8 posts tagged “Jeff Cole”

A New Way to Import “Blue Button” Patient Data from the VA

Posted January 23rd, 2012 by

Download the PatientsLikeMe Open Source BlueButton Parser

I love the conveniences that come from having my data moved around online (with my permission, of course).  For example, TurboTax will pull all my information from my investment bank and the IRS, and then calculate how much I owe.  With me doing hardly anything, I’m done in about 20 minutes!   Similarly, Mint.com can pull in my bank and credit card transactions to scold me about how much I’m over-spending on Amazon and restaurants.

Sadly, my healthcare data is not nearly as portable or accessible as my financial data.  It’s a shame, because there are many talented people in health start-ups who want to build tools to help people make sense of their health data.   It’s been 15 years since HIPAA was passed to promote this accessibility and portability of data, but many obstacles have gotten in the way of implementation:  debates about data standards, the cost of updating information systems, debates about whether patients should really own their data and more.

The "Blue Button" Initiative Allows Veterans to Download Their Personal Health Data with One Click

This is exactly why the U.S. Department of Veterans Affairs (VA) should be commended.  The VA cut through these obstacles and implemented data download for all the veterans using their “My HealtheVet” online health services portal.  With the click of a single button, users can now download appointment information, medication histories, lab results and more.  To date, nearly a half million veterans have already downloaded their data.  What’s more, the VA is encouraging other health providers to follow their lead:  they would love to see every health portal have a big, blue button that allows users to download their data with a single click.  They are calling this the “Blue Button” initiative.

Blue Button is an ambitious undertaking, and we’re just beginning to understand its potential.  However, Blue Button doesn’t necessarily make it easier for a patient to move data to other services.  In fact, there are no data formatting standards for Blue Button, a decision meant to motivate providers to participate because they wouldn’t get bogged down in an argument about which standard is best (for example, Continuity of Care Document (CCD) vs. Continuity of Care Record (CCR).)   This lack of standardized data output means it will be more work for any third-party services that want to import it.

Moreover, the VA’s implementation of Blue Button for My HealtheVet poses some additional challenges for data portability.  The sample data export from My HealtheVet is just a free-text file with very little structure to it.  While it is easily read by humans, it is not in a format that can easily be parsed by computer programs, such as XML or comma-separated-value (CSV) files.

To help facilitate the portability of the VA’s Blue Button download data, PatientsLikeMe is releasing an open-source Blue Button parser, which translates the free-text data file into structured data.  Our goal is to make it easier for programmers to use this data for their own applications, or even for building tools to translate the data into a more established health data standard like CCD or CCR.  Because the parser is open-source, it is not only free, but improvements made by any developers can be contributed back so that others may benefit.  We believe sharing is a good thing.

There actually have been a couple prior attempts at parsing the My HealtheVet records to date.  One person made a great start at an online tool for parsing My HealtheVet  files.  Also, Microsoft’s HealthVault service will read Blue Button VA files, but, as far as we can tell, the parser they use for this is not available as open source yet.

The lack of a defined data format “standard” for BlueButton frees us from endless debating over nuances of one standard versus another, but at the cost of data portability. PatientsLikeMe believes Blue Button can be even more powerful if patients have more options for what they can do with that data.  By releasing a standard open-source parser, PatientsLikeMe hopes to give providers and other services a way to participate in Blue Button without worrying about the lack of definition.

What does this mean for patients?  Hopefully we’re a little bit closer to all having a Mint.com for our health.

PatientsLikeMe member jcole


Tech Talk: A PatientsLikeMe Year in Review (Part IV – Tech)

Posted January 6th, 2011 by

tech5The PatientsLikeMe engineering team is excited to highlight some of the work that went on behind the scenes in 2010 to make this site what it is today.  We tend to write more specifically about our work on a separate blog (http://tech.patientslikeme.com), so feel free to follow our work there as well.

In addition to building the new site features you see (discussed in other blog posts), our team of engineers work tirelessly to continuously improve the site for you.  Here are some highlights of the work they’ve done in 2010:

The Team
Early in 2010, Co-Founder Jeff Cole moved over to our data operations team where he now leads the way in analyzing the data you share.  In leading the engineering team this year, I’m thrilled to report that we accomplished one of our top goals – to grow the team without detracting from the culture that makes us great.  With 13 team members and growing, we closed out 2010 with a larger team than we had in 2009 and have maintained the high caliber of engineers by refining our hiring process during the year (see the PatientsLikeMe Tech blog for more details).  We pride ourselves on hiring the best of the best Ruby on Rails engineers; Ruby is an open-source framework that lets you write beautiful code and share it with other engineers to learn and improve.

The Process
To make the site run smoothly for 80,000+ members, we need to have a solid set of processes.  This year, we used a set of processes called “Scrum,” an iterative methodology used for agile software engineering.  Here’s a peek at what happens behind the scenes to help make changes to the site more efficient and seamless to you:

  • Sprints: We break our work into two week chunks called an iteration, or a sprint, during which time we complete, test and push site enhancements – everything from bug fixes to new features. By committing to getting changes out every two weeks, we can roll out new features and incorporate your feedback more quickly than before.
  • Demo/Retro: We added two new Scrum ceremonies to our standard set of processes, demo and retro. At the end of each iteration, we demonstrate (“demo”) the accomplishments of our last sprint for the entire company to 1) help everyone see what is new and ask questions that we anticipate from you and 2) help us get feedback that we can use to make things better. After demo, we have a retrospective (“retro”) on the work we just did to the site. This is all part of our drive for continuous improvement.
  • Tech and Wow Weeks: PatientsLikeMe has always had a philosophy of keeping technical debt (or the slow build up of tech problems) as low as possible. In 2010, we formalized our strategy for dealing with technical debt in Tech Week. To make the site more efficient for you, every two sprints we take a week to prioritize and remove pain points (such as performance issues, upgrades and bugs) or make infrastructure improvements (including server changes or new tools). After Tech Week, we then take a week where individuals around the company can work on what ever they want to “Wow” us.  Wow Week is our opportunity to try out new ideas. Some of thescreen-shot-2011-01-06-at-41223-pmm are great and become site features, including the new “symptom sandwich” charts (see right). We also work on ideas you’ve submitted to us during that time, like a prototype of a mobile application for the site.
  • Performance: Have you noticed the site loading more quickly in 2010? We dramatically improved our performance monitoring tools to help make some big improvements in site performance. (Note: there’s more work to be done in making the “slow” pages faster.)

Looking Ahead to 2011

Here are a few of the engineering improvements we have in mind for 2011:

  • Continued Performance Improvements: We will be constantly working to make the site perform better, even as we add new features. We crunch a lot of data on each page, and try to customize many of them for each of you. It can be a challenge doing this at “webspeed,” but we have new hardware for the servers in the works and will continue working on our software to improve this.
  • Continued Team and Process Growth: To get even more done for you this year, we need to continue to grow the team with a high caliber of engineers and continuously improve the way we do our work. You may not see much of this directly, but you will see the results.
  • Thought Leadership: PatientsLikeMe is a thought leader in healthcare and we have one of the best engineering teams in the business. This year, we will be more aggressive in sharing our tools and ideas with our software engineering community to learn and improve on what we do.

While we’re excited about our accomplishments in 2010, we promise to continue making improvements to the site in the coming year to help you make the most out of the sharing you do through our site.  Here’s to a faster, stronger, better platform in 2011.

PatientsLikeMe member shammond