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  • Articles (2,274)
  • Limited IOp’s a drag on benefits

    For several years, health informaticians and other eHealth’s ICT experts have recognised the link for effective Interoperability (IOp) and eHealth benefits. Now, US finance executives have added to the case for more IOp.

    A US Healthcare Financial Management Association (HFMA) survey of 117 financial executives identified their views. It found an increasing need for an increased IOp priority, slightly up to from 68% in 2015 to over 70%. Almost a quarter, 24%, said their organisations can’t share data effectively with other providers and payers.

    Their views extended to external and internal IOp. Both are seen as a combined, upcoming primary focus of healthcare providers. Three drivers are:

    Current shortcomingsAnticipated future needIncreasing demand for access to numerous data sources.

    While the survey may not have revealed much that’s new about IOp, it’s a valuable reminder that progress is slow. For Africa’s health systems, it confirms the long timescales needed to reach high IOp levels. If it’s taking the rich US health systems so long, Africa’s can’t expect rapid results. Slow, steady and sustained seem to be their IOp plan.

  • Healthcare enters the blockchain ecosystem

    Over the last few years, healthcare has seen a record number of security breaches involving healthcare data.  This has prompted several start-ups to realise the work that needs to be done on the cyber-security front to make healthcare data secure.  Blockchain offers one potential solution to this challenge. Other solutions offered by blockchain include interoperability and the ability to connect data silos for more seamless systems and improved patient safety.

    SimplyVital Health is one of those start-ups experimenting with blockchain technology to give the healthcare industry a facelift. The company has developed a decentralised open-source protocol that will enable frictional-less sharing of healthcare data.  Their Health Nexus is a public-permissioned blockchain. It provides a platform to build advanced healthcare applications while maintaining the privacy and security required in the healthcare industry. 

    The developer tools on the Health Nexus are open source and available for free.  Members are able to build and deploy distributed apps utilising the blockchain protocol for transactions, identity and smart contracts, and a distributed hash table (DHT) for data storage, managed by a governance system. This will allow developers to create valuable solutions for pharmacies, healthcare providers, insurers, clinical researchers or patients.  

    Blockchain is certainly paving opportunities for new business models in healthcare.  The trajectory it will follow in the coming years, however, is an unmapped terrain waiting to be explored.  The road ahead for blockchain and healthcare will also require substantial intra-industry cooperation as well as dialogues between the public and private sectors regarding standards and regulatory frameworks.

     

  • EMGuidance web-platform to simplify medication look-up in South Africa

    Since the launch of their clinical support platform in 2016, EMGuidance has become one of the most popular medical apps in South Africa, even extending to other parts of the globe.  Its popularity is largely due to the comprehensive, up-to-date and locally relevant clinical guides and protocols made easily available to health professionals.

    In fact, the response from health professionals has been so great that EMGuidance is now available as a web-based platform.  The web-based platform essentially functions as a Google search engine with a twist.  This niche search engine only returns locally relevant information – fulfilling a great gap in clinical support tools in South Africa.  Health professionals will now be able to search for relevant South African therapies by trade name, active ingredient or registered indication. 

    Realising the potential for other African countries, EMGuidance has launched a slim-line version of their tool in Sierra Leone.  The positive response from the local community has spurred plans to expand to Kenya, Tanzania and other African countries.  It’s activities and initiatives like EMGuidance that will springboard eHealth in Africa to first-world healthcare delivery.

  • Top ten algorithms that can help healthcare

    As algorithms become more prevalent in eHealth, it’s important to have a clear development path for their use. Two core principles are:

    No single algorithm works best for every problemA learning a target function (f) maps input variables (X) to an output variable (Y), so: Y = f(X), used for predictive modelling.

    An article by James Lee in Towards Data Science sets out ten top algorithms. They’re: 

    Linear regression, a long-standing techniques from some 200 years ago, but a good starting pointLogistic regression, suitable for binary classification problems and their two class valuesLinear discriminant analysis, where prediction rely on calculating a discriminate value for each class and making a prediction for the class with the largest valueClassification and regression trees represented by a binary treeNaive Bayes, a simple, powerful algorithm for predictive modelling using two types of probabilities, one of each class, the other the conditional probability for each class given each x valueK-Nearest Neighbours (KNN), a simple and effective algorithm, where predictions are derived from  new data points by searching  entire data sets for the K most similar instances, the neighbours, and summarizing output variables for those K instancesLearning Vector Quantisation (LVQ), a KNN relative, and an artificial neural network algorithm enabling choices of the number of instances to hang onto, learning precisely what the instances should look likeSupport Vector Machines (SPV) are possibly one of the most popular, using a hyperplane to separate points in input variables spaces by their class, either class 0 or class 1Bagging and Random Forest (BBR), another popular algorithm, called Bootstrap Aggregation or bagging, and can estimate quantities from data samplesBoosting and AdaBoost, an ensemble technique aiming to create strong classifiers from several weak classifiers by building a model from training data then creating a second model that attempts to correct the errors from the first model.

    Selecting algorithms in eHealth uses, four questions need answering, what’s:

    The size, quality, and nature of the dataThe available computational timeThe urgency of the taskThe data to be used for.

    The answers aren’t easy to find. Lee points out that experienced data scientist can’t tell which algorithm’s best before trying different ones. It seems that Africa’s eHealth needs time to ponder these before settling on a preferred short list.

  • Ghana will have a national telemedicine service next year

    Pilotitis become a phenomenon a few years ago as scaling-up eHealth pilots became too challenging. Good scale-up news is the recent  telemedicine initiative by Ghana Health Service and The Novartis Foundation, They’ve announced the successful integration and scale-up of a telemedicine service. National coverage’s planned for 2019. 

    The 24-hour telemedicine service uses mHealth for community health workers to consult specialist health professionals at teleconsultation centres on a range of health topics, including emergencies. It builds from the telemedicine pilot started in 2011 in the Ashanti Region’s Amansie West District.

    An important lesson for other African countries’s the timescale. Seven years may seem like a long time, but eHealth does take time to come to fruition. Over the period, telemedicine has encountered some specific changes. mHealth opportunities have replaced conventional conferencing technology, now obsolete and looking a bit clumsy and chunky.

    Ghana may have set a standard for other African countries to follow. It represents a considerable technological achievement in modernising and transforming healthcare. 

  • mHealth to drive Cote d’Ivoire's immunisation project

    Like falling snow, announcements at the World Economic Forum come thick and fast. Taking place in Davos Switzerland, Thursday 25th, 2018, one of the world’s leading telecommunications operators, Orange SA and the Vaccine Alliance Gavi announced a partnership with Côte d’Ivoire’s Ministry of Health to boost immunisation rates in the countries’ regions and districts with the lowest vaccine coverage.

    A report in Ventures Africa says it’s a joint US$ 5.47m five-year project. Half the money’s from the Gavi Matching Fund, a mechanism financed by the Bill & Melinda Gates Foundation to motivate and provide incentives for private sector investment in immunisation. It builds from Gavi’s longstanding role in the country starting form 2001, Gavi supported Côte d’ Ivoire in introducing eleven vaccines.

    It all fits with the M-Vaccin Côte d’ Ivoire initiative. It uses Orange mobile technology to inform parents about the importance of vaccination. Sending text and voice messages in local languages and targeting messages about keeping immunisation sessions are standard themes. Reminders of their children’s schedules and dates are the main goals.

    The initiative should be transferrable to all African countries. It’ll be good to see vaccination rates above 95% soon.

  • 3D printing makes a breakthrough in personalised healthcare

    3D printing may open up a whole new chapter of opportunities in the pharmaceutical industry.  There are a number of ways it could be used; drug dosage forms, supporting delivery, or helping to research cures.

    3D printing, also called stereolithography, creates objects by fusing different materials, layer by layer, to form a physical version of a digital 3D image. In the last 15 years, 3D printing has expanded into the healthcare industry, where it’s used to create custom prosthetics and dental implants. 

    Now, there may be an opportunity to use it for personalised healthcare as well.  This was achieved by Aprecia Pharmaceuticals who became the first pharmaceutical company to produce an FDA approved 3D printed pill for epilepsy in 2015.   The drug is made using their proprietary ZipDose Technology platform to produce a high-dose of leviteracetam in a rapidly disintegrating, easy-to-swallow form. 

    Personalised 3D-printed medications, deploying customised dosages, may serve particularly well for patients who respond to the same drugs in different ways.  It may also allow pills to be printed in a complex construct of layers, using a combination of drugs to treat multiple conditions at once.  This could help reduce adverse drug reactions and poor adherence to medications for patients on multiple medications. For Africa, this could be a solution for adherence to ARV and TB medication, especially amongst children and the elderly.

  • Analytics offers expanding opportunities for better health

    EHRs alone are no longer enough. Their rich source of data alongside other readily available data such as social media sources, can improve EHRs cost and benefit curves. A whitepaper from Insight, available from Health IT Analytics sets out a way to do it. As Africa’s health systems move their programmes for EHRs forward, they need to run analytics in parallel to maximise benefits for all types of stakeholders. 

    Achieving Success in the Big Data Analytics Era With Microsoft SQL Server says healthcare

    faces new realities about clinical care and business processes, with patient satisfaction scores, performance metrics and risk-based arrangements becoming routine. It’s switching decision on short-term expediency to using data make the choices for raising quality, improving populations’ health and lowering costs.

    Many healthcare organisations are unprepared, even though almost 75% of hospitals’ chief financial officers say EHRs are insufficiently sophisticated enough for complex risk modelling needed to improve performance One solution’s Microsoft SQL Server.

    It’s a database engine plus a full suite of components, resources, connections and community that supports organisations’ entire data platforms. It can help to analyse historical data and reveal current performance and trends that need addressing. Examples are avoiding patient harm, closing healthcare gaps and preventing duplicated or unnecessary services.

    Its set of services includes: 

    Reporting,  to create interactive reportsAnalysis,  to mine and manipulate  data for actionable insightsIntegration, streamlining Extraction, Transformation and Load (ETL) processesR, to develop and deploy applications to enhance data assets’ usefulness and  reduce the time to insight.

    As analytics becomes more routine, Africa’s health systems will need both skills and tools to benefit from them. Insight offers a tool. Health systems will have to invest in the skills too.

     

  • HELINA wants papers for its October conference

    In the lead up to its conference in Nairobi on 1 to 5 October 2018, Health Informatics in Africa (HELINA) has released its timetable for its call for papers. It’s:

    Paper submission deadline: 30 April, using the online systemNotification of paper acceptance: 15 JulyPapers ready for publication: 15th September.

    Submissions have to comply with the Uniform Requirements for Manuscripts to Biomedical Journals. There’s a help line for support.

    The main conference themes are:

    National and regional eHealth strategies and policiesInteroperabilityQuality, continuous quality improvement and using health data and systemsHuman capacity building for eHealthApplying technology in supply chain managementSustainable ICT solutions for health service deliveryTechnology-enabled health financing.

    There’s a host of other topics too:

    Health facility management information systemsPHR information systemsHIEIoT and wearablesPoint of care information management solutionsHealth informatics standardsMobile healthHealth financing information managementHealthcare research informaticsHealth systems M&EDecision support systems for low resource settingsBiomedical devices integrationMedical imaging and radiology information systemsLaboratory information systemsPharmacy management information systemsData mining and Big Data analyticsAI and machine learning.

    This considerable, attractive array offers a strategic profile for Africa’s health systems. It’d be goo to see cyber-security added.

  • Why blockchain may be the future of healthcare

    The blockchain revolution has made its way to the healthcare industry.  If you haven’t heard about it yet, blockchain is a distributed system which records and stores transaction records.  Think of it as a database which stores information.  The main difference is that the data is located in a network of personal computers called nodes where there is no central administrator, such as a government or bank controlling the data.

    On permission-less blockchains, all parties can view all records. On permissioned blockchains, privacy can be maintained by agreement about which parties can view which transactions and where, masking the identity of the party. 

    Blockchain principles were first applied in the financial world as the technology that allowed Bitcoin to operate.  It has applications for many industries and more promisingly for healthcare. 

    This disruptive innovation would be able to solve many of the issues that plague healthcare today, while enjoying unprecedented security benefits because records are spread across a network of replicated databases that are always in sync.  

    A common database of health information can facilitate better sharing of research and evidence-based practices.  It would allow healthcare professionals to access patient records no matter what electronic record system they used and,  even improve supply chain management to prevent resource deficits.

    Blockchain won’t be a cure-all for the industry today, but it would certainly be a step in the right direction. 

  • Virtual reality better than pain killers?

    So we’ve heard how virtual reality(VR) can enhance our social lives. Now we’re going to discuss the medical benefits of the technology. Particularly in pain management.  VR has is being studied for its potential to ease pain by serving as a distracting force during medical procedures like wound care sessions for burn victims. Already, studies and papers on the subject have provided evidence that VR can lessen the sensation of pain, both chronic and acute. 

    While VR is a promising, drug-free option for pain treatment, existing VR systems are expensive and use unconvincing graphics. However, recent advances can allow the development of more realistic and more cost-effective applications. These include;

    improved realismimmersion using 360-degree 3D technologymore affordable delivery systems

    Applied VR, a company in Los Angeles, is already capitalising on these advances. The company is working with hospitals and doctors to get patients using the technology on Samsung’s Gear VR headset and to study its effectiveness as well.   So far, the company has created three different virtual-reality pain applications, as well as one for reducing anxiety.

    Not so far in the future, your doctor might prescribe VR sessions to ease aches and pains, rather than popping a pill.  The greatest challenge it faces right now is finding software developers who want to make applications that target specific medical problems.  Perhaps this is an opportunity for African start-ups looking to innovate in the eHealth space this year.

  • ISfTeH International Conference prepares to set sail

    Organising conferences is seldom plain sailing. ISfTeH hopes its’ event will be. This year's ISfTeH International Conference theme’s eHealth2018 - Health Communities Facing Cyber Transformation event. It’s aboard a cruise ship on the Baltic Sea between Helsinki, Finland and Stockholm, Sweden, on 15 to 17 March 2018.The Finnish Society of Telemedicine and eHealth.is the organiser.

    Presenters include representatives from:

    ·      Finnish Heart Association·      European Commission·      Cancer Society·      Karolinska Institute·      Finnish Coast Guard·      European Network of Living Labs. The event should be both intellectually and meteorologically bracing. A long-range weather forecast hints at Baltic’s temperatures below 10oC, with winds of about 50kph from the North West.

     

  • mHealth sigue expandiéndose, pero África y Sudamérica están detrás

    El mercado de mHealth ha estado creciendo constantemente y se mantendrá. En su informe “mHealth App Economics 2017 Current Status and Future Trends in Mobile Health”, Research2Guidance (R2G), una empresa de asesoramiento de estrategia e investigación de mercado, evalúa cómo los “intrusos digitales” se están apropiando del mercado de la salud.

    Este año, hay 325,000 aplicaciones de salud y acondicionamiento físico disponibles en todas las principales tiendas de aplicaciones. Son 78,000 más que el año pasado.

    La mayoría de los profesionales de eHealth vienen de Europa, 47% y 36% de los EE. UU., Un 83% combinado. Asia-Pacífico representa el 11%. Sudamérica y África están en el 4% y 2% respectivamente, lo que confirma la necesidad de un mayor desarrollo de capacidad humana. 

    Otros hallazgos incluyen:

    Android adelanta a Apple en los números de aplicaciones de salud84,000 editores de aplicaciones de salud lanzan aplicacionesAmpliación de la demanda y la brecha de oferta, con un alto número de desarrolladores y bajas tasas de crecimiento de las descargasInversión de US $ 5.4bn en empresas de eSalud que abastecen al mercadoLos usuarios descargarán aproximadamente 3.6bn de aplicaciones en 201718% no está desarrollando aplicaciones de salud debido a regulaciones inciertas53% de los profesionales de eHealth esperan que los seguros de salud sean el canal de distribución futuro con el mejor potencial de mercado. 

    Dos tipos de aplicaciones pueden tener un gran impacto en la atención médica. La Inteligencia Artificial (IA) es vista como la tecnología más disruptiva. Se considera que la combinación con el monitoreo remoto es la tecnología que más perturbará la atención médica. El perfil: 

    AI 61% Monitoreo remota y asistencia 43% “Wearables” 34% IoT 30% Realidad virtual e inteligencia 27% Impresión 3D 22% “Blockchain” 18% 5G 8% Otro 5%. 

    Parece que hay una oportunidad para que los sistemas de salud de África respalden y amplíen su oferta de aplicaciones de salud local.

  • A portal doesn’t improve US hospital outcomes

    As the internet and web have spread across healthcare, portals have been seen as an essential link between patients and clinical teams. It seems they don’t make any difference to hospital outcomes. A study at Mayo Clinic Hospital, Jacksonville, published in the Journal of the American Medical Informatics Association (JAMIA), found the 30-day re-admissions, inpatient mortality and 30-day mortality rates were virtually the same for hospital patients who used portals without prompting and those who didn’t have accounts to use them. The 30-day rates were adjusted for Lengths of Stay (LOS).

    Interpreting the results needs to incorporate the limitations of the portal. It has no specific features for communication between patients and healthcare teams. It only includes admission notes, operative notes, consultations and laboratory studies in real time. Daily progress notes can’t be viewed, and there’s a 72-hour delay in viewing radiology and pathology reports. There’s no educational material about patient-specific diseases and processes.

    Patients with portal accounts seem to drop their access on admission. About 44% of patients who had a portal account when they were admitted, but fewer than half, about 21%, accessed it when they were inpatients. Other studies have found similar results, such as 34% and 23%. For tertiary services, the rates were 25% and 16%.

     of registered users accessed their account.22 The lack of features designed specifically for inpatient use was previously emphasised in a systematic review.14 Consequently, several medical centres designed hospital-specific applications aimed at improving the use and usability of inpatient portals.23–25 In a realistic review, Roberts indicated that patient participation with inpatient health information technology (including patient portals) can be augmented by interactive learning focused on information sharing, self-assessment and feedback, tailored education, user-centred design, and user support. Outpatients with severe diseases use portals more frequently. 

    Patients who access portals have better outcomes for some chronic conditions such as: 

    ·             Diabetes, with lower haemoglobin (HbA1c) after 6 months

    ·             Hypertension, with improved blood pressure control at 12 months)

    ·             Depression management, with increased medication adherence

    ·             Preventative care, such as up-to-date immunisations and mammograms. 

    Portals can have benefits. African health systems need to be explicit about what their portals can achieve and ensure that these are maximised.

  • South Africa’s mHealth has opportunities and bigger barriers

    Much has been made of the growth in mobile phones and their opportunities for Africans’ better health. A qualitative study in Science Direct found that there may not be a high positive correlation. It says while mobile phones have been evolving to fill South Africa’s primary care services gaps, there are barriers to access. Poor digital infrastructure and low digital literacy are two main longstanding inhibitors. 

    The study investigated mobile phone use by a wide range of people. It included patients with chronic diseases, pregnant women and health workers in Mpumalanga, South Africa. In 2014, semi-structured in-depth interviews were completed with 113 patients and 43 health workers from seven primary healthcare clinics and a district hospital.

    Some health workers and patients used their own mobile phones for healthcare, bearing the cost themselves, Bring Your Own Device (BYOD) initiatives. Patients used their mobile phones to remind themselves to take medication or attend clinic visits. They appreciated receiving voice call reminders.

    Some patients and health workers accessed websites and used social media to gather health information, but lacked web search strategies. Patients and health workers’ use of websites and social media was intermittent due to affordability constraints for airtime. Many didn’t know what to search for and where to search. 

    Doctors developed their own informal mobile health solutions for their work needs. It also overcomes resource constraints due to rurality. 

    Removing these seemingly unresponsive barriers needs investment in people and infrastructure. It’s a critical component of successful eHealth.

     

  • Technology’s healthcare transformation is core

    As their name implies, the two fictional robot clans of transformers were good at it. For healthcare, it’s a constant, striving ambition. A health policy statement from the American College of Cardiology (ACC) sees it as relying on successful adoption of technological innovations in big data analytics, precision medicine and eHealth. Published in the Journal of the American College of Cardiology, 2017 Roadmap for Innovation—ACC Health Policy Statement on Healthcare Transformation in the Era of Digital Health, Big Data, and Precision Health puts healthcare transformation as a product of a shared vision of a broad range of stakeholders. It has to establish healthcare delivery’s future and develop new patient-centred, evidence-driven models that reward value over volume.

    It sets out six steps that Africa’s health systems can adopt and adapt:

    Continuously engage a multidisciplinary group of stakeholders in an innovation collaborative to foster an understanding of how patient care guides the development and integration of new technologiesDrive patient-centric innovation by broadening patient access to health information, consumer empowerment and clinician activationSupport research into new innovations, including national and international academic activities, and incorporate rural and underserved populations in phases of device and precision-based clinical trialsDevelop a compact for human-centred design and a commitment to measuring the impact of new innovations on health, access, equity, costs, and outcomes through evidence generation and development of best practice modelsHarness the principles of evaluation, integration, patient and clinician engagement and measures of care efficiency as innovation platforms in an inclusive and iterative model to advance new technology development centred around factors important to patients, clinicians, and healthcare institutionsIdentify mile markers for innovation success, including new innovation groups to guide activities that represent types of clinician and professionals in training.

    These are rigorous activities. They can help Africa’s health systems move their eHealth services into a new phase with a firm strategic foundation.

     

     

  • Cisco’s umbrella can help deal with cyber-attacks

    Simple, open, automated and effective: these are the four cornerstones of Cisco Umbrella set out in its solution brief. Cisco sees its value in dealing with the complexity, range and reach of eHealth services. It’s continuously expanding, along with its cyber-security requirements and gaps. Available from Health IT Security, the brief sets out its functions as: 

    Covering gaps without any hardware to install or software to manually updateProtecting any device and every port without configuration changes or latencyExtending existing protection and incident response data through integrationsProtecting all devices, locations, and users on and off networksPredicting threats before they happen by learning where attacks are stagedBlocking malicious domains and IPs before connections are establishedStopping threats before they reach networks and endpointsIdentifying infected devices faster and preventing data exfiltration.

    Cisco recognises that cyber-security isn’t an absolute, 100% state. Its goals are to maximise prevention and achieve early, effective responses to cyber-attacks.  This is realistic, and offers an option for Africa’s eHealth.

  • EHRs can be more efficient, with better quality

    Better efficiency and quality are two main eHealth benefit groups. They don’t stand alone. Benefits in one group can lead to benefits in the other. Imprivata  emphasises two lessons in its white paper, available from EHR Intelligence.  Saving time, improving care Two lessons to remember when integrating a new EHR sees efficiency gains liberating resources for better quality. 

    Its proposition’s that clinicians can waste 13 seconds waiting unnecessarily with the time they log into EHRs. Aggregating these across all clinicians’ logins can create a valuable chunk of their time, about 13,000 hours a week for a typical hospital. On this scale, clinicians’’ time, can be redeployed to improving health care quality. This simple arithmetic looks appealing, but it’s consistent with an EHR challenge of redeploying each clinician’s small time savings and efficiency gains. It’s an essential, but not an easy activity. 

    Three important findings from a study by American EHR illustrate the difficulties:

    42% of professionals who found it difficult to improve efficiency with EHRs72% found it difficult to decrease workload with EHRs54% said EHRs increased total operating costs.

    These confirm the need for eHealth to be highly usable. It’s a prerequisite for benefit realisation. 

    Imprivata suggests early types of EHRs incorporate these constraints. Modern versions can overcome them, and more benefits will result. It points Africa’s health systems to the need to test the efficiency and performance of EHRs that they’re considering in their procurements. Better EHRs offer better benefits. It looks encouraging for Africa’s healthcare.

  • Some employees can be a cyber-security threat

    Uncomfortable as it may be, Imperva says employees are the greatest cyber-security risk. They may be careless, become compromised or have malicious intent, and their trusted access to data can expose organisations. 

    An Imperva blog proposes the action needed to minimise the risk.7 Steps to Protect Your Data From Insider Threats are: 

    Discover and classify sensitive dataMonitor all user access to dataDefine and enforce organisational policiesLeverage advances in artificial intelligence detectUse interactive analytics tools to investigate security incidentsQuarantine risky usersGenerate reports to document security events.

    These aren’t proposed as absolute solutions. Imperva offers them as a guide to help detect and contain insider threats. Perhaps the most modern feature’s using machine learning to uncover unknown threats. It can sift through massive amounts of detailed data access logs so security teams can establish behavioural baselines of users’ access to data and rapidly identify changes, inappropriate or abusive data access. Drilling down’s more manageable. 

    The seven steps provide a framework for Africa’s eHealth cyber-security. Applying them needs resources, especially skilled people to manage and operate the process.

  • US ONC mission: to IOp and beyond!

    Buzz Lightyear, a Toy Story celebrity and star, saw his environment extending “To infinity, and beyond.” The US Office of the National Coordinator (ONC) sees interoperability (IOp) having an equivalent horizon. In an interview with EHRIntelligence, Genevieve Morris, ONC’s Principal Deputy National Coordinator, says the emergence of new technology and data sets means that IOP extends beyond a conventional EHR-to-EHR connectivity, which is becoming  an IOp  foundation.

    Extending IOp into genomic data and all other data needed for precision medicine’s ONC;s goal. They’re different data sets to mainstream healthcare data in EHRs. Learning health systems comprise totally integrated healthcare environments where IOp takes on a new and expanded meaning. This is a concept embedded in the ONCs’ updated healthcare IOp roadmap reported by eHNA. 

    While IOp and beyond may seem like a leap into the unknown, ONC’s approach’s pragmatic and incremental. It includes underlying standards and technical components needed for medical device integration and patient-generated health data. 

    Provenance’s an example. It identifies people and devices that create data elements and specifies when and where. This meets healthcare providers’ needs to know who and where data comes from as part of clinical data exchanged between EHRs.

    Africa’s IOp strategies and initiatives need to stretch out into these extra territories. It’s a continuous commitment to skills, resources and finance. EHRs are a start, not an end.