Hacking Healthcare A Guide to Standards, Workflows, and Meaningful Use

ISBN-10: 1449305024
ISBN-13: 9781449305024
Edition: 2011
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Description: Meaningful Use underlies a major federal incentives program for medical offices and hospitals that pays doctors and clinicians to move to fully electronic health records. This book is a rosetta stone for the IT implementer that will teach you to  More...

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Book details

Copyright year: 2011
Publisher: O'Reilly Media, Incorporated
Publication date: 10/29/2011
Binding: Paperback
Pages: 248
Size: 7.00" wide x 9.00" long x 0.75" tall
Weight: 1.166

Meaningful Use underlies a major federal incentives program for medical offices and hospitals that pays doctors and clinicians to move to fully electronic health records. This book is a rosetta stone for the IT implementer that will teach you to bring organizations to implement and use electronic health records.

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 the difficult 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 the ClearHealth 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 also oversees 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.

Preface
Introduction
Health IT and Medical Science
Meaningful Use and What It Means to Be an EHR
Why So Late?
Health IT in Health Reform
Evolution of Meaningful Use
Accountable Care Organizations
EHR Functionality in Context
An Anatomy of Medical Practice
How Patients Reach Healthcare Organizations
Lab Sample Collection Before a Visit or Admission Date
HIPAA and Patient Identification
Intake, Demographics, Visits, and Admissions
Precertification and Prior Authorization
Emergency Admissions
Prioritization and Triage
Outpatient Care
Inpatient Care
Labs
Imaging
Administration and Billing
Medical Billing
Who Pays, and How
Claims
Eligibility
Treatment
Billing
The Billing Process
Complexities in Billing
Adjudication
The Patient's Burden
The Bandwidth of Paper
Workflow Tokens
Why Leave Paper?
Step 0: Health IT Humility
Normalized Data
Good Boundaries Mean Good Data
Data at Peace with Itself: Linked Data
Flexible Data
Assume Health Data Changes
Free Text Data
Herding Cats: Healthcare Management and Business Office Operations
Major Business Office Activities
Insurance
Records
Demographics
Revenue Collection
Auditing
Accounting
Reporting
Licensing, Credentials, and Enrollments
Nonhealthcare Interactions
The Evolution of the Business Office
Patient-Facing Software
The PHR as Platform
Sharing Data in Patient-Facing Software
Patients Using Normal Social Media
E-patients
The Quantified Self
Patient-Focused Social Media
Patient Privacy in PHR Systems
Specific PHR and Patient-Directed Meaningful Use Requirements
Human Error
The Extent of Error
Dangerous Dosing
Discontents of Computerization
Process Errors and Organizational Change
Deep Medical Errors and EHR Solutions
Errors Caused by Human-Computer Mismatch
Best Practices
Meaningful Use Overview
Outpatient Guidelines and Requirements
Inpatient Guidelines and Requirements
A Selective History of EHR Technology
MUMPS: The Programming Language for Healthcare
Where Can We Buy Some Light Bulbs?
Fragmentation
In an Environment with Gag Clauses and No Consumer Reports
VistA History
Ontologies
A Throw-Away Ontology
Learning from Our Example
CPT Codes, Sermo, and CMS
International Classification of Diseases (1CD)
E-patient-Dave-gate
Crosswalks and ICD Versions
Other Claims Codes
Drug Databases
SNOMED to the Rescue
SNOMED Example
SNOMED and the Semantic Web
UMLS: The Universal Mapping Metaontology
Extending Ontologies
Other Ontologies
Sneaky Ontologies
Ontologies Using APIs
Exercising Ontologies
Interoperability
Some Lessons from Earlier Exchanges
The New HIE Rules
Strong Standards
Winning Protocols
The Billing Protocols
HL7 Version 2
First-Generation and Second-Generation HIEs
Continuity of Care Record
HL7 v3, RIM, CDA, CDD, and HITSP C32
The IHE Protocol
HIE with IHE
Managing Patient Identifiers with IHE
IHE Data Exchange, the Library Model
IHE in the NWHIN
The Direct Project/Protocol
The PCAST Report
The SMART Platform
Technology and Policy Were Sitting in the Tree
HIPAA: The Far-Reaching Healthcare Regulation
Does HIPAA Cover Me?
Responsibilities of Covered Entities
HIPAA: A Reasonable Regulation
Duct-Tape HIPAA Strategies
Breach Notification Rules
In Summary
Open Source Systems
Why Open Source?
Major Open Source Healthcare Projects
ClearHealth
Mirth Connect
VistA Variants and Other Certified Open Source EHR Systems
OpenMRS
Appendix: Meaningful Use Implementation Assessment

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