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The dirty little secret about ‘Blue Button’

Since last summer, various government agencies, notably the Department of Veterans Affairs, have been touting the Blue Button Initiative as an easy way of  sharing electronic data with patients. Just click the blue button in the patient EHR portal and download data into a personal health record or a printout. Sounds simple enough.

Late yesterday, my successor at a publication I was the primary writer of until late last year, cited the importance of the Blue Button, particularly when coupled with Microsoft’s HealthVault PHR platform. (If I turned in my story as late as 4:52 p.m. for that client, I would have been docked at least $150, but that’s neither here nor there.)

The fact that HealthVault and other “untethered” PHRs are non-starters when it comes to the public notwithstanding, Blue Button has a serious, perhaps fatal flaw. It outputs data in unstructured text form that’s not easily readable by an EHR. There’s no Continuity of Care Record, no Continuity of Care Document, no form of Clinical Document Architecture at all.

Just. Plain. Text.

One techie doctor I know calls this data essentially useless.

UPDATE 10 a.m. EST: The techie doctor I mentioned is Dr. Enoch Choi of Palo Alto Medical Foundation, per his comment below. He tweeted about this last month.

February 22, 2011 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 gives Telus exclusive HealthVault rights in Canada

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.

May 6, 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.

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.

My BNET commentary on the Google-HIPAA issue

I’ve got a new outlet for my work, namely the BNET Healthcare Blog. My first post went up today after a couple of weeks of refining and editing—worth it only because the faster I get the hang of BNET’s style, the more I get to post on this big stage.

The subject is the denials by Google and Microsoft that their PHR offerings are not subject to the new HIPAA requirements, even though the language seems clear to me and to several experts I’ve talked to. I specifically quoted Dr. David Brailer in this post, from a conversation we had a couple of weeks ago for a story I wrote on the stimulus bill. Brailer consulted extensively with congressional staff during the legislative process.

I expect BNET to put up another post of mine on Wednesday, hopefully before HIMSS09 ends at 2:30 p.m. CDT.

April 7, 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.

James Mault’s TEPR+ keynote

PALM SPRINGS, Calif.—Here’s a quick rundown of today’s keynote address at the TEPR+ conference from James Mault, M.D., director of new products and business development in the Microsoft Health Solutions Group:

He showed data suggesting that more than 90 percent of consumers favor some form of health IT, and framed that in the context of politics, noting that whenever 90 percent of people agree on something, elected officials pay attention. But healthcare organizations often do not. “Why is it that I can go online and see my Starbucks purchase from this morning on my credit card, but I can’t see my cholesterol [test results]?” Mault asked.

Mault reiterated Microsoft’s intention to introduce HealthVault outside the United States “not too long for now.” He did not give a time frame or any geographic clues, but said that Microsoft has had inquiries from with health systems globally, including in South America and Africa.

At least 10 of the Fortune 100 companies are in various stages of updating their human resources sites to link employee portals to HealthVault, according to Mault. Already, technology vendors to Microsoft’s own HR department must make their products compatible with HealthVault.

In showing how HealthVault is being used for telemedicine and mobile applications, Mault showed a slide that included images of Apple iPhones. Shocking perhaps? Mault told me that the Redmond Empire gets royalties for each iPhone sold because Apple links to Microsoft Exchange Server. Mault then whipped out his own iPhone.

Apparently, though, Microsoft CEO Steve Ballmer is not so enthusiastic about the iPhone.

Granted, Ballmer gave this interview in January 2007. Microsoft signed the Exchange Server deal with Apple in March 2008.

February 3, 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.

‘Today’ and Redbook notice mobile PHRs

Regular readers know about my skepticism toward personal health records, given the minuscule level of consumer acceptance. Manhattan Research highlighted the low uptake of PHRs in a study released Jan. 15.

“Despite significant interest in this type of service, only 7 million U.S. adults actually use PHRs,” the company said. “Compelling offerings from vendors ranging from Google, WebMD, and Microsoft to multiple insurers and employers have sparked buzz around PHR in the past year. But for average consumers not motivated by a serious illness, significant barriers such as privacy concerns, lack of understanding, and doubts to PHR efficiency hinder adoption”

At least one consumer publication thinks that might change this year. Last Friday on NBC’s “Today Show,” Redbook health editor Camille Chatterjee talked about the magazine’s 10 health trends for 2009.

Amongst such topics as the Wii Fit and, ahem, vaginal fitness, Chaterjee included online and mobile PHRs, specifically mentioning AllOne Mobile and Microsoft’s HealthVault.

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The PHR discussion starts at about 2:00. You can read the accompanying story here. Also, check out the podcast I did with AllOne Mobile’s Frank Avignone last year.

Meanwhile, HIMSS last week released a new book, “Personal Health Records: The Essential Missing Element in 21st Century Healthcare,” by Dr. Holly Miller, Dr. Bill Yasnoff and Howard Burde, all familiar names in health IT circles.

This follows on the heels of CMS launching a PHR pilot for Medicare beneficiaries in Arizona and Utah.

Are all these developments more hype or do they represent real progress?

January 26, 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.

Greetings from MaRS

TORONTO—I’m here at the Medicine 2.0 Congress, a very international meeting put on by Dr. Gunther Eysenbach of the Centre for Global eHealth Innovation, a project of the University Health Network and the University of Toronto.

The meeting is in a place called the MaRS Centre, in the heart of what’s being called the Discovery District. It’s at the corner of College and University, right around the corner from several major hospitals, including Toronto General, Princess Margaret Hospital and Mount Sinai Hospital.

According to the Web site: “MaRS is not an acronym. It was originally a file name and the words “Medical and Related Sciences” were later attributed to it. Since we promote the convergence of a full range of science and technology disciplines, we’ve dropped ‘Medical and Related Sciences’ from our name and we’re back to just ‘MaRS.'”

So here we are in the fourth paragraph and I haven’t said a word about the conference itself. You’re going to have to wait a bit longer. I’m humbled to say that I am going to be cross-posting this week with the world-renowned Health Care Blog. It just so happens that at least two other contributors to that site are here: John Sharp and Jen McCabe Gorman—and the latter also blogs in Dutch. Rod Ward made the trip from the UK and is posting to his Informaticopia blog, Maarten den Braber from Amsterdam is Twittering and Denise Silber, who flew in from Paris, also has a blog—en français.

The conference even has its own blog: http://medicine20.crowdvine.com. So I shall try to come up with something original.

OK, paragraph six and we’re finally getting down to business. Eysenbach opened the proceedings this morning with a discussion about what health 2.0 and medicine 2.0 really mean. I’ll just link to an article that appeared in Eysenbach’s Journal of Medical Internet Research earlier this year.

Don’t believe the hype? Peter Murray, the International Medical Informatics Association‘s VP for strategic planning, just put up a slide of this graphic:

Moving along, Eysenbach suggested that Google Health and HealthVault are not personal health records but “personal health applications” or platforms. That should make the marketing folks in Mountain View and Redmond very happy, since they keep denying that they offer PHRs.

Speaking of which, even though PHRs haven’t exactly captured the public’s imagination, Eysenbach said we are moving into the realm of PHR 2.0, where people should be able to disclose information within their own PHR to others to form communities around commonalities. A prime example, he said, is Patients Like Me.

Anyway, there are 180 participants from 19 countries here, with a slant toward the academic side of medical informatics. In fact, there are proceedings of this conference that are freely available. There are some 67 poster presentations for me to peruse at some point.

More to come. If anything, I will lead in links per post.

September 4, 2008 I Written By

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

Out of hibernation

It’s been since March 29 that I’ve updated this blog. That was much longer than I had anticipated. I know it’s been too long when I start getting e-mails wondering what happened to me. Honestly, I didn’t realize this blog was that popular. Aw, shucks. I know some people have noticed that I haven’t been writing much lately for Digital HealthCare & Productivity either. I will have stories there next week, however.

As I mentioned nearly two months ago, I was buried in a huge assignment from Doctor’s Digest. I’m actually still working on some loose ends. I also took 10 much-needed days for a vacation in Italy. (Thanks, Jane Sarasohn-Kahn for your tips on Florence.)

What’s the occasion of this post? I have plenty of material saved up that will not make it into Doctor’s Digest, and I do plan on posting some of it here once the copy is finalized, likely sometime in June. For now, I choose to comment on next week’s TEPR Conference.

The sponsoring organization, the Medical Records Institute, is expecting just 2,000 people and little more than 100 exhibitors this year. That’s half what the conference drew at its peak three or four years ago. As of today, some of the invited speakers had not even been confirmed.

The spin I’m getting is that the number and quality of educational sessions have been increased. I’ll buy that one because last year featured presentations only from actual users, not vendor representatives.

Also, MRI is planning some special things for next year, the 25th edition of TEPR. First off, it will be Feb. 1-5, 2009, rather than the spring, on account of HIMSS ’09 being in April to accommodate the Chicago weather. (FYI, it was 48 degrees on the shores of Lake Michigan yesterday, May 12. Consider yourself warned.) I will be happy to go to Palm Springs, Calif., for a February TEPR next year.

Secondly, MRI is planning to pump up attendance next year by rolling back prices on registration and exhibit space to the level of the first conference in 1985.

A major focus of this year’s event is going to be the cell phone as a conduit for interoperability. The iPhone certainly is a big part of that. Somehow, I don’t expect Dr. James Mault of Microsoft to mention the iPhone during his TEPR keynote next Tuesday, however.

Speaking of Microsoft, this is the first time I’ve blogged on my new HP Pavilion notebook, running Windows Vista, and it’s really slow when I want to highlight blocks of text for hyperlinks. At least one other site I’ve used recently recomments the Mozilla Firefox browser for a Java application. I wonder if I’m having a similar problem here. Any thoughts?

May 13, 2008 I Written By

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

Pre-HIMSS scuttlebutt

ORLANDO, Fla.—Congress, are you listening? Steroids have hit health IT.

National Coordinator for Health Information Technology Robert Kolodner, M.D., admitted to me this morning that he’s juicing. He even showed me the pills, surreptitiously hidden in the inside pocket of his suit jacket.

Yeah, so what if he had a prescription, and he was using the ’roids to cure his laryngitis before he has to deliver a keynote address Tuesday morning to thousands of HIMSS conference attendees? If other media can hype steroid use in baseball, why can’t I do it in health IT?

One person I mentioned this to today said he would support the use of performance-enhancing substances for anyone promoting greater adoption of health IT. So I guess the consensus is to take the Bud Selig approach and look the other way as long as it’s for the good of the game.

(Full disclosure: I took prednisone last year to treat a rash that resulted from an allergic reaction to the antibiotic Bactrim. I guess that makes me a juicer, too.)

Keep reading, I’ve got all the pre-HIMSS dirt right here.

Peter Basch, M.D., medical director for eHealth at MedStar Health in Washington, D.C., is the HIMSS physician of the year, and will be honored at the HIMSS Awards Dinner on Tuesday.. The Davies Award winners have been public for several months, and I don’t have word on other award winners.

The HIMSS partnership with the Association of Medical Directors of Information Systems has produced data showing that an increasing number of chief medical information officers are reporting to executives other than chief information officers, often the CMO, CFO or even CEO.

E-prescribing vendor DrFirst is remaining independent, but has agreed to add Meditech to its roster of EHR partners it promotes to e-prescribing customers.

News of Google’s long-awaited health product got out last week, so it’s widely known the Cleveland Clinic will test a personal health record with 1,500 to 10,000 patients. (The leak, of course, came from the Cleveland Clinic, and not from tight-lipped Google.) However, I have learned that the public launch of the product likely will come near the end of the first quarter. Google CEO Eric Schmidt likely will make it official when he delivers a keynote here on Thursday morning.

Note to skeptics: I have learned that Patient Privacy Rights Foundation founder Deborah Peel, M.D., has not been paid by Microsoft to tout the privacy benefits of HealthVault. I understand that the only financial gain she will receive is from the fee Microsoft will pay her organization to certify HealthVault against privacy standards Peel is developing.

The annual, midyear HIMSS Summit will run concurrently with National Health IT Week this year, in Washington, D.C. The summit is set for June 9-10. HIMSS Advocacy Day will take place June 11 on Capitol Hill. The week ends with the seventh-annual Center for Information Therapy conference on June 12-13. I believe this is the first time the Ix conference has been held anywhere besides Park City, Utah.

Also, if you aren’t registered for HIMSS, you still can participate in several public meetings here staged by the federal government:

American Health Information Community meeting, Tuesday, 10 am to 4 p.m.
Establishing the AHIC Successor, Tuesday, 3:30 to 5:30 p.m.
HIT Terms Project: Network Workgroup Public Forum, Tuesday, 4 to 6 p.m.
HIT Terms Project: Records Workgroup Public Forum, Wednesday, 11 a.m. to 1 p.m.

All times are Eastern, and all meetings take place in the Orange County Convention Center, Orlando, Fla.

February 24, 2008 I Written By

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