Health

GovFresh guide to openFDA

Photo: FDA / Michael J. Ermarth

Photo: FDA / Michael J. Ermarth

The U.S. Food and Drug Administration’s openFDA initiative aims to “make it easier for web developers, researchers, and the public to access large, important public health datasets.”

openFDAInitial areas of focus include adverse event and recall enforcement reports and product labeling data (see “Drugs,” “Devices,” “Foods“). It currently provides an application programming interface of information that was previously unavailable or easily-accessible to the public, including millions of reports submitted to the FDA from 2004 to 2013.

History

The U.S. Department of Health and Human Services identified “Open FDA” as a priority in its open government “Plan Version 3.0.” Led by the FDA’s Office of Informatics and Technology Innovation, the project began in March 2013 and launched a public beta in June 2014.

Timeline

  • March 2013: Taha Kass-Hout named FDA chief health informatics officer.
  • March 2013: Work on openFDA begins.
  • July 2013: White House Presidential Innovation Fellows join to support openFDA development.
  • December 2013: FDA creates the Office of Informatics and Technology Innovation lead by Kass-Hout.
  • June 2014: openFDA launches in beta.

Quotable

“The openFDA initiative leverages new technologies and methods to unlock the tremendous public data and resources available from the FDA in a user-friendly way. OpenFDA is a valuable resource that will help those in the private and public sectors use FDA public data to spur innovation, advance academic research, educate the public, and protect public health.”

– FDA Chief Operating Officer and Acting Chief Information Officer Walter S. Harris

“In the past, these vast datasets could be difficult for industry to access and to use. Pharmaceutical companies, for example, send hundreds of Freedom of Information Act (FOIA) requests to FDA every year because that has been one of the ways they could get this data. Other methods called for downloading large amounts of files encoded in a variety of formats or not fully documented, or using a website to point-and-click and browse through a database – all slow and labor-intensive processes.”

– FDA Chief Health Informatics Officer Taha Kass-Hout

Developers

Connect

References

HHS seeks entrepreneurs for year-long fellowships

Applications for the Department of Health & Human Services HHS Entrepreneurs program are now open to innovators interested in working for a year-long stint alongside federal government employees on “high-risk, high-reward projects.”

“The ideal HHS Entrepreneur is a passionate expert in problem solving equipped with modern tools who is ready to shake government up, push the boundaries of the bureaucracy and act as agents of the IDEA Lab to transform the culture of a large organization,” writes HHS Chief Technology Officer Bryan Sivak on the HHS Idea Lab blog.

Projects include:

Created in 2010 and originally called the HHS Innovation Fellows Program, HHS Entrepreneurs was established “in response to difficulties in finding expertise and unique skill sets necessary to solve some of the critical challenges we face in health, health care, and the delivery of human services.” The program was renamed HHS Entrepreneurs in 2012.

Application deadline is July 16. Apply here.

HHS Entrepreneurs Overview

Obama’s IT ‘trauma team’ and recruiting Silicon Valley

Photo: U.S. Health & Human Services

Photo: U.S. Health & Human Services

Steven Brill has a great in-depth, behind-the-scenes write-up on the HealthCare.gov IT aftermath and the team that helped steer the project to success.

Brill’s “Obama’s Trauma Team” features U.S. Chief Technology Officer Todd Park, Obama fix-it man Jeff Zients, presidential innovation fellows, venture capitalist John Doerr, members of Obama’s campaign tech team and some of Silicon Valley’s brightest entrepreneurs.

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The politics of physics (and healthcare.gov)

Photo: U.S. Health & Human Services

Photo: U.S. Health & Human Services

Since last October the U.S. media, in full orgasmic throng, has been barking madly over the fate of the Healthcare.gov rollout. There has been overwhelming and obdurate polarization around positions on issues that would, in other arenas, be viewed through the objective lens of what most agree are facts.

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We the People petitioners want access to healthcare.gov source code

We the People

A new We the People petition opened Sunday calling for the federal government to make the healthcare.gov source code publicly available “so we may help fix any found issues.”

From the petition:

It is believed that the enrollment issues with healthcare.gov are likely due to poor coding practices in components that are unavailable to the world’s development community to evaluate. Code funded by taxpaying citizens should be made available to the general public as government funded development is generally public domain software. Please release the code so we may help fix any found issues.

The petition has more than 1,000 signatures, still a ways away from the 100,000 needed by November 19 to receive an official White House response.

More discussion on open sourcing healthcare.gov can be found here, here and here.

In the meantime, the Department of Health & Human Services released a statement on Sunday saying it will bring in the “best and brightest from both inside and outside government to scrub in with the team and help improve HealthCare.gov.”

President Obama addressed healthcare.gov technical issues at a Monday speech at the White House:

Data Challenge Spotlight: Visualizing Health Reform

Illinois Health Matters

“Data Challenge Spotlight” is a collaboration with the National Conference on Citizenship and GovFresh that highlights winners of the 2012 Civic Data Challenge. Follow the Civic Data Challenge on Twitter (@CivicData) and on Facebook.

What?

Visualizing Health Reform from Illinois Health Matters

Give us the 140-character elevator pitch.

We are the go-to source for factual, easy-to-understand information on health care reform in Illinois.

What problem does Visualizing Health Reform solve for government and/or your community?

While a handful of reputable sites and media outlets examine health policy on a national/state level, very few do it on a community level. Our mapping tool takes complex public policy and translates it to real people.

What’s the story or inspiration behind creating Visualizing Health Reform?

The Affordable Care Act (ACA), passed in 2010, is complex. We wanted to make it easy to see the ways in which Illinois residents will be impacted by the new health reform law so that businesses, health care providers and community groups can prepare.

What are its key features?

An interactive heat map of Illinois provides information on who is uninsured, where they live, and the impact of health reform on their ability to attain health care coverage in 2014. Data can be examined on three levels—state, regions and community. The tool is versatile – it can also be viewed “on the go” on a smartphone or tablet and PDF versions of the maps can be downloaded.

How can those interested connect with you?

Connect with Illinois Health Matters on our website at www.illinoishealthmatters.org, Twitter (@ILHealthMatters), Facebook (facebook.com/IllinoisHealthMatters) or email info@illinoishealthmatters.org for specific data and customized reports on health care reform.

HHS launches Healthcare.gov

The Department of Health & Human Services launched Healthcare.gov, an all-in-one healthcare information site related to the Affordable Care Act dedicated to helping citizens ‘take health care into your own hands.’

Features include Find Insurance Options, Get Prevention Tips, Compare Care Quality and Understand the Law.

Announcing the new site, HHS Chief Technology Officer Todd Parks said, “It’s a website designed to help you take control of your health care – by putting the power of information at your fingertips. It’s the first website to collect both public and private health insurance options across the nation in a single place. Even better, our insurance options finder automatically sorts through this huge catalog of options to help you identify the ones that may be right for you. Other highlights of the site include extensive information about your rights as a consumer, how to navigate the health insurance marketplace, and how the Affordable Care Act can help you – all tailored to you.”

Video tour:

Visit Healthcare.gov:

Healthcare.gov

HITECH Act and government access to private health records

When the Electronic Freedom of Information Act was passed into law, ordinary citizens were allowed access to previously secret government data. With the new Health Information Technology for Economic and Clinical Health Act (the HITECH Act) the government is now attempting to view and organize our country’s private health records. It’s quite a project.

As part of the economic stimulus package, the purpose of the HITECH Act is to organize health data nationally. The federal government has established the National Coordinator for Health Information Technology to oversee this process. The committee is charged with the difficult task of developing secure health data exchanges within and across state lines. The project will require a set of standards, services, and policies that enable the secure exchange of health information.

This is how the program will work. For the next six years, through 2016, health care providers may qualify for up to $29 billion in HITECH Act subsidies. To qualify, they must meet twenty-five criteria to be considered “meaningful users” of health IT. It is not entirely clear what “meaningful use” means at this point in time. The topic has been the subject of recent debate on social networking sites in the health care sector.

At the same time this new plan is being implemented, the Health Insurance Portability and Accountability Act (HIPAA) rules were amended to enhance notice requirements and fines for security breaches. HIPAA requires a formal notice be sent to patients for a breach when their private Protected Health Information (PHI) data is revealed to the public. The DHHS has started recently to post these breach notices on their website. Software systems, like paper systems, come with a set of liabilities. As software applications proliferate there is a legitimate concern about privacy and security.

The consensus among observers and officials is the new HITECH Act plan will take many years to implement. Insiders believe all the money in the world will not make an inefficient health care delivery system more efficient unless underlying changes are made in how care is paid for. Most participants agree that physician input is a key factor but as we all know some health care providers have more readily adapted to technology than others.

As the Public Sector moves in to medical care, there is still great uncertainty. Former public officials believe that hospitals and businesses that benefit from the status quo are less likely to change. Some have suggested reevaluating the twenty-five HITECH Act criteria to make it less difficult to participate in the program.

The administration has attempted to jump start the process organizing a pilot program including the Department of Defense, Social Security Administration, Veterans Health Administration, Kaiser Permanente and MedVirginia. Here are some good ideas the committee recommends:

  1. Balance the need for a consistent level of interoperability and security with the reality that not all users are at the same point on the path to comprehensive interoperability
  2. Consider consumers who may have simpler needs for information exchange, or less technically sophisticated capabilities
  3. Broaden the systems’ use to include a wider variety of providers
  4. Identify standards and services for direct electronic communication among providers

GovRx: Prescription for immigrant healthcare

Regardless of nationality, people from all over the world are treated in American hospitals. You don’t have to be a U.S. citizen to purchase private health insurance in the U.S. nor do you have to be a citizen to pay to see a doctor. The U.S. has a private healthcare system that is open to everybody, who pays.

Unfortunately, the cost of health care and insurance can be as much as a family annual income depending on the type of work you do. So why do some wait until a health problem requires the most expensive emergency room care to treat it? One reason is the federal law. In 1996, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) sought to reduce federal spending. This law has had the opposite effect.

Some who are uncertain of their immigration status do not apply for benefits because they are afraid.

Under this legislation, undocumented immigrants became ineligible for Medicaid and other federally-funded social services, and only eligible for emergency medical assistance. The Act also requires that all state and federal welfare agencies report any illegal immigrants who apply for benefits to the Immigration and Naturalization Service (now the Department of Homeland Security) unless it’s health care delivered in the emergency room.

Emergency Medicaid is predominantly a program for childbirth coverage, although use and spending are shifting toward non-pregnant adults, particularly those who are elderly and disabled. Whether or not a person is eligible for Medicaid will depend on the State where he or she lives. Medicaid spending for emergency care, of recent and undocumented immigrants (although a small proportion of the total Medicaid budget) is increasing in some states. While states are not required to identify or report their Medicaid expenditures specific to undocumented aliens, some states do provide data suggesting that most of their emergency Medicaid expenditures were for services provided to undocumented aliens.

According an article in the Journal of the American Medical Association, treatment of unauthorized immigrants contributes to uncompensated care costs, but the main reason such costs are increasing is the rise in the number of people who lack health insurance. Immigrants represent only about 20% of the uninsured.

We now have a growing, uninsured, aging population. We need a better alternative to our current system because in the end, we are all paying for this expensive emergency room care. Here are a few suggestions.

  • Reduce costly healthcare expense by creating legislation that does not direct people to the emergency room
  • Encourage the sharing of aggregate, non-confidential provider data to track expense trends
  • Consider alternatives to voluntary, ad hoc state reports in guiding national health policy
  • Focus on reducing government expense and not enforcement in the healthcare setting