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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How do you find a patient? It seems all too common that a provider or health analyst would say “How many patients are taking a statin?” or “How many patients didn’t have their physical?”. These are the fundamental questions of population health. The advent of electronic health data was supposed to make answering these questions easy and compared to a system on paper it does. So, when we want to know
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Health Care Reform With an on-again, off-again alphabet soup of legislative mandates and variants moving forward – ACHA, BCRA, GCHF – health care organizations are doing their best to plan for an uncertain future. What this means for the solution providers – ourselves included – is that we need to invest in flexible, scalable frameworks to deploy new outputs in support of this rapidly changing landscape. Going Forward Without a crystal ball to know the future, I am certain of one thing – the questions that organizations ask in the future are unknown today.
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Medication Days Over the past 150 years, some of the most influential medical breakthroughs have been medications that cure disease, relieve symptoms and ultimately extend life and wellness. Considering medication data is essential for measuring the health status of a patient or population, the standards we use to measure compliance with prescriptions should be widely available. Yet processing medication data into useful statistics presents a set of unique challenges.
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Million Dollar Burden “Health care is complicated.” It’s the joke I keep hearing at every meeting over the past two months and with health data it’s absolutely true. Even the most advanced health information systems are left with data that is classified into hundreds of thousands of granular codes. The formats of the documents are then more complicated with either EDI transactions C-CDA documents, FHIR, or just trying to make sense of a flat-file created for a point-to-point exchange.
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Open Clinical Standards and Measure Calculation with MITRE This is part 2 in our series on Open Clinical Standards with MITRE. Here is a link to part 1 Last week, we were fortunate to have been invited up to meet the staff at MITRE’s MITRE CMS Alliance to Modernize Healthcare. If you have never heard of MITRE, they are part of a consortium of Federally-Funded Research & Development Centers. Basically, MITRE serves to explore new technologies and areas for research for the US Government.
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Open Clinical Analysis There is tremendous innovation going on in the world of health analysis and health applications. From companies like ours that are using data science to learn more about patients to consumer facing apps that help manage disease or engage patients with providers. Even with all of this innovation, it can be difficult to see how all these new capabilities should knit together and communicate. There is no healthcare equivalent of the ubiquitous ACH transactions used in banking, at least not yet.
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The Trouble with Good Intentions While attending the National Quality Forum Annual Meeting this Tuesday, Farzad Mostashari MD unleashed a 29-part tweet storm that was like a quick summary of almost a decade of challenges in quality reporting. If you don’t know Dr. Mostashari, he is the former National Coordinator of Health IT and the founder of Aledade, a firm dedicated to implementing the promise of value-based care. I encourage folks to read Dr.
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Predicting Emergency Room Visits: Why Melbourne’s proof of concept is likely to succeed. Through research into modeling care pathways, I came across Dr. Chris Pearce & team’s proposed study to gauge a patient’s risk of an emergency visit. The proof-of-concept study will use the clinical data warehouse in East Melbourne to train a predictive machine learning algorithm to identify patients likely to present at the emergency department. In one sense, this program is typical of various population health efforts.
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How Much is That?

How much is that service? If you have ever tried to analyze healthcare claims data, you are likely looking at a flat file of several thousand claim lines each encoded to different HCPCS or ICD codes. Your goal is probably to measure some sort of cost. But what field reflects the true cost? Consider the Colorado APCD medical claims layout, it contains fields for the Charge Amount, Paid Amount, Prepaid Amount, Co-Pay amount, Coinsurance Amount, Deductible Amount.
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CMS Assignment & Care Pathways We were fortunate enough to have this poster selected for presentation at the MIT Sloan Health and Bio-Innovations Conference. A portion of this analysis also appeared in the Arcadia Data Gallery Creating the research poster allowed us to test Algorex Health’s underlying mission, how does advanced analytics actual get done in healthcare. So we created a research question and tried to solve it. Along the way, we documented how we solved the analytical challenges we faced and plan to structure or libraries and APIs to accelerate the next analyst faced with an assignment question.
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Sloan Health & Bio-Innovations Conference We were lucky to have a poster selected for the MIT Sloan Health & Bio-Innovations Conference held this Friday (Feb 24, 2017). There is detail about our poster in a future post but I thought I would share some thoughts about the conference as a whole. The MIT conference had two keynote speakers and three panel discussions. I find these formats difficult because there is very little opportunity for the challenge some biases or false information.
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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