clair054

You should (federally required) have access to View , Download , and Transfer your medical data. View View just means you should be able to login to some web portal and see the data. Not very useful, but everyone should be able to do this. It is most helpful when you want to see the data that the doctor just talked to you about, but when the doctor was talking to you the information overload was too much. So you want to look at it later, at home, where you can spend a bit more time with it. The idea is also that you then get a chance to think of questions for the next time you talk to the doctor. These "Views" of the data are often not the best quality, or easy to understand. Download Download means that from that same web portal you can download a copy of the data. This 'should' be a higher quality, and should be in a 'standard' format. This is where my work comes in. Most things are available in a summary report. This might be referred to as "Blue Butto...

The IHE IT Infrastructure Technical Committee has published a new Handbook as of August 20, 2018: Document Sharing Metadata The above document is available for download at https://www.ihe.net/Technical_Frameworks/ or at User Handbooks . The full IHE formal announcement The Document Sharing profiles from IHE including XDS and XCA, enable a Community to share Patient specific medical documents. This is described in the Enabling Document Sharing through IHE Profiles white paper (HIE using IHE) . Each document shared is described by metadata. A Community deploying an HIE this way needs to define some metadata constraints and practices, so that the documents are found when they are needed. This handbook helps a Community to come up with appropriate constraints. Purpose of the Document Sharing Metadata Handbook This handbook is intended to assist the reader on the steps necessary to define how document metadata would be used, how to enforce and propagate that use, and how to evolve the docu...

Smart-Contracts are a very important part of blockchain. The openness of blockchain is another. I have presented a possible way to use these features of blockchain to enable a Patient to be able to sell access to their data. I include some features also enabled by blockchain, such as micro-payments and escrow for breach of terms. I think these are critical to Patient selling access to their Data, and the ability to add this is simple given the Bitcoin example of Blockchain. This all said, Smart-Contracts are hard to write correctly, and easy to get wrong. So I think there needs to be far more maturity to the space of Smart-Contracts before they are actually controlling access to Patient data. Patient data for sale for Clinical Research So a patient might offer access to their data, managed on a FHIR Server, to anyone that can satisfy a smart-contract they put into a public chain. I first described over two year ago as a response to Grahame's original ask Healthcare Blockchain - Bi...

I went to the ONC Interop Forum in DC. The security track focused on blockchain all morning. There was nothing new mentioned. This not to say that the audience didn't get any value, just that I didn't hear anything new. This lack of new insight is itself an important point. It indicates that much of the interest in Blockchain is very niche, that any efforts have not yet found the 'killer app'. This is also not an indication that no killer app is going to appear, just that it has not yet been found. The panelists were surprised by this question. All the experts were clear that this early days. Caution, but excitement. They were all full of encouragement to try stuff out. All recognized that there is much misinformation and hype. All recognized anyone using blockchain is taking a big risk. None would state any prediction of the future. They also all recognized that those that have succeeded have reaped great rewards. They are all fully committed and excited... There was n...

As the IHE ITI Planning Co-Chair... I want to bring attention to the opportunity to bring an Interoperability Problem to IHE to be solved and formulated into an IHE Profile (Implementation Guide). The planning cycle has begun! The IT Infrastructure (ITI) and Patient Care Coordination (PCC) Domains are soliciting work item proposals for the 2018 Publication Cycle. The Call for Proposals concludes September 21, 2018. For detailed information visit the IHE Call for Proposals Wiki site . If you are new to the IHE International Call for Proposal Process? Watch the online webinar to learn more about submitting a proposal and the evaluation process. Ready to participate in the Call for Proposals? Interested parties are invited to submit a brief proposal (template form) for new IHE Profiles and/or White Papers to be considered for development in the new Publication Cycle. Proposals should be entered using the attached Brief Profile Proposal template. They should address the following: W...

When it comes to Patient Data exchange, I want us to be inclusive of "Mediated" exchange, "Directed" exchange, "Controlled" exchange, and "Negotiated" exchange. I have not seen these formally defined, so here is my informal definition. Let me know if you know of another mode of communication. Mediated Exchange -- where the Patient themselves is an active part of the communication pathway. Such as carrying the data within their possession, using a personal device and application, --- Such as using a phone resident App using FHIR to download their data, then upload that data to some recipient.  Directed Exchange -- where the Patient actively requests that the information flow to a selected destination. --- Such as a patient using Direct Secure Messaging, or where a patient requests that the data be pushed. Controlled Exchange -- where the Patient does not get directly involved in the communication, but should be understanding of the communication a...