5 takeaways from AHIP 2014 & Digital Health Experience

Earlier in June I got an opportunity to attend AHIP Institute 2014 showcase and the Digital Health Experience launch event.

AHIP stands for America’s Health Insurance Plans. It’s the trade association representing about 1300 member companies and the health insurance industry. From the show floor you can clearly see that two things were on top of the mind for this group :

  1. Accountable Care Organization (ACOs): Every organization had a way or a solutions for health plans to participated in the shared risk aspect of accountable care organizations. Some took an approach of accountable care plans with a plethora of care co-ordination tools. I think the market offering is still evolving here.
  2. Health Exchanges: On the other hand, nothing can be as concrete as a shopping cart product for purchasing health insurance! Number of companies had private, public and employer enabled health insurance exchanges. However the work for public organization like ONC, and others with agencies like IDEO really caught by eye — http://www.ux2014.org/. UX 2014 is an effort to drive a standard enrollments and a user experience for health insurance exchanges! The work is very impressive and complete, which they had a reference implementation as well!

Digital Health Experience (DHX) was a side event for AHIP and had an impressive line up of talks from folks from academia and industry. The event distributed a copy of the book ePatient 2015, which is good resource of all things happening around patient engagement in digital health. Among other trends the book highlights care hacking as a mechanism in which consumers are trying to take control of their health. Among the talks at Digital Health Experience, following are my top 3 takeaways –

  1. Academia is innovating in health care and actually closing an end to end loop for new models of behavior change.
  2. Reward platforms are hitting critical mass with retails health offerings. Channels do matter
  3. Health plans are thinking about behavior chance driven by real time data from – shopping habits to clickstream!

mHealth–Mobiles can fuel a big change quickly!

I was at mHealth Dec 2012 and have been following the conference on twitter this year. The major topics and number upstarts seems to be trending along the lines of –

  • Wellness / Behavior Modification
    Last year I spoke to numerous startups working on consumer solutions for nutrition, weight management, diabetes management – MyGlucoHealth, FatSecret and others. This seems no different there is continued momentum in this category.
  • Patient Engagement / Hospital Mobility
    Various companies offering concierge medicine and enabling communication with the patients – coretext, tigertext, celltrust, mHealthCoach, medhelp and others. Solutions targeting meaningful use 2, readmissions management, medication adherence and care collaboration. This year healthloop is creating fair bit buzz with its recent 10M funding round.
  • Consumer Devices / Self Tracking
    Rewards platforms like kiip, socialwellth, everymove; device ecosystems like Qualcomm 2net, strava; gaming in health like zamzee, lumosity. This year seems like healthrageous folded but rest of the crew is continue to make buzz with renewed push from wearable devices.

There are number of technologies fueling healthcare at the moment but mobile devices and cellphones in particular are poised to make significant impact as they are driving use from end users!

Notes from Direct Boot Camp

On Aug 13-14 2013, ONC hosted the second Direct boot camp. For me this was a great venue to connect with partners, customers, team members and like minded folk in general! It was also great to see that conversation on Direct had graduated from learning to demonstrate what the community is doing to drive adoption of the communication standard and bring it to scale!

Among other things following were the key items discussed at the boot camp –

What it takes to get accredited?
Among other things DirectTrust and its members talked about the accreditation process for Direct and how its members have successfully gone through the process. Since the boot camp DirectTrust with ENHAC  has published the guidelines for the process and a number of entities are ramping up for accreditation.

Update: Alan Viars has open sourced his Direct CA project, which in conjunction with the Direct reference implementation can be used to create a complete open source HISP, CA and RA. Additionally, Digicert also has made its certified Direct CA offering publicly available.

What are new technical developments in the Direct project?
The Direct project introduced two key technical achievements – Trust Bundles and Policy Engine. Both these capabilities allows fine grained control of how certificates are utilized. Infact, Direct trust has its trust bundle available here and the blue button project has its available here.

What’s next?
I’m hoping to write more about the the Direct project, Blue button and associated technologies. What would you like to know more about? Provider Directories, Certificates, CCDA ? Hopefully I’ll get a chance to cover a bit of those in coming posts.

Public Cloud for Healthcare–The odds and ends

As computing and storage becomes more ubiquitous, its natural to ask when can regulated industries utilize the quality and economies of scales. Maybe utility computing could  have alleviated some aspects of healthcare.gov by flipping the switch to an alternative powergrid, if you will. However there are number if interesting challenges and nuances for public clouds to offer utility computing and storage to healthcare customers.

So what are the problems?

  • Security & Privacy: Unlike electricity, utility computing is too ingrained in to processes and innovation for existing businesses.
  • Compliance: Utility companies to be able to comply with data audit policies as well as have a business structure which enables signing of business associate agreement.
  • Lock in and interoperability: Developing a solution too ingrained in to a utility architecture can effect the core business of a company
  • Co-innovation: In past decade most businesses have innovated by adopting IT strategically. We see a CIO as part of every organization, to continue that innovation the public computing utility needs to offers ways to co-innovate easily.

So what are the current solutions?

  • Well most cloud-based healthcare organization keep maintain their own cloud infrastructure.
    • The data is encrypted at REST either by Database Transparent Data Encryption (TDE). Both Oracle and SQLServer support it.
    • File system encryption
  • Healthcare organizations sign a HIPAA BAA and most data centers are certified to one of the standards – (SAS 70, ISO etc.)

What’s needed?

  • More public cloud vendors should sign HIPAA BAAs – Microsoft Azure, AWS and most recently Google Cloud already do.
  • Co-innovate for security and compliance solutions like AWS CloudHSM
  • Make encryptions at rest easy – blob store keys are a great start.

EHR Meaningful Use 2 and ONC Direct Secure Transport

This is a series of blog posts touching on a few pertinent curiosities from HIMSS 2013.

Meaningful Use 2 mandates Electronic Health Records to support secure health transport to specifically fulfill the following measures:

  • Measure #1: Providers should send a summary of care for more than 50% transitions of care and referrals.
  • Measure #2: Providers should electronically transmit summary of care for than 10% transitions of care and referrals.
  • Measure #3: At least one summary of care document sent electronically should be to a recipient with a different EHR vendor or to CMS test EHR.

Continue reading

Nine links to help you ‘get’ HealthIT

Interesting nine links to introduce Healthcare IT!

1. Innovators Prescription: http://innovatorsprescription.com/
2. Redefining HealthCare: http://www.amazon.com/Redefining-Health-Care-Value-Based-Competition/dp/1591397782/ref=pd_sim_b_1

3. Patients Like Me: http://www.patientslikeme.com
4. Keas : http://keas.com/

5. John Halamka’s Blog: http://geekdoctor.blogspot.com/
6. Sean Nolan’s Blog: http://blogs.msdn.com/familyhealthguy/

7. EHR: http://en.wikipedia.org/wiki/Electronic_health_record

8. Whitepaper on EMRs in Ambulatory Care: http://www.himss.org/content/files/Amb_EHR_Implemention081507.pdf

Decision Support in EMR / EHR:
9. CDC Paper: http://cdc.confex.com/cdc/phin2009/webprogram/Paper21024.html

Windows Phone 7 Health and Life Sciences App Contest

Get your creative geek on and be part of the Health and Life Sciences application contest. The ten winning entries get an XBOX 360 console with Kinect for each team participant and a chance to make difference in Healthcare!


In addition to the application ideas on the contest website feel free to use the resources from Health hack-a-thons. Perhaps it will be great to see some mash-ups using data from http://www.data.gov/health.

Drop me a note if you need help connecting your mobile applications with HealthVault or are trying to explore the Health datasets.

Update: If you want to take your project to the next level, RockHealth might have some seed funding for you!