Health Level Seven(HL7) International, the global authority on interoperability of health information technology with members in 55 countries, announced election results for its board of directors at the 32nd Annual Plenary and Working Group Meeting in Baltimore, Maryland. The 2018 class of HL7 Fellows and the 2018 recipients of the W. Edward Hammond, Ph.D. volunteer of the year awards were also recognized at the event.
Incoming Board Chair
Walter Suarez, M.D., M.P.H., executive director, health IT strategy and policy, Kaiser Permanente, was selected by the membership to serve as the chair-elect in 2019 and as the board chair, 2020-2021.
HL7 Board Member Elections
Four members were elected to the HL7 board of directors for the 2019-2020 term:
Director — Kensaku Kawamoto, M.D., Ph.D., associate chief medical information officer, University of Utah Health Care
Director — Janet Marchibroda, fellow, Bipartisan Policy Center
AffiliateDirector — Diego Kaminker, owner, Kern-IT SRL and member, HL7 Argentina
2018 HL7 Fellows
The HL7 Fellow Award was presented to five individuals during HL7’s 32nd Annual Plenary and Working Group Meeting in Baltimore. The award was established to recognize HL7 members with at least 15 years of active membership as well as outstanding service, commitment and contributions to HL7. The 2018 recipients of the HL7 Fellowship Award include:
David Hay, M.D.
Beat Heggli
Patrick Lloyd
Rob McClure, M.D.
Corey Spears
HL7 Volunteers of the Year
HL7 honored three members with the 22nd annual W. Edward Hammond, Ph.D. Volunteer of the Year Award. Established in 1997, the award is named after Dr. Ed Hammond, one of HL7’s most active volunteers and a founding member as well as past board chair. The award recognizes individuals who have made significant contributions to HL7’s success. The 2018 recipients include:
Brett Marquard, principal, WaveOne Associates, Inc.
Ulrike Merrick, lead specialist, informatics terminology, APHL – Association of Public Health Laboratories and public health information specialist, Vernetzt, LLC
Bryn Rhodes, owner, Database Consulting Group and chief technology officer, HarmonIQ Health Systems Corporation
About the Volunteers:
Brett Marquard, has been a member of HL7 since 2008. Brett has held several positions throughout his 10-year tenure at the organization. For seven years, he co-chaired the HL7 Structured Documents Work Group. In addition, Marquard has served as the vice chair of the HL7 US Realm Steering Committee since 2016 and has chaired the newly established CDA Management Group since 2017. He is active in the effort to advance HL7 Fast Healthcare Interoperability Resources (FHIR®) and works with the ONC within the context of addressing their HL7 requests. Finally, Marquard been instrumental in the standards development process as the primary editor of the Consolidated CDA (C-CDA) and US FHIR Core implementation guides.
Ulrike Merrick, has been an active member of HL7 since 2008. She has served as a co-chair of the Orders and Observations Work Group since 2014 and was recently appointed to HL7’s newly established Version 2 Management Group. In addition, Merrick was elected to serve on the HL7 Technical Steering Committee beginning in January 2019 as the co-chair of the Administrative Steering Division. Much of her involvement in HL7 is focused on lab testing and reporting, and she has used her background in this area to engage the CDC in HL7 initiatives. Merrick has leveraged her broad network in the laboratory community to provide input from subject matter experts in relevant HL7 specifications, such as the HL7 Specimen Domain Analysis Model.
Bryn Rhodes, has participated in HL7 for several years and joined as a member in 2018. He serves as an interim co-chair of the Clinical Decision Support Work Group. Rhodes has also been involved in the efforts to extend HL7 FHIR into the clinical decision support and clinical quality measurement domains. He is the co-author of several HL7 specifications including the following: Clinical Quality Language (CQL), FHIRPath, FHIR Clinical Reasoning Module, QI Core/Quick and the CQL-based HQMF. In addition, Rhodes oversaw the transfer of the CMS electronic quality measure (eCQM) work using the CQL across multiple measure developers. Finally, he was instrumental in the Centers for Disease Control and Prevention (CDC) Adapting Clinical Guidelines for the Digital Age project’s incorporation of FHIR clinical reasoning and FHIR resources into the CDS L3 output and operationalizing the process by use in a CDC opioid management clinical guide.
Included amongst the segments of healthcare such as post-acute care that until recently had been mostly overlooked, specialty pharmacy now is in the spotlight as a key area of healthcare utilization and spend in the U.S. Critical, expensive and often life-sustaining medications for high complexity disease states, as well as care management programs that help patients through their healthcare journey, are at the core, driving nearly $175 billion in drug spend for the 2 percent to 3 percent of the U.S. population considered medically complex. Specialty pharmacy operations typically involve a cross-functional staff of insurance experts, patient care coordinators, nurses and pharmacists that interact with patients and stakeholders to ensure therapeutic success in a historically fragmented, manual process-driven model.
Challenges in specialty pharmacy operations
As with many aspects of the healthcare system, specialty pharmacy operations are fraught with many pragmatic, economic, and clinical care challenges.
Operational, pragmatic challenges include:
Multiple fax and phone communications between prescriber and specialty pharmacy supporting referrals, prescriptions, authorizations and patient care coordination
Challenging and fragmented patient engagement combining traditional phone-based communication with other methods such as texting with mixed results
Overlapping prescriber and patient communications among health plan, pharmaceutical manufacturer patient service hubs, prescribers and specialty pharmacy
These process challenges are creating an economic strain for the pharmaceutical industry, the payer, the provider, and most importantly the patient – where insurance benefit and funding source determinations often create confusion between overall coverage and patient out-of-pocket costs. This is compounded by complex coordination of benefits, billing and payment processing of medical and pharmacy claims, as well as other sponsored funding sources. Increasing patient cost share can make specialty drugs unaffordable for many patients which impacts medication adherence and ultimately patient outcomes.
The resulting clinical challenges make it difficult for critical patient care information to be easily shared (e.g. labs, patient assessments, medication profiles, side-effects, etc.). Additionally, treatment objectives often overlap among specialty pharmacy channel providers, resulting in crossed communications and patient confusion. In the end, key success metrics (both economic and clinical) are not easily measured, and often not operationally and clinically aligned.
The power of data accessibility and real-time analytics
Compressed specialty pharmacy margins require significant technology investment to offset operating costs and increasing service expectations. Technological advances help to address several of these challenges and as a result drive improvement in patient care and satisfaction, lower operating costs and more informed clinical decision-making.
Several of these technological advances that are showing early evidence of changing the historical paradigm include:
Interoperability with EHRs and other critical patient history data sources providing access to holistic views of patient medical records which can improve patient engagement, therapeutic interventions and reduce unnecessary procedures
Sophisticated workflow software driven by data-informed electronic protocols to support overall multi-party process efficiencies
Robust and timely analytics that provide comparative and predictive insights that influence optimal patient care at the lowest cost as well as provide more timely, accurate patient insights that drive patient success, including medication adherence
Integrated patient engagement technologies that improve patient interactions when and how the patient wishes to engage
Impact across the continuum
The application of advanced capabilities in connectivity and analytics in the specialty pharmacy space creates a more efficient system and a better result for all involved. Successful implementation of these technologies accelerates patients onto the most appropriate therapy, optimizes patient treatment plans and improves the overall patient experience which support medication adherence goals. It can also help establish innovative and more productive relationships between health plans, employers, providers, specialty pharmacies, pharmaceutical manufacturers and patients.
Global IT consulting firms, especially those with an India heritage, have had a long run at high growth rates, fueled by one idea: Outsourcing information technology (IT) operations to countries with low labor costs and a skilled engineering talent pool with a strong English language proficiency offered a huge arbitrage opportunity. The Indian IT services industry monetized this idea with a single-minded focus over the past 25 years and is now estimated to be more than $150 billion. Over the past decade or so, many western multi-national firms, including end-user clients for these companies, have jumped on the labor arbitrage model.
My firm has been focusing on how global technology consulting firms have been doing in the healthcare markets, and reviewing their financial and operating performance since 2015. Our latest mid-year review of 11 publicly held global technology consulting firms indicates that organic growth from the healthcare vertical is trailing overall company growth for most consulting firms, and is slowing down relative to previous quarters. Three of the 11 firms we cover in our report have seen leadership exits for the healthcare business, and the Board of Directors of one high-profile firm is looking to replace its CEO. No major contract signing in healthcare has been reported by any of the firms.
Where is the whole sector headed next? No one knows for sure, but the labor arbitrage model is now surely past its sell-by date. The question therefore is: what’s the next killer app for global IT consulting firms ?
If one were to go by the term most-often used by these firms in earnings calls, annual reports, and marketing messages, it would seem that the new killer app goes by the all-encompassing name of “digital.”
However, unlike a clear concept like low cost labor, digital is much harder to understand. In much the same way as that other overused term – artificial intelligence or AI — the technology vendor market has whipped itself up into a frenzy of “digital” offerings, with each firm defining “digital” in its own way.
However, the global IT consulting firms, and in particular the India heritage firms, seem to discuss a common theme when referring to digital. They are mostly referring to automation when they say digital. These firms are betting on intelligent automation (IA) as the killer app for the future of their business model.
Consulting firm KPMG has released a report declaring that IA is fueling the next generation of outsourcing. As IT operations move to the cloud, automation targets the same IT operations that substituted high-cost labor pools a generation ago, and is eliminating the low-cost pools with even lower cost robots a.k.a robotic process automation or RPA. The implications are like a double-edged sword: Automation is a new revenue opportunity, but it is one that necessarily cannibalizes a current revenue opportunity. The implications reach far beyond the board rooms of multi-billion dollar tech firms, and raise questions about a low-cost labor-pool based model of IT services.
In other words, the killer app of tomorrow is killing the jobs of yesterday, a fact that the KPMG report delicately refers to as a “negative though not significant (at least in the near term) impact on the use of traditional outsourcing and shared services.” However, the Schumpeterian principle of creative destruction may be at play here, with an entirely new class of jobs and entirely new revenue opportunities on the horizon arising from the increasing savings and efficiencies brought about by automation.
The Datica platform manages all ongoing compliance and security burdens not covered by AWS and Microsoft Azure. Through the platform, customers deploy cloud-native applications and integrate with EHRs. The HITRUST CSF Certified Datica platform services all who handle PHI in the cloud, from startups to the Fortune 100.
Elevator Pitch
Datica removes the risks for digital health in the cloud.
Founders’ story
Travis Good, MD
When CEO Travis Good, MD, and co-founder Mohan Balachandran, began solving healthcare’s universal hurdle in building applications in the cloud — HIPAA — the two entrepreneurs solved the problem. Along the way, they realized that other development companies had also been trying to solve the same problem. They thought: Why should any of us reinvent the wheel? With the compelling market need in front of them, they built their HIPAA-compliant platform and made it available to other development teams, and eventually enterprises. Knowing that trust, security, and compliance would remain the pillars to their platform, the founders sought certifications and audits through HITRUST, SOC 2, and GDPR to make the Datica Platform the most trusted foundation on which to build applications in the cloud.
Marketing/promotion strategy
Datica helps healthcare enterprises and digital health vendors accelerate innovation to improve healthcare through the use of its HIPAA compliant platform. We promote Datica to both market segments through outbound and inbound channels, direct outreach through webinars and local/national presentations around the company’s framework for digital health success, as well as through its podcast, quarterly reports, and executive speaking.
Market opportunity
The market opportunity for the Datica platform is extensive, touching all B2B healthcare stakeholders who store, manage and transmit personal health information in the cloud. Our target audience is 60/40 enterprise (healthcare providers, pharma, and payors), as well as digital health vendors. World-class companies like Johnson & Johnson, Zipnosis, Healthloop, Propeller Health, Methodist Le Bonheur, Stony Brook Medical, Optum and more, trust Datica to remove the risks of digital health in the cloud.
Who are your competitors?
Our largest competitors in the compliant cloud space aren’t other PaaS vendors but rather managed service solutions on one of the major IaaS vendors like Amazon’s AWS or Microsoft’s Azure. With Datica, developers can deploy application workloads to their Datica environment instead of directly to another IaaS to eliminate the burden of compliance. With the Datica Platform, a customer gets the benefits of AWS, Azure, or other infrastructures as the foundation of our platform, plus Datica automates all DevOps and DevSecOps requirements in the cloud. Developers can deploy services & workloads in minutes that are fully in compliance with HIPAA and HITRUST.
How your company differentiates itself from the competition and how Datica differs.
Datica differentiates itself in two ways. The first is through open source resources. Datica has a strong belief in open source resources as the fastest and best way to promote healthcare innovation. Datica open sourced its company policies and resources early in the company life. During HIMSS18, we also announced that the Datica platform now uses Kubernetes (an open source system for automating deployment) as its underlying container orchestration, granting customers greater technical flexibility.
Second, Datica stands apart from other PaaS competitors through its firm commitment to third-party audit and verification of the Platform’s trusted security. Datica is HIPAA compliant, HITRUST CSF Certified and has certifications for SOC 2, GDPR, and GxP.
There’s no question that the forward march of medical technology has improved personal and public health, creating lasting positive change for humanity. New technology, however, sometimes comes with risks. While those risks rarely outweigh the potential advantages, fully exploring and preparing for them is an important responsibility.
New Solutions Pose New Dangers
One demonstration of this relationship occurred as we were developing medical devices meant to be used inside the human body. Using medical devices internally presents the problem of contamination from external sources, and we learned that killing bacteria isn’t enough — specifically, we discovered that the endotoxins produced by dead bacteria can also be harmful.
That particular issue, we’ve already solved. It is, however, an excellent example of how new benefits can present dangers that we hadn’t contended with before: our ability to kill bacteria presented a new problem as our technology continued to improve, and we started putting medical devices inside the body. We realized that some types of dead bacteria are still dangerous, and that our sterilization standards had to improve.
This relationship between new advancements and new risks continues today, although it takes different forms. The hot-button issue these days has more to do with data and privacy, which while not directly health related, has significant risks when breached.
Healthcare Data Innovations and Breakthroughs
Our ability to collect, process, and draw conclusions from ever larger amounts of data has been a huge boon to the medical industry.
Asset tracking is the process of using fluid, regularly updated databases to keep track of physical assets and tools at a facility. However, it’s useful in many more ways than inventory management. Scanning and mobile device technology allows an asset to be kept track of at every point in its journey, from storage to use.
This method of tracking and categorizing physical assets, as well as patients, can be very useful in preventing serious accidents caused by miscommunication. Even life-threatening mistakes, such as wrong-site surgery, can be prevented by good data management. Timing, types, and amounts of medication can also be streamlined with this process, which could for example automatically sweep a database for potential adverse reactions or conflicts before a drug is prescribed to a patient.
Giving doctors access to a digital database that covers a patient’s entire history is another advantage that advanced data technology can provide. These databases can be populated with information from several different sources, including family doctors, specialists, and even self-reported data. A doctor can have access to the notes of their peers in the medical community quickly and easily, vastly improving the care that a patient receives.
From a management point of view, new data technologies allow administrators to streamline the operations of their offices and hospitals. Understanding how to best utilize staff for a balance of efficiency quality has a direct impact on the health of patients.
Predictive analytics are another area which can be hugely beneficial to the healthcare field. Basically, it’s an automated process that does much of the work a doctor does already: look at a patient’s history, compare it with current medical knowledge, and use it to make predictions about that patient’s future needs. The difference is the scale at which it can be performed when automated and the sheer volume of up-to-date data that can be included. Doctors can’t be expected to keep up to date with every new study, but a database can be populated with that information to compare against.
On both a wide and individual scale, the applications of our improving data technology are saving lives and improving the quality of life of patients.
All this integration, however, comes with those pesky risks. Not nearly enough to warrant halting progress but enough to need heavy consideration.
Cybersecurity in Healthcare
The problem with health data is it’s often some of the most private and consequential data about human beings. That, unfortunately, makes it some of the most profitable to identity thieves, and even advertisers with few scruples. Healthcare data can be held to ransom, used for identity theft, or even insurance fraud. As DeVry University notes: “Your name, address, date of birth and Social Security number are all in one convenient location — ripe for stealing. Cybercriminals can take your private health information (PHI) and sell it for high prices. In fact, stolen medical records sell for 10 to 20 times more than stolen credit card numbers.”
Without a doubt, medical assistants play a vital role in healthcare. Not only do they assist physicians and allow them to see more patients, but they also interface with various groups on a regular basis.
More often than not, they are the first and last face a patient will see during their visit. Because of their ever increasing demand, there has been an increased number of people joining online courses for becoming a phlebotomist to enter the medical field as they are quite in demand. If you have chosen this rewarding career, you might be in need of some great MA resources. After all, medical assistant training isn’t always enough to stay current.
Check out our handy list of organizations, blogs, and more:
American Association of Medical Assistants (AAMA): This fantastic organization strives to provide medical assistants with education, certification, networking opportunities, scope-of-practice protection, and so much more.
American Registry of Medical Assistants (ARMA): This non-profit organization provides continuing education as well as certification opportunities. Their website also maintains several helpful sections, such as an online forum, job listings, a handy FAQ page, and an events tracker page.
American Society of Podiatric Medical Assistants (ASPMA): According to ASPMA’s mission statement, their purpose is to “promote, foster, improve, sustain, and advance the profession of Podiatric Medical Assistants.” They seek to raise the standard of education for Podiatric Medical Assistants and enlighten the public. Along with networking, continuing education, and certification opportunities, ASPMA also awards scholarships through the Zelda Walling Vicha Memorial Trust Fund.
American Health Care Association (AHCA): As their website states, the AHCA is a “non-profit federation of affiliate state health organizations” that represents approximately 13,500 nursing facilities, assisted living, developmentally disabled, and sub-acute care providers. For Medical Assistants in long-term care, there are numerous benefits to becoming a member of the AHCA (it maintains a career center, too.)
Legal Eye on Medical Assisting (Blog): Follow this blog for insightful posts about Medical Assisting, current events, and professional certification. Helmed by Donald A. Balasa, chief executive officer and legal counsel for the American Association of Medical Assistants, this blog keeps readers informed about the field of medical assisting. Posts include topics like medical assistant scope-of-practice issues, key legislation that affects the profession, CMA (AAMA) credential, national health care initiatives, and more.
Medline (Blog): To stay as up-to-date as possible, you might want to follow Medline: The voices of healthcare. Experts in the field write posts about improving patient care, achieving desired clinical outcomes, discovering new solutions, and so much more. There are also posts that specifically include tips and extra information for medical assistants. Check out their “Hot Topics” section to learn more about current events in healthcare.
National Healthcareer Association (Blog): According to their website, this association works with “educators adding certification to their programs, employers empowering their team, and individuals earning and maintaining certification.” Their blog posts provide readers with insight into healthcare and medical assisting. Additionally, they also maintain a job board and a professional development section on their website.
Medical Assistant Resources (Blog): The Medical Assistant Resources blog posts valuable information about medical assisting. Some of their older posts have included headlines like the following: “How to Write a Medical Assistant Resume Objective,” “Pros and Cons of Online Medical Assistant Programs,” “A Day in the Life of a New York Medical Assistant,” etc.
A relentless parade of fronts from communication to banking, shopping seems to be unfolded, all thanks to the emerging technology. But somehow healthcare used to stay behind because many of you believed it was too complicated to be fixed. Well, that’s just not true! Now, more than ever, technology has not just succeeded in improving the consumer experience but also has removed the unnecessary cost from the entire healthcare system.
In order to maintain standards of care and improved outcomes for patients, hospitals and medical centers, technology is providing ever-smarter ways like never before. Enacted by the U.S. Congress in 1996, HIPAA was introduced because of the increasing need to address growing technological changes and problems. According to the HIPAA Privacy rule, saving, accessing and sharing of medical and personal information is prohibited. Moreover, it specifically outlines national security standards to protect health data created, received, maintained or transmitted electronically (ePHI — electronic protected health information).
Apart from this, there are a few primary components one needs to be concerned with:
Privacy rules emphasize on what qualifies as PHI (protected health information) and who is mainly responsible for ensuring that nothing would get disclosed improperly. It includes covered entities ranging from health plans to health care clearinghouse, health care providers who have the right to transmit any health information electronically regarding the Department of Health and Human Services (HHS). Other than covered entities, privacy rules even encompass of business associates (anyone who stores, collects, maintains, or transmits protected information on behalf of a covered entity).
On the other hand, security rules relate specifically to electronic information and set guidelines for how to secure PHI. Administrative, physical and technical are the three main categories in which it is broken down. As the name implies, administrative revolves around access control and training, physical safeguards are for actual devices, and technical relates to the data itself.
HIPAA Breach Notification Rule is basically a set of standards that covered entities and business associates must follow in the event of a data breach containing PHI and ePHI. This rule, in particular, emphasizes on two kinds of breaches; minor breaches and meaningful breaches. As a result, organizations are required to report all type of breaches, regardless of size to HHS OCR, but the specific protocols for reporting change depending on the type of breach.
Omnibus Rule: This rule was enacted in order to apply HIPAA to business associates, in addition to covered entities. According to the rule, business associates must be HIPAA compliant.
We can all agree the healthcare system in the United States is in dire need of an overhaul. Technological advances propel us into the twenty-first century, but the way data is created, maintained, and shared is archaic and confusing (and deliberately-so.) Instead of collaboration and transparency, healthcare is (in the eyes of many) a confusing minefield littered with smoke and mirrors.
Many people (even those with insurance) forgo treatment through choice or necessity–hoping things will get better–and instead end up in the emergency room. This adds bloat to an already-overtaxed, inefficient ecosystem, and patients end up footing the bill.
What does this have to do with blockchain? Well, blockchain thrives in an environment where lots of parties (who don’t trust each other) need to have consensus on the “correct” version of the truth. Broadly-speaking, blockchain helps integrate layers of trust and efficiency that have otherwise been missing in healthcare. It is essentially a distributed database that can’t be “gamed”, as any attempts by bad actors to change records to “bend the truth” are impractical and improbable.
Put another way: blockchain rewards desirable behavior (truth, accuracy, information flow), while helping to mitigate undesirable behavior (ex: lying, cheating, stealing.) Truth and accuracy breed possibility.
Imagine a world where every single ingredient inside every single pharmaceutical you take is traced from start to finish, so you know you’re not being poisoned, misled or ripped-off. Imagine having verifiable reviews from actual doctors based on verifiable outcomes to help you compare healthcare procedures and practitioners just like you would compare insurance or blenders.
Imagine being compensated for taking better care of your own health, or for securely-sharing your medical data to help advance research. All of this is possible with blockchain technology (and more.) Long-term, blockchain technology has tremendous potential when paired with technologies like artificial intelligence (AI), where meaningful healthcare research can be advanced, shedding new light on trends and unlocking a holistic, real-time picture of the global healthcare landscape.
With all its positives, blockchain isn’t itself a magic, one-size-fits-all solution to the many problems plaguing healthcare. However, what blockchain technology can do is provide a framework that opens up the secure flow of information between healthcare consumers, practitioners, and everyone else in between. Access to more and better information helps streamline inefficiencies, thus reducing costs and elevating the level of care that can be provided.
Health Level Seven (HL7) International, the global authority on interoperability of health information technology with members in 55 countries, announced election results for its board of directors at the 32nd Annual Plenary and Working Group Meeting in Baltimore, Maryland. The 2018 class of HL7 Fellows and the 2018 recipients of the W. Edward Hammond, Ph.D. volunteer of the year awards were also recognized at the event.
The 
There’s no question that the forward march of medical technology has improved personal and public health, creating lasting positive change for humanity. New technology, however, sometimes comes with risks. While those risks rarely outweigh the potential advantages, fully exploring and preparing for them is an important responsibility.