Hacking Healthcare

Auteur

Fred Trotter is a hacktivist. He works for social change by coding and promoting Open Source Health Software. In recognition of his role within the Open Source Health Informatics community, Trotter was the only Open Source representative invited by congress to testify on the definition of 'meaningful use' for the federal health care incentives law (Meaningful Use). Trotter also represented the Open Source EHR community in negotiations with CCHIT, the leading EHR certification body.

Trotter is the original author of FreeB, the worlds first GPL medical billing engine. In 2004 Fred Trotter received the LinuxMedNews achievement award for work on FreeB. Fred Trotter was an editor for the Open Source EHR review project with the American Medical Informatics Association (AMIA), Open Source Working Group (oswg). Fred is a member of WorldVistA and is the programmer behind Astronaut Shuttle which is the first cloud-based VA VistA offering.

Fred Trotter is a recognized expert in Free and Open Source medical software and security systems. He has spoken on those subjects at the SCALE DOHCS conference, OSCON, LinuxWorld, DefCon and is the MC for the Open Source Health Conference. He has been quoted in multiple articles on Health Information Technology in several print and online journals, including WIRED, ZSnet, Government Health IT, Modern Healthcare, Linux Journal, Free Software Magazine, NPR and LinuxMedNews. Trotter has a B.S in Computer Science, a B.A in psychology and a B.A in philosophy from Trinity University. Trotter minored in Business Administration, Cognitive Science, and Management Information Systems. Before working directly on health software, Trotter passed the CISSP certification and consulted for VeriSign on HIPAA security for major hospitals and health institutions. Trotter was originally trained on information security at the Air Force Information Warfare Center.

David is CEO of ClearHealth Inc. which created and supports ClearHealth, the first and only open source Meaningful Use certified Comprehensive Ambulatory EHR. Coming from a background of supply chain systems and big business ERP for companies including DEC, Micro Systems, Motorola, and EDS, David entered health care in 2001 as CTO for the OpenEHR project. One of the first companies to try commercializing open source healthcare systems, OpenEHR met face first with thedifficult realities of bringing proven mainstream technologies into the complicated and sometimes nonsensical world of health care. In 2003 David became CEO of ClearHealth and created theClearHealth system based on VistA that was originally developed by the Veterans Health Administration.

ClearHealth's software is open source (GPL) and powers more than 1,000 sites from small offices to mega-institutions servicing millions of patients per year. As CEO of ClearHealth Inc. David alsooversees outsourced management and operations consulting of several general practice groups and in 2013 will begin operating it's own general practice facilities.

A frequent speaker and writer David has presented and OSCON, TEPR, LinuxWorld, SCALE, OSHC, and others. You can see his work online in Modern Health Care, Wired, Linux Journal, and on his blog: Health 365.

Texte du rabat

Ready to take your IT skills to the healthcare industry? This concise book provides a candid assessment of the US healthcare system as it ramps up its use of electronic health records (EHRs) and other forms of IT to comply with the government’s Meaningful Use requirements. It’s a tremendous opportunity for tens of thousands of IT professionals, but it’s also a huge challenge: the program requires a complete makeover of archaic records systems, workflows, and other practices now in place.

This book points out how hospitals and doctors’ offices differ from other organizations that use IT, and explains what’s necessary to bridge the gap between clinicians and IT staff.

• Get an overview of EHRs and the differences among medical settings
• Learn the variety of ways institutions deal with patients and medical staff, and how workflows vary
• Discover healthcare’s dependence on paper records, and the problems involved in migrating them to digital documents
• Understand how providers charge for care, and how they get paid
• Explore how patients can use EHRs to participate in their own care
• Examine healthcare’s most pressing problem—avoidable errors—and how EHRs can both help and exacerbate it

Contenu

Preface; Audience; Organization; Conventions Used in This Book; Using Code Examples; Safari® Books Online; How to Contact Us; Acknowledgments; Chapter 1: Introduction; 1.1 Health IT and Medical Science; 1.2 Meaningful Use and What It Means to Be an EHR; 1.3 Why So Late?; 1.4 Health IT in Health Reform; 1.5 Evolution of Meaningful Use; 1.6 Accountable Care Organizations; 1.7 EHR Functionality in Context; Chapter 2: An Anatomy of Medical Practice; 2.1 How Patients Reach Healthcare Organizations; 2.2 Lab Sample Collection Before a Visit or Admission Date; 2.3 HIPAA and Patient Identification; 2.4 Intake, Demographics, Visits, and Admissions; 2.5 Precertification and Prior Authorization; 2.6 Emergency Admissions; 2.7 Prioritization and Triage; 2.8 Outpatient Care; 2.9 Inpatient Care; 2.10 Labs; 2.11 Imaging; 2.12 Administration and Billing; Chapter 3: Medical Billing; 3.1 Who Pays, and How; 3.2 Claims; 3.3 Eligibility; 3.4 Treatment; 3.5 Billing; 3.6 Adjudication; 3.7 The Patient's Burden; Chapter 4: The Bandwidth of Paper; 4.1 Workflow Tokens; 4.2 Why Leave Paper?; 4.3 Step 0: Health IT Humility; 4.4 Normalized Data; 4.5 Good Boundaries Mean Good Data; 4.6 Data at Peace with Itself: Linked Data; 4.7 Flexible Data; 4.8 Assume Health Data Changes; 4.9 Free Text Data; Chapter 5: Herding Cats: Healthcare Management and Business Office Operations; 5.1 Major Business Office Activities; 5.2 The Evolution of the Business Office; Chapter 6: Patient-Facing Software; 6.1 The PHR as Platform; 6.2 Sharing Data in Patient-Facing Software; 6.3 Patients Using Normal Social Media; 6.4 E-patients; 6.5 The Quantified Self; 6.6 Patient-Focused Social Media; 6.7 Patient Privacy in PHR Systems; 6.8 Specific PHR and Patient-Directed Meaningful Use Requirements; Chapter 7: Human Error; 7.1 The Extent of Error; 7.2 Dangerous Dosing; 7.3 Discontents of Computerization; 7.4 Process Errors and Organizational Change; 7.5 Deep Medical Errors and EHR Solutions; 7.6 Errors Caused by Human-Computer Mismatch; 7.7 Best Practices; Chapter 8: Meaningful Use Overview; 8.1 Outpatient Guidelines and Requirements; 8.2 Inpatient Guidelines and Requirements; Chapter 9: A Selective History of EHR Technology; 9.1 MUMPS: The Programming Language for Healthcare; 9.2 Where Can We Buy Some Light Bulbs?; 9.3 Fragmentation; 9.4 In an Environment with Gag Clauses and No Consumer Reports; 9.5 VistA History; Chapter 10: Ontologies; 10.1 A Throw-Away Ontology; 10.2 Learning from Our Example; 10.3 CPT Codes, Sermo, and CMS; 10.4 International Classification of Diseases (ICD); 10.5 E-patient-Dave-gate; 10.6 Crosswalks and ICD Versions; 10.7 Other Claims Codes; 10.8 Drug Databases; 10.9 SNOMED to the Rescue; 10.10 UMLS: The Universal Mapping Metaontology; 10.11 Extending Ontologies; 10.12 Other Ontologies; 10.13 Sneaky Ontologies; 10.14 Ontologies Using APIs; 10.15 Exercising Ontologies; Chapter 11: Interoperability; 11.1 Some Lessons from Earlier Exchanges; 11.2 The New HIE Rules; 11.3 Strong Standards; 11.4 Winning Protocols; 11.5 The Billing Protocols; 11.6 HL7 Version 2; 11.7 First-Generation and Second-Generation HIEs; 11.8 Continuity of Care Record; 11.9 HL7 v3, RIM, CDA, CDD, and HITSP C32; 11.10 The IHE Protocol; 11.11 HIE with IHE; 11.12 The Direct Project/Protocol; 11.13 The PCAST Report; 11.14 The SMART Platform; 11.15 Technology and Policy Were Sitting in the Tree; Chapte…