To nstrate how vital materialism can be applied to empirical research material as an analytical lens, I will use a vignette from my empirical research on people who use digital devices to engage in self-tracking of their bodies. Great lens, really interesting resource. This works great for the 1700 clinicians in BIDPO, but does not support pull transactions across competing organizations. Push is great for some workflows, but pull is needed for emergency rooms to obtain critical treatment data in a timely fashion to ensure safe, quality care. There will need to be a consent mechanism for providers to pull patient data from multiple data sources as needed for care. A push architecture supports provider initiated consent – the clinician can ask the patient before pushing data. Protecting privacy is foundational and we should only exchange data per patient preference. Since no patient identifiers are involved there is a reduced risk for privacy breaches.
In the first stage of meaningful use, there are limited data exchanges – ePrescribing, a nstration of pushing data from provider to provider, and public/population health exchanges for lab, immunizations, and syndromic surveillance. In our community EHR rollout of eClinicalWorks via our private cloud (a physically secure, environmentally controlled, generator supported co-location facility that is professionally operated and provides all the inbound interfaces needed for meaningful use), we’ve designed our infrastructure to support consent for Stage 1 exchanges. In our community EHR rollout of eClinicalWorks, we’ve designed our infrastructure to support consent for Stage 2 exchanges. In Stage 2, I expect that such consent will be federated, stored in various EHRs and community exchanges. I believe that Stage 3 which include several community, state, and national data exchanges to support care coordination and population health. The patient’s data sharing preferences must be stored somewhere so that when data is pulled, only those data elements consistent with patient privacy preferences for that type of clinical encounter are shared. Per Jon Perlin, the afternoon of the HIT Standards Committee meeting including a rich discussion of the Privacy and Security Tiger Team Update by Deven McGraw/Paul Egerman, an Enrollment Workgroup Update, and public comment.
This post has been done with version.
During the public comment period, the committee was deeply moved by a speech from the mother of a child with a serious illness. She thanked the committee for all their work to date to empower patients and improve the quality, safety and efficiency of care. An article in AACN Advanced Critical Care reports an alarm analysis at The John Hopkins Hospital in Baltimore, Maryland, revealed an average of 350 alarms per patient per day over a 12-day period. A clinician asks a patient if the clinician can push a summary of their care to another clinician such as a primary caregiver/specialist or hospital/primary caregiver data exchange. Aggregating de-identified data for public health purposes is permitted by HIPAA and ARRA without consent. 3. Data can flow from provider to provider with NEHEN or the eCW push product (P2P), but that is at the provider’s discretion after consent of the patient is obtained. We use the EHX product from eClinicalWorks which includes an opt in consent database, a clinical summary data store, and means for clinicians to pull data across practices if a patient opts in to support it. Pull requires a different approach.
Although the CCR can use ICD9, the CCD/C32 implementation guide requires SNOMED-CT. In Massachusetts, we have legislation (Chapter 305) and a community standard which requires an opt-in consent for data sharing between healthcare organizations. A clinician asks a patient (or the patient signs a paper-based general consent in the office or hospital) if the clinician can retrieve their national medication history from Surescripts during the course of e-prescribing. In addition, through a distributor, Convergence Systems, Arcus is being delivered to Khon Kaen University Hospital in Thailand. We nurses don’t look at it and think of the negative connotations associated with it from ancient mythology, we regard it as being a image of pride. It is nonetheless important for one to ensure the credibility and legitimacy of a program being offered by a particular institution online. No one has clarified this yet. Waksal, who received a tip in December of 2001 that the US FDA was going to reject his application for a colon cancer drug, sold 80,000 of his company’s shares one day before the FDA handed down its rejection of the drug. Marketing Sherpa is not a software application per se, but the company does offer advice on how to tailor marketing emails, social marketing campaigns and other sales campaigns.