Andy Oram

Andy Oram is an editor at O'Reilly Media. An employee of the company since 1992, Andy currently specializes in open source technologies and software engineering. His work for O'Reilly includes the first books ever released by a U.S. publisher on Linux, the 2001 title Peer-to-Peer, and the 2007 best-seller Beautiful Code.

Visualizing Health IT: A holistic overview

O'Reilly report covers major trends and tries to connect the neurons

If visualization is key to comprehending data, the field of health IT calls for better visualization. I am not talking here of pretty charts and animations. I am talking, rather, of a holistic, unified understanding of the bustle taking place in different corners of health: the collection and analysis of genetic data, the design of slim medical devices that replace refrigerator-sized pieces of equipment, the data crunching at hospitals delving into demographic data to identify at-risk patients.

There is no dearth of health reformers offering their visions for patient engagement, information exchange, better public health, and disruptive change to health industries. But they often accept too freely the promise of technology, without grasping how difficult the technical implementations of their reforms would be. Furthermore, no document I have found pulls together the various trends in technology and explores their interrelationships.

I have tried to fill this gap with a recently released report: The Information Technology Fix for Health: Barriers and Pathways to the Use of Information Technology for Better Health Care. This posting describes some of the issues it covers.

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Can data provide the trust we need in health care?

Collecting actionable data is a challenge for today's data tools

One of the problems dragging down the US health care system is that nobody trusts one another. Most of us, as individuals, place faith in our personal health care providers, which may or may not be warranted. But on a larger scale we’re all suspicious of each other:

  • Doctors don’t trust patients, who aren’t forthcoming with all the bad habits they indulge in and often fail to follow the most basic instructions, such as to take their medications.
  • The payers–which include insurers, many government agencies, and increasingly the whole patient population as our deductibles and other out-of-pocket expenses ascend–don’t trust the doctors, who waste an estimated 20% or more of all health expenditures, including some thirty or more billion dollars of fraud each year.
  • The public distrusts the pharmaceutical companies (although we still follow their advice on advertisements and ask our doctors for the latest pill) and is starting to distrust clinical researchers as we hear about conflicts of interest and difficulties replicating results.
  • Nobody trusts the federal government, which pursues two (contradictory) goals of lowering health care costs and stimulating employment.

Yet everyone has beneficent goals and good ideas for improving health care. Doctors want to feel effective, patients want to stay well (even if that desire doesn’t always translate into action), the Department of Health and Human Services champions very lofty goals for data exchange and quality improvement, clinical researchers put their work above family and comfort, and even private insurance companies are trying moving to “fee for value” programs that ensure coordinated patient care.

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Big data and privacy: an uneasy face-off for government to face

MIT workshop kicks off Obama campaign on privacy

Thrust into controversy by Edward Snowden’s first revelations last year, President Obama belatedly welcomed a “conversation” about privacy. As cynical as you may feel about US spying, that conversation with the federal government has now begun. In particular, the first of three public workshops took place Monday at MIT.

Given the locale, a focus on the technical aspects of privacy was appropriate for this discussion. Speakers cheered about the value of data (invoking the “big data” buzzword often), delineated the trade-offs between accumulating useful data and preserving privacy, and introduced technologies that could analyze encrypted data without revealing facts about individuals. Two more workshops will be held in other cities, one focusing on ethics and the other on law.

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Internet of Things in celebration and provocation at MIT

IoTFest reveals exemplary applications as well as challenges

Last Saturday’s IoT Festival at MIT became a meeting ground for people connecting the physical world. Embedded systems developers, security experts, data scientists, and artists all joined in this event. Although it was called a festival, it had a typical conference format with speakers, slides, and question periods. Hallway discussions were intense.

However you define the Internet of Things (O’Reilly has its own take on it, in our Solid blog site and conference), a lot stands in the way of its promise. And these hurdles are more social than technical.

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Health hackathon brings to life agile solutions for unmet needs

Winners of the Blue Button Innovation Challenge

I think the main achievement of hackathons can be measured not by what apps are developed–reportedly, few are commercialized and maintained–but by people who find each other. The Blue Button Innovation Challenge brought together a lot of professionals who had never met before, and many formed teams that created really fun and useful apps that make you think, “Why hasn’t anyone done this yet?”

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Health technology brings care plans alive

Finalists at Merck|Heritage Provider Network Innovation Challenge

Challenges and hackathons are meant to surprise you. If the winner is a known leader in the field with lists of familiar credentials festooning the team’s resumes, there was no point to starting the challenge in the first place.

Pharmaceutical company Merck and the Heritage Provider Network, the largest physician-led health network in the US, were looking for something new when they launched their challenge on diabetes and heart disease. These conditions are virtual epidemics, world-wide.

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23andMe flap at FDA indicates fundamental dilemma in health reform

We must go beyond hype for incentives to provide data to researchers

The FDA order stopping 23andM3 from offering its genetic test kit strikes right into the heart of the major issue in health care reform: the tension between individual care and collective benefit. Health is not an individual matter. As I will show, we need each other. And beyond narrow regulatory questions, the 23andMe issue opens up the whole goal of information sharing and the funding of health care reform.

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Geographic data is the glue for public health and treatment

Esri conference highlights uses of GIS data

We’ve all seen cool maps of health data, such as these representations of diabetes prevalence by US county. But few people think about how thoroughly geospacial data is transforming public health and changing the allocation of resources at individual hospitals. I got a peek into this world at the Esri Health GIS Conference this week in Cambridge, Mass.

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Where are the chances for change in health care – top-down or bottom-up?

Impressions from Strata Rx bolster different philosophies

Everyone seems to agree that health care is the next big industry waiting to be disrupted. But who will force that change on a massive system full of conservative players? Three possibilities present themselves:

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Ticking all the boxes for a health care upgrade at Strata Rx

What is needed for successful reform of the health care system?

Here’s what we all know: that a data-rich health care future is coming our way. And what it will look like, in large outlines. Health care reformers have learned that no single practice will improve the system. All of the following, which were discussed at O’Reilly’s recent Strata Rx conference, must fall in place.

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