Earnest Engineer

  In many healthcare applications, often due to the cloistered nature of the use cases – e.g. it will only be accessed by users authorized in a particular facility, such as an operating room suite – the needs for Authentication and Authorization are minimized when the system is designed and implemented. This presents a risk as soon as you allow for the possibility of users with ill-intent or that otherwise want to operate outside their given roles. Custom applications need to consider these possibilities and implement the following measure to ensure the integrity of the system. 1.   Authentication and Authorization Controls: Multi-Factor Authentication (MFA): Implement MFA for all user logins. This adds an extra layer of security beyond just a username and password. Role-Based Access Control (RBAC): Grant users access only to the data and functionalities they need for their specific role. This minimizes the potential for unauthorized access. Strong Password Policies: ...

In watching advances in medical devices, it's obvious the trend is pushing devices out into patients hands. This allows diagnostic tests to happen when they are needed during the patients normal life, rather than simply at the point of care. This allows right time diagnostics.  For other patients isn't the necessity of catching a problem at the right time, but getting the diagnostic devices to where the patient is, rather than the patient coming to the diagnostics. This allow devices to be in the right place. This is enabled by the ubiquity of smartphones - capable computers which disguise themselves as consumer communications devices. In this arena, there is a recently introduced ECG device from Sanatmetal called WIWE . It communicates via Bluetooth to the users smartphone, which provides the visual output and feedback as well as communications back to the clinicians who will use the data collected. This is a good example of creating a "Right Time" diagnostic to...

Right from the get-go, I was intrigued by this post which used the phrase "Data Liquidity" since this term is new to me, but I grasp a meaning for it right away. The post points out the importance of interoperability for care continuity and how this impacts value and quality driven care. As a technologist, ideas and concepts like this always interest me and it represents an area I've dealt with as a software engineer responsible for tying systems together into a coherent whole. I understand the need for continuing technology improvements in this area. But an even more frustrating and worrisome impediment to data liquidity are institutional barriers . I have often run into mazes of siloed data, groundless HIPPA fear-reactions, lack of data management infrastructures, turf wars and other strictly institutional impediments . I understand that hospitals and healthcare systems are large and complex organizations. But I find that often the data management policies in bu...

Here is a glossary of terms useful in Healthcare and Health Informatics ACO (Accountable Care Organization) MEDICARE’s outcomes-based contracting approach Arden Syntax an approach to specifying medical knowledge and clinical decision support rules in a form that is independent of any EHR and thus sharable across hospitals ARRA (American Recovery and Reconstruction Act) the Obama administration’s 2009 economic stimulus bill Blue Button an ASCII text based standard for heath information sharing first introduced by the Veteran’s Administration to facilitate access to records stored in VistA by their patients. The newer Blue Button + format provides both human and machine readable formats. CCD (Continuity of Care Document) an XML-based patient summary based on the CDA architecture CCOW (Clinical Context Object Workshop) an HL7 standard for synchronizing and coordinating applications to automatically follow the patient, user (and other) contexts to allow the clinical u...