials, pharmaceutical giants are now setting their sights on connected drug delivery platforms that will automatically detect and log patients’ medication use to improve adherence. Now, while I may disagree that the only current driver of Health IT deployments are sales brochures I find the broad sentiment most compelling. Awareness about the disease and treatment is saving lives, while lack of effectively managed data might place this information at risk. However, there are some pearls within, and some very important ideas, such as privacy/confidentiality/consent annotation and a learning healthcare information system, which should not be persued just because they were advocated in this report. Under the new ERISA requirements (“CRS Report for Congress”, April 10, 2008), a company has seven years to make up a pension shortfall, over which the minimum company contribution is equal to the “target normal cost”, which is equal to the benefits expected to be paid out in the current year. That’s what keeping me up at night this year.

Ever Increasing Demands for Compliance and Security – Just as with HMS, there will be numerous compliance efforts in the next year – FLSA compliance with advanced time keeping systems, followup to our Joint Commission and CMS visits to ensure we meet all their criteria, and increasingly sophisticated monitors/audits to address new Massachusetts Data Protection requirements. SNOMED CT to ICD-10-CM – NLM is currently inserting ICD-10-CM into the UMLS Metathesaurus, which will create the synonymous mappings between SNOMED CT and ICD-10-CM. In addition to the Kaiser donation, below is a guide to other freely available resources, such as crossmaps from SNOMED CT to ICD-9-CM and ICD-10-CM. The rule-based map includes IF-THEN rules for selecting the appropriate ICD-9-CM code for a condition in those cases when a SNOMED CT concept could map to more than one ICD-9-CM entry. Code obfuscation means to mask the code’s logic, purpose, and even the embedded values in it. For example, in order to select the appropriate ICD-9-CM code for infertility, you must look elsewhere in the patient’s record to determine whether the patient is male or female. This article has been created with !

2. Novel Sources of Data – The American Recovery and Reinvestment Act (ARRA) and its related healthcare IT regulations are encouraging clinicians and patients to record healthcare data in electronic form. 3. Mining those novel sources of data with Shrine – Petabytes of data does not change healthcare, but transforming that data into information, knowledge and wisdom does. Shrine enables researchers, with appropriate oversight and approval, to study the de-identified data of 10 million patients at Harvard affiliates. With proper privacy controls and institutional review board oversight, this new data can provide support for comparative effectiveness research, population health monitoring, and pharmacosurveillance. We’re creating the foundation by ensuring BIDMC can send and receive healthcare data with patient consent to any provider organization, public health entity, or registry which measures outcomes on our behalf. Preparing for healthcare reform and accountable care organizations – Is it better to create a strategic plan to become an Accountable Care Organization or be an opportunist, creating affiliations and IT integration on the path of healthcare reform over the next few years, given the continuously changing policy landscape?