Jonathan Blum, Principal Deputy Administrator, Centers for Medicare & Medicaid Services : “Today the Centers for Medicare & Medicaid Services (CMS) took a major step forward in making Medicare data more transparent and accessible, while maintaining the privacy of beneficiaries, by announcing the release of new data on medical services and procedures furnished to Medicare fee-for-service beneficiaries by physicians and other healthcare professionals (http://www.cms.gov/newsroom/newsroom-center.html). For too long, the only information on physicians readily available to consumers was physician name, address and phone number. This data will, for the first time, provide a better picture of how physicians practice in the Medicare program.
This new data set includes over nine million rows of data on more than 880,000 physicians and other healthcare professionals in all 50 states, DC and Puerto Rico providing care to Medicare beneficiaries in 2012. The data set presents key information on the provision of services by physicians and how much they are paid for those services, and is organized by provider (National Provider Identifier or NPI), type of service (Healthcare Common Procedure Coding System, or HCPCS) code, and whether the service was performed in a facility or office setting. This public data set includes the number of services, average submitted charges, average allowed amount, average Medicare payment, and a count of unique beneficiaries treated. CMS takes beneficiary privacy very seriously and we will protect patient-identifiable information by redacting any data in cases where it includes fewer than 11 beneficiaries.
Previously, CMS could not release this information due to a permanent injunction issued by a court in 1979. However, in May 2013, the court vacated this injunction, causing a series of events that has led CMS to be able to make this information available for the first time.
Data to Fuel Research and Innovation
In addition to the public data release, CMS is making slight modifications to the process to request CMS data for research purposes. This will allow researchers to conduct important research at the physician level. As with the public release of information described above, CMS will continue to prohibit the release of patient-identifiable information. For more information about CMS’s disclosures to researchers, please contact the Research Data Assistance Center (ResDAC) at http://www.resdac.org/.
Unprecedented Data Access
This data release follows other CMS efforts to make more data available to the public. Since 2010, the agency has released an unprecedented amount of aggregated data in machine-readable form, with much of it available at http://www.healthdata.gov. These data range from previously unpublished statistics on Medicare spending, utilization, and quality at the state, hospital referral region, and county level, to detailed information on the quality performance of hospitals, nursing homes, and other providers.
In May 2013, CMS released information on the average charges for the 100 most common inpatient services at more than 3,000 hospitals nationwide http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Inpatient.html.
In June 2013, CMS released average charges for 30 selected outpatient procedures http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Outpatient.html.
We will continue to work toward harnessing the power of data to promote quality and value, and improve the health of our seniors and persons with disabilities.”
In Austria, council uses app to crowdsource community issues
Springwise: “Civic authorities can’t be everywhere at once and often rely on citizens to inform them of the improvements that need making. The NYPD already launched its own crowdsourcing crime reports app, and now the Bürgerforum Vorarlberg mobile app is enabling citizens to flag community issues that need addressing by sending photos and text direct to the council.
Available for all residents to download from the App Store and Google Play, the app has been developed by Vorarlberg news outlets VN and Vol.at. Users who have found a problem on the streets of the Austrian province can take a photo and add a caption, while the app automatically adds a geolocation tag. The issue is then added to a map of complaints and concerns filed by other residents. The idea is that local authorities can then easily see the issues that need to be dealt with.
Website: www.buergerforum.vol.at
Contact: www.twitter.com/vorarlberg“
AU: Revitalising and revising the Innovation Showcase
From the Public Sector Innovation Toolkit unit of the Australian Government: “Do you have any case studies of innovative initiatives in the public service?
An important part of the public sector innovation agenda is sharing examples of innovation in practice. That’s why we created the Public Sector Innovation Showcase.
As noted in the APS Innovation Action Plan, “The Public Sector Innovation Showcase will enable government agencies and departments to share and celebrate case studies of innovation, and to consider how they might apply such innovative practices within their own operations to achieve better outcomes.”
The Showcase was a joint initiative with the Department of Finance and has been operating for a number of years now. We thought it time for some changes and that it needs some new examples.
To make the showcase more useful we have incorporated it into this site – you can see the examples here. We are eager to receive more examples from the public sector – from the Commonwealth, state, territory and local governments.
Please get in contact with us if you have an example that might be suitable as a case study of innovation in the public sector. The sort of things we’re after in the case studies are spelled out in our Showcase submission guidance.
We’re seeking examples that demonstrate doing things differently, rather than doing what we do now but slightly better.
The Data Mining Techniques That Reveal Our Planet's Cultural Links and Boundaries
Emerging Technology From the arXiv: “The habits and behaviors that define a culture are complex and fascinating. But measuring them is a difficult task. What’s more, understanding the way cultures change from one part of the world to another is a task laden with challenges.
The gold standard in this area of science is known as the World Values Survey, a global network of social scientists studying values and their impact on social and political life. Between 1981 and 2008, this survey conducted over 250,000 interviews in 87 societies. That’s a significant amount of data and the work has continued since then. This work is hugely valuable but it is also challenging, time-consuming and expensive.
Today, Thiago Silva at the Universidade Federal de Minas Gerais in Brazil and a few buddies reveal another way to collect data that could revolutionize the study of global culture. These guys study cultural differences around the world using data generated by check-ins on the location-based social network, Foursquare.
That allows these researchers to gather huge amounts of data, cheaply and easily in a short period of time. “Our one-week dataset has a population of users of the same order of magnitude of the number of interviews performed in [the World Values Survey] in almost three decades,” they say.
Food and drink are fundamental aspects of society and so the behaviors and habits associated with them are important indicators. The basic question that Silva and co attempt to answer is: what are your eating and drinking habits? And how do these differ from a typical individual in another part of the world such as Japan, Malaysia, or Brazil?
Foursquare is ideally set up to explore this question. Users “check in” by indicating when they have reached a particular location that might be related to eating and drinking but also to other activities such as entertainment, sport and so on.
Silva and co are only interested in the food and drink preferences of individuals and, in particular, on the way these preferences change according to time of day and geographical location.
So their basic approach is to compare a large number individual preferences from different parts of the world and see how closely they match or how they differ.
Because Foursquare does not share its data, Silva and co downloaded almost five million tweets containing Foursquare check-ins, URLs pointing to the Foursquare website containing information about each venue. They discarded check-ins that were unrelated to food or drink.
That left them with some 280,000 check-ins related to drink from 160,000 individuals; over 400,000 check-ins related to fast food from 230,000 people; and some 400,000 check-ins relating to ordinary restaurant food or what Silva and co call slow food.
They then divide each of these classes into subcategories. For example, the drink class has 21 subcategories such as brewery, karaoke bar, pub, and so on. The slow food class has 53 subcategories such as Chinese restaurant, Steakhouse, Greek restaurant, and so on.
Each check-in gives the time and geographical location which allows the team to compare behaviors from all over the world. They compare, for example, eating and drinking times in different countries both during the week and at the weekend. They compare the choices of restaurants, fast food habits and drinking habits by continent and country. The even compare eating and drinking habits in New York, London, and Tokyo.
The results are a fascinating insight into humanity’s differing habits. Many places have similar behaviors, Malaysia and Singapore or Argentina and Chile, for example, which is just as expected given the similarities between these places.
But other resemblances are more unexpected. A comparison of drinking habits show greater similarity between Brazil and France, separated by the Atlantic Ocean, than they do between France and England, separated only by the English Channel…
They point out only two major differences. The first is that no Islamic cluster appears in the Foursquare data. Countries such as Turkey are similar to Russia, while Indonesia seems related to Malaysia and Singapore.
The second is that the U.S. and Mexico make up their own individual cluster in the Foursquare data whereas the World Values Survey has them in the “English-speaking” and “Latin American” clusters accordingly.
That’s exciting data mining work that has the potential to revolutionize the way sociologists and anthropologists study human culture around the world. Expect to hear more about it
Ref: http://arxiv.org/abs/1404.1009: You Are What You Eat (and Drink): Identifying Cultural Boundaries By Analyzing Food & Drink Habits In Foursquare”.
PatientsLikeMe Gives Genentech Full Access
Susan Young Rojahn in MIT Technology Review: “PatientsLikeMe, the largest online network for patients, has established its first broad partnership with a drug company. Genentech, the South San Francisco biotechnology company bought by Roche in 2009, now has access to PatientsLikeMe’s full database for five years.
PatientsLikeMe is an online network of some 250,000 people with chronic diseases who share information about symptoms, treatments, and coping mechanisms. The largest communities within the network are built around fibromyalgia, multiple sclerosis, and amyotrophic lateral sclerosis (ALS), but as many as 2,000 conditions are represented in the system. The hope is that the information shared by people with chronic disease will help the life sciences industry identify unmet needs in patients and generate medical evidence, says co-founder Ben Heywood.
The agreement with Genentech is not the first collaboration between a life sciences company and PatientsLikeMe, named one of 50 Disruptive Companies in 2012 by MIT Technology Review, but it is the broadest. Previous collaborations were more limited in scope, says Heywood, focusing on a particular research question or a specific disease area. The deal with Genentech is an all-encompassing subscription to information posted by the entire PatientsLikeMe population, without the need for new contracts and new business deals if a research program shifts direction from its original focus. “This allows for a much more rapid real-time use of the data,” says Heywood.
In 2010, PatientsLikeMe demonstrated some of its potential to advance medicine. With data from its community of ALS patients, who suffer from a progressive and fatal neurological disease, the company could see that a drug under study was not effective (see “Patients’ Social Network Predicts Drug Outcomes”). Those findings were corroborated by an academic study published that year. Another area of medicine the network can shed light on is the quality of care patients receive, including whether or not doctors are following guidelines established by medical societies for how patients are treated. “As we try to shift to patient-centered health care, we have to understand what [patients] value,” says Heywood.
In exchange for an undisclosed payment to PatientsLikeMe, Genentech has a five-year subscription to the data in the online network. The data will be de-identified– that is, Genentech will not see patient names or email addresses. Heywood says his company is hoping to establish broad agreements with other life sciences companies soon.”
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A European platform to support law proposals drafted by citizens:
Medicare to Publish Trove of Data on Doctors
Louise Radnofsky in the Wall Street Journal: “The Obama administration said it would publish as early as next week data on what Medicare paid individual doctors in 2012, aiming to boost transparency and help root out fraud.
The move, which faced fierce resistance from doctors’ groups, would end a decadeslong block on making the information public.
Federal officials said they planned to release reimbursement information on April 9 or soon after that would show billing data for 880,000 health-care providers treating patients in the government-run insurance program for elderly and disabled people. It will include how many times the providers carried out a particular service or procedure, whether they carried it out in a medical facility or an office setting, the average amount they charged Medicare for it, the average amount they were paid for it, and the total number of people they treated.
The data set would show the names and addresses of the providers in connection with their reimbursement information, officials at the Centers for Medicare and Medicaid Services said. The agency hasn’t previously released such data.
Physicians’ organizations had sought to prevent the release of the data, citing concerns about physician privacy. But a federal judge last year lifted a long-standing injunction placed on the publication of the information by a federal court in Florida, in response to a challenge from Dow Jones & Co., The Wall Street Journal’s parent company.
Jonathan Blum, principal deputy administrator at CMS, informed the American Medical Association and Florida Medical Association in letters dated Wednesday that the agency would move to publish the data soon.
Ardis Dee Hoven, president of the American Medical Association, said the group remained concerned that CMS was taking a “broad approach” that could result in “unwarranted bias against physicians that can destroy careers.” Dr. Hoven said the AMA wanted doctors to be able to review and correct their information before the data set was published. The Florida Medical Association couldn’t immediately be reached.
Mr. Blum said that for privacy reasons, data related to subsets of fewer than 11 Medicare patients would be redacted.
In the letters, Mr. Blum said the agency believed that news organizations seeking the information—which include the Journal—would be able to use it to shed light on problems in the Medicare program. He also specifically cited earlier reporting by the Journal that had drawn on similar data.
“The Department concluded that the data to be released would assist the public’s understanding of Medicare fraud, waste, and abuse, as well as shed light on payments to physicians for services furnished to Medicare beneficiaries,” Mr. Blum wrote. “As an example, using similar payment information, The Wall Street Journal was able to identify and report on a number of instances of Medicare fraud, waste, and abuse, using Medicare payment data in its Secrets of the System series,” Mr. Blum wrote. That series was a finalist for a Pulitzer Prize in 2011.”
'Hackathons' Aim to Solve Health Care's Ills
Amy Dockser Marcus in the Wall Street Journal: “Hackathons, the high-octane, all-night problem-solving sessions popularized by the software-coding community, are making their way into the more traditional world of health care. At Massachusetts Institute of Technology, a recent event called Hacking Medicine’s Grand Hackfest attracted more than 450 people to work for one weekend on possible solutions to problems involving diabetes, rare diseases, global health and information technology used at hospitals.
Health institutions such as New York-Presbyterian Hospital and Brigham and Women’s Hospital in Boston have held hackathons. MIT, meantime, has co-sponsored health hackathons in India, Spain and Uganda.
Hackathons of all kinds are increasingly popular. Intel Corp. recently bought a group that organizes them. Companies hoping to spark creative thinking sponsor them. And student-run hackathons have turned into intercollegiate competitions.
But in health care, where change typically comes much more slowly than in Silicon Valley, they represent a cultural shift. To solve a problem, scientists and doctors can spend years painstakingly running experiments, gathering data, applying for grants and publishing results. So the idea of an event where people give two-minute pitches describing a problem, then join a team of strangers to come up with a solution in the course of one weekend is radical.
“We are not trying to replace the medical culture with Facebook culture,” said Elliot Cohen, who wore a hoodie over a button-down dress shirt at the MIT event in March and helped start MIT Hacking Medicine while at business school. “But we want to try to blend them more.”
Mr. Cohen co-founded and is chief technology officer at PillPack, a pharmacy that sends customers personalized packages of their medications, a company that started at a hackathon.
At MIT’s health-hack, physicians, researchers, students and a smattering of people wearing Google Glass sprawled on the floor of MIT’s Media Lab and at tables with a view of the Boston skyline. At one table, a group of college students, laptops plastered with stickers, pulled juice boxes and snacks out of backpacks, trash piling up next to them as they feverishly wrote code.
Nupur Garg, an emergency-room physician and one of the eventual winners, finished her hospital shift at 2 a.m. Saturday in New York, drove to Boston and arrived at MIT in time to pitch the need for a way to capture images of patients’ ears and throats that can be shared with specialists to help make diagnoses. She and her team immediately started working on a prototype for the device, testing early versions on anyone who stopped by their table.
Dr. Garg and teammate Nancy Liang, who runs a company that makes Web apps for 3-D printers, caught a few hours of sleep in a dorm room Saturday night. They came up with the idea for their product’s name—MedSnap—later that night while watching students use cellphone cameras to send SnapChats to one another. “There was no time to conduct surveys on what was the best name,” said Ms. Liang. “Many ideas happen after midnight.”
Winning teams in each category won $1,000, as well as access to the hackathons sponsors for advice and pilot projects.
Yet even supporters say hackathons can’t solve medicine’s challenges overnight. Harlan Krumholz, a professor at Yale School of Medicine who ran a many-months trial that found telemonitoring didn’t reduce hospitalizations or deaths of cardiology patients, said he supports the problem-solving ethos of hackathons. But he added that “improvements require a long-term commitment, not just a weekend.”
Ned McCague, a data scientist at Blue Cross Blue Shield of Massachusetts, served as a mentor at the hackathon. He said he wasn’t representing his employer, but he used his professional experiences to push groups to think about the potential customer. “They have a good idea and are excited about it, but they haven’t thought about who is paying for it,” he said.
Zen Chu, a senior lecturer in health-care innovation and entrepreneur-in-residence at MIT, and one of the founders of Hacking Medicine, said more than a dozen startups conceived since the first hackathon, in 2011, are still in operation. Some received venture-capital funding.
The upsides of hackathons were made clear to Sharon Moalem, a physician who studies rare diseases. He had spent years developing a mobile app that can take pictures of faces to help diagnose rare genetic conditions, but was stumped on how to give the images a standard size scale to make comparisons. At the hackathon, Dr. Moalem said he was approached by an MIT student who suggested sticking a coin on the subjects’ forehead. Since quarters have a standard measurement, it “creates a scale,” said Dr. Moalem.
Dr. Moalem said he had never considered such a simple, elegant solution. The team went on to write code to help standardize facial measurements based on the dimensions of a coin and a credit card.
“Sometimes when you are too close to something, you stop seeing solutions, you only see problems,” Dr. Moalem said. “I needed to step outside my own silo.”
The Persistence of Innovation in Government
New Book: “In The Persistence of Innovation in Government, Sanford Borins maps the changing landscape of American public sector innovation in the twenty-first century, largely addressing three key questions:
- Who innovates?
- When, why, and how do they do it?
- What are the persistent obstacles and the proven methods for overcoming them?
Probing both the process and the content of innovation in the public sector, Borins identifies major shifts and important continuities. His examination of public innovation combines several elements: his analysis of the Harvard Kennedy School’s Innovations in American Government Awards program; significant new research on government performance; and a fresh look at the findings of his earlier, highly praised book Innovating with Integrity: How Local Heros Are Transforming American Government. Ho also offers a thematic survey of the field’s burgeoning literature, with a particular focus on international comparison.”
Benchmarking open government: An open data perspective
Paper by N Veljković, S Bogdanović-Dinić, and L Stoimenov in Government Information Quarterly: “This paper presents a benchmark proposal for the Open Government and its application from the open data perspective using data available on the U.S. government’s open data portal (data.gov). The benchmark is developed over the adopted Open Government conceptual model, which describes Open Government through data openness, transparency, participation and collaboration. Resulting in two measures, that is, one known as the e-government openness index (eGovOI) and the other Maturity, the benchmark indicates the progress of government over time, the efficiency of recognizing and implementing new concepts and the willingness of the government to recognize and embrace innovative ideas.”