Often, when we think about innovation, we immediately think of hi-tech devices, software or platforms.
In the midst of this year's Joslin Diabetes Center's Diabetes Innovation
conference, even acknowledging that many people with diabetes are
joined at the hip (literally) to some pretty hi-tech tools, it was worth
slowing down for a moment to consider the value and efficacy of
decidedly low-tech solutions.
Earlier this year, Susannah Fox (a
speaker at this year's conference) coauthored a report published by the
Pew Research Center entitled Tracking for Health.
This report collects survey data showing that while 60% of U.S adults
track diet or exercise, and 33% track their own health -- 49% track only
in their heads, 34% use paper and only 21% use technology (web, app,
device) for personal tracking.
Health care diagnostic and treatment tools are on a trajectory of development that is making science fiction of five decades ago into fact. Two current examples: The X Prize contest to develop a real “tricorder” – a handheld wireless device that monitors and diagnoses health conditions – comes to us courtesy of Star Trek (the original U.S. television series was set in the 23rd century) and the recently-announced prototype of a miniaturized implantable continuous blood monitor the size of a 1.5 cm length of pencil lead developed by a team at EPFL in Lausanne brings to mind the movie Fantastic Voyage, in which a surgical team in a submarine was miniaturized and injected into a patient’s bloodstream.
I spoke yesterday at the StrataRx conference in Boston, as part of the data liquidity track. This was sort of a blue sky presentation (as you can tell from the first slide); the thought was to explore the notion of building big data analytics on top of a data store populated by health record information obtained as a result of patient requests. Why? Because doing it that way would bring the data out from under HIPAA and HITECH regulations. Patients could contribute as much or as little of the data as they wish, patients could be compensated for their contributions, and other pesky HIPAA restrictions would fall by the wayside. I used one company's newly-announced service as an example, but there are others in this space as well.
I recently caught up with Nate Gross (@ng), co-founder of Doximity (@Doximity), to hear about how the company is building out the social graphs of physicians. Earlier this year, Doximity hit a milestone -- doc #200,000 -- and Nate filled me in on where the company has been, and where it's going.
Nate will be speaking at Connected Insight Summit, the annual conference presented by Activate Networks, taking place October 8-9, 2013, in Cambridge, MA (use discount code: HARLOW50 for 50% off registration).
Have a listen to our entire conversation, and see the transcript below.
We're inching closer to promulgation of final regulations that will
likely make all lab test results more easily accessible to patients, by
making them subject to the HIPAA rules ensuring patient access.
(Currently, lab test results and psychiatric notes are the two lone
categories of patient data not subject to HIPAA; however "in-house" labs
drawn at a health care facility or medical practice are already
accessible to patients under HIPAA.) This change is significant in no
small part because there was no change in the law that prompted the
change in regulation -- the only thing that changed was the rising voice
of patients insisting on access ... and a more receptive set of ears in
Washington. The proposed change in the regulation was first published
two years ago. As I wrote then in a post on lab test results and proposed changes to the HIPAA rules:
carveout of lab results from patient-accessible records has long been a
thorn in the side of the e-patient. This month, the federales
announced that they would step forward as Androcles to the e-patient
lion (to jumble a reference or two), and pull out the thorn, by proposing
to amend both the CLIA regs and the HIPAA regs. The HIPAA regs include
the exception described above: all records must be made accessible upon
request except labs and a couple others. The lab results exception
will be deleted from the HIPAA regs if the change is finalized. The
CLIA regs prohibit lab delivery of results directly to patients. The
proposed amendment says that the labs “may” release the results directly
to patients. The net effect is that patients will have the right to
request the results, and since labs will be permitted to release them,
they will have to do so.
Your faithful HealthBlawger will be out and about at a number of conferences and events over the next month or so, mostly in Boston, speaking, moderating and just hanging out ("on air" and in real life).
I hope to see you at one or more of these. See descriptions below for links to registration and in some cases, discount codes.
With H-Hour (the HIPAA Omnibus Rule compliance date) just a week away, the federales have come through, delivering a useful compliance tool with the HIPAA Notice of Privacy Practices requirements -- a set of model forms released during the Consumer Health IT Summit. At first blush, the forms seem extremely user-friendly, and they are certainly briefer, and are written in a tongue that bears a closer resemblance to English, than the NPPs with which most of us have had to labor. Kudos to the agencies for undertaking the effort to draft and field-test these forms.
While the field-testers' favored format, we are told, is the booklet, I much prefer the layered online form. The first page has a high-level summary of the HIPAA privacy and security rules as they pertain to patients, and details are set forth on the pages that follow.
I was disappointed, however, with one of the examples given in the model NPP:
"Serve a paper and sue me ...." Is this really the only way to get HHS to agree to promulgate long-promised guidance for medication adherence contractors and others that face "restrictions on remunerated refill reminders and other communications." under the HIPAA Omnibus Rule?
Apparently it is.
The final rule was promulgated eight months in advance of the compliance date coming up on September 23, yet Adheris (great name, eh?) found it necessary to seek an injunction earlier this month barring HHS/OCR from enforcing the Omnibus Rule insofar as it would infringe on the company's constitutionally-protected right of free (commercial) speech.