April 23, 2013
This year, we’re celebrating the 20th anniversary of the HIV Outpatient Study (HOPS). The HOPS was initiated by the CDC for purpose of describing and monitoring trends in demographics, symptoms, diagnoses, treatments, complications, outcomes and risk behaviors among persons getting outpatient care for HIV infection.
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June 15, 2012
As I discussed previously, onsite clinic and pharmacies are one way employers are addressing how to get, and keep, employees healthy. This location shift for traditional health care services can certainly prove beneficial for both the employer and the employee. But what about looking for ways to reduce the overall need for those services?
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May 31, 2012
The question for employers now becomes how to help their employees get healthy and stay healthy. One way that employers are pursuing this is by offering on-site care through clinics and pharmacies. It is important to note that on-site care has many advantages, but also responsibilities and risks.
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May 22, 2012
Around Cerner we think of health care as “health AND care,” separating out each component as significant to the overall picture of well-being. Part of our “health” journey has included developing a collection of solutions and services that help both us (we are self-insured) and our employer clients manage costs and improve health-related outcomes through better coordination of care, evidence-based practice and patient education. Our overall aim is to improve the health of our, and our clients’, associates (and, when included, their dependents) through prevention, early detection, treatment and condition management and occupational health services.
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April 17, 2012
The value of more diverse communities’ using this data may be in the serendipitous opportunities that it creates. Not only will different communities look to new data sets with which to combine the primary data (research networks, and even social networks such as Facebook or Twitter), but they may also approach the problem from new angles.
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March 28, 2012
The promise of timely and reliable evidence in sufficient quantities to statistically ‘power’ health care decisions depends on its quality, its interoperable ontological mapping of concepts (so that “apples” are really “apples”) and on the accessibility of the data on which to base discoveries and conclusions. These aspects are improving rapidly in health care Big Data recently, making that promise real. Detecting, identifying and doing analytical, descriptive-statistics procedures: there is no doubt that these must inform and define the best matches and optimal choices and improvement actions and predictive models.
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December 19, 2011
There is a book (Justifying Intellectual Property) published last June by Robert Merges of Harvard and Cal-Berkeley law schools that you will want to read. It is exciting, beautifully written, and has strong relevance to discoveries and inventions that arise from observational research involving re-use of health data, including ‘panel’ or population-level data such as are stored in multi-institution EHR-derived data warehouses and HIE repositories. In the book, Merges defends the importance of strong intellectual property protections in the present populist, pervasively-interconnected, social-network-obsessed information age that is so enthralled with unfettered collaboration for collaboration’s sake.
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October 20, 2011
During the annual Cerner Health Conference last week, several clients came up to discuss my previous post and associated essay on de-identified health data. In my essay, I basically agree with Marc Lappé and others who have asserted that medical ethics as it exists and is practiced today is different from—and historically antagonistic toward—public health ethics (‘communitarian ethics’). This point of view is covered at some length in a paper by Eric Meslin and Ibrahim Garba in the September issue of Human Genetics.
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September 13, 2011
Cerner and many of our client institutions participate in de-identified databases that support observational and translational research. Such databases, called data warehouses, constitute a comprehensive source of de-identified, confidentiality-protected, real-world health data collected as a by-product of patient care. Cerner aggregates the data provided by participating facilities and uses stringent quality assurance processes to ensure the ongoing integrity of the information.
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April 19, 2011
In discussing the ultimate objectives of Cerner solutions, the phrase “closing the loop” is often mentioned. In research circles, this “loop” usually starts with the electronic capture of health information during the course of patient care. This information is then used to improve the management of that patient’s care. In some instances, the information is collected and de-identified in order to be used for research purposes. Research using these health data drives medical progress, from accelerating development of new therapies to informing point of care decisions. These changes are identified, their outcomes documented and evaluated for effectiveness in further research, and so on. In short, in this system, patient care drives discovery, and discovery drives patient care.
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