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Interoperability and Patient Access Just Became Law

This article by Ambra CEO, Morris Panner,  was originally published on HIT Leaders & News on January 5, 2017. 

Cancer Moonshot 2020When President Obama signed the 21st Century Cures Act (HR 34) into law in December, the world of healthcare IT was turned on its ear. Interoperability and access – two concepts that have eluded old-school healthcare IT vendors – became enshrined as the cornerstone of the newest and most comprehensive healthcare innovation legislation to date.

In addition, although the Act didn’t intend to push healthcare IT into the cloud age, it may very well have, as the required access and sharing will be exceedingly difficult to accomplish without an agile cloud-based system. Like the financial services industry and others before it, the cloud may become a key driver of how information can be easily shared and consumers can be empowered.

Some leading edge vendors and institutions were already making waves by breaking down data barriers both within and across facilities that have previously impeded the creation of a holistic patient health record. The holistic patient health record not only reduces risks of medical errors and dangers such as radiology overexposure, but it can also provides a goldmine for medical research across shared and readily accessible data.

During last January’s State of the Union address, President Barack Obama announced the establishment of the Cancer Moonshot Initiative. The initiative was put into motion by Vice President Joe Biden following his son’s battle with brain cancer. The focus of Moonshot is to make new treatments available to patients and also to improve our ability to detect and prevent cancer in the first place. The 21st Century Cures Act was designed to enable the Moonshot, improving research and, in the process, changing the role of healthcare IT.

At a series of health conferences this Fall, including the Congress of Neurological Surgeons meeting in San Diego, panels and speakers discussed Moonshot and its potential impact on hard-to-treat brain cancers and the progress made by clinical trials. Across all medical specialties, Moonshot has made several key recommendations such as providing easy access to current and prior patient data, increasing preventive cancer measures, focusing on immunotherapy as the future of cancer care, and establishing a nationwide clinical trial network that will auto-match patients based on genetic profile. Not one individual can accomplish all of this alone. Instead, patients, providers, and vendors must work as a team to accomplish these goals.

Here at Ambra Health, we’re focused on making access to patient imaging easy, whether in an individual, provider, facility, or clinical trial setting. Why? We believe in the old adage that a picture is worth a thousand words and is a medical necessity.

The priority for interoperability and access has taken on a new urgency for providers, as well.  Few are prepared for the mandates contained in the Cures Act, including potential mandates contained in Sections 4003 and 4004 (interoperability standards and a ban on information blocking) as well as Sections 4006 and 4008 (patient empowerment and access to information mandates). Although final rules are still in process, there can be no doubt that now is the time to get prepared. Moreover, it is the right thing to do.

Patient medical records are complex documents and medical imaging is a particularly critical piece of the puzzle. Whether patients are seeking preventive screenings like mammograms, lung cancer screenings, and CT colonography and/or accessing prior patient imaging as a point of comparison for ongoing treatment, an easy to access and secure image management system is critical.  Today’s PACS systems and other onsite archives simply won’t cut it. The cloud has been a key technological innovation for the storage of large imaging sets and easy access to patient priors through automated matching.

The cloud has certainly had an enormous overall impact on the way we think about the distribution of medical imaging and associated data. Cloud-based suites can integrate image management into existing workflows. Modern cloud-based APIs can integrate with upstream and downstream systems like portals for patient self-service, or into EMRs/EHRs to improve physician productivity and access. A cloud-based viewer also allows image access from anytime and anywhere.

In the clinical trial world with the cloud, there are no more CDs, VPNs or FTP set-up that make it hard to connect to sending sites for trials. Better yet, by eliminating physical media, we can improve the percentage of submission-compliant images automatically, reduce errors, and provide secure archive. Finally, a cloud-based repository make possible the type of large scale data analysis and analytics that are enabling innovations large and small across other areas of the economy.

As healthcare systems continue to turn toward Health IT as new a leader in cancer care, let’s hope the goals of Moonshot can be a reality by 2020.

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Morris Panner HIMSS

About Morris Panner

As CEO of Ambra, Morris Panner leads the company on its mission of delivering better care through better technology. Morris is an active voice in the cloud and enterprise software arena, focused on the services and healthcare verticals. He is a frequent contributor to business, healthcare, and technology publications. Before Ambra, Morris built and sold an industry-leading business-process software company, OpenAir, to NetSuite (NYSE:N). He once served as the US Embassy Resident Legal Advisor in Bogota, Colombia; and his first job ever was as a janitor at his old high school while on summer break from college. Both of these very different experiences taught him valuable lessons about the human condition, and make him cherish his time with family that much more. Morris has a BA from Yale University and a JD from Harvard University.

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2 comments on “Interoperability and Patient Access Just Became Law”

  • I have a question about ownership of the cloud-based images. With the creation of the imaging still being done at healthcare facilities who bill insurance companies for services, how does the cloud infrastructure affect the ownership rights over the images? I guess my question is, who owns the rights to the images? Can the physician who reviews them bill the insurance company for time spent looking at the images? Just one aspect of cloud imaging not mentioned above I would like addressed. Thank you Ambra for the important work you are doing in cloud imaging.

  • Hi Jennifer,

    Thank you very much for your question and your nice words about our company.

    You have touched on an important question that is becoming even more important as researchers are thinking about how to use imaging in big data research projects.

    The first answer is that the cloud doesn’t change image ownership. That said, images in the cloud become an important research asset. So, there are questions about who can see them and who can use them. In many ways, there are still questions, although a few basic guidelines exist.

    The images belong to the patients. That is true whether they reside in the cloud or in a local storage environment. In addition, the images can be use for a wide-range of purposes defined under HIPAA and the associated BAA agreements. Traditional responses ensure that images can be viewed by treatment professionals and also for billing purposes. In addition, newer interpretations suggest that imaging data can also be used for research, as long as the patient information is protected (we call it de-identification).

    Thank you for your inquiry and please let me know if we answered your question.

    Best regards,

    Morris
    617-680-3725

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