Health

Dr. Kevin Vigilante is chief medical officer at Booz Allen Hamilton. This article was co-written with Angela Jones, program manager in digital health transformation at Booz Allen Hamilton. In our last article, we noted that many health systems and federal health agencies have been understandably preoccupied with addressing the immediate priorities of the COVID-19 pandemic by accelerating their adoption of telehealth capabilities to circumvent physical, in-person care limitations.  We encouraged healthcare organizations to broaden their view of how today's technological advances – not only in telehealth, but also data analytics, digital sensor technologies, 5G networks, artificial intelligence and machine learning, genomic medicine, and elsewhere – can transform healthcare as we know it....

Imagine that you are a policymaker and an academic researcher shows you evidence for a new health intervention that will dramatically improve health outcomes. He shows you the study results, the estimated impact and a p-value that is less than 0.05. How much credibility should you give to this result? What quantiative approach should you take to determine if the government should recommend using this new health intervention? One approach for making this decision is the BAyeSian Interpretation of Estimates (BASIE) approach. BASIE was originally proposed in 2019 Mathematica Report (see other relevant papers at the end of this post). BASIE aims to estimate the probability that an intervention will have a meaningful effect, given the impact estimate and prior evidence regarding ...

At a time when healthcare is increasingly dependent on digital technologies that enable and inform our providers, clinicians and care delivery systems, the invisible infrastructure framework behind the scenes becomes critically vital to ensuring a stable and predictable environment. Like a utility, we often take it for granted as it runs in the background, and we simply expect it to work. This expectation is as it should be. Our caregivers' highest priority is providing the best care possible using tools that help them navigate patient information, associated workflows, and supplement their clinical expertise. The reliance and growth of these systems requires resilient and redundant architecture that is designed to "keep those lights on", anticipate failure, and self-correct to ensure a...

In the past, seniors in Medicare had to pay for all their prescription drugs out-of-pocket. For elderly individuals with multiple medical conditions, this lack of coverage was highly burdensome. To address this issue, in 2006, Medicare Part D began which provided some coverage for prescription drugs. To keep the cost of Part D down, however, it contained a coverage gap (colloquially known as the “donut hole”) in which after patients met some deductible and had some coverage, they would again be responsible for all prescription drug cost until they reached their catastrophic coverage levels. To address the donut hole’s burden on senior’s, the Affordable Care Act gradually reduced Medicare Part D beneficiaries’ coinsurance rate in the donut...

In many countries including the US and England, hospitals are paid by payers (i.e., commercial insurers and governments) on a per-admission basis with more reimbursement for treating patients with more severe conditions and lower reimbursement for treating patients with less severe conditions. This system is known in the U.S. as the diagnosis-related group (DRG) system, since DRGs are used to assess admission severity and also hospital reimbursement levels. In England, the change in the system was implemented as described in Aragón et al. (2022): From 1989 the intention was for purchasers to enter into contractual agreements with hospitals with discretion as to exactly what form those agreements took. However, the system of setting hospital level budgets – known in the purcha...

Multifactor solutions have become the end all and be all of remote access security control. Thanks to password reuse, poor password selection and phishing attacks, the username and password combination is just not good enough. In fact, multi-factor authentication is such an expected security standard now that I would be surprised if an organization could get cyber insurance if they didn’t have an MFA solution in place, assuming they weren’t already completely compromised with ransomware. So, what if I told you that I have observed, through security data, seeing upwards of 4% or more percent of your employees could be negating the value of MFA by accepting unsolicited push notifications – effectively allowing a malicious actor to bypass the controls offered by that second factor? This mi...

Angela Jones is a program manager in digital health transformation at Booz Allen Hamilton. This article was co-written with Dr. Kevin Vigilante, chief medical officer at Booz Allen Hamilton. For the past two years, healthcare agencies have been preoccupied with addressing the immediate priorities of the COVID-19 pandemic. Throughout, they have been dramatically accelerating their adoption of telehealth capabilities to circumvent physical, in-person care limitations imposed by the pandemic. Without realizing it, agencies have taken their first steps towards the promising future of intelligent healthcare. The confluence of today’s technological advances – in data analytics, digital sensor technologies, 5G networks, artificial intelligence and machine learning, genomic medicine, and elsewh...