Due to my own personal budget cuts, I’m unable to attend the Health 2.0 Meets Information Therapy that began today in Boston, but there are plenty of others out there blogging and/or tweeting the event.
I’m sure there will be lots of news and lots of hype masquerading as news coming out of that conference. Of note, A.D.A.M. is using the occasion to launch its iPhone app, called the Medzio Mobile Health Network. It’s a free download from the Apple App Store.
A.D.A.M. showed me a demo of its iPhone version a good six months ago at the fall Health 2.0 Conference in San Francisco. I guess it took this long to work out all the bugs and sign up partners.
Meanwhile, coincidentally or not, the Mayo Clinic yesterday finally launched its Mayo Clinic Health Manager project with Microsoft‘s HealthVault. Left unanswered so far is whether Mayo convinced Microsoft to sign a HIPAA business associate agreement.
Source:Health 2.0 Meets Ix
Step up to the smorgasbord that’s the latest edition of Health Wonk Review, over at the Workers’ Comp Insider blog.
There’s plenty about the health-industry deal with President Obama to reduce health spending by $2 trillion over a 10-year period, the $10 million extortion attempt with Virginia health records and, of course, swine flu, but it also includes my post on teletrauma care.
Source:Gorging on Health Wonk Review
Kudos to The Health Care Blog for publishing a long, two-part treatise this week from the legendary Dr. Larry Weed and his attorney son, Lincoln Weed, who talk about how “evidence-based medicine” really just represents educated guessing.
Dr. Weed has been arguing for close to half a century in favor of computers in medicine to aid in decision-making because the unaided human mind simply cannot recall all possible permutations of symptoms at the point and time of care. It’s been an uphill battle his whole career because he directly challenges so many elements of the medical establishment, but this is someone whom Don Berwick considers a hero.
It’s a long piece, broken into five installments, and it’s highly academic, even including endnotes, but worth your while.
Part 1: Medicine’s Missing Foundation for Health Care Reform
Part 2: Medicine and the Development of Science.
Part 3: Economy of Knowledge in Decision Making
Part 4: Harvesting Medical Knowledge from Patient Care
Source:A must-read from Dr. Weed
The Senate today confirmed Kansas Gov. Katherine Sebelius as secretary of Health and Human Services, on Barack Obama’s 99th day as president. Sebelius, who was sworn in this evening, is the last member of Obama’s Cabinet to win confirmation, and it’s not a moment too soon, as someone has to deal with the outbreak of swine flu that has some people panicked.
Here is what Reuters had to say.
Now that we have an HHS secretary, we need people to head all the department’s agencies. Stay tuned.
Source:Breaking news: Sebelius confirmed as HHS secretary
I’ve suspected for a while that one reason why personal health records haven’t taken off was because the “untethered” kind that are not tied to a specific provider organization’s electronic medical record or portal tend to be built with claims data. That is, an insurer or employer combs through billing codes to piece together records that ostensibly contain clinical records.
There are numerous problems with this, of course. First off is the workflow issue. If the doctor doesn’t have an EMR to import PHR data, then the PHR represents an extra step that the typical physician isn’t willing to take.
Then there is the reputation of managed care. Health insurers often are just slightly above oil companies, politicians and Bernie Madoff on the public’s trustworthiness scale. I imagine they’re even lower from the perspective of doctors who are asked to accept these claims-based records and use them in the practice of medicine. I’m sure there are some payer-sponsored PHRs that are fairly accurate, but they don’t ever get much of a chance because of this perception.
That said, claims-derived PHRs can never be fully accurate representation of health status because the ICD-9 (and soon, ICD-10) billing codes are completely different than CPT diagnosis codes. Don’t believe me? Ask Dave deBronkart, aka E-Patient Dave.
DeBronkart’s story is widely known among health IT types, but he was featured Monday in the Boston Globe. That article tells something I didn’t know, that there was inaccurate data in a Google Health PHR that had suggested cancer had spread to his brain or spine, as well as a few other false alarms.
The Globe quotes many of the usual suspects, notably deBronkart’s personal physician, Danny Sands, as well as Drs. Paul Tang, David Kibbe and John Halamka. While this may not be news for those in health IT, I think this story should be required reading for anyone considering a personal health record.
Source:Google Health and claims data
Attention editors of technology and general-interest publications: Hospitals & Health Networks this month has a short InBox item I wrote about live video links from ambulances to emergency departments and trauma centers. Emergency medical services in Tucson, Ariz., and, more recently, Baton Rouge, La., make use of municipal Wi-Fi networks to triage and diagnose trauma cases before patients even arrive.
This is a story I’ve known about for more than a year and a half and only recently, when Baton Rouge turned the first piece of what soon will be a parish-wide system, did any editor, HHN Senior Editor Matthew Weinstock, show interest in this story. All he had the room or budget for was this 450-word InBox item, though.
If you believe the telemedicine experts I interviewed, this kind of technology may become the norm in urban and suburban areas within a few years, and that, IMHO, makes it worth a much longer feature story in a publication that reaches beyond healthcare. There was some MSM coverage of the Baton Rouge launch, but nothing that examined the big picture.
I toured an ambulance and got a live demonstration of the technology when I was in Tucson in February, and have leads on other municipalities that are considering such a system, plus some cities that are using different technologies to achieve the same results. I’ve got photos, too.
Editors, I await your call.
Source:Live video from ambulance to ED
Canadian telecommunications firm Telus has signed an exclusive deal with Microsoft to market the HealthVault platform in Canada. This marks the first expansion of HealthVault outside the U.S.
According to both companies, Telus is licensing HealthVault and will brand it in Canada as “Telus Health Space, powered by Microsoft HealthVault.” The Toronto-based telecom says in a press release that it will develop a consumer-focused service and Telus Health Space to organizations such as governments, health regions, hospitals, insurers and employers, but apparently not directly to consumers.
Telus says it will store all data in Canada. There has been some concern among Canadian companies in the past that using U.S.-based servers or databases for health information would make them subject to the USA Patriot Act and open them up to all sorts of reporting requirements and other bureaucratic hassles.
Source:Microsoft gives Telus exclusive HealthVault rights in Canada
Philip M. Pead has been named president and CEO of health IT vendor Eclipsys, replacing the departing R. Andrew Eckert, according to a company press release.
If the name sounds familiar, it’s because Pead was chairman, president and CEO of Per-Se Technologies until that company was taken over by McKesson in 2007. He’s also been a director of Eclipsys.
Eugene V. Fife remains as chairman of Eclipsys.
According to the company, Eckert is leaving for family reasons. “Eclipsys needs a leader committed to operate from Atlanta and usher the Company through the next phases of its development. Given my family ties to Silicon Valley, it was not realistic for me to continue in my role as CEO. I am pleased that Eclipsys is in the hands of an experienced executive who will help the company continue to achieve its business objectives,” Eckert said in a company statement.
Source:Former Per-Se boss to head Eclipsys
As I mentioned earlier this month, I’m writing the new FierceMobileHealthcare, which premiered last week.
I’m particularly proud of this week’s Editor’s Corner, in which I expound on the Hospitals & Health Networks story I wrote about the videoconferencing and telemedicine technology in ambulances in Tucson, Ariz., and Baton Rouge, La. (I blogged about the same thing on Monday, but the Fierce piece adds many details.)
I still think the story belongs in the national, mainstream press. I guess I risk having a staff reporter steal the story, but I’m still the only reporter outside Arizona or Louisiana who’s seen the technology in action. I also have some insights about which other cities are considering systems of their own. Another Arizona municipality has approved a bond issue to build a similar network.
While I continue to shop that story, I’ve also been busy on a prototype issue for yet another FierceMarkets publication, called FierceEMR. If you go to that site now, you can register for a free subscription. I’m awaiting word on the launch date, but it seems like the e-newsletter will debut June 4 and be published on Thursdays.
In a comment on this very blog last week, FierceMarkets COO and Publisher Maurice Bakley explained the rationale behind launching new titles in a crowded marketplace.
Personally, I can think of about 19.2 billion reasons why new health IT publications are popping up and established ones are thriving even as the wider publishing industry tanks.
I’m leaving Friday morning for a wedding in Toronto and will be there through Monday, which is Victoria Day in Canada. Apparently, they do have the Internets (“das Internetz” in German) north of the border, so I’ll try to post while I’m up there, but I’m not going to make any promises.
Source:Even more 'Fierce'
From InformationWeek via the Health Care Law Blog comes news that the Virginia Department of Health Professions has received a $10 million ransom demand for 8.3 million patient records and 35.6 million prescription records.
Let me repeat: someone allegedly is extorting the State of Virginia for $10 million over a security breach involving millions of electronic health records.
I’d write more, but it seems like Bob Coffield has covered the issue pretty comprehensively on the Health Care Law Blog. He cites the alleged ransom note, Virginia’s response and a very interesting blog post about HIPAA notification responsibilities from John Moore of Chilmark Research.
Source:Virginia gets $10 million ransom demand for data breach
Today, HIMSS released its final registration figures from last month’s annual conference in Chicago:
27,429 total registrants
6% decrease from the 29,177 at HIMSS08 in Orlando
13% increase over the 24,202 at HIMSS07 in New Orleans12,564 total professional registrants
2.5% decrease from the 12,867 at HIMSS08
19% increase over the 10,523 at HIMSS07Registration included:
1,388 clinicians
4,567 C-Suite attendees
4,044 healthcare facilities14% of attendees were not based in the U.S.
38% of attendees were decision makers
37% of attendees were decision influencers
26% of attendees indicated this was their first HIMSS conference907 exhibiting companies and organizations
4% decrease from the 942 at HIMSS08
2% increase over the 889 at HIMSS07
Obviously, multiple, competing factors were in play here. Clearly, the recession has had an impact on corporate travel for everyone. On the other hand, the fact that health IT is getting a net $19.2 billion from the economic stimulus legislation has energized this whole sector.
Chicago was a change from the normal Sun Belt cities that HIMSS meets in. This year’s conference was moved from February to April to account for the weather, and it still snowed during first day of the conference. Yet, people still got to town. The past two years, snowstorms in the Northeast and Midwest played havoc with airline schedules and prevented some people from making it to HIMSS.
Two years ago, New Orleans had its own, unique challenges, thanks to Hurricane Katrina. By February 2007, hotel capacity had rebounded to close to what it was before the 2005 storm, but the city’s population had not. There were fewer flights available to the Crescent City, and, hampered by a labor shortage, hotel services were limited and restaurant waits seemed interminable at times. I imagine some people were scared away by reports of violent crimes against tourists, too.
This came after HIMSS06 drew a then-record 26,000 people to San Diego, creating a serious shortage of hotel rooms. Some people were forced to stay as far away as La Jolla, a good 45 minutes from downtown during rush hour. From what I understand, HIMSS will not be going back to San Diego before that city expands its convention center next decade and, more importantly, builds more downtown hotels.
Next year’s meeting is in Atlanta, which has a large convention center, plenty of flights and thousands of rooms in all price categories, but severe traffic problems and, in my opinion, not enough to do downtown after hours. I guess there is no such thing as a perfect venue.
Source:Final numbers from HIMSS
As the Department of Health and Human Services attempts to make sense of the stimulus legislation and create a health IT incentive program, the National Council on Vital and Health Statistics is holding a hearing next week on “meaningful use” of health information technology. Under the American Recovery and Reinvestment Act, HHS must define that term before the end of 2009.
The meeting will take place April 28-29 at the Marriott Wardman Park Hotel, 2660 Woodley Rd., N.W., Washington, D.C. The hearing also will be webcast. Click here for details.
Source:NCVHS to examine 'meaningful use'
I’m looking back over my notes from last month’s HIMSS conference and I came across something from MEDecision. The care management software company, now a subsidiary of Blue Cross and Blue Shield licensee Health Care Service Corp., is defining an electronic health record simply as an “actionable clinical summary.”
That makes sense, given that MEDecision in the past has pushed payer-based health records that were derived from claims and then run through a clinical verification engine of some sort to create clinical summaries. Just before HIMSS, MEDecision also announced a deal to acquire HxTechnologies, which specializes in aggregation of clinical data from lab and imaging systems.
At HIMSS, MEDecision President and COO Scott Storer also told me that because the company now can add real clinical information to the claims data it already processes, this will help providers achieve the type of “meaningful use” required to capture stimulus funding for health IT.
However, in the wake of the recent revelation that claims data can produce inaccurate clinical records, I’m wondering if this is changing this type of strategy. MEDecision is a partner of Google Health, which was blamed for the misinformation in Dave de Bronkart‘s personal health record.
And please, don’t get me started on the low adoption rates of PHRs in general. As you know, I tend to ignore any boasting that someone has a PHR that can revolutionize healthcare.
Source:More thoughts on 'meaningful use'
I’ve just read open-source advocate Fred Trotter’s blog post regarding the meeting the open-source community had with the Certification Commission for Healthcare Information Technology at HIMSS09. (CCHIT recorded the session and posted the audio and presentation slides here.)
Trotter says he was authorized by some of his colleagues to “go nuclear” and perhaps launch an alternative EHR certification program if CCHIT didn’t listen to their concerns. That was not necessary, he says, because the commission Chairman Mark Leavitt and Director Dennis Wilson gave them a fair hearing and agreed to consider the impact of CCHIT rules on developers of free and open-source software.
The most serious problem for open source seems to be that the true cost of certification is not the actual testing and maintenance fees, but the expense of continually updating products to meet standards that get more stringent each year. Since the whole idea behind open-source is to share code rather than protect it with licensing fees, the first FOSS developer to build to CCHIT standards will effectively be paying the bulk of the certification cost, while competitors will benefit from that investment when the first company releases its source code.
Trotter explains: “Under the current certification model I could wait for ClearHealth Inc. to figure out how to pass the current CCHIT tests, and then republish the changes to the current ClearHealth codebase required to pass CCHIT. ThenI could apply for CCHIT certification with my friendly fork of ClearHealth…. So I would be getting a certification for about 1/10th the price that ClearHealth pays.”
Thus, there is a definite disincentive for ClearHealth to spend big bucks—Trotter estimates $300,000 a year—on creating a product that will pass CCHIT testing.
Some of the comments that follow Trotter’s report then veer into uncharted territory, namely the prospect of self-certification. Since CCHIT makes its testing requirements public, there are those that suggest small vendors should get together and run their own testing program, following CCHIT protocols.
I’m sure there are some small EHR vendors out there telling their customers that their products are just as good as anything that has passed CCHIT testing, but I wonder about both liability and copyright issues. One commenter, Tim Cook, suggests that CCHIT should put together a self-certification affidavit that companies can sign to make sure CCHIT is not held liable for any software faults or resulting medical errors.
This makes me wonder several things:
- Would CCHIT even consider this if it became clear that someone was starting a competing certification program?
- Would more than a fringe group of the EHR customers—hospitals, physician practices and other care providers—want the risk that comes with using a “self-certified” product?
- How much money would vendors save anyway if they’re still updating their products to meet the same standards? Granted, they wouldn’t be paying the testing fees, but the consensus seems to be that the real cost of certification is in the development, not the actual testing.
- And, of course, the biggest question remains, will non-certified EHRs still be eligible for stimulus money?
Source:Self-certification?
COACH, Canada’s Health Informatics Association has announced a memorial service for founder Steven Heusing, who died April 12 at the age of 64. Heusing also was executive director of the International Medical Informatics Association.
The service will take place Wednesday at 2 p.m. MDT in Edmonton, Alberta. The COACH site has details.
Dr. Peter Murray, IMIA representative in the UK, informs me that an IMIA announcement about commemorating Heusing is forthcoming.
Source:Memorial for Steven Heusing
Though I’m still skeptical of Twitter and not ready to sign up for fear of having too many messages to read from anyone I decide to follow, I found something I might use it for. I’ve just learned that Children’s Hospital Omaha is getting ready to go live with EpicCare in orthopedics. That could have been handled in a single tweet, rather than a full blog post.
That said, I continue to fight a losing battle against e-mail. How in the world would I ever keep up with Twitter feeds?
Also, I don’t like the URL shorteners the Twitterati (did I just coin a new word?) like to use to conserve characters. With so many phishing scams out there, I’m wary of clicking on URLs that don’t make sense to me. Particularly alarming are the ones with country-specific top-level domain names. I’ve seen plenty of is.gd (Grenada) and bit.ly (Libya) and ow.ly (also Libya) links of late. With apologies to the legitimate sites out there, would you knowingly click on a cryptic URL from either an offshore tax haven or a country that formerly sponsored terrorism? What about Internet scam bases such as Russia (.ru) or Nigeria (.ng)? Just asking.
Again, Children’s Hospital Omaha is about to turn on EpicCare in orthopedics. Anyone want to tweet that for me?
UPDATE, 10:53 p.m. CDT: “Twitterati” already exists, but it’s a fairly new word. Urban Dictionary’s oldest definition related to Twitter is from Feb. 13. (There’s another, older usage that refers to Hollywood dingbats.)
Source:More thoughts on Twitter
As promised, I have written something about Google‘s reaction to the inaccurate information that got into cancer survivor Dave deBronkart‘s personal health record, as chronicled in the Boston Globe. It’s over on the BNET Healthcare Blog.
Thanks to Enoch Choi for alerting me to the happenings at the Health 2.0 Meets Information Therapy conference, which I was unable to attend.
Source:Google listens
The International Medical Informatics Association has named Peter J. Murray as acting executive director. The appointment follows the April 12 death of Executive Director Steven Heusing. (I posted an obituary for Heusing earlier this month.)
Murray, who had been serving as IMIA associate executive director for the last few months, also was the organization’s vice president for strategic planning. He is an independent health informatics and telematics consultant in Nocton, England. He holds a Ph.D. in nursing informatics and educational technology and teaches health informatics at both the University of Winchester (UK) and Walter Sisulu University in Mthatha, South Africa.
Source:Peter Murray named acting director of IMIA
There’s some fairly significant news coming out of Washington tonight: A CNN Money report via Yahoo! says that six key private-sector health industry groups have agreed to participate in the Obama administration’s effort to reform healthcare by pledging to take $2 trillion in costs out of the system over the next 10 years.
“Six trade associations representing unions, hospitals, insurers and the drug industry have signed on to the commitment,” the story says. An Associated Press story says doctors are participating as well. Based on these stories, we can safely assume that coalition includes the AMA, AHA, AHIP, PhRMA and probably the Blue Cross and Blue Shield Association and the Service Employees International Union.
We’ll know for sure Monday when representatives from the six participating groups join President Obama at a press conference.
CNN reports that Obama will make reference to the AHIP-backed ad campaign that torpedoed reform efforts during the Clinton administration. “It is a recognition that the fictional television couple, Harry and Louise, who became the iconic faces of those who opposed health care reform in the ’90s, desperately need health care reform in 2009. And so does America,” Obama reportedly will say Monday.
Source:Breaking news: Private-sector health groups agree to work with Obama
Dr. John Halamka, CIO of Harvard Medical School, has officially given up on the idea that people will want to carry their medical records on implanted RFID chips, Michael Millenson reports on The Health Care Blog. Halamka had a chip implanted in 2004, but doesn’t think the public will ever widely accept the technology.
So far, no PHR technology has been widely accepted, but that’s another story.
I’m sure this won’t stop Halamka from experimenting with technologies. He was just the second person to have his genome sequenced and published on the Internet.
Interestingly, the news comes one day after the ECRI Institute included RFID on its list of 10 technologies for hospital executives to watch this year. Of course, there is a difference between tagging assets or employee badges and surgically implanting chips in people’s arms.
Source:Halamka gives up on implantable PHRs
I mentioned Wednesday morning that Microsoft and the Mayo Clinic launched their trial with HealthVault. “Left unanswered so far is whether Mayo convinced Microsoft to sign a HIPAA business associate agreement,” is what I wrote.
I then posed this question in an e-mail to Microsoft, and got a response from a publicist: “No, Microsoft did not sign a HIPAA business associate agreement with Mayo. I can tell you that Microsoft is committed to complying with applicable laws and currently complies with existing State breach notification laws. They are also committed to complying with ARRA statutes on their effective dates.”
So there’s the answer.
Meanwhile, Google seems to be taking the recent criticism about the accuracy of claims data in Google Health PHRs seriously and constructively. More on that later, as I may actually write something that I’ll get paid for. You might want to keep an eye on Dave DeBronkart’s blog, too. There’s nothing up there yet, but I imagine there will be soon. John Halamka posted his thoughts last Friday.
Source:Microsoft's answer: No
Anne Zieger, editor of FierceHealthIT and other publications, is running a contest of sorts on LinkedIn: Design a social media marketing and communication system for a medical practice. It’s part of a LinkedIn discussion group, and it looks as if she’s doing this on her own, not as a representative of any publication.
I’m not sure of any prizes, but it sounds like there might be a business opportunity there for the right ideas.
See, just because I’m skeptical of Twitter doesn’t mean I don’t see value in social networking sites. In fact, here is my LinkedIn profile page.
Source:Social media for physician practices?
Thanks, I guess, to the stimulus, healthcare, and specifically health IT, seems to be countering the trend in publishing. Case in point is another new title coming this week. FierceMobileHealthcare, from FierceMarkets. How do I know this? I’m going to write it. In fact, there is a prototype issue up at the site now.
The real thing debuts tomorrow.
Source:Another new HIT publication
This seems to be the week for launching new programs.
A group called the Electronic Healthcare Network Accreditation Commission is going to start accrediting ASPs and other hosted EHR systems. Government Health IT has a story, which asks the obvious question of whether this will compete or complement the efforts of the Certification Commission for Healthcare Information Technology, but doesn’t exactly answer it.
Health EDI firm Edifecs has started HIPAApedia. I think that one is self-explanatory, but here is the press release.
But the big news so far this week is the Markle Foundation has come up with a framework document for discussing and defining “meaningful use,” which is the standards by which providers will qualify for health IT funding under the American Recovery and Reinvestment Act.
Source:New programs, new ideas
The newest Health Wonk Review is riding a “Carousel of Progress” over at the Pizaazz blog. Hosting this blog carnival is Glenn Laffel, who takes us for a ride around the freak show commonly known as U.S. healthcare. IT even gets its own section.
Thanks, Glenn, for including the post about my experience at the doctor last week, and for the well wishes. I’m feeling a lot better now, though the cough is lingering. I guess that’s how bronchitis works.
Source:Health Wonk Review makes progress
Journalists who have been around for a few decades may remember one of the “in” jokes that circulated after the birth of USA Today , the joke that claimed that there was going to be a new Pulitzer Prize awarded for the best investigative paragraph. That joke isn’t very funny for the journalists who are being asked to handle giant, complex topics in smaller and smaller amounts of space on faster and faster deadlines
See the original post:
Celibacy wars: In very brief
H.J.RES.5 Title: Proposing an amendment to the Constitution of the United States to repeal the twenty-second article of amendment, thereby removing the limitation on the number of terms an individual may serve as President. Sponsor: Rep Serrano , Jose E. [NY-16] (introduced 1/6/2009) Cosponsors (None) Latest Major Action: 2/9/2009 Referred to House subcommittee.
View post:
HJRes5: To repeal Presidential term limits