Interoperability solved by worker bee

In response to “Procuring Interoperability” just published by the
National Academy of Medicine, the ONC Workshop on Interoperability,
and the AMIA Interoperability Debate, this worker bee would
like to share her solution to interoperability.

I have prepared three detailed videos where I prove interoperability
is alive and well.

Exporting patient data – (12 minutes) –

Transporting patient data – (4 minutes) –

Importing patient data – (10 minutes) –

In short, I can take a patient’s ENTIRE electronic health record and:
wrap it, post it to the patient portal, sign it, encrypt it, send it,
receive it, decrypt it, import it, reconcile it, and then use it on the target machine.

I have a quantitative metric that details the accuracy
of the transaction.

Your CDA is empty!

I had an interesting encounter with some data this morning.

As you know, I have been obsessed with the <entry> component of the CDA. Well, I found a screaming example of why interoperability is having such a difficult time here in America.

Consider an example CDA taken from here.

Here’s the CDA <text> component. Remember, the <text> component is the human readable part we see.

CDA Problem List

Here’s the true content of the <entry> component formatted in a friendly format. Remember, the <entry> component is the part the computer understands.

DiData Problem List

There’s not much “real” data there. Let’s see why.
Continue reading “Your CDA is empty!”

What’s really inside of your CDA?

The CDA is  the instrument of interoperability in healthcare. It’s the format clinicians use to exchange healthcare data. The Office of the National Coordinator for Health Information Technology (ONC) requires its use for EHR certification.

I believe the CDA is severely flawed, if not outright dangerous. What “you” see is not always the data “they” get.

The CDA consists of two components, the “human readable” part, and the “data” part. These two parts are almost totally disjoint. The clinician only sees the human readable part. She almost never sees the “data” part. I believe errors are going undetected. Continue reading “What’s really inside of your CDA?”

Clinical Trials – Enrollment

I have been obsessed with the problem of slow enrollments in clinical trials for years. An article stated: “less than 4% of cancer patients enroll in trials each year, more than 80% of trials fail to meet original enrollment timelines, and nearly 1/3 of trial budgets are spent on recruitment.” Even Siddhartha Mukherjee stated, “Enrollment in clinical trials remains very threatened today”.

This should not be the case, because the solution is so simple. Continue reading “Clinical Trials – Enrollment”