Could the President’s Data Breach Proposal Affect Health Care?

Law and Health Blog
Written by Law and Health Blog
on January 23, 2015

Sony. Target. Home Depot. Community Health. Data breaches have Americans scared. The Identity Theft Resource Center (ITRC) reported 783 data breaches in 2014, an increase of 27.5 percent as compared to 2013; 42 percent of those breaches occurred in the Medical/Health Care industry. On January 12, 2015, President Obama announced a legislative proposal he referred to as the Personal Data Notification & Protection Act. The Act would create a single national standard that companies would follow to notify consumers within 30 days of a breach. The President is expected to expand upon this proposal in his upcoming State of the Union speech. Read further >


Clinical Quality Language

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on January 12, 2015

HL7 is currently balloting a draft standard for a new language to represent clinical quality and clinical decision support expressions. This new language is called Clinical Quality Language (CQL). For decades, hospital systems have used different languages to represent medical knowledge, making it difficult to author decision support applications that can be used across institutions. This problem has been previously addressed through other standards such as the Arden Syntax and GELLO, but Arden is supported only by a limited number of electronic medical record (EMR) vendors, and GELLO implementations are few and far between. The new CQL standard allows the authoring of logic for both clinical quality measurement (CQM) and clinical decision support (CDS) use cases. In addition to a human-readable form (CQL), it provides a machine-friendly representation in XML using something called the Expression Logical Model (ELM). Read further >


Quality of C-CDA documents

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on December 22, 2014

Consolidated Clinical Document Architecture (C-CDA) documents are being used in the United States to exchange patient data between providers. In the current issue of JAMIA, the authors D’Amore, Mandel, Kreda, et al, evaluated the quality of a sample of these documents. They conducted a detailed review of 21 C-CDA samples received from different vendors. Read further >


Highlight on California: Courts Side with Providers in Golden State Data Breaches, For Now

Law and Health Blog
Written by Law and Health Blog
on December 08, 2014

Two recent cases decided by two California appellate courts shed some light on what one source describes as “judicial reluctance” to award damages to individuals whose information was potentially leaked in a security breach. At least this was the result in these matters where the plaintiffs could not prove anything beyond minimal harm stemming from the breaches. Considering these decisions as well as the sharp increase of reports of breaches of security information in California and across the country, the question is raised, to what extent will these precedents be followed in other jurisdictions? Moreover, will the results change if the plaintiffs are able to prove more than minimal harm and what does that entail? Read further >


AMIA 2014

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on November 24, 2014

Last week, I had the pleasure of attending the AMIA Annual Symposium in Washington, DC. I’ve attended this meeting most years for the last 20 years, and it continues to be a great opportunity to learn about what’s new in medical informatics and to network with old and new friends and colleagues. The keynote address was given by Dr. Amy Abernethy, who discussed the importance of learning from the streams and rivers of healthcare data to make better and better decisions. She asserted that even after death, patients live on through their data, which can help other people. Read further >


Highlight on Hawaii: Can a Turn to the Business Realm Cure the Aloha State’s Ailing Exchange?

Law and Health Blog
Written by Law and Health Blog
on October 24, 2014

The Hawaii Health Connector, the state’s Health Insurance Exchange, announced the appointment of its new executive director recently. Jeffrey Kissel, the former CEO of HawaiiGas, will become the Exchange’s third director within the last year when he replaces current interim director, Tom Matsuda. Besides leadership turnover, the Exchange in Hawaii has experienced several other issues since its creation in 2013, including funding and provider shortages. Unlike other Exchange directors, Kissel does not have a background in the health or insurance industry. So will this change be the cure for what ails the Hawaii Exchange as the upcoming enrollment season approaches? Moreover, to what extent have other state Exchanges’ successes or failure stemmed from leadership in those Exchanges? Read further >


LinkedIn as a Professional’s Publishing Platform?

John Barker
Written by John Barker
on September 26, 2014

Like many lawyers, accountants, knowledge workers, and other professionals, I maintain a LinkedIn profile. LinkedIn’s investor presentations, which I recommend reading, reveal ambitions far beyond being merely a social networking space for knowledge workers. In addition to wanting to be the professional network for connecting all of the world’s professionals, LinkedIn also wants to “be the definitive professional publishing platform.” Read further >


Clinical Decision Support on FHIR

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on September 22, 2014

Last year, I wrote about the federal (US) Health eDecisions (HeD) initiative, which resulted in various standards for clinical decision support (CDS), including an XML schema for representing a “knowledge artifact” and a Virtual Medical Record (VMR) for representing patient data. In HeD, knowledge artifacts can be event-condition-action rules, order sets, or documentation templates. Since that time, a new federal initiative has been underway called the Clinical Quality Framework (CQF). This initiative seeks to harmonize standards for CDS and clinical quality measurement (CQM). With respect to patient data models, the CDS domain has the VMR, but the quality domain has something called the Quality Data Model (QDM). One of the goals of CQF is to harmonize VMR and QDM into a single model called Quality Improvement and Clinical Knowledge (QUICK). Read further >


IPF Quality Reporting: CMS Plunges Ahead Without NQF Endorsment

Law and Health Blog
Written by Law and Health Blog
on September 01, 2014

On August 6, 2014, CMS issued the Inpatient Psychiatric Facility (IPF) Medicare Prospective Payment System (PPS) Fiscal Year (FY) 2015 Final Rule. In addition to adjusting rates and addressing ICD-10 implementation, the Final rule also included changes to the IPF Quality Reporting (IPFQR) Program. The IPFQR applies to both inpatient psychiatric hospitals and psychiatric units within acute care and critical access hospitals. Read further >


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