Browsing by Author "Terry, Nicolas P."

Now showing 1 - 10 of 82
  • Thumbnail Image
    Item
  • Thumbnail Image
    Item
  • Thumbnail Image
    Item
  • Thumbnail Image
    Item
    Anticipating Stage Two: Assessing the Development of Meaningful Use and EMR Deployment
    (2012) Terry, Nicolas P.
    This article begins by briefly restating the concepts behind the "meaningful use of certified EMR technology" and the types of requirements included in the MU stage 1 regulation of 2010. Second, the article provides additional context for the design of stages 2 and 3, noting, for example, the impact of more general healthcare reform and some studies that have been critical of the MU strategy. Third, the article briefly explains the processes behind the development of stage 2 and the criticisms leveled at early drafts. Finally, with Department of Health and Human Services ("HHS") Agencies apparently once again bowing to HIT and healthcare industry pressure (or, depending on your perspective, showing flexibility), some key questions are posed as to the eventual success of the subsidy program.
  • Thumbnail Image
    Item
  • Thumbnail Image
    Item
    Appification, AI, and Healthcare's New Iron Triangle
    (2018) Terry, Nicolas P.
    This paper proceeds as follows. First, I reflect on the original Iron Triangle before introducing its young sibling, and discuss their differences, similarities, and intersections. However, just as the points of the original Iron Triangle only begin to tell the healthcare, story so Automation, Value, and Empathy are only the first layer or lens for discussion. Next, I take in order the points of the new triangle, drilling down into some of their properties, suggesting frames for analysis and themes for further study. I conclude by returning to a further comparison of the original and more recent "triangles."
  • Thumbnail Image
    Item
    Assessing the Thin Regulation of Consumer-Facing Health Technologies
    (2020) Terry, Nicolas P.
    This article addresses the data protection and prod- uct safety regulatory models currently applied to con- sumer-facing health technologies. These are technolo- gies that increasingly support citizen science or other research not currently regulated by the NIH/Com- mon Rule/IRB triad. They also may facilitate corpo- rate “research,” the generation or aggregation of health or wellness data that data-driven companies seek to leverage to drive advertising or broader data-broker businesses. Regulatory questions arise because these technologies impact a broad array of ethical, legal, and social issues, in particular challenging our notions of safety, quality, efficacy, and data protection. The article explains how the design and structures of existing data protection and safety regulation in the U.S. have resulted in exceptionally thin protection for the users of consumer-facing devices and products that rely on or that facilitate consumer collection or aggregation of health and wellness data. It also exam- ines some appealing legislative alternatives to the cur- rent thin model used in the U.S. and suggests a frame- work for prioritizing ameliorative regulation.
  • Thumbnail Image
    Item
    Big Data Proxies and Health Privacy Exceptionalism
    (2014) Terry, Nicolas P.; Robert H. McKinney School of Law
    This article argues that, while “small data” rules protect conventional health care data (doing so exceptionally, if not exceptionally well), big data facilitates the creation of health data proxies that are relatively unprotected. As a result, the carefully constructed, appropriate, and necessary model of health data privacy will be eroded. Proxy data created outside the traditional space protected by extant health privacy models will end exceptionalism, reducing data protection to the very low levels applied to most other types of data. The article examines big data and its relationship with health care, including the data pools in play, and pays particular attention to three types of big data that lead to health proxies: “laundered” HIPAA data, patient-curated data, and medically-inflected data. It then reexamines health privacy exceptionalism across legislative and regulatory domains seeking to understand its level of “stickiness” when faced with big data. Finally the article examines how health privacy exceptionalism maps to the currently accepted rationales for health privacy and discusses the relative strengths of upstream and downstream data models in curbing what is viewed as big data’s assault of health privacy.
  • Thumbnail Image
    Item
    Bricks Plus Bytes: How "Click-and-Brick" Will Define Legal Education Space
    (2001) Terry, Nicolas P.
    Herein, I present a number of technological, commercial and profes- sional scenarios that cumulatively suggest that the law school of the near future must be re-engineered and become what is known in e-commerce as "click-and-brick" or "click-and-mortar.' In a click-and-brick law school, distributive learning techniques will fill much of the space, supplementing traditional class experiences and substituting for many others. But a true click-and-brick will also integrate distance learning methodologies, reach- ing out to remote students, enabling collaboration with off-campus faculty and consuming remote content. I draw this not entirely happy conclu- sion from analyzing the commercial and technological forces that are si- multaneously energizing and threatening traditional legal education, and from my belief that, properly re-engineered, the traditional law schools can retain their relevance and continue in their role as the guardians of the intellect of the law. In the sections that follow, I first address the qualitative and institu- tional arguments frequently raised against such non-traditional legal edu- cation (Part II). I then suggest that the law school of the future will be quite a different place from the one we are familiar with, both because of the implications of the new enabling technologies (Part III) and because law school space is no longer a self-contained, autonomous and insulated environment (Part IV). I argue that, before we can aspire to a sustainable click-and-brick model, we will be forced to make some significant changes to how we fill our virtual and physical law school space (Part V). Finally, I suggest that, in designing our click-and-brick model, we pay particular at- tention to the ways in which law practice is being reshaped, and suggest other areas where the law school curriculum will require major re-tooling to be relevant to the Information Age (Part VI).
  • Thumbnail Image
    Item
    Certification and Meaningful Use: Reframing Adoption of Electronic Health Records as a Quality Imperative
    (2011) Terry, Nicolas P.
    This article examines the promise of the Health Information Technology for Economic and Clinical Health Act ("HITECH") to reduce or eliminate the market failures that have impeded the adoption of Electronic Health Records ("EHR"). Specifically, the article considers a key provision of the statute, a condition for receiving EHR subsidy funds, namely meaningful use. This deceptively simple requirement, that a health care provider must make "meaningful use of certified EHR technology," has become both the regulatory core and the talisman for the next decade's implementation of health information technology. This article describes the background of the subsidy program and examines the specifics of the "certification" and "meaningful use" regulations that have followed. The article concludes by taking a broader view of "meaningful use" and relating it to the concept of more fundamental health care reform. The provisions of the HITECH Act are best understood not as investments in technology per se, but as efforts to improve the health of Americans and the performance of their health care system . . . . Combined, [the HITECH] programs build the foundation for every American to benefit from an EHR, as part of a modernized, interconnected, and vastly improved system of care delivery.