This post is part of a larger series of posts that examines the use of declarative logic programming in implementing a healthcare-specific risk score called the HCC Risk Score. The scope of this series runs through such topics as healthcare-intensive dissection of SAS code and translation into Python and PyDatalog a generic introduction to Logic Programming with Prolog and SQL (this post) discussions on the role of declarative programming in a technical organization the difference between forward-chaining and backward-chaining as an implementation strategy in logical/declarative technologies the choice of a forward-chaining embedded language called CHR for re-implementing our code from PyDatalog This post has the following characteristics:
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The following post is an introduction and summary on what will be a series of posts about the use of declarative programming, specifically logical programing, within one of Algorex’s more important libraries – the HCC (hierarchical code categories) risk calculator. It is our hope that this series of posts might be interesting to several classes of reader: The imperative programmer (regardless of field) who has never encountered the term ‘logical programming’ before.
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Calculating Growth and Obesity from FHIR Messages When parents bring their kids to the pediatrician, one of the most important checks is to have the child’s height, weight, and BMI plotted on growth charts to understand their development. The charts, a image of which appears below, are ubiquitous and critical to the tracking the health of kids. Sure enough, many many EHRs automatically show the graph and the patient’s position on the chart right inside the workflow making it easy for physicians and patients to review.
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A Listening Tour There has been much speculation about Amazon & JP Morgan & Berkshire Hathaway healthcare joint venture. Recently, the newly appointed CEO of the effort, Atul Gawande, announced he was embarking on a “listening tour” of the 1.2 million employees who work under that umbrella. We thought we would compile the dream health care itinerary. Each stop, according to publicly available data, shines a light on the tremendous hurdles in the healthcare sector that any policy maker or executive needs tackle.
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What Supplements Health? Buried in a recent CMS announcement was a seemingly small policy change related to helping Medicare members with their social determinants of health. Medicare, the insurance program for the elderly and disabled in the United States, is really two independent programs. In one, the beneficiary medical costs are covered directly by the federal government. This is often referred to as Original Medicare or Medicare Fee-For-Service. The second option is for individuals to obtain Medicare insurance through private insurance companies.
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Everything You Never Wanted to Know about Geographic Charting Before the start of seventh grade, my family moved, and I started a new school that had as required module, cartography. Over a few weeks, we painstakingly drew maps of states, continents and eventually the entire world. My backpack became filled with various stencils, a compass, colored pencils, pens of multiple weights, and even tracing paper. It was one of the more frustrating parts of my schooling and I remember thinking “Why would I ever need this?
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Almost 10 PieCharts 10 Python Libraries Here is a follow-up to our “10 Heatmaps 10 Libraries” post. For those of you who don’t remember, the goal is to create the same chart in 10 different python visualization libraries and compare the effort involved. All of the Jupyter notebooks to create these charts are stored in a public github repo Python-Viz-Compared. Each Jupyter notebook will contain one chart (bar, scatter etc) and then up to 10 different ways of implementing them.
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The Trump administration, as portrayed in an recent Axios piece by Sam Baker is more than quietly revolutionizing Medicaid, it is reducing membership in the safety net payor through administrative gates, work requirements, and enforcing premiums as low as $1. Readers note: Medicaid has historically not charged premiums and this action reduces membership by adding additional barries. Additionally, most billings activities are more expense than the revenue gained. These efforts have one goal - reduce the number of individuals on Medicaid.
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Food Access is loosely defined as “people’s ability to find and afford food”. However, there are a number of related concepts and terms depending on the mode of study being employed. A recent Tufts University study, categorized ten variations on the term including the colorful geographic nomenclature “food desert”, “food swamp”, and “food hinterland”. Food access is a difficult issue to categorize because of tremendous variation in prices, cultural preferences, and skill sets.
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What's the price?

Today the Health Care Cost Institute (HCCI) posted their annual report of United States health care spending. With an enviable data set of claims from commercial under 65-yr populations from. Aetna, Humana, Kaiser and UnitedHealthcare, HCCI concluded that health spending grew by 4.6% in 2016. In a vacuum that number may be seen as a success given historical year over year growth. Diving into the details we can view multiple trends that create opportunities in better managing care and ultimately supporting a reduction of costs in the future.
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this post is part of a series of in depth posts about specific modules in our Social Determinant Platform In many cases, patients put off or delay seeking care when they are not sure how they can pay for it. According to Commonwealth Fund surveys, 20% of patients did not see a doctor because of cost, and 18% did not get a recommended test. Other studies have reiterated these results.
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“Neighborhood stress” or neighborhood socioeconomic context, has long been a focus of public health research. The following summarizes the unique opportunities neighborhoods provide when researching health effects: …the “meso” level of neighborhoods is of interest for three important reasons. First, many of these broader social determinants are manifested, and directly affect individuals, through neighborhood social and physical environments. Thus the study of neighborhoods provides an opportunity to understand the processes linking these broader social and economic factors … in very concrete ways.
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Non-clinical factors including social determinants of health (SDOH) are responsible for, depending on the source, 20%, 60%, 70%, 80% of a persons overall health. (for more on the weighting debate see Different Perspectives on Assigning Weights to Determinants of Health) Whether a person is made directly sick through environmental exposure or lacks the means to engage in a complex treatment plan, these factors all combine to seriously determine outcomes. As health organizations adopt value-based payment schemes social determimnants impact the bottom line and deserve greater attention from value-seeking organizations.
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Medicaid, the federally financed but state-run insurance program for the poor, now covers 1 in 5 Americans nationwide. In seven states, the number is higher ranging from 24% to 29%. The increasing size and scope is starting to draw attention from government budget directors and policy wonks, but has not drawn the attention of new technology or innovation investment given the tremendous size and market potential. The California Health Care Foundation (CHCF), a nonprofit grantmaking philanthropy based in Oakland, is trying to change that.
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Innovation in Medicaid

Innovation in Medicaid Medicaid continues to be an area for tremendous growth and disruption in the health care market. Served by traditional Medicaid programs, Medicaid Managed Care Organizations, and increasingly through Medicaid Accountable Care Organizations under state-based 115 waivers, the innovation and opportunities for new solutions is growing rapidly. The majority of our work focuses on bringing new solutions to Medicaid and other underserved populations. One key element that drives our work is the need for greater emphasis on non-clinical factors – specifically social determinants of health (SDOH).
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Algorex Health Technologies

A blog for technology, policy, and grievances in the Open Health World

Opening the Healthcare Technology Doors

Boston, Massachusetts