HealthNex

IBM Chief Health Officer Janet Marchibroda on Smarter Healthcare

Janet Marchibroda is the chief health care officer of IBM

"As President Obama and Congress take on what the president in his American Medical Association speech called the "ticking time bomb" of health care costs, they need to know that they can't succeed without harnessing the massive data generated by modern medicine. Getting the best information into the hands of doctors and patients, while protecting patient privacy, is not just a desire but an overriding need if we are to get a handle on spiraling costs and also improve care. "(read the rest @ There Can Be No Health Care Reform Without An Information Revolution - Forbes.com)

System S: Stream Computing for Healthcare

IBM System S, which was released in May, has been in the works for more than 20 years. The software uses a new streaming architecture and mathematical algorithms that can analyze thousand of simultaneous data streams in real-time. Officials say organizations, like those in the healthcare industry, will benefit from the technology’s ability to help them improve decision-making. Traditional computing models retrospectively analyze stored data and don’t have the ability to continuously process massive amounts of incoming data streams, they say. (via IBM unveils “stream computing” software | Healthcare IT News)

For more on Smarter Healthcare, see The Smarter Health channel on our Tumblr site.

Jack Mason, Strategic Programs & Social Media
IBM Global Business Services
http://smarterplanet.tumblr.com

Are medical costs the leading cause of U.S. bankruptcies?

The 60 Second Science Blog, from Scientific American, reports:

"Analyzing data from 2,314 randomly selected 2007 (pre-mortgage-meltdown) bankruptcy filings revealed that most of those who had claimed bankruptcy because of medical expenses had health insurance, owned homes, were in their mid-40s and had middle class incomes. "

Smarter Planet: Healthcare, This Week's Focus

This week, Smarter Planet moves to the pressing issue of healthcare.  As the "op-ad" thought leadership story for this vital topic notes:

"The problems with our healthcare system are well known and well documented and endlessly debated. What's not so apparent is that many of them arise because our healthcare system isn't, in fact, a system."

Adam Christensen's post on the Building a Smarter Planet blog picks up on how of all aspects of smarter planet, healthcare is understandably one that is both deeply personal, as well as a societal front that we all have a vested interest in.

On the Smarter Planet Tumblr site, we've added a channel for all posts the touch on the way in which healthcare is becoming instrumented, interconnected  and ultimately, infused with a new kind of intelligence.  You can see more about this frontier of advance analytics, predictive modeling, simulation, business decision support via the New Intelligence channel on our Tumblr site.

Health Record Banking Advances

(reblogging this interesting update on health record banking, the idea of all patient data flowing to an account they, not doctors, control)

Channel:

Source: Patty Enrado, NHINWatch.com

Date: February 2, 2009

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Sometime during the next two months, through grants totaling $1.7 million, the Washington State Health Care Authority, or WSHCA (pdf), will launch three consumer-controlled health record bank pilots in the communities of Bellingham, Spokane and Cashmere.


WSHCA’s efforts are part of a movement toward implementing health record banking, or HRB, systems, said William Yasnoff, MD, PhD, managing partner of NHII Advisors and founder of the Health Record Banking Alliance.

Does Your Doctor Have a Virus?

David Spellmeyer, Almaden Services Research, IBM Research

This country and many others are on a big push to implement interoperable electronic health records.  Certainly, the benefits in quality of life improvements and reduced errors are more than enough to justify the cost of implementation.  We really do need this to happen.

A recent visit to my dentist’s office highlighted what I consider to be a significant vulnerability of my own electronic medical records.  Alas, I have a cracked tooth, that required an x-ray.  My dentist just moved into a brand-spanking new office which is now equipped with a brand-spanking new digital x-ray system.  Those digital x-rays are stored on a dedicated computer system.  The software helps dramatically in diagnosis, and requires only one-eighth the radiation as the old film versions.  This is a significant advance for him and for me as a patient.

But, here is where I started to get worried.  My dentist was very pleased to say that he’s installing a DSL line to the office and this machine in particular.  I asked him how he was going to back up and protect the images.  Was he going to use an ASP?  His response was that he had a computer guy who was going to install a virus checker and firewall.  Ugh.  Those are worlds apart.  In addition to finding out that I need more dental work, I found out that my dentist is not an IT expert.  And, I really do expect more from his office systems in terms of my privacy, my security, and my confidentiality. 

Like my dentist, most practitioners are not IT experts.  They do not want, nor need, to spend their time worrying about IT issues.  The vast majority of my own records are stored in my practitioners’ offices.  Because these practitioners are not IT experts, it is precisely these systems that are most vulnerable to things like malware, viruses, security attacks, hard drive failure, backup failure, power outages, and so much more.

Our privacy, security, and confidentiality are most likely to be breached in our individual doctor’s offices.  A recent report from the Seattle Post-Intelligencer suggests that even larger organizations are vulnerable.  Frankly, patients never should have to worry about these issues. Neither should dentists in solo practices.  Neither should doctors in the smallest group practices.

It should be the responsibility of companies like IBM – as IT infrastructure providers – to ensure that privacy, security, and confidentiality be embedded in our hardware, software, and middleware.

Good news.  We and other companies really do take privacy, security, and confidentiality seriously.  For a bit more on that, take a look at a recent post by my IBM colleagues Paul Grundy and John Bliss on sharing anonymized healthcare data.

It is only by doing so that we will assure ourselves that we may store and share our health information safely.  Until then, I am hoping that my dentist doesn’t get a virus, or something worse.

I know for certain that I would rather trust my dentist to repair my cracked tooth than to have him install a reliable, robust, and secure IT system.  After all, that’s what he went to school for, right?

IBM HealthNex Privacy Security

Guidelines for RFID Privacy

Harriet Pearson,  Vice President, IBM Corporate Affairs & Chief Privacy Officer

I wanted to alert people to a story in the May 1 NYTimes that describes a new set of guidelines for best practices around RFID technology and privacy.

RFID has implications for healthcare across many fronts, such as in home health monitoring systems, pharmaceutical tracking or reducing medication errors in hospitals.  But RFID technologies have been somewhat slowed by consumer wariness about how their privacy might be affected by "smart tags" in everyday items such as clothing or supermarket goods.

For more than a year, the Center for Democracy and Technology (CDT), a public interest group in Washington, DC, has been developing guidelines for RFID best practices.  IBM has been a member of the CDT's best practices working group, along with Proctor & Gamble,  the National Consumers League, General Motors, Microsoft, the Electronic Frontier Foundation and others.

These guidelines represent the first time a consumer/industry coalition has worked together to agree on how to enable privacy in light of increasing use of sensors and RFID solutions.

While not everyone involved in the development of the guidelines agreed with the end results, this work does represent a critical mass of support for some fundamental best practices. Some of those principles:

• RFID use should be transparent to the end consumer (and thus those that have the direct relationship with consumers should notify consumer of such use)
  

• Consumers should have choice to opt out of additional uses of personal information collected by RFID

• Organizations such as IBM, who are upstream of the consumer interaction, should also do our part by encouraging such consumer notification and choice.

To these ends, IBM has developed an  RFID design for a "clipped tag" that contains a disabling feature that limits the chip's ability to broadcast its signature. We've also developed an internal set of best practices for our client-facing teams.

Finally, these guidelines are an interim draft. The broad healthcare ecosystem of providers, patients, employers and all other interested parties should become part of the process for refining and extending this first iteration.

And that process can begin here. Are there other principles or practices that you believe should be included in the next revision? Please share your comments here, and tell others about these guidelines.

IBM HealthNex Privacy RFID

Healthcare Innovation: An Inside Story

Paul Grundy, MD, MPH, IBM Well-Being Director, Global Well Being Services and Health Benefits

John Bliss, JD, Privacy Strategist, IBM IBM Software Group, Entity Analytic Solutions

You hear it everywhere: innovation today depends on collaboration, often across disciplines and geography.

But who would have thought that a new solution to securely--and anonymously--share healthcare data would have come from our partnership: a physician working in IBM Human Resources and a privacy strategist from a newly acquired software firm.

What’s more it all started right here on the HealthNex blog.

In 2005, IBM acquired Systems Research and Development (SRD), a software company that specialized in detecting “who is who” across disparate operational systems.

Dr. Paul Grundy, Well-being Director in IBM’s corporate HR department, discussed some of the possibilities and implications of the company’s technology in healthcare in an early test post (during HealthNex’s development phase, which alas, was later deleted.)

Fortunately,John Bliss, an attorney and privacy strategist who came to IBM with the SRD acquisition, saw the post and got in touch with Paul. The pair’s different perspectives helped figure out a way that the SRD technology could improve health care through better analysis, while simultaneously protecting the privacy and anonymity of patients.

What the technology could enable is new kinds of data-intensive medical research, as well as easier ways to make health care costs and outcomes more transparent to patients and the public. Such price transparency is considered essential to supporting the range of changes and paradigm shift that IBM is calling “patient-centric healthcare.”

The problem is that there are two types of data that need to come together to make a quantum leap forward in health care – translation: innovation that matters:

• The first kind—called transactional data—is all the personal health history we typically think of as patient information or electronic health records, as well as financial info such as the cost of a procedure or treatment.

• The second is analytical data, using large pools of transactional data, potentially from thousands of patients, for medical research or other kinds of analyses (such as measuring which patients had the best outcomes for the lowest cost.)

As you can imagine, privacy protections have made it difficult to enable large volumes of patient data to be made available for research databases. What our combined insights hit upon was just such a  way to bring these two silos together: to strip out the identity of patients’ data, yet still allow the pooled information to be processed in ways that would reveal valuable patterns.

The following may sound kind of gorpy, but the process uses encryption algorithms known as one-way hashes and some proprietary preprocessing technology, but it means that patient and financial data can be anonymized and then correlated and analyzed while still in its masked form (a technique not previously known and now the subject of several new IBM pending patents).

SRD had been using similar clear-text approaches for confirming “who is who” in certain homeland security applications.  In addition, this anonymization technology is already in operation with our government and a foreign government.  Once Paul understood how it worked, he started talking to John and Jeff Jonas, SRD Founder and now Entity Analytic's Chief Scientist, about how it could help crack a major data problem in healthcare informatics.

And today, their collaboration has resulted in Entity Analytic's Anonymous Resolution product.

Tailored for health care, AR offers promise to give researchers realtime results. As soon as patient data flows into the analytical pool, results and insights are appropriately published.  What’s more, each new piece of data—say the next results from a liver test—will improve the next analysis. This solution is roughly analogous to how the continual flow of financial data into credit bureaus changes each of our credit ratings with every transaction we make.

Of course, the purpose of this post is not to be some disguised press release or promotion for IBM software.  What we think is really instructive here is that innovation happens when different kinds of expertise and experience come together.

Making those kinds of opportunistic connections happen is important for any company or organization that wants to increase its ability to innovate. Our small advance is really just an example of the evolving nature that innovation is taking. Of course, we’d like to hear some of your examples of how innovation is happening in healthcare in new ways. And how we might apply this new healthcare data anonymizing technology to serve other healthcare innovations.

Lastly, this innovation insider story also circles back to the mission for this HealthNex blog: to be an intersection for the kinds of connections that feed innovation, such as the recent Blogposium that brought so many healthcare bloggers and experts together.

FYI: Attached is a very thoughtful piece by a noted privacy and health care policy expert, Peter Swire, that describes Anonymous Resolution and its promise in the health care industry in a bit more detail.

Also, our colleague Jeff Jonas blogs about this and other privacy enhancing technologies at www.jeffjonas.typepad.com.

IBMHealthNexHealthcare Privacy

Blogposium is a Go: April 18-19

Jack Mason, IBM Strategic Communications, HealthNex Producer

The consensus from the health IT blogosphere is....let's do this thing! So mark April 18-19 on your calenders.

To reiterate: Blogposium will be a two-day, virtual collaboration among our circle of bloggers to show the world that together, we can do real and practical work. To make this cross-blog cooperative experiment a success, we'll keep the work and the objective relatively simple:

The Objective:  to help flesh out The Clinical Informatics Wiki started by Dean Sittig with a dozen or more new entries, so that this wikipedia-like resource will become more useful for all.

The Work:  In the next few weeks, each participating blogger will choose a topic related to healthcare IT  (I'll take on Biobanking, for example) research it, and prepare a first draft for an entry in the ClinfoWiki. Entries should include basic definitions, links to supporting material, etc.

April 18: Bloggers will post their first drafts on and all of us, as well as all our readers, will provide comments, suggests and edits on each other's work. Everyone should include links at the bottom of their draft to the preliminary drafts of fellow Blogposium participants, so that we will pass traffic and editorial eyeballs around.

April 19: Based on community input, bloggers will post their second draft, for ultimately inclusion in the wiki.

The beauty of this approach, we hope, is that each participant can draw on their particular interests or expertise, and contribute something of practical value with only a short commitment of time and effort. 

And if we can succeed with this fairly straightfoward effort, perhaps we can take on tougher assignments in the future, and demonstrate that a confederation of bloggers can be  a really useful engine, to paraphrase my 3-year-old's Thomas the Tank Engine obsession.

How to Participate:  Shahid Shah was kind enough to register people's previous interest in this collaboration. He's currently traveling. But in the expectation that he can create a similar registration page for people to declare their topics, that will be the plan.  Stay tuned.

How to Help:  First, spread the word to fellow bloggers who might have the kind of expertise to participate, as well as to the broader audience who can lend their collective intelligence to make our entries smarter and sharper.

Second, alert the media! This is by no means an exercise in self-promotion, but a public experiment to push the boundaries of what a ring of bloggers and readers can accomplish together. In this case, the greater the attention, the more productive this collaboration will be. For my own part, I will be working with my IBM colleagues to shine a light on this project.

Of course, if you have other thoughts on how to make this collaboration a success please add your comments hear or send them to me at healthnex@gmail.com

This should be an exciting and fun little piece of work for all of us. And given the enthusiasm so many of you have shown towards the idea of working together toward some common good, I'm proud to be connected to all of you.

Blogposium Countdown: t-minus 20 days and counting.

IBMHealthNex

How to Anonymize Healthcare Data

Jack Mason, IBM Strategic Communications, HealthNex Producer

Just came across an interesting article in MIT Technology Review that features my colleague Jeff Jonas on how data can be made anonymous yet also be searched and mined. While he doesn't specifically talk about healthcare in the story, the technology he pioneered does have implications for, and applications in, areas such as biobanking and public health research.

IBMHealthNex