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New programs, new ideas

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.

April 30, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Peter Murray named acting director of IMIA

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.

April 29, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

A must-read from Dr. Weed

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

Part 5: Patient Autonomy

I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Breaking news: Sebelius confirmed as HHS secretary

The Senate today confirmed Kansas Gov. Kathleen 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.

April 28, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Google listens

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.

April 23, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

NCVHS to examine ‘meaningful use’

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.

I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Microsoft’s answer: No

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.

April 22, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Health 2.0 Meets Ix

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.

I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Memorial for Steven Heusing

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.

April 19, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Self-certification?

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?
I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.