From the wiki.... probably the most useful one page I've read on Hadoop.
Thursday, October 23, 2014
Tuesday, August 26, 2014
Are EHRs Life Savers? Maybe So, According to Preliminary Research
Are EHRs Life Savers? Maybe So, According to Preliminary Research
Clearly a proponent of EHRs, Skinner says that those who criticize the technology for not providing clinicians enough value might not be accurately measuring what the “value” really is. “It may be that a specific clinician hasn’t found much value to him or her, but that doesn’t mean his or her use of the EHR hasn’t proved value to the patient, to the institution as a whole, or to other parts of the institution,” he says.
Skinner notes that the case is easier to make at the organizational level than it is than it is at the individual physician level. “Providers do have a point in that they are being asked to do more and put their hands on a tool they never had to worry about. So there’s no question they have acquired added burdens. But the real question is, ‘Has the institution and its patients gotten sufficient benefit to justify that extra burden?’”
Suppose so but when I'm on the table on what to see the value to me.
Clearly a proponent of EHRs, Skinner says that those who criticize the technology for not providing clinicians enough value might not be accurately measuring what the “value” really is. “It may be that a specific clinician hasn’t found much value to him or her, but that doesn’t mean his or her use of the EHR hasn’t proved value to the patient, to the institution as a whole, or to other parts of the institution,” he says.
Skinner notes that the case is easier to make at the organizational level than it is than it is at the individual physician level. “Providers do have a point in that they are being asked to do more and put their hands on a tool they never had to worry about. So there’s no question they have acquired added burdens. But the real question is, ‘Has the institution and its patients gotten sufficient benefit to justify that extra burden?’”
Suppose so but when I'm on the table on what to see the value to me.
Midwest SAS Users Group Conference 2014 in Chicago
I'll be there for the entire conference. Feel free to stop me and say hello. A list of papers to be presented can be found here. SAS Conferences always good opportunities to learn and much of it happens out in the halls between sessions.
cya
Monday, June 23, 2014
SAS University Edition
About time SAS did this....
SAS University Edition isn't a watered-down version of our software. You get the most recent releases of the same world-class analytics software used by more than 70,000 business, government and university sites around the world, including 91 of the top 100 companies on the Fortune Global 500® list. That means you'll be using the most up-to-date statistical and quantitative methods whenever and wherever – right on your own PC, Mac or Linux workstation.
Follow the link and download yourself a copy.
SAS University Edition isn't a watered-down version of our software. You get the most recent releases of the same world-class analytics software used by more than 70,000 business, government and university sites around the world, including 91 of the top 100 companies on the Fortune Global 500® list. That means you'll be using the most up-to-date statistical and quantitative methods whenever and wherever – right on your own PC, Mac or Linux workstation.
Follow the link and download yourself a copy.
From Quants to Data Scientists
A nice blog post by Yves de Montcheuil on the journay from Quant to Scientist.
Steve Miller on Data Distributions
A nice blog post on distributions using R.
....the first priority with a new data set revolves on determining the distribution of values for each of the attributes. Initially, we wish to see frequencies for the responses of each variable. Those give us a general sense of the data, its distribution and its quality. For categorical attributes, we prefer to visualize frequencies sorted from most to least in an unadorned graphic; for numeric attributes that assume many different values, we like histograms – and perhaps even the more sophisticated kernel density plots – to detail the shape of the data.
Ought to be some kind of rule that nothing can start until histograms are done. Count the number of times you see an average referenced during the day with no sense of it's dispersion. Seems like data analyst malpractice 'cept we're never the ones speaking, and only find ourselves quoted.
....the first priority with a new data set revolves on determining the distribution of values for each of the attributes. Initially, we wish to see frequencies for the responses of each variable. Those give us a general sense of the data, its distribution and its quality. For categorical attributes, we prefer to visualize frequencies sorted from most to least in an unadorned graphic; for numeric attributes that assume many different values, we like histograms – and perhaps even the more sophisticated kernel density plots – to detail the shape of the data.
Ought to be some kind of rule that nothing can start until histograms are done. Count the number of times you see an average referenced during the day with no sense of it's dispersion. Seems like data analyst malpractice 'cept we're never the ones speaking, and only find ourselves quoted.
Tuesday, November 26, 2013
SAS's ZipCityDistance() function
I knew SAS could do just about anything but I didn't realize there was a function for counting the miles between zipcodes.
Below an example taken from a listserv at work,
data _null_;
distance=zipcitydistance('94103', '04401');put 'Distance from San Francisco, CA, to Bangor, ME: ' distance 4.' miles';
run;
Monday, November 25, 2013
Healthcare IT News: Epic to open source code to OHSU
Via Healthcare IT News,
Epic Systems Corp. will build two laboratory installations of its EpicCare electronic health record at Oregon Health & Science University for medical informatics education and research purposes. On the research side, the school will have access to Epic's source code.
This is Epic's first partnership with an academic informatics program and possibly an important turning point for the company. While Epic does release its source code to commercial customers, it historically has conducted research and development almost exclusively on its sprawling campus in Verona, Wis., where all of its employees are based.
"It's a little bit of a change for Epic," said William Hersh, MD, chair of the Department of Medical Informatics and Clinical Epidemiology at OHSU in Portland, Ore. Hersh said it took several years of cajoling to get the vendor to commit to an academic partnership.
Epic Systems Corp. will build two laboratory installations of its EpicCare electronic health record at Oregon Health & Science University for medical informatics education and research purposes. On the research side, the school will have access to Epic's source code.
This is Epic's first partnership with an academic informatics program and possibly an important turning point for the company. While Epic does release its source code to commercial customers, it historically has conducted research and development almost exclusively on its sprawling campus in Verona, Wis., where all of its employees are based.
"It's a little bit of a change for Epic," said William Hersh, MD, chair of the Department of Medical Informatics and Clinical Epidemiology at OHSU in Portland, Ore. Hersh said it took several years of cajoling to get the vendor to commit to an academic partnership.
Cajoing indeed....
Tuesday, October 15, 2013
Ben Domenech on Affordable Care Act's worst case scenario
Domenech lays it out here.
I'd add one further nasty step to the worst case. People who have lost their insurance and unable to sign up timely on the exhanges, and then faced with a health catastrophe in January would face the cruelist of fates. Sick, without insurance, and a penalty for not having it. None of it any fault of their own.
I'd add one further nasty step to the worst case. People who have lost their insurance and unable to sign up timely on the exhanges, and then faced with a health catastrophe in January would face the cruelist of fates. Sick, without insurance, and a penalty for not having it. None of it any fault of their own.
Sunlight Group: Good enough for government work? The contractors building Obamacare
InforWorld writes,
The biggest problem with Healthcare.gov seems simple enough: It was built by people who are apparently far more familiar with government cronyism than they are with IT.
That's one of the insights that can be gleaned from the work done by the Sunlight Foundation Reporting Group, a Washington, D.C.-based nonprofit that focuses on government transparency. In a report filed this past week, the group examined why the system broke as horribly as it did: The contracts awarded to those who built it were, by and large, existing government contractors with "deep political pockets."
Download the Sunlight Group's report for a list of all the vendors. Yes, the lobbying and contributions explain some, but the biggest failure I suspect will be lack of imagination. They did it the same old way.
The biggest problem with Healthcare.gov seems simple enough: It was built by people who are apparently far more familiar with government cronyism than they are with IT.
That's one of the insights that can be gleaned from the work done by the Sunlight Foundation Reporting Group, a Washington, D.C.-based nonprofit that focuses on government transparency. In a report filed this past week, the group examined why the system broke as horribly as it did: The contracts awarded to those who built it were, by and large, existing government contractors with "deep political pockets."
Download the Sunlight Group's report for a list of all the vendors. Yes, the lobbying and contributions explain some, but the biggest failure I suspect will be lack of imagination. They did it the same old way.
Affordable Care Act's Software Vendors
In case your wondering the trio's "CGI Federal for the website itself, "Quality Software Systems Inc. (QSSI) for the information "hub" that determines eligibility for programs and provides the data on qualified insurance plans, and "Booz Allen for enrollment and eligibility technical support."
Below via Obamacare site hits reset button on passwords as contractors scramble,
The result of the headlong rush to October 1 was a system that had never been tested at anything like the load it experienced on its first day of operation (if it was tested with loads at all). Those looking for a reason for the site's horrible performance on its first day had plenty of things to choose from.
First of all, there's the front-end site itself. The first page of the registration process (once you get to it) has 2,099 lines of HTML code, but it also calls 56 JavaScript files and 11 CSS files. That's not exactly optimal for heavy-load pages.
Navigating the site once you get past registration is something of a cheese chase through the rat-maze. "It's like a bad, boring video game where you try to grunt and hack your way through to the next step," one site user told Ars.
Once you get through all that, it's not clear that it's going to do you any good. Underlying problems in the back-end code—including the data hub built by QSSI—have been causing errors in determining whether individuals are eligible for subsidized plans under the program. In DC, that means health care plan prices won't be available to people registering through DC's portal until November. It may also mean that others who have registered already at the federal and state exchanges may get sticker shock later.
A Federal IT Acquistion a heck-of-a-thing to hang one's Political Legacy upon. Administration will end up seeking a delay and that's what'll be remembered about this shutdown.
Below via Obamacare site hits reset button on passwords as contractors scramble,
The result of the headlong rush to October 1 was a system that had never been tested at anything like the load it experienced on its first day of operation (if it was tested with loads at all). Those looking for a reason for the site's horrible performance on its first day had plenty of things to choose from.
First of all, there's the front-end site itself. The first page of the registration process (once you get to it) has 2,099 lines of HTML code, but it also calls 56 JavaScript files and 11 CSS files. That's not exactly optimal for heavy-load pages.
Navigating the site once you get past registration is something of a cheese chase through the rat-maze. "It's like a bad, boring video game where you try to grunt and hack your way through to the next step," one site user told Ars.
Once you get through all that, it's not clear that it's going to do you any good. Underlying problems in the back-end code—including the data hub built by QSSI—have been causing errors in determining whether individuals are eligible for subsidized plans under the program. In DC, that means health care plan prices won't be available to people registering through DC's portal until November. It may also mean that others who have registered already at the federal and state exchanges may get sticker shock later.
A Federal IT Acquistion a heck-of-a-thing to hang one's Political Legacy upon. Administration will end up seeking a delay and that's what'll be remembered about this shutdown.
Tuesday, July 16, 2013
Wednesday, June 05, 2013
Becker's: 5 Reasons Hospital ORs Score Low on Key Quality Measures
Via Becker's
The VBP Program tracks several measures from the Surgical Care Improvement Project. The program also incorporates patient satisfaction scores from the HCAHPS survey. Starting in fiscal year 2015, VBP will weave in several surgical complication measures, which are tracked by the American College of Surgeons National Surgical Quality Improvement Program.div>VBP allready favors Medical Centers that can cherry pick their patients and disfavors disporportinate share Providers. Adding NSQIP really aggrevates the destruction this "no child left behind" styled approach to reform will wrought on health care.
So pay attention to the advice in this article on improving your Surgical programs although it's going to be futile for many I think.
Wednesday, May 22, 2013
Becker's Hospital Review: 6 Value-Based Credit Rating Metrics Hospital CFOs Need to Know
One through five on the list I would have guessed but #6 a new one to me,
Maybe I've just been too removed from the nuts-and-bolts of reimbursement to have had #6 cross my mind.
6. Risk-based revenues. Hospitals provide data on traditional forms of payment such as diagnosis-related groups, per diems and capitation, but Moody's will also be looking at how much a hospital receives from risk-based revenues. These include bundled payments and pay-for-performance reimbursement, or any other reimbursement that is based on the hospital's ability to delivery care at a lower cost.
Maybe I've just been too removed from the nuts-and-bolts of reimbursement to have had #6 cross my mind.
Sunday, January 27, 2013
Friday, January 18, 2013
Study: Electronic Medical Records Not Generating Expected Savings
Study: Electronic Medical Records Not Generating Expected Savings
Solutions create tomorrow's problems....
Shaun Alfreds, Chief Operating Officer of HealthInfo Net - a Maine company that manages a centralized health records database for the state - says part of the problem may be the rush to implement EMRs over the past few years.
"And in this particular case, the focus was getting the systems to be electronic, not necessarily about changing the workflow of how health care is delivered." Because ultimately, Alfreds says, that's what EMRs are about: workflow.
Another problem that RAND identified is the inability of EMR systems to communicate with each other. "It's the bigggest challenge I've had in my career," says Ralph Johnson, chief information officer at Franklin Memorial Hospital in Farmington, which has been named among the nation's most wired hospitals.
Solutions create tomorrow's problems....
Shaun Alfreds, Chief Operating Officer of HealthInfo Net - a Maine company that manages a centralized health records database for the state - says part of the problem may be the rush to implement EMRs over the past few years.
"And in this particular case, the focus was getting the systems to be electronic, not necessarily about changing the workflow of how health care is delivered." Because ultimately, Alfreds says, that's what EMRs are about: workflow.
Another problem that RAND identified is the inability of EMR systems to communicate with each other. "It's the bigggest challenge I've had in my career," says Ralph Johnson, chief information officer at Franklin Memorial Hospital in Farmington, which has been named among the nation's most wired hospitals.
Thursday, December 27, 2012
Who's "We" Dr. Ashish Jha
I'm always unsettled when experts use We as Dr Jha does below, when he's quoted saying the Government's not going quite far enough with its new value-based purchasing program.
The CMS on Thursday released a list of hospitals' bonuses and penalties under the value-based purchasing program. Health policy experts have applauded such incentives, but some have questioned whether the money at stake will be enough to motivate hospital officials and doctors to adopt changes that will reduce waste and improve quality. "The purpose here is really straightforward and very reasonable," said Dr. Ashish Jha, an associate professor of Health Policy and Management at Harvard University. "Forever we have paid for a quantity of healthcare. We have not really paid for quality, and CMS has decided they want to change that."Explaining just who We are no easy task I suspect. Whether the CMS that's decided they want to change that the We cited just before, a nice start Dr. Jha. Who's the We you're talking about Doc and how do you read its mind? Does We know CMS working its will on We's behalf?
Crains: Chicago medical records exchange falters
It all comes down to the dollars.
The price is too high for Loyola University Health System, says Arthur Krumrey, chief information officer at the Maywood-based hospital network.
Loyola, Evanston-based North-Shore University HealthSystem and Ann & Robert H. Lurie Children's Hospital of Chicago, which already use the same software system for their internal medical records, are discussing setting up their own exchange.
Advocate has not joined, but executives are “working on it,” says John Norenberg, a vice president at the Oak Brook-based system, with 11 hospitals statewide.
Mr. Norenberg, who is also chairman of MCHC's exchange advisory board, adds: “It's turned out to be a bit more difficult to get the players moving on this than I think anybody expected.”
Read more: http://www.chicagobusiness.com/article/20121222/ISSUE01/312229988/chicago-medical-records-exchange-falters#ixzz2GHEcBxUS
Stay on top of Chicago business with our free daily e-newsletters
HHS Stops Short Of Calling For Safety Regulation Of Digital Records – Capsules - The KHN Blog
HHS Stops Short Of Calling For Safety Regulation Of Digital Records – Capsules - The KHN Blog
The Obama administration Friday urged cooperation between software companies and caregivers to prevent patient harm caused by faulty electronic records. But it stopped short of calling for regulation or a federal requirement to report computer mistakes that pose a risk to patients.Sounds a bit collusional to me, but I'm not a legal sort.
“We are saying to the vendors: Step up and prove your ability to create a code of conduct that would be enforceable, that would bind you voluntarily to reporting safety events,” Dr. Farzad Mostashari, the administration’s coordinator for health information technology, said about the report. “And what we’re saying is: If you don’t step up, we can always look at more classic regulatory approaches.”
Subscribe to:
Posts (Atom)