“What is entity identity management? It simply means that an ER system can store and maintain a record of identity information that persists over time. Entity identity management is essential for an ER engine to operate in identity resolution or identity capture mode and for it to maintain persistent entity identifiers.”
“Why are they moving to the cloud? Rarely because it’s considered cheaper. In some cases, the cloud represents a faster, more flexible way to get a new system up and running. Oftentimes, it’s the ease of integration afforded by the cloud servers, using standard Web service practices, that lets a company launch a new mobile application faster or run a business process that cuts across many partners more efficiently.”
“A little over a year ago, Rand Corporation said that the Unique Patient Identifier would cost $11 billion, and pay off nationwide in reducing these sorts of medical errors, and in simplifying the nationwide effectiveness of the Electronic Health Record (EHR), which in turn can introduce a high level of efficiency, and a way to enforce patient privacy.”
“Enrollment in Personal Care Service requires approval from a qualified health care professional. This approval is missing in the cases of a ’substantial percentage’ of the 17,500 individuals who have received 24-hour care since 2000, claims the lawsuit. The lawsuit lists several examples of patients allegedly not properly assigned to the Personal Care Service. A 65-year-old woman was deemed to only need limited care, being of sound mind and body. Instead, she was provided with 24-hour care on the federal government’s bill.”
“Results from the National Ambulatory Medical Care Survey (NAMCS) show that between 2009 and 2010, the percentage of physicians reporting having an electronic medical record/electronic health record (EMR/EHR) system that meets the criteria of a basic system increased by 14% and a fully functional system increased by 46%.”
“In the global marketplace, businesses, suppliers and customers are creating and consuming vast amounts of information. Gartner predicts that enterprise data in all forms will grow 650 percent over the next five years. According to IDC, the world’s volume of data doubles every 18 months. This flood of data, often referred to as “information overload,” “data deluge” and “big data,” clearly creates a challenge for business leaders.”
“The era of Big Data has only just begun. In the latest edition of Database Trends & Applications, I provided a series of predictions about the year ahead, with an emphasis on data management. Here are 10 of them…”
“The segment of the cloud Salesforce leads, SaaS (software as a service), has grown from a tiny sliver of the enterprise software market just a few years ago to 10 percent in 2009, according to Gartner, which predicts that slice will expand to 16 percent by 2014. Even more dramatic is the firm’s projection that 85 percent of all new software will be delivered as a service by 2010.”
“In 2005 the United Kingdom embarked on the largest investment ($18 billion) in health information technology in the world. Yet despite expectations that the system would increase efficiency and reduce medical errors, their efforts neither improved health nor saved money — in fact in some cases, they may have led to patient harm. Britain’s government-run medical system is obviously different from our complex public-private insurance system.”
“‘This is where Secure Flight, the government-run program that is now vetting passengers before they receive their boarding passes, comes in. It replaces a more ad hoc system run by the carriers. ‘Prior to Secure Flight, the airlines themselves were responsible for matching all of their passengers against the watch lists, so each airline had their own system for doing that,’ said Greg Soule, a spokesman for the Transportation Security Administration. ‘Secure Flight takes the passenger watch list matching process away from the airlines and puts it all in one program under TSA, so it is a more consistent process across the board.’”
“Even if EHRs reduce the risk of errors overall, they may produce entirely new ones, Edward Fotsch, CEO of PDR Network, which will provide network operations for the new reporting system, tells the Health Blog. For example, EHRs may cut the risk of failing to alert a patient to an abnormal test result, but confusing user interfaces may produce their own mistakes and need tinkering.”
“Even with these differences, a human can rapidly determine that they refer to the same individual for two reasons. The first is that the values that differ across the pair of records are not too different from each other, and the second is that there seems to be enough support from across each pair of attributes to assert some degree of similarity.”
“Beginning in 2015, providers who have not successfully demonstrated meaningful use will face cuts in the amount of Medicare reimbursement they receive. It will begin with 99-percent payment in 2015, and drop to 97 percent by 2017, according to information from the Centers for Medicare and Medicaid Services. ‘So if your practice has not implemented an EHR and have meaningful use, you’re going to get reimbursed less dollars for the same service as someone who does,’ Brull said.”
“‘Information is being created faster than organizations can make sense of it,’ he says. The gap between the growth of information and understanding is widening because the tools for understanding are not scaling as fast as the growth in data and information. ‘As computers are getting faster and the world is getting more sensors, the organizations have been getting dumber,’ he said. ‘The percentage of what is knowable is on a decline.’”
“Several years ago, the Department of Homeland Security (DHS) published guidelines for creating fusion centers at the state, local, and federal levels. Since then, fusion centers have become a hot trend in the law enforcement community… If governmental agencies with common concerns can band together to create fusion centers, it seems possible that private companies with common goals could use technologies such as identity resolution to achieve them.”
“According to a release (PDF) from the office of Attorney General J.B. Van Hollen, 36 year-old Tyna Dull of Arena was charged in Iowa County Circuit Court, and 28 year-old Travis Ferguson of Gotham was charged in Richland County Circuit Court, each with one count each of Attempted Theft By Fraud. Dull and Fergison told Special Agent from the state Division of Criminal Investigation that the Lottery tickets presented by the agents as part of a Lottery compliance check, were not winning tickets.”
“Texas Health started installing its electronic medical records system four years ago and expects to spend more than $200 million by 2012 in capital and operating expenses to put the system in place, said Edward Marx, chief information officer. The hospital system expects to receive about $70 million in federal stimulus money over five years, beginning in early 2011, Velasco said. Patients are already experiencing the benefits of digitized records in Texas Health Resources hospitals, because the records are accessible to the appropriate care-giving team regardless of where the patient is moved in the hospital, Velasco said.”
”The program, called ‘Secure Flight,’ was first implemented in August 2009. The government has given airlines more than a year to comply. The names will be checked with a federal database of terrorism suspects. The TSA says the added information will prevent many passengers from being misidentified as a potential terrorist. ‘Worst case scenario, if the person doesn’t have this information, they’ll be redirected back to the ticket counter to provide the information so they can get the boarding pass,’ TSA spokesman Luis Casanova said.”
“The National Institute of Standards and Technology (NIST) published a set of approved procedures used to test information-technology systems that work with electronic health records (EHRs), with an emphasis on building out a nationwide health information network for better patient care. The report was released earlier this year in draft form, and now the finalized testing procedures are available for use, said Bettijoyce Lide, program coordinator and senior advisor for NIST’s health IT section.”
“By the end of this year, all 72 fusion centers should be able to analyze information and spot trends in order to effectively share timely intelligence – with local law enforcement, and with DHS, so the information can also be used by others within the Intelligence Community. To support this vision: we’re prioritizing fusion centers in our FY2011 grants, and looking for ways to support them through additional technology and personnel, including the deployment of highly-trained experts in critical infrastructure; we’re deploying experienced DHS analysts to every one of these centers – 64 at last count – and we won’t stop until we have them in every one; and we’re linking them together, and with DHS headquarters, through the classified Homeland Security Data Network.”
“Prosecutors said Elliott filed bills for therapy sessions that never happened, employed non-licensed personnel and provided unwarranted therapy. Tricare, the military equivalent to Medicaid, lost $1.17 million in the scheme, while Medicaid lost $712, 548, authorities said.”
“The EHRs are designed to be digital replications of the hard-copy, paper health records commonly in use today. They are also engineered to be easily transferable among different doctors and hospitals so as to eliminate the creation of duplicate or disparate records among different health care providers, thus allowing any health care office to access a patient’s complete medical record at each visit.”
“‘There’s an awful lot of talk about it and there is consumption of cloud,’ said Al Gillen, an analyst at IDC. But ‘organizations don’t simply make change because they can. There has to be good justification.’ Harry Weller, a general partner at New Enterprise Associates, said start-ups and new businesses will likely be among the first to move to the cloud. A need to hold down costs is often an overriding factor in their decision, he said.”
So bad is the state budget pressure that some state workers’ compensation agencies have had to freeze hiring and sharply limit training and travel. This clearly hurts the efficient administration of workers’ compensation laws.
The increased costs come in several forms, all driven by the need to comply with the new laws. One example is the move toward a universal Electronic Health Record that dictates a standard medical record format that any agency touching the healthcare system must support. Workers’ compensation agencies aren’t explicitly called out since “medical bill payers are not covered entities under HIPAA” yet “they will be required to have ‘business associate agreements’ with HIPAA covered entities for the electronic exchange of patient health information. It remains to be seen how this will force workers’ compensation payers to modify their business practices.”
What is clear is that there will be a financial impact on state workers’ comp agencies, and no provision was made in the legislation to cover increased costs necessitate by the new rules. Despite the impending pressure on state agencies, they will be expected to continue efficiently administering the system in the face of budget and personnel cuts. Increasing efficiency by doing more with less will lead to an increased usage of advanced technology such as entity resolution.
“Last week Rep. Scott Murphy of Glen Falls (D-NY) told a House panel that more effective policing of Medicare and Medicaid fraud claims is imperative in order to reduce the estimated $60 billion in fraudulent claims that is disbursed each year. We agree with the expressed intent, and we are hopeful that CMS and others involved in decision-making will take advantage of any and all technologies to stamp out fraud, including identity resolution.”
“The scheme to defraud is alleged to have begun in April 2004, through Logic World, with the last allegedly false claim having been filed in February 2010 through Roben Medical. During this time period, Essien and Akpan allegedly billed and caused the billing of Medicaid for claims totaling approximately $2,341,293.64 and received payments for those claims totaling approximately $1,455,837.91.”
“The Congressional Budget Office estimates electronic health records could save the U.S. $12 billion over 10 years, which seems very modest in comparison to the estimated $2.2 trillion spent on healthcare in the U.S in 2010. While workers’ compensation medical bill payers are not covered entities under HIPAA they will be required to have “business associate agreements” with HIPAA covered entities for the electronic exchange of patient health information. It remains to be seen how this will force workers’ compensation payers to modify their business practices.”
“A recent video story on KING5 in Seattle highlighted the aggressive efforts state agencies take to ferret out employment fraud. This particular story highlights an agency’s success in identifying and prosecuting unlicensed contractors.”
Infoglide Software provides entity resolution and analysis solutions for retail, banking, insurance, government, and law enforcement. Without the need for data cleansing or warehousing, Infoglide Software's Identity Resolution Engine™ (IRE) analyzes all of the information relating to individuals and/or entities from multiple sources of data and then applies...
Subscribe to this blog