3 health IT questions to ask your family this Thanksgiving (and 3 to avoid)

Thanksgiving is all about tradition: the familiar family recipes; the sound of football in the background; the after-dinner torpor when Uncle Bobby invariably falls asleep on the couch. 

On one hand, it’s comforting and heartwarming when the same scenes play out in the same way every year. On the other hand, there are some parts of the holiday weekend that deserve a little shakeup every now and then – and chief among them is the tired old chit-chat about the weather that fills the time between bites of sweet potatoes and pecan pie. 

It’s time to take the conversation to the next level this year with some thought-provoking questions about hot topics in the world of digital health…after trying to explain to your grandparents what you do for a living again, of course (yes, “something with computers” is an acceptable answer after the seventeenth attempt). 

In the spirit of gratitude for more than a decade of health IT progress, here are three interesting but not-too-contentious questions to bring to the table – and three to avoid for all but the most daring of households.  

What do you think about Hospital at Home programs?

With multiple generations gathered at the table, you might get some intriguing answers to this one.  Hospital at Home programs offer a high level of continuous monitoring and acute care services to certain patients who are stable enough not to need the full resources of the hospital at every moment, allowing people to remain in a familiar environment while freeing up beds on campus. 

The option is becoming increasingly popular with patients, who like the convenience, as well as with hospitals that are seeing cost savings and greater efficiencies in managing patient flow. 

But not everyone is sold, especially patients who are more wary of technology or require a greater level of personalized care during a trying time. Some researchers and executives are also on the fence since these relatively new initiatives haven’t yet shown repeatable, scalable results in terms of quality and savings. 

Would your relatives be interested in the option to get more care at home, or do they prefer the inpatient experience? What would the ideal Hospital at Home setup look like?  

Would you want AI involved in making clinical decisions about your care?

Clinicians have been cautious about bringing AI into the realm of direct clinical decision-making, but it’s only a matter of time before advanced models start becoming a more active participant in the patient-provider relationship.  

At the moment, patients are curious about the potential for AI to assist with diagnoses and treatments.  But many aren’t entirely on board with the idea of having an algorithm suggest what’s best for their health, citing ongoing concerns about bias, accuracy, and quality. 

What would it take to build trust and confidence in AI for clinical care? How would you like to see AI used to support better experiences and outcomes? What should clinicians, developers, and regulators keep in mind from the patient perspective?  

Would you pay the ransom?

This one might be a little spicier, as it touches on issues related to the contentious geopolitical landscape, but the resulting debate might help clear the brain fog after consuming a plate full of carbs.  

Ransomware attacks are becoming increasingly common across the healthcare industry, and leaders are being forced to make tough decisions about whether or not to fork over cash or crypto to the cybercriminals assaulting their systems.   

Executives have gone both ways, with some arguing that paying out will avoid disruptions to care, and others stating that capitulation only emboldens criminals and funds future attacks.  

With challenging examples like the recent Lehigh Valley Health Network attack to fuel the conversation, you’ll be talking about this one all through dessert and beyond. 

That might be a good thing, since it won’t leave too much time for these three questions that you should probably leave out of the discussion. 

What do you think about the ONC’s proposal in HTI-2 to adopt the HL7 FHIR Bulk Data Access (v2.0.0: STU 2) implementation specification (Bulk v2 IG) in § 170.215(d)(2) and incorporate it by reference as a subparagraph in § 170.299?

Please note that the ONC’s proposal to adopt the Bulk v2 IG in § 170.215(d)(2) implicates all certification criteria that reference the implementation specification in § 170.215(d), and in this proposed rule these certification criteria are: § 170.315(f)(23), (f)(25), (g)(10), (g)(20), (g)(31), (g)(32), and (g)(33).

The ONC thinks that requiring Bulk v2 IG would raise the floor for interoperability without adding significantly to the burden for developers. It adds requirements to adopt features such as the “_since” parameter, which allows for date and time filtering, as well as the “_type” filter that allows a requesting system to provide a list of FHIR resource types for the responding system to use, which limits the resources returned to a specific subset.  

Don’t forget that ONC plans to continue requiring mandatory support for the “group-export” “OperationDefinition” defined in the Bulk v2 IG for certification to § 170.315(g)(10), as well as proposing to require support for the “group-export” “OperationDefinition” in the proposed new certification criteria in § 170.315(g)(20), (31), (32), and (33). The agency refers readers to sections III.B.13.f and III.B.20.c for additional discussion on the proposed new certification criteria in § 170.315(g)(20), (31), (32), and (33) and proposed Bulk IG requirements. 

Uncle Bobby will definitely rouse himself from his slumber to get a piece of this action. 

What do you think of the new administration’s picks to run HHS and CMS?

Listen, we’re not even going to touch this one. You probably shouldn’t, either. 

Is this a phishing email? 

Bored of the usual party games? If you really want to get the household in an uproar, run a phishing test on them by presenting them with an email designed to test their ability to distinguish a real message from a cyberattack.  

Research from cybersecurity companies shows that anywhere from 10% to more than30% of employees will fail to identify a phishing email, leaving organizations open to incursions by bad actors. 

The details can sometimes be very subtle, including swapped letters in domain names, misleading hyperlinks, slightly suspicious grammar, or an overly urgent tone.  

It’s a fun exercise that could actually protect your family members from scams in their personal lives and at work.  Just be warned that for some hyper-competitive people, failure to spot a tiny telltale mistake could be worse than losing a lengthy game of Monopoly to their baby cousin. 

Whether or not you tackle the tougher questions this holiday, Digital Health Insights hopes you have a restful, inspiring, and joyful Thanksgiving!  

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.  She can be reached at jennifer@inklesscreative.com.