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Health Orgs Were In Talks To Collect SDOH Data From Facebook

Posted on April 9, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

These days, virtually everyone in healthcare has concluded that integrating social determinants of health data with existing patient health information can improve care outcomes. However, identifying and collecting useful, appropriately formatted SDOH information can be a very difficult task. After all, in most cases it’s not just lying around somewhere ripe for picking.

Recently, however, Facebook began making the rounds with a proposal that might address the problem. While the research initiative has been put on hold in light of recent controversy over Facebook’s privacy practices, my guess is that the healthcare players involved will be eager to resume talks if the social media giant manages to calm the waters.

According to CNBC, Facebook was talking to healthcare organizations like Stanford Medical School and American College of Cardiology, in addition to several other hospitals, about signing a data-sharing agreement. Under the terms of the agreement, the healthcare organizations would share anonymized patient data, which Facebook planned to match up with user data from its platform.

Facebook’s proposal will sound familiar to readers of this site. It suggested combining what a health system knows about its patients, such as their age, medication list and hospital admission history, with Facebook-available data such as the user’s marital status, primary language and level of community involvement.

The idea would then be to study, with an initial focus on cardiovascular health, whether this combined data could improve patient care, something its prospective partners seem to think possible. The CNBC story included a gushing statement from American College of Cardiology interim CEO Cathleen Gates suggesting that such data sharing could create revolutionary results. According to Gates, the ACC believes that mixing anonymized Facebook data with anonymized ACC data could help greatly in furthering scientific research on how social media can help in preventing and treating heart disease.

As the business site notes, the data would not include personally identifiable information. That being said, Facebook proposed to use hashing to match individuals existing in both data sets. If the project were to have gone forward, Facebook might’ve shared data on roughly 87 million users.

Looked at one way, this arrangement could raise serious privacy questions. After all, healthcare organizations should certainly exercise caution when exchanging even anonymized data with any outside organization, and with questions still lingering on how willing Facebook is to lock data down projects like this become even riskier.

Still, under the right circumstances, Facebook could prove to be an all but ideal source of comprehensive, digitized SDOH data. Well now, arguably, might not be the time to move ahead, hospitals should keep this kind of possibility in mind.

Study Offers EHR-Based Approach To Predicting Post-Hospital Opioid Use

Posted on March 27, 2018 I Written By

Sunny is a serial entrepreneur on a mission to improve quality of care through data science. Sunny’s last venture docBeat, a healthcare care coordination platform, was successfully acquired by Vocera communications. Sunny has an impressive track record of Strategy, Business Development, Innovation and Execution in the Healthcare, Casino Entertainment, Retail and Gaming verticals. Sunny is the Co-Chair for the Las Vegas Chapter of Akshaya Patra foundation (www.foodforeducation.org) since 2010.

With opioid abuse a raging epidemic in the United States, hospitals are looking for effective ways to track and manage opioid treatment effectively. In an effort to move in this direction, a group of researchers has developed a model which predicts the likelihood of future chronic opioid use based on hospital EHR data.

The study, which appears in the Journal of General Internal Medicine, notes that while opioids are frequently prescribed in hospitals, there has been little research on predicting which patients will progress to chronic opioid therapy (COT) after they are discharged. (The researchers defined COT as when patients were given a 90-day supply of opioids with less than a 30-day gap in supply over a 180-day period or receipt of greater than 10 opioid prescriptions during the past year.)

To address this problem, researchers set out to create a statistical model which could predict which hospitalized patients would end up on COT who had not been on COT previously. Their approach involved doing a retrospective analysis of EHR data from 2008 to 2014 drawn from records of patients hospitalized in an urban safety-net hospital.

The researchers analyzed a wide array of variables in their analysis, including medical and mental health diagnoses, substance and tobacco use, chronic or acute pain, surgery during hospitalization, having received opioid or non-opioid analgesics or benzodiazepines during the past year, leaving the hospital with opioid prescriptions and milligrams of morphine equivalents prescribed during their hospital stay.

After conducting the analysis, researchers found that they could predict COT in 79% of patients, as well as predicting when patients weren’t on COT 78% of the time.

Being able to predict which patients will end up on COT after discharge could prove to be a very effective tool. As the authors note, using EHR data to create such a predictive model could offer many benefits, particularly the ability to identify patients at high risk for future chronic opioid use.

As the study notes, if clinicians have this information, they can offer early patient education on pain management strategies and where possible, wean them off of opioids before discharging them. They’ll also be more likely to consider incorporating alternative pain therapies into their discharge planning.

While this data is exciting and provides great opportunities, we need to be careful how we use this information. Done incorrectly it could cause the 21% who are misidentified as at risk for COT to end up needing COT. It’s always important to remember that identifying those at risk is only the first challenge. The second challenge is what do you do with that data to help those at risk while not damaging those who are misidentified as at risk.

One issue the study doesn’t address is whether data on social determinants of health could improve their predictions. Incorporating both SDOH and patient-generated data might lend further insight into their post-discharge living conditions and solidify discharge planning. However, it’s evident that this model offers a useful approach on its own.

#HIMSS18: Pushing Inpatient Care Out

Posted on March 9, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

At present, we need acute care hospitals. Despite the fact that many types of care can now be delivered in outpatient settings, and chronic conditions managed remotely for connected health, there are still some treatments and procedures which can only be done in a big, expensive building.

That being said, some of what I saw at HIMSS18 has convinced me that the drive to push hospital-type services into the community has begun to pick up speed. While nobody seems to have a completely mature solution to decentralizing acute care, I saw some tools that might begin to solve the problem.

Perhaps the most direct example of this trend was offered by a Taiwanese company called Quanta Computer. (The booth was staffed with five company representatives who had flown here all the way from Taiwan, which may suggest that they are not fooling around.)

Quanta was here to pitch QOCA, whose capabilities include offering a “smart hospital at home.”  QOCA Home, an eldercare/assisted living solution including a central, easy to use terminal supporting a wide range of telehealth and connected health services. While the idea is not completely new, the way this blends a smart home approach with connected health intrigued me.

Other vendors took a different approach to some of the same core problems, i.e. managing the patient effectively outside of the hospital. For most exhibitors, this seemed to involve a blend of connected health, care management and patient/provider collaboration.

For example, vendor Virtual Health promises to deliver “whole person health” by tying together providers, healthcare execs, patients and care coordinators. Two points of interest: its solution include a collaborative workflow tool which seems to include patients, something I don’t believe I’ve seen before. Its platform, which is designed to support patients with highly complex medical needs, also addresses social determinants of health, including financial concerns and nutrition.

Now, I’m not here to tell you that any of this is revolutionary. The industry has been kicking around concepts like virtual hospital care, care coordination platforms and the integration of social determinants of health for quite some time, and I’m not suggesting that any of the vendors I saw seem to be all the way there.

Still, what I saw suggests to me that tech vendors are further along in delivering these options than they have been. If you haven’t looked into new platforms that address these issues, now might be the time. They may not be completely ready for prime time, but they’re well on their way.

Hospital Takes Step Forward Using Patient-Reported Outcome Data

Posted on December 6, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

I don’t usually summarize stories from other publications — I don’t want to bore you! — and I like to offer you a surprise or two. This time, though, I thought you might want to hear about an interesting piece appearing in Modern Healthcare. This item offers some insight into how understanding patient-generated determinants of health could improve outcomes.

The story tells the tale of the Hospital for Special Surgery, an orthopedics provider in New York City which provides elective procedures to treat joint pain and discomfort. According to the MH editor, HSS has begun collecting data on patient-reported outcomes after procedures to see not only how much pain may remain, but also how their quality of life is post-procedure.

This project began by doing a check in with the patient before the procedure, during which nurses went over important information and answered any questions the patient might have. (As readers may know, this is a fairly standard approach to pre-surgical patient communication, so this was something of a warm-up.)

However, things got more interesting a few months later. For its next step, the hospital also began surveying the patients on their state of mind and health prior to the procedure, asking 10 questions drawn from the Patient-Reported Outcomes Measurement Information System, or Promis.

The questions captured not only direct medical concerns such as pain intensity and sleep patterns, but also looked at the patient’s social support system, information few hospitals capture in a formal way at present.

All of the information gathered is being collected and entered into the patient’s electronic health record. After the procedure, the hospital has worked to see that the patients fill out the Promis survey, which it makes available using Epic’s MyChart portal.

Getting to this point wasn’t easy, as IT leaders struggled to integrate the results of the Promis survey into patient EHRs. However, once the work was done, the care team was able to view information across patients, which certainly has the potential to help them improve processes and outcomes over time.

Now, the biggest challenge for HSS is collecting data after the patients leave the hospital. Since kicking off the project in April, HSS has collected 24,000 patient responses to nursing questions, but only 15% of the responses came from patients who submitted them after their procedure. The hospital has seen some success in capturing post-surgical results when doctors push patients to fill out the survey after their care, but overall, the post-surgical response rate has remained low to date.

Regardless, once the hospital improves its methods for collecting post-surgical patient responses, it seems likely that the data will prove useful and important. I hope to see other hospitals take this approach.

Connecting Data with Effective Interventions

Posted on September 9, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently had a chance to talk with Robert Slepin, Executive Vice President and Chief Product Officer at Axispoint Health. They’re doing some fascinating work in population health management. During our conversation he pointed out what I think has been the missing connection in most of the health analytics solutions I see on the market today. Most healthcare analytics doesn’t connect the data to the intervention. Obviously, Robert and Axispoint Health are striving to fix that disconnect.

I think most of us agree that data is going to drive many costs savings and health benefits in the future. This is true with the limited data sets that are available today and is only going to get better as the data becomes higher quality and more comprehensive. It’s great that we’re collecting all of this data and understanding what it means, but then what?

The same is true for the many interventions that are available to improve someone’s health. There are a plethora of solutions on the market, but many of the patients that need these solutions don’t know their options. If you missed Melissa Adams VanHouten’s story on Gastroparesis, you’ll see first hand what I mean. There were solutions available, but the data that said she had Gastroparesis wasn’t connected to the possible interventions that could help her.

The moral of the story is that we need to better tie the health solutions with the data if we’re going to move the needle in healthcare. It’s not enough to just know what’s wrong with someone or which patients are going to cost the most money. We have to do something with that data and connect those patients with the assistance they need. Otherwise we’re going nowhere fast.

This also came up in a conversation I had with Mandi Bishop from Aloha Health. We were talking about SDOH (Social Determinants of Health) and pushing that data to the point of care. While it would be great to inform a doctor about the various SDOH that are impacting a patient, what next? What’s the doctor suppose to do with a patient who has a fever because they can’t afford heat in their home? That’s right. It’s not enough for us to push the data to the provider. We have to also connect them to the tools and interventions that can impact the patient.

Meeting Patients Where They Are

Posted on November 19, 2015 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

Last week the sixth pediatric school clinic in Toronto opened its doors at the Nelson Mandela Park Public School. This clinic is part of the model schools pediatric health initiative – a joint program between St. Michael’s Hospital, the Toronto District School Board (TDSB) and the Ontario Ministry of Education.

This clinic represents some truly inspired thinking. Despite Canada’s universal healthcare system, there are families that fall through the cracks. Just because you don’t have to pay for the care in Canada, there is still a cost associated with healthcare – the cost of getting yourself to the doctor and taking time off work are two examples. For economically challenged families where both parents work, taking time to bring their children to a doctor is a luxury they cannot afford – even though the visit itself is free. Many therefore forgo care.

By opening a pediatric clinic inside an inner city school, the TDSB and St. Michael’s Hospital are not only bringing healthcare to where it’s needed most, they are doing it in a manner that is convenient for families too. Since parents are dropping off their children at their local school anyways, there are no extra transportation costs. On top of that, children don’t miss an entire day of school and their parents can still make it back to work. This is a win for families.

These clinics may also be a win for the health system. By providing care to people who would otherwise forgo it, they are reducing health risks and potentially eliminating future hospital ER visits. St. Michael’s and the TDSB are studying the impact of the six in-school pediatric clinics to quantify the impact on public health.

This initiative is a fantastic example of innovative healthcare thinking. Faced with the problem of poor pediatric health, healthcare and educational officials didn’t opt for the “easy solution” – a public awareness campaign to get parents to bring their children to a doctor. Instead they flipped the problem on its head met patients where THEY ARE. They brought healthcare to a trusted place in the community – schools.

Healthcare needs more innovative ideas like this one.

Should Every Patient Have a Number of Health Scores?

Posted on September 4, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In today’s #HITsm chat, I saw an interesting tweet from Gus Gilbertson (@gusgilbertson) about incorporating various environmental scores into the healthcare analysis we do:


Which I retweeted with a question:

In another tweet (which I can’t seem to find), someone else suggested that every patient should have a health score as well. I think it’s interesting that Gus compared these scores to the FICO score that we each have. Would it make sense for every patient to have their own FICO like health score?

My question above was sincere: Would a score be enough to do any good?

My feeling is that the answer to that is no. Unless of course we were given a whole range of scores as opposed to one overall health score. For example, maybe we’re given a diabetes score and a cholesterol score and a heart disease score, etc. If we were actually treating a healthy patient and trying to keep them healthy, then having these scores could help a doctor focus on the things that were most at risk for a patient. Plus, the change in score could help the doctor tell a story to the patient which would hopefully encourage the patient to change some behaviors like eating right or exercise.

I’ve seen some related scoring in hospitals already. The Rothman index is one example. As I understand it, that index essentially scores a patient in the hospital on how they’re doing and if that patient’s condition is deteriorating. Could we apply that same principle to a patient’s health status? Even those patients who “feel” healthy?

What’s clear to me is that we have too much data that’s heading doctors way. We need to find some way to present this data and the change in data to the doctor so they can actually use that data for the patient’s benefit. Plus, the data might promote a patient to seek medical care earlier. No doubt all of these changes will transform how we think about medical care. I think that’s a very good thing!

Are 3 Square Meals the Key to Avoiding Hospitalizations?

Posted on July 16, 2015 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

We’d like to welcome a new guest blogger to our ranks. If you’re on social media, you probably know Colin Hung (@Colin_Hung), Co-Host of #hcldr. Colin is also head of Marketing for @PatientPrompt, a product offered by Stericycle Communication Solutions. We look forward to many posts from Colin in the future.

On our weekly #hcldr (healthcare leadership) tweetchat, we had two special guests who have done pioneering healthcare work – Leonard Kish (@LeonardKish) and Dave Chase (@chasedave). Together Kish and Chase authored the #95Theses, a wonderful call-to-action for those of us in healthcare that’s written in same style as the seminal Cluertain Manifesto.

The first topic of last night’s #hcldr chat was “What are some creative/effective ways patients can use to avoid hospitalizations?”. There were many interesting and insightful answers, but one tweet from Chase really caught my eye:

The first statement was fascinating – Meals on Wheels as a way to reduce hospital admissions.

This concept is at the heart of the discussion around Social Determinants of Health (#sdoh) – a topic that has gotten a lot of buzz over the past couple of years. There is a really great definition of SDOH on the WHO website. I’d also recommend this blog post from John Lynn on a similar topic from earlier this year.

As we move towards a system that is based on wellness rather than sickness, I wonder if healthcare providers and organizations will look to preventative measures such as providing meals or teaching basic nutrition as a way to keep their communities healthy? Will the day come when this type of service will become necessary for a provider to remain relevant?

I doubt that most providers and healthcare organizations will reach this point by their own volition. However, I do believe that some innovative organization and entrepreneurial companies will emerge that will make this a reality in specific communities.

I would love to see a future where we will have community wellness centers where we used to have hospitals – places where local people can gather to learn about how to stay healthy and get social as well as emotional support from their peers. These centers would be helped by a network of technologies that combine an individual’s personally tracked data with insights gleaned from “Big Data” analytics resulting in a personalized wellness plan. A plan that includes recommendations for 3 square meals each day that would optimize a person’s health and has the facilities to then create those meals and a mechanism to deliver them (especially to elder adults who lack mobility).

I am excited and intrigued by the possibility that something as simple as a meal can be the key ingredient in reducing healthcare costs while improving health.

Know anyone who is doing this already?