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Technology changes faster than you think

How much do things change in seven-plus years? Perhaps more than you think.

According to Wikipedia, the following happened in April 2005:

  • Google doubles the storage space of its Gmail service to two gigabytes.
  • Pope John Paul II passes away at the age of 84.
  • A group of at least 40 Iraqi insurgents attacks Baghdad’s Abu Ghraib prison, using car bombs, grenades, and small arms. At least 20 American soldiers and 12 Iraqi prisoners are injured, but the US Army says it has put down the assault.
  • American newscaster Peter Jennings states that he has lung cancer and will begin chemotherapy.
  • Sinn Féin leader Gerry Adams appeals to the IRA to stop violence.
  • Eric Rudolph agrees to plead guilty to four bombings including the 1996 Centennial Olympic Park bombing in exchange for four life sentences.
  • Prince Charles marries Camilla Parker Bowles
  • Adobe Systems buys Macromedia for $3.4 billion.
  • Victims and families observe 168 seconds of silence on the 10th anniversary of the Oklahoma City bombing.
  • YouTube is founded and launched.
  • Pope Benedict XVI is formally installed as pope of the Catholic Church in an inaugural mass.
  • Venezuelan president Hugo Chávez ends military cooperation with USA, claiming that US Army training officers in the country have been agitating unrest against him.
  • The new Airbus A380 performs its maiden flight, in Toulouse, France.

And smartphones were not exactly common in healthcare. How do I know this? I just unearthed the following program from AMIA’s 2005 Spring Congress:

Yes, indeed, that’s a Pocket PC, a personal digital assistant without a phone. Microsoft dropped the name in 2006 in favor of Windows Mobile. A year after that, Apple introduced the iPhone, and the rest is history.

I’m about to go on a long-overdue vacation for the rest of the year, including a week of staycation to catch up on everything I’ve neglected at home in this difficult year. You probably will see my byline in MobiHealthNews and InformationWeek Healthcare next week, but I won’t be on the job. I have a couple of pieces of multimedia I’ve put off for months, and I may get around to processing and posting them before the end of 2012. If not, I’ll see you in January.

December 13, 2012 I Written By

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

HIMSS12 notes

I’ve just returned home from HIMSS12. As usual, it was a grueling week, made more grueling by the fact that I arrived a day earlier than usual. But I do have to say that this was the least stressful HIMSS I have been to in years.

Maybe it’s because the conference layout within the massive Venetian-Palazzo-Sands Expo complex was surprisingly compact for my purposes, and I didn’t have to do as much walking as normal. Maybe it was because I only set foot on the show floor once, thanks, in part, to the announcement of the Stage 2 “meaningful use” proposed rules on Wednesday, which caused me to cancel one vendor meeting (in the exhibit hall) and cut another one (in the media interview room) short so I could knock out my story for InformationWeek. Or maybe it’s because I spent too much time in the casinos. Let’s go with the first two, OK?

HIMSS12 broke all kinds of records, drawing 37,032 attendees, beating last year’s former record of 31,500 by nearly 18 percent. The final exhibitor count was 1,123, also the most ever. After I tweeted the attendance figure, at least one person thought this rapid growth was an indication that the conference was “jumping the shark”:

jumping the shark? RT @: #HIMSS12 draws record 37,032 attendees, crushing last year's mark of 31,500. http://t.co/Mw1TDYSA #HealthIT
@apearson
Aaron Pearson

I have thought in recent years than HIMSS may be becoming too big for its own good. This time around, I heard mixed reviews.

Personally, like I said, it was less stressful than normal. It’s always good to catch up with old friends, particularly my media colleagues. This year, I also met up with a couple of friends from back home who happen to work for vendors. We kept the fun going all the way back to Chicago, since at least three other health IT reporters and a few others I know were on the same flight as me.

I also have to say I had a wonderful time on a “Meet the Bloggers” panel on Wednesday afternoon, where I joined Healthcare Scene capo John Lynn, fellow Healthcare Scene contributor Jennifer Dennard, Carissa Caramanis O’Brien of Aetna and moderator Brian Ahier for some lively dialogue about social media in health IT. I know that at least one audience member took some video, and I’ll link to that once it’s posted.

Later that evening, I saw nearly every one of the same people at Dell’s Healthcare Think Tank dinner, where I participated in a roundtable discussion about health IT with a bunch of supposed experts. It was streamed live, and I believe the video will be archived. Many of the participants, including myself, tweeted about it, using the hashtag #DoMoreHIT. I really am adamant about the public needing to be explained the difference between health insurance and healthcare.

Speaking about misunderstandings, I am in 100 percent agreement with something Dr. Wendy Sue Swanson, a.k.a. Seattle Mama Doc, said during an engaging presentation Monday at the HIMSS/CHIME CIO Forum. She made the astute observation that there needs to be better distinction between expertise and merely experience when it comes to celebrities being held up as “experts” in healthcare and medicine. Let’s just say that Swanson, as a pediatrician, is no fan of some of the things Jenny McCarthy and Dr. Mehmet Oz have told wide audiences.

There definitely were some people among the 37,000 who were not enamored with the cheerleading at HIMSS. There was talk around the press room that HHS really dropped the ball by not having the meaningful use Stage 2 proposal out a week earlier, before the conference started. In reality, blame the delay on the White House. Every federal rule-making has to be vetted by the bean counters and political operatives in the Office of Management and Budget, and it’s hard to tell how long the OMB review will take once an administrative agency, in this case, HHS, sends the text over.

I admit, I was wrong in expecting the plan to be out earlier, too. Instead, we got the news Wednesday morning and saw the text Thursday morning, forcing thousands of people to scramble to scour the proposed rules.

I know HIMSS had a team at the ready, who dropped everything to read the proposal and get a preliminary analysis out by the end of the day Thursday. Lots of consulting firms did the same. I’ll save some of the commentary I received for another post.

The wireless Internet in the Venetian’s meeting areas was truly terrible. Either that, or I need to replace my aging laptop. I’m thinking both.

I had no trouble getting my e-mail over the Wi-Fi network, but I really couldn’t do anything on the Web unless I was hard-wired to one of the limited number of Ethernet cords in the press room, and those workstations filled up fast. Bandwidth was particularly poor on Thursday, when I presume thousands of people were downloading the Stage 2 PDF. CMS officials said the Federal Register site crashed from the heavy demand, and I’m sure a lot of it came from inside the Venetian and the Sands Expo.

There didn’t seem to be enough attention paid to safety of EHRs, at least according to Dr. Scot Silverstein of the Health Care Renewal blog, who wrote this scathing critique of the sideshow the exhibit hall has become, making Las Vegas perhaps “fitting for people who gamble with people’s lives to make a buck.”

Personally, I thought ONC and CMS took the recent Institute of Medicine report on EHR-related adverse events pretty seriously. Plus, one of the IOM report authors, Dr. David Classen, presented about the study findings at the physician symposium on Monday and again during the main conference.

Mobile may also have gotten a bit of a short shrift, despite the recent launch of mHIMSS and last’s week’s news that HIMSS had taken over the mHealth Summit from the NIH Foundation. The mobile pavilion was relegated to the lower level of the Sands, the area with low ceilings and support pillars every 30 feet or so. (I called that hall “the dungeon.”) I have a feeling you will like Brian Dolan’s commentary in MobiHealthNews next week. I’m still figuring out what I will write for that publication, but I have to say I did hear some positive things about mobile health this week.

I still don’t know what GE and Microsoft are doing with Caradigm, their joint venture in healthcare connectivity and health information exchange that didn’t have a name until a couple of weeks ago. The name and the introductory reception they held Tuesday evening at HIMSS seemed a bit rushed, IMHO. The Web address the venture reserved, www.caradigm.com, currently redirects to a GE page. Other than the fact that Microsoft is shifting its Amalga assets to Caradigm, I’m at a loss.

Popular topics this year were the expected meaningful use and ICD-10, plus the buzzwords of the moment, business analytics and big data. I’d be happy I never hear the word “solution” as a synonym for “product” or “service” again. To me, that represents lazy marketing. Get yourself a thesaurus.

 

February 24, 2012 I Written By

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

PHRs that don’t have the cachet of Microsoft and Google

In case you were still of the opinion that Google and Microsoft were the major players and groundbreaking pioneers of personal health records, here’s a partial list of other companies that have been at it for at least as long. I believe CapMed goes back as far as 1991. Some have been bought by larger firms, but many are still independent.

Clip and save, or pass on to your favorite tech journalist that got snookered by the Google PR machine.

Access Strategies

CapMed

ActiveHealth Management

MEDecision

HealthCapable

MyMedLab

NoMoreClipboard.com

Carefx

Good Health Network

iPHER

MedicalDrive.com

MediKeeper

Applied Research Works

In any case, I remain unconvinced that the direct-to-consumer, “untethered” model—no connection to an electronic medical record unless the patient sets it up that way (and really, can any EMR today be configured like that anyway)—can grab more than a small subset of data geeks as customers.

July 18, 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.

Imagine Cup participants show smartphone malaria diagnosis app

About three months ago, I wrote about the Imagine Cup, an annual student technology competition sponsored by Microsoft, in a commentary for MobiHealthNews. I mentioned a winning project in the U.S. competition, a smartphone-based imaging system that can help diagnose malaria in far-flung corners of the globe.

Today, the creators of that system and a few other Imagine Cup participants are in New York for the international finals. A few of the students appeared with Microsoft CEO Steve Ballmer on CNN’s American Morning early Friday. CNN said the malaria app is 94 percent accurate, better than the traditional field test for malaria.

Another project, Harmonicare, incorporates a tablet computer to add a musical aspect to the “blowing” test used to help patients regain respiratory function while recovering from pneumonia.

Watch the video and see for yourself:

 

July 8, 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.

Facebook + health data = all sorts of HIPAA questions

“Time’s Person of the Year is Mark Zuckerberg. Sorry, Julian Assange, I guess you didn’t violate enough people’s privacy.” — Stephen Colbert, Dec. 15, 2010.

Yes, Facebook has issues with privacy. Just Monday, the Electronic Privacy Information Center, the Center for Digital Democracy, Consumer Watchdog and the Privacy Rights Clearinghouse formally asked the Federal Trade Commission to stop Facebook from launching a facial-recognition feature. Last week, European regulators said they would investigate Facebook after it came out that Facebook’s 500 million to 700 million users were automatically opted in to facial recognition.

And now we hear that Microsoft is adding Facebook authentication to its HealthVault health information platform.

Let me repeat: You can now sign in via Facebook to a HealthVault personal health record.

Though I’m not a lawyer, I’m wondering if Microsoft might not be treading in some dangerous territory. What if it’s possible to link HealthVault updates to Facebook so your entire social network knows that you just got a lab test result back? What if the Facebook location tagger indicates that you’ve just visited an STD clinic? Yeah, sometimes discretion is in order, and Facebook generally isn’t the place to be discreet.

According to Healthcare IT News’ MobileHealthWatch blog, Microsoft’s Sean Nolan was practically giddy about this arrangement helping HealthVault go mobile. I think mobility will help make PHRs a bit more attractive to patients, but I still think PHRs are DOA if they don’t link to EHRs.

I just don’t see a lot of medical practices being willing to send electronic data back and forth to HealthVault accounts if Facebook is handling the security, making MobileHealthWatch’s claim that, in wake of the supposed demise or at least de-emphasis of Google Health, HealthVault is now “more or less unchallenged as the PHR of record” a joke. There’s no such thing as a PHR of record, and there won’t be as long as authentication passes through Facebook.

 

June 13, 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.

Bosworth: PHRs need to do more than just store data

You may have heard news of Google essentially putting its Google Health PHR platform in cold storage. Whether it’s true or not, the “untethered” PHR—one not connected to a health system’s EHR—has been a non-starter for years. I’ve been particularly critical of the undeserved attention Google Health and Microsoft HealthVault have received, when many smaller companies have been working on PHRs for much longer.

The original head of the Google Health project, Adam Bosworth, left the company in 2007 under suspicious circumstances—did he quit or was fired?—prior to the way overhyped 2008 introduction of this vaporware. Bosworth has gone on to start a new company, Keas, that produces a PHR that incorporates care plans. Keas got some undeserved hype itself, in the form of an October 2009 story in the New York Times that, from what I understand, was suggested by a Times editor who also was advising Keas. (That editor is no longer with the Times.)

Keas itself hasn’t gained much traction, either. I reported in September 2010 that Keas abandoned its original plans to sell direct to consumers in favor of partnering with insurance companies and large employers. That was the last I had heard about Keas until last week, when TechCrunch TV posted the following short interview with Bosworth, entitled, “Adam Bosworth On Why Google Health Failed”:

Bosworth said that Google simply didn’t offer anything the public really wanted. “They basically offered a place to store data,” he said. “Our data shows people don’t really want a place to store data per se. They want to do something fun and engaging. If it’s not fun, if it’s not social, why would they do it?” Yes, that makes sense.

Bosworth said that people need encouragement and even peer pressure to practice healthy behaviors. Bosworth said he lost 22 pounds in 18 weeks by walking 4 miles each way to and from his downtown San Francisco office four times a week, and he credited the encouragement he got from checking in on Keas.

That’s a great sign, but I wonder how many other stories like his there are out there? My guess is, not many. I’m thinking online communities of like-minded people or those facing similar health issues have been far more successful. Last night’s post is a prime example.

Feel free to prove me wrong.

June 6, 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.

News and notes: Cool healthcare tech, telemed pushback and more

It’s Friday afternoon, and I realize it’s been days since I’ve posted here. (Make sure you catch my posts on EMR and HIPAA every Thursday, including my latest on Dr. Larry Weed and his critiques of current health IT systems.) I think it’s time for a rundown of some interesting developments this week.

Weed apparently is not the only one who’s disappointed in the pace of change in healthcare. Dr. Bill Crounse, senior director of worldwide health for Microsoft, was at the World of Health IT conference in Budapest, Hungary, to deliver some scathing remarks at about North American health IT. According to Canadian Healthcare Technology, Crounse called the U.S. and Canada the “worst of the worst in the industrialized world in the use of IT in healthcare.”

He explained: “I see physicians in perhaps less developed countries bypassing all that legacy technology and using commodity off-the-shelf contemporary solutions, using tablets and speech recognition and doing their discharges, all with technology that costs pennies on the dollar, and then I come home to America and look at these $150 million systems and say, ‘wouldn’t we be better spending that on patient care instead of IT?’”

EMRs just store health information, Crounse said. “It’s really what you do next that counts. Once we have information digitized, that doesn’t buy you value. It’s what you do with the information, how you use it to manage care, and to collaborate.”

While we’re talking about overseas events, Hello Doctor, a telemedicine service in South Africa, apparently is on hold less than a month after its April 17 launch. In an e-mail newsletter (not available on the Web, as far as I can tell), Telemedicine & E-Health reported:

Under fire from South Africa’s healthcare bureaucracy, Hello Doctor has suspended its telemedicine services, pending a meeting between representatives of the company and the Health Professions Council of South Africa (HPCSA). The council referred to its undesirable business practice committee Hello Doctor and two companies that have announced plans to offer a joint telemedicine service later this year, MTN Group and Sanlam. HPCSA has alleged that the companies violated rules that require a healthcare practitioner to do a physical examination and assess a patient before a diagnosis can be made. [News Alert, May 6 ]. HPCSA is drafting its own guidelines for telemedicine, an emerging competitor to nationally-licensed doctors.

The South African Medical Association also is fighting the service. “”It is no different from blind-dating. How sure are you whether you are getting the real doctor or not?” SAMA Chairman Dr. Norman Mabasa told Independent Online. Hmm, aren’t these the same kinds of objections we see in America? When will the medical establishment wake up and see that telemedicine is not a threat to their authority?

Well, at least some physicians are embracing new technologies. That’s the subject of a feature I just had published on Medscape,  “10 Totally Cool and Incredibly Useful Medical Gadgets: Technology That’s Changing Medical Care.” Feel free to argue with me and add your own.

And speaking about telehealth and arguing with me, I was the victim of intimidation of the media this week. A certain story I wrote about a telemedicine technology vendor was pulled from the Web yesterday after the company threatened to sue the small company that published it. The company accused me of writing a “defamatory” story and wondered if a competitor didn’t actually help me write the piece. Sorry, but I have a lot more integrity than that. I also was accused of mischaracterizing the state of the deactivated ambulance telemedicine service in Tucson, Ariz., which I said was “failed.”

The accuser referred to an April article in Telemedicine & E-Health written by Dr. Rifat Latifi, one of the driving forces behind Tucson ER-Link, and several colleagues that showed the efficacy of ER-Link in performing remote intubation. That’s great, but there needs to be a working network to support the “videolaryngoscope.” Tucson, unfortunately, no longer has one.

 

May 20, 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.

Park defends plain-text format of ‘Blue Button’

Todd Park

Well, I guess everything else pales in comparison to the news late Sunday night that Osama bin Laden has been killed and that his body is in U.S. custody, but I had been meaning to bring you something from another part of the government. So now, nearly three hours after I sat down to start writing, here goes.

Remember back in February how I reported that the Blue Button Initiative that HHS, the VA and the Department of Defense had been touting was much ado about nothing because the add-on outputs data in plain, unstructured text that’s essentially useless when imported into an EHR? Well, government officials continue to defend it.

At the Microsoft Connected Health Conference last Wednesday in Chicago, HHS CTO Todd Park extolled the virtues of Blue Button, saying that it was a conscious decision on the part of the people behind the idea—particularly ex-Google and Microsoft star Adam Bosworth and author/Internet scholar Clay Shirky—to export patient information in untagged text format as a quick means of “liberating” data from proprietary systems. It then is up to the patient and his/her providers to decide what do do with the exported record.

“We decided that the burden shouldn’t have to be on the vendor to parse the data,” Park told me offstage.

Well, what do you think of that? Should Blue Button follow some established protocol that organizes data in discrete format like the Continuity of Care Record, Continuity of Care Document or Clinical Document Architecture, or is raw, unorganized text good enough?

UPDATE, 10:50 pm CDT: I found the rest of my notes and see that Park said 270,000 unique users have downloaded data through Blue Button, an average of three times each, even though the government hasn’t done much in the way of marketing. “Simplicity is the key,” he said.

 

May 1, 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.

Post-HIMSS Health Wonk Review is heavy on health IT

The first Health Wonk Review since last week’s HIMSS conference is up, courtesy of Jared M. Rhoads of the Lucidicus Project. While I’m no fan of organization’s ideological bent (it seems to think CMS Administrator Don Berwick is more interested in socialism than in improving healthcare), I’m happy to say this roundup has more IT than normal.

For one thing, Rhoads mentions my post detailing my injury at HIMSS and the consumerism and EMR use that played into the care I received at a walk-in clinic in Orlando, Fla. I’m happy to report that I got the stitches out on Tuesday and the deep laceration is healing well. There’s a good chance that the resulting scar might kind of blend into my eyebrow, so I’m hoping it won’t be too conspicuous.

Four other IT-related items made it into this biweekly roundup of healthcare blogging and punditry, including Jane Sarasohn-Kahn’s discussion of remote health monitoring, based on a just-published white paper she wrote for the California HealthCare Foundation. You’ll also find posts about health insurance exchanges, the Direct Project to foster health information exchange and the recent “Developer Challenge” that Microsoft sponsored in the Boston area.

March 3, 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.