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.

What do you call a banker that sends out a financial transaction without first eyeballing the actual data? Unemployed.

I created a utility that will display the “data” part of the CDA in a human readable format. Its purpose is to encourage you to compare the “data” part with your “human readable” part. We should be logging these errors before someone dies from one. This tool is free, just click on Tools. Of course, you must only use this tool with a de-identified CDA.

Clinical Trials – Slow Enrollment

We 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.

Clinical trials need patients.
Patients are seen by doctors.
Doctors keep medical records.
Medical records can be prepared as a CCDA.
Most eligibility statements can be reduced to a SQL query.
When you apply the query against the medical record dataset, qualified patients are identified.
The doctor “consents” the identified patients … and presto … the slow patient enrollment, poorly qualified leads problem is SOLVED.

Solved in MINUTES.

We can fix this … ask us how …