The early reports regarding the October 1 transition to ICD-10 have been remarkably positive. In fact, it’s been the absence of reports that have impressed the experts  – in that respect, the changeover from ICD-9 has been a lot like the “Y2K bug” issue at the turn of the century. There was enough apocalyptic doom-and-gloom in the last couple of years to ensure that most providers and payers were prepared for even the worst-case scenarios.


Now two weeks in, I spoke with Pam Jodock, Senior Director for Health Business Solutions at the Healthcare Information and Management Systems Society (HIMSS), following a review meeting of the HIMSS ICD-10 Task Force. The task force includes providers from both hospitals and practices, as well as payers, consultants and vendors.


“We’ve been pleasantly surprised by how few problems have been reported,” Jodock said, summing up the meeting. “It’s too early to fly the victory flag, but anecdotally, we’ve not seen a spike in claims or pended claims from either CMS or other payers.”


Meanwhile, task force chair Bonnie Sunday, MD, has promised “to monitor for challenges that arise after the October 1 transition date and [to] make education available on mitigation strategies for problems that may be encountered.”


Jodock pointed me to a RelayHealth web site that uses internal data to monitor potential disruptions to claims data. The site is tracking four metrics to measure the impact of the transition: (1) Days to Final Bill, (2) Days to Payment, (3) Denial Rates, and (4) Reimbursement Rate. The data show that all metrics for the first two weeks of ICD-10 are equivalent to, or better than, the three months preceding the transition.


Based on both anecdotes and available claims data, Jodock concludes that organizations which used the time between the final rule’s publication in 2009 and this month’s implementation to prepare have experienced “business as usual.”


Reports from the field support that assessment.


“Many in the press have asked me about the first few days of ICD-10,” John Halamka, CIO at  Beth Israel Deaconess Medical Center in Boston, blogged. “The answer for my institution, like many, is that other than a few small refinements, the impact has been unnoticeable.”


Stacey McIntosh, an HIM Project Manager at Memorial Hermann Health System, echoed those sentiments in her comments to Healthcare Finance News. “We didn't really expect any major issues day one,” she said at the end of the go-live date. “The few items that we experienced today were relatively minor. We expect bigger bumps in the road as we start coding in ICD-10 and send claims off to payers."


But it hasn’t been problem-free. Jodock said some providers with homegrown systems have found the transition challenging. And physicians have reported some glitches which could prove expensive if not addressed.


Writing a blog that appeared in The Medical Practice Insider, Linda Girgis, MD, a family physician in South River, N.J., catalogued a number of “glaring and disruptive” issues she faced in the first week. She worried that commercial payers wouldn’t follow Medicare’s lead on a grace period for accepting unspecified codes as long as they were n the right family. She also said her clearinghouse kicked out all unspecified codes and wouldn’t submit them to payers.


“Some insurance on-line sites were updating and unavailable for the first 2 days,” Girgis wrote, noting that her office couldn’t check eligibility on some patients. “Any patient I saw on the first two days of October who we were unable to verify their insurance was treated for free and [there’s] nothing I can do about it. I know some people will say not to see them without this verification but they were sick. What good is a doctor who doesn't treat sick patients?”


So now that the actual transition date has passed, what’s next? The American Academy of Family Physicians recommends that providers take the following steps to ensure that transition goes as planned:


  • Monitor all claims acknowledgement and acceptance/rejection reports.
  • Promptly correct and resubmit all rejected/denied claims.
  • Evaluate post-implementation cash flow until claims filed with ICD-10 are consistently paid.
  • Evaluate need for contingency activities (e.g., overtime, consultant, credit line).
  • Monitor payer news regarding claims adjudication issues and resolutions.
  • Monitor reimbursement accuracy and timeliness of payer per contract.
  • Conduct coding review for accuracy and compliance.


Do you think that the relative smoothness of the transition and the consistency of claims data over the past two weeks portend an equally smooth reimbursement process?


What should healthcare CIOs be thinking about when it comes to leveraging big data? In the above clip, Nolan Joiner from MarkLogic explains what healthcare CIOs need to understand about relational database technology and data integration.


Watch the short video and let us know what questions you have. Are you using your data to the fullest potential?

According to the most recent HIMSS Leadership Survey, 72 percent of respondents report that consumer and patient considerations will have a major impact on their organization’s strategic efforts over the next two years. In other words, patient engagement, patient satisfaction and quality of care remain center stage in the healthcare industry.


This type of thinking also means that, as in other industries like banking and travel, technology will be a major driver of facilitating a shift in focus and providing better outcomes and more personal user experiences.


It’s no surprise that today’s episodic and reactive healthcare delivery costs too much and compromises patient safety, satisfaction and outcomes. In order to receive care, patients must go to a clinical setting, where decisions often lack collaboration, coordination and continuity and relevant individual and cohort data is often absent. To transcend these challenges, the healthcare IT and medical devices industries will need to seamlessly connect patients, their clinicians and their data to deliver holistic and proactive care wherever they are.


That’s why change is coming.


Growth of Distributed Care

To succeed and meet the demands of a growing, and changing, patient population, it’s important that the healthcare industry provide virtual and remote innovations that greatly expand coordinated and continuous care delivery options to patients beyond the clinical setting. This requires an interoperable and integrated infrastructure that facilitates distributed care and digitization across locations and at different stages of deployment and sophistication. Consider these recent findings:



By embracing a more distributed care model using telehealth technology, a revamped healthcare infrastructure would provide a compelling user experience that helps shift clinicians to a new way of interacting with patients and with each other in care decision making and delivery. Smaller, more portable and capable medical devices with better connectivity and interoperability are crucial to providing new options for care delivery that work best for patient and clinicians. Payers, providers and public policy should encourage adoption by rewarding new types of care delivery and collaboration that improve outcomes and drive accountability and flexibility into sector business models.


Make it Personal

At Intel, we’re delivering technology solutions that make it possible for patients to receive optimal, personalized care wherever they are. Our clinical analytics and big data tools empower key insights and discoveries for better, more preventive and personalized treatment. New client devices with innovative and novel user experiences deliver faster and richer clinical data flows. Our gateway, wearables, PaaS and security technologies, among others, support a distributed care platform that connects patients and their care teams with faster, easier and secure access to needed information in a variety of care settings. Our work with medical device manufacturers miniaturizes and optimizes their solutions to deliver better care when, where and how the patient needs it. Plus, Intel provides comprehensive security solutions that allow new levels of sharing and collaboration while safeguarding individual and institutional data.


The bottom line is that the individual will be the driving force in healthcare in the coming years. I envision technology being the driver of effective care plans tailored to individual needs and circumstances. From data analytics for more precision, to intuitive, adaptable and secure clients and devices, to more effective and innovative care delivery options like telehealth, personalized healthcare is the key to addressing cost, quality and access while improving outcomes and patient satisfaction.


What questions do you have?

In my last couple of blogs, Healthcare Breaches from Loss or Theft of Mobile Devices or Media and Healthcare Breaches from Insider Risks: Accidents or Workarounds, I looked at breaches resulting from loss or theft of mobile devices containing sensitive patient data, and breaches resulting from healthcare worker accidents or use of workarounds respectively. In this blog I build on these with another common type of breach that results from cybercrime hacks of healthcare organizations.


In the Ponemon 2015 Cost of Data Breach Study, 47 percent of breaches resulted from malicious or criminal attacks. In these kinds of breaches the attacker is a remote hacker that is often part of organized cybercrime, or even a nation state. The target is the healthcare organization backed database containing all patient records. Since the cost of a breach depends on the number of patient records compromised, and the backend master database contains all patient records, this type of breach is usually much more impactful that one resulting from loss or theft of a mobile device which often contains just a small subset of the overall number of patient records. According to this research study, the total average cost of a single data breach event is $6.53 million, or $398 per patient record (the highest across all industries). This is inclusive of all types of breaches. Cybercrime breaches tend to be even more impactful and costly since they often involve all the patient records, and can run into the tens of millions of dollars and even north of $100 million per breach event.


An example of this type of breach is shown in the infographic below, and involves a series of failures, starting with ineffective security awareness training for healthcare workers. The next failure involves a spear phishing email being sent to a healthcare worker and the healthcare worker clicking on a malicious link in the email, resulting in drive by download of malware. The malware, now installed behind the firewall of the healthcare organization, proliferates and key logs, all the while looking for privileged credentials to use to access all patient records in the master database. Once DB administrator credentials are captured the malware then begins to exfiltrate patient records “low and slow” covertly to avoid detection, resulting in a breach. Many organizations lack the ability to detect such intrusions. As a result this type of breach can often go undetected for months or years before a watchful administrator happens to notice suspicious activity on the database. The huge delay between intrusion and detection with these types of breaches often results in much greater breach impact to the healthcare organization since the longer the breach goes on the more patient records are compromised.


David_Cyber attack.png


Security is complex, and there are many safeguards required to effectively mitigate this type of breach. Maturity models have achieved wide adoption and success in healthcare, for example the HIMSS EMRAM (EMR Adoption Model) has been used by 5300+ provider organizations worldwide. Maturity models are a great way to simplify complexity and enable rapid assessment of where you are and what you need to do to improve.


In the infographic above, beneath the sequence of events leading to this type of breach, is a breach focused maturity model that can be used to rapidly assess your security posture and determine next steps to further reduce residual risk. There are three levels in this maturity model, Baseline includes orange capabilities, Enhanced adds yellow capabilities, and Advanced adds green capabilities. Only safeguards relevant to mitigating this type of breach are colored in this maturity model. Other grayed out blocks, while important in mitigating risk of other types of breaches, do not play a significant role in mitigating risk of breaches from cybercrime hacks. There are many risks in healthcare privacy and security. This model is focused on breaches. A holistic approach is required for effective security, including administrative, physical and technical safeguards. This maturity model is focused mostly on technical safeguards. Risk assessments are required by regulations such as HIPAA, and standards such as ISO27001. The ability to rapidly assess breach security posture using a breach security maturity model is complementary and not a replacement to risk assessments. Below I briefly review each of the safeguards relevant to cybercrime breaches.


A baseline level of technical safeguards for basic mitigation of healthcare breaches from insider risks requires:


  • User Awareness Training: educates healthcare workers on how to be privacy and security savvy in delivering healthcare, and avoid clicking on spear phishing emails
  • Anti-Malware: detects and remediates malware infections of healthcare worker devices, including malware employees may accidentally encounter through drive by downloads
  • Vulnerability Management and Patching: involves proactively identifying vulnerabilities and patching them to close security holes before they can lead to a breach. This is particularly important with healthcare worker devices used to access the Internet and at risk of being exposed to drive by downloads of malware
  • Penetration Testing / Vulnerability Scanning: involves proactively testing IT and scanning for vulnerabilities to identify security holes and vulnerabilities that can be remediated proactively to reduce risk of these being used in exploits
  • Email Gateway:  helps defend against malware attached to emails, and phishing attacks
  • Web Gateway: can detect malware from healthcare workers web browsing the Internet, and defend against attempted drive-by-downloads that may otherwise lead to data loss and breach
  • Firewall: malware used in cybercrime attacks attempts to make contact with C&C “Command & Control” servers to receive instructions and exfiltrate patient records. A good firewall can help defend against this.


An enhanced level of technical safeguards for further improved mitigation of risk of this type of healthcare breach requires addition of:


  • Secure Remote Administration: enables healthcare IT to efficiently, securely and remotely administer endpoint devices so they are up to date with the latest patches and safeguards to defend against breaches from accidents and workarounds
  • Intrusion Prevention System: can detect and defend against anomalous activity on the healthcare organizations network such as would occur with malware communicating with C&C servers


An advanced level of security for further mitigation of risk of this type of breach adds:


  • Client and Server Application Whitelisting: block unauthorized executables on clients and servers and can stop even the most sophisticated zero day attack malware
  • Network DLP Prevention: ensures that sensitive healthcare data only leaves the healthcare network when appropriate, and can help defend against loss of sensitive healthcare information being exfiltrated as part of a cybercrime breach
  • Threat Intelligence Exchange / Collaboration: connects your security IT together with external threat intelligence for improved detection and response to malware and cybercrime attacks
  • SIEM: integrates and analyzes event, threat and risk data for improved detection of malware, intrusions, and cybercrime breaches
  • DB Activity Monitoring: improves your ability to detect malware attacking your database, as in the case of a cybercrime breach. This safeguard also enables you to define policies that can help defend against this type of breach
  • Digital Forensics: enables you to determine in the event of a cybercrime intrusion whether a breach actually occurred, and if so the nature of the breach, and exact scope of patient data compromised


Healthcare security budgets are limited. Building security is an ongoing process. The maturity model approach discusses here can be used in a multi-year incremental approach to improve breach security while keeping within limited annual budgets and resource constraints.


What questions do you have?

Read Part I of this blog series on wearables in healthcare

Read Part II of this blog series on wearables in healthcare


As I mentioned in the first part of this blog series, wearables have become more than a passing trend and are truly changing the way people and organizations think about managing health. I hear from many companies and customers who want to understand how the wearables market is impacting patient care as well as some of the changes taking place with providers, insurers, and employers. In this blog series, I'll share some of their questions and my responses. This blog’s question is:

What are the primary challenges that companies face in collecting, analyzing, and sharing data generated by wearables?


Data integration and technology interoperability pose challenges. Data in healthcare is still very siloed. In most cases, the provider owns and maintains the electronic health record, the payer the claims data. Lab and prescription data are in their own systems. It’s difficult to access this data where it resides and pull it into a unified repository. Some of the leading electronic healthcare record vendors have built adaptors to pull in some fitness and wellness data. However, a lot of the wearable manufacturers compound the problem by being very insular and not offering an easy API for transferring the data. And there are no standards in place for wearables data. So it can be challenging to integrate patient generated data into traditional healthcare applications.

However, with healthcare today, one can argue there are bigger fish to fry than wearables when it comes to interoperability.

Another big issue is privacy: how will the data be used? When you start tying wearable data to corporate wellness programs and health plans, there is natural concern by employees and members wondering if the data can be used against them. The successful programs are often opt-in, and some include financial incentives or lower premiums if certain performance milestones are reached. Those are the “carrots” that will get people to participate. I have not heard of an example where employees are required to participate in wearing devices, but I imagine that would be less successful.


What questions about data do you have?

Danone is a company which deserves much admiration. For thousands of years, the ‘lactobacillus bulgaricus’ cultured milk - as indicated by analysis of this bacteria’s genome - was consumed as yogurt. Let’s not underestimate this historical disruption. Probably due to a chance event somewhere in Central Asia, this bacteria-cultured product extended the useful life of plain milk from less than a day in warm climates to three days or more. Useful, considering the lack of refrigeration at the time.


A few decades ago came the incremental innovations of adding Bifidus Actiregularis bacteria to yogurt and packaging it in an organic compound called PLA Igneo instead of polystyrene plastic. Danone promoted this nutritionally advanced and re-packaged product as a ‘probiotic’ with their successful Activia brand, and thus created an annual $4 billion market. Not bad for a commodity product right? Well, labelling yogurt as a probiotic was no hype as per Danone’s commercial success shows.


Big Data - Hype or Reality?

I recently had the privilege of co-hosting a short talk on Big Data with the Chief Medical Officer of Dell Health and Life Sciences, Dr. Nick van Terheyden, to a group of distinguished guests at the NHS Innovation Expo in Manchester, UK. Dr. van Terheyden spoke about the flood of data originating from behavioral, demographic, social and financial domains and underscored the importance of predictive analytics that will not only shape delivery of healthcare but also define the science of prevention in the next decade.


If you’re on the customer side of the healthcare industry, I would suggest that you have the full right to do a sanity check on whether you’re being hyped by the concept of big data. Is the whole IT industry repackaging plain old yogurt cultured by a mixture of Data Warehousing, Data Mining and Business Intelligence tools under the Big Data label? Well if Activia is any guide, architectures, packaging and delivery methods have changed considerably.



Does your data require surgery?

You no longer have clusters of computers crammed into a datacenter for high performance computing. Dell’s Active Infrastructure HPC for Life Sciences is comparable in size to a fridge and can sequence up to 13,000 genomes in a year or 37 per day. Delivery methods have also been transformed by cloud-based technologies and as this blog post indicates, you can rent a Dell based SAP Hana appliance over the Amazon Web Services for as low as $3500 per month before you decide to go with an on-site solution. It’s important to reinforce at this point that privacy and security is a major concern for the healthcare industry so careful consideration must be taken when choosing a solution.


So big data has arrived. It’s no longer a hype but the main question remains of its probiotic value - is Big Data any good for the healthcare industry? Well, according to this WebMD article, probiotics are good for our health so if we carry the same analogy, we may claim Big Data is also good for the healthcare industry. But let’s hold on to that thought for a second. Sometimes, probiotics come short of curing human ills and you may have to undergo a medical intervention including surgery. With that in mind, Dell and Intel is promoting a 'Does your data require some serious surgery?' campaign offering all our customers a free assessment on your Big Data needs. Reach out to us by filling out this request form and we will happily be at your service.


Contact Afsar Akal on LinkedIn



The King Faisal Specialist Hospital and Research Centre (KFSHRC) is the pinnacle of the healthcare system in the Kingdom of Saudi Arabia. With facilities in Riyadh and Jeddah, plus a children’s cancer center, KFSHRC provides care for the most seriously ill patients from anywhere in Saudi Arabia. Along with delivering advanced treatments, the center conducts leading-edge research and helps train the next generation of physicians, nurses and other clinicians.


Like many nations, Saudi Arabia faces an increasing demand for healthcare services as its population is growing, people are living longer, and lifestyle diseases are on the rise1

KFSHRC recognized that modernizing its technology infrastructure would be essential to meeting future challenges in a reliable, cost-effective way. So, the center is migrating much of its data center infrastructure to servers and storage systems based on the Intel® Xeon® processor E5 family. KFSHRC is also adopting 2 in 1 devices with the Intel® Core™ i5 vPro™ processor for clinicians on the go.

KFSHRC leaders say their technology strategy is enhancing care givers’ productivity and delivering an optimized data center that supports innovative healthcare IT solutions. For example, they have:

  • Reduced capital costs as well as ongoing costs for licensing, support, and maintenance
  • Reduced floor space requirements by 50 percent
  • Reduced cabling inside the data center by 70 percent
  • Improved system availability by 90 percent
  • Enhanced agility by enabling them to deploy new capabilities rapidly


KSFHRC’s technology strategy delivers important benefits for patients and healthcare providers alike. These include:

  • More coordinated, patient-centered care. Powerful healthcare IT solutions and mobile computing can empower treatment teams to provide more coordinated care before, during, and after the patient’s hospital stay.
  • Higher patient satisfaction and engagement. Patients and their families can experience shorter wait times, greater convenience, and fewer redundant procedures. Tools such as portals can help engage patients in managing their own health.
  • Improved productivity, hiring, and retention. Healthcare IT solutions can help medical professionals work more productively and reduce stress. Healthcare IT modernization help KSFHRC attract and retain doctors, nurses, and other clinicians.
  • Readiness for Healthcare 2020. KSFHRC is positioning itself to take advantage of technology-enabled advance that are transforming medicine.

Read the case study to learn more about KFSHRC’s technology strategy and its use of Intel technologies.


1 For example, see data from the United Nations World Population Prospects, summarized in Demographic Profile of Saudi Arabia and the news release Saudi Health Interview Survey finds high rates of chronic diseases in the Kingdom of Saudi Arabia, based on a study conducted by the Saudi Ministry of Health and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, available at


Software and workloads used in performance tests may have been optimized for performance only on Intel microprocessors. Performance tests, such as SYSmark and MobileMark, are measured using specific computer systems, components, software, operations and functions. Any change to any of those factors may cause the results to vary. You should consult other information and performance tests to assist you in fully evaluating your contemplated purchases, including the performance of that product when combined with other products. For more information go to

Intel does not control or audit the design or implementation of third party benchmark data or Web sites referenced in this document. Intel encourages all of its customers to visit the referenced Web sites or others where similar performance benchmark data are reported and confirm whether the referenced benchmark data are accurate and reflect performance of systems available for purchase.

Located in Northwest Louisiana—one of the poorest areas of the United States—University Health System strives to deliver top-quality care to some of the sickest of the sick and the neediest of the needy. The two-hospital system is affiliated with Louisiana State University School of Medicine and maintains a Level One Trauma Center.


Healthcare budgets in Louisiana are tight and getting tighter. So when UHS’s technology leaders saw an opportunity to get their Epic* infrastructure on a more sustainable footing, they did their due diligence and then made the move. Today, their Epic* EMR and InterSystems Caché database run on the Intel® Xeon® processor E7 and E5 families powered by Red Hat Enterprise Linux* and VMware*.


In this short video, UHS CIO Marcus Hobgood (below, left) and executive IT director Gregory Blanchard (below, right) tell what they were after—and what they’ve achieved. (Hint: Zero downtime, 40 percent faster responsiveness, 50 percent lower acquisitions costs—and very happy clinicians.)

Marcus Hobgood and Gregory Blanchard.jpg


Watch the video and share your thoughts or questions in the comments. Have you moved your EMR database to an Intel® platform? Are your results similar to Marcus and Greg’s? Any insights to share based on your transition?


Join and participate in the Intel Health and Life Sciences Community.


Learn more about Intel® Health & Life Sciences.


Stay in touch: @IntelHealth, @hankinjoan

I'm excited to be leading a workshop on 'Accelerating Innovation in Healthcare' at IDC's Pan-European Healthcare Executive Summit in Dublin this week. The theme of integrated care and collaboration across the entire healthcare ecosystem is underpinned by innovation, whether that be innovation in hardware such as mobile devices or innovation in thinking around perceptions by providers of what is possible.


Rapid Growth of IoT in Healthcare

I'm particularly interested in how the Internet of Things, robotics and natural language interfaces can change the way healthcare providers deliver high quality care. You may wish to read my earlier blog for a great example of how the Internet of Things is having meaningful impact today, with MimoCare helping the elderly live a more independent life through the use of sensor technology. It is estimated that the Internet of Things in healthcare could be worth $117bn by 2020 so given that we're still in the relatively early stages of IoT implementation in the sector you get some idea of how rapid the adoption of these new technologies is likely to be. Healthcare providers need to be open to collaborating with innovators in this space and, encouragingly, there has been a lot of positive conversation about just that here in Dublin. The result of embracing IoT in healthcare? Lower costs, better patient outcomes and a real move towards prevention rather than cure.


Innovation for the Now

Other technologies discussed at the event included the Intel® RealSense™ Camera which has the potential to be used across a range of scenarios. Bringing 3D depth-sensing technology to healthcare offers up some exciting potential uses from being able to track the 22 joints of a hand to assist in post-operative treatment after hand surgery, to assessing the facial expressions with emotion-detection in patients recovering from a stroke. This is not innovation for the future, this is innovation for the now. We've worked with GPC in the area of wound care management and I think the impact of RealSense™ is summarised succinctly by GPC Medical Director, Dr. Ian Wiles, who said: "[This is] not 3D for the sake of 3D, but better care using 3D".


NLP brings Streamlined Workflows and Lower Costs

When I look at disruptive technologies in healthcare I'm seeing lots of discussion around Natural Language Processing (NLP). NLP has the potential to transform Electronic Medical Records (EMRs) by extracting structured information from unstructured text. Imagine taking historical medical data in the form of freestyle notes and being able to pull that data together into a more structured format to monitor performance and critique clinical decisions. The benefits of NLP to providers are obvious, streamlining workflows, better decision-making and lower costs, all of which benefits the patient too. This will of course require all players in the healthcare ecosystem to be more flexible when it comes to exchanging data. It's still early stages for NLP but I will share some of the work Intel is undertaking in this area in a future blog. If you'd like to be kept up-to-date on this topic and others across the healthcare and life sciences spectrum please do leave your details here.


The theme of convergence and making integrated care work resonated throughout the opening day of IDC’s Pan-European Healthcare Executive Summit in Dublin. It's fantastic to see how much collective drive there is amongst the healthcare community to collaborate and be more flexible to achieve this paradigm shift which will help to deliver innovative, safer and sustainable care.


Major Healthcare Challenges Today

As the foundation sponsor keynote speaker I thought it was important to set the scene to understand the challenges that lie ahead if we are to truly push forward with a more integrated system of healthcare delivery. And I wanted to share that with you here too. I see 4 major issues in global health today:

  • Ageing Population1 - 2bn people over 60 years old by 2050
  • Medical Inflation2 - 50% increase in worldwide health costs by 2020
  • Consumerism3- Increasingly engaged patients via apps, device, wearables, etc
  • Worker Shortage4 - 4.3m global shortfall of doctors and nurses today


All of these issues are interconnected, for example, an ageing population highlights the need for us to robustly tackle chronic conditions, such as diabetes, respiratory disease and dementia, which are soaking up healthcare resources. I've talked previously of how the changing narrative of care can help to reduce healthcare costs but it's integration and collaboration across the entire healthcare ecosystem that will accelerate change.


The Foundations to Deliver Precision Medicine

Technology can help us to move towards a pervasive, continuous notion of healthcare by interconnecting all of the players which deliver health and well-being to the population. Think not just of primary care, but of community/home care too, throw lifestyle and environment into the mix alongside omic profiling and we begin to create the foundations to deliver precision medicine at the bedside.


I think we'd all agree that the quality of life of a patient is enhanced when they enjoy independent healthy living - it's also more cost-effective for healthcare providers too. Integrated care means that the patient benefits from a fully-joined up approach from providers, care is seamless so that time in hospital is kept to a minimum and patients and carers are armed with the right support to prevent readmissions.


Innovation Today

The obvious example (and one where some countries such as Sweden are really forging ahead) is easily accessible Electronic Medical Records which can be updated and shared by caregivers across a range of settings to ensure the most up-to-date clinical information is available at the right place and at the right time, but I'm also seeing some fantastic innovations around how the Internet of Things is benefiting both patient and provider too. This is not about future-gazing, this is about prevention rather than cure, using the technology we have available today to join the dots where it has simply been too difficult, costly or, in some cases, impossible to do until now.


Managing Complex Healthcare Ecosystem

I'm always keen to emphasise that the really, really hard stuff is in fact the soft stuff. We have brilliant engineers here at Intel who are doing incredible things to move healthcare forward, but it's changing the perceptions and realities of the players within the healthcare ecosystem that is the big challenge. We must accept that every player should be interconnected, that includes the patient, the payer, the device-maker and the researcher - no single piece of this hugely complex jigsaw should be operating in isolation if we want to collectively reduce costs and better manage those chronic diseases. Business models are changing and relationships are changing, they have to, so it's great to see that conversation playing out so positively here in Dublin this week.



1 United Nations, Population Ageing and Development 2009

2 Bain & company, 2011. From “The Great Eight: 20 Trillion Growth Trends to 2020.”

3 Worker Shortage: World Health Organization, 2007

4 Inefficiency and Poor Patient Experience: The Institute of Medicine, "Better Care at Lower Cost"

Healthcare reform is a hot topic, and for good reason. We have a healthcare system that lacks a personalized approach to solving the puzzle of today’s most invasive diseases. We have a system that is expensive, fragmented and largely inaccessible to our underserved communities. The question is, how do we fix it? eric_dishman.jpg


Make healthcare personal

We talk a lot about scaling patient engagement, but what does that mean and what are the benefits? It’s simple. An engaged and informed patient is more likely to own their health and proactively work with their doctor and various care teams. Two-way collaboration gives clinicians greater access to more actionable patient-generated data, making collaborative care possible while increasing the quality and accuracy of patient electronic health records (EHRs).


Precision requires diverse data

Combining patient, clinical, diagnostic and ‘omic data will give us a more diversified data set, changing the way we view health data and potential treatments.  But to analyze such diverse and large data sets will require new architectural approaches.  We will need to collect and store patient data in central and secure repositories when we can.  We will also need solutions that can accommodate large amounts of genomic data which isn’t efficient to move from the hospitals that generate and store it. Next-generation high performance computing (HPC) platforms that enable researchers from across our country to conduct large scale collaborative analytics on millions of people’s data wherever it resides, in an open and secure trust model will be key. On September 17, the Precision Medicine Initiative Working Group formed under the National Institutes of Health (NIH) made a very bold announcement that could change the future of medicine.  A cohort of one million or more Americans will volunteer to have their various healthcare data incorporated into a precision medicine platform that will accelerate research across many areas of health and disease. Researchers will now have a huge pool of diverse data to help them discover and quantify factors that contribute to illness, and then test approaches that can preserve health and treat disease.


Securing the ability for participants and institutions to efficiently access this broader dataset will be crucial. With imaging, genomic, and consumer generated data beginning to scale, we should start with commitments to and validation of interoperability standards from the outset, so we do not recreate the problems seen in traditional EHR data.


What questions do you have?


Learn more:


US Senate Committee on Health Education, Labor and Pension’s hearing

National Institutes of Health one million research cohort to help millions of Americans who suffer from disease


To close Big Data Week, this panel discussion with experts from Intel, Ayasdi and UnitedHealthcare explores using machine intelligence to gain insights and what big data access means for organizations.


Listen to the full discussion and let me know what questions you have. How is big data and analytics impacting your healthcare organization?

It’s great when two different parts of my life at Intel collide.


Last week I had the opportunity to chat with Andrew Lamkin, a colleague at Intel who has been working on a project to put the prototyping of new healthcare wearables in the hands of anyone with a 3-D printer and a desire to create a useful new device.


In this project, Andrew’s team published a 3-D model for a wristwatch bezel that can be fitted with an Intel Edison and one or more breakout boards with sensors. (See for example, The Edison’s computing power, combined with its ability to communicate via WiFi and Bluetooth, make it ideal for recording and transmitting a variety of signals from a user’s wrist. Data from accelerometer, temperature and a number of other sensors can be streamed from the device.


This is very thought-provoking for anyone interested in wearables and the data they produce…particularly if you recently attended the Working Group meeting for the President’s Precision Medicine Initiative, as I did on July 27 and 28. The Working Group is tasked with making recommendations to the President on what data should be recorded and made available for analysis in a national research cohort of one million patients to support the advancement of precision medicine. The topic of this working group session was “Mobile and Personal Technologies in Precision Medicine.”


The discussion covered a wide range of topics around the potential value of data from wearables, along with potential challenges and risks.  Interesting use cases that were exposed ranged from the measurement of environmental health factors to identification of stress and stress-relieving activities in college students. Of course, many challenges cropped up, and the question of whether a limited set of devices would be included in the initiative or whether the million patient cohort would be “BYOD” was left unresolved until the final report.

Dr. Francis Collins, the Director of the NIH, suggested that the NIH use some of its “prize-granting” funds to hold a bakeoff of wearable devices to decide what might be included in the design of the Million Patient Cohort.

After talking to Andrew about his Edison prototyping project, I became enamored with the idea of an army of device prototypers using his designs to prototype new and interesting wearables that might just end up as part of the Million Patient Cohort.


And as a data scientist, regardless of which devices are included, the thought of all the streaming data from one million patients gives me great optimism for the future of precision medicine in America.


What questions about wearables do you have?


Predicting Population Health

Posted by jhankin1 Sep 17, 2015


Continuing our Big Data Week theme this week. In this newest video, Graham Hughes, MD, chief medical officer at SAS, talks about population health and how healthcare can leverage lessons from other industries, like retail, to take data analytics and predict behaviors.


What other industries are outpacing healthcare when it comes to big data analytics? Why?

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