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The definition of irony

ORLANDO, Fla.—Today in the press room at the HIMSS conference was the following media advisory:

IBM Unveils Healthcare Island on Second Life
3:30 p.m. EST, Feb. 27, 2008
IBM Booth # 5563—HIMSS
Orange County Convention Center, Orlando, Florida

IBM will unveil its Virtual Healthcare Island on Second Life at this event. The IBM Virtual Healthcare Island is a unique, three-dimensional representation of the challenges facing today’s healthcare industry and the role information technology will play in transforming global healthcare-delivery to meet patient needs. Visiting “avatars” experience the private and secure creation of a functioning Personal Health Record as they progress through the island’s various stations, including a medical laboratory, clinic, pharmacy, hospital, and emergency room.

All this is from IBM. You know, the company that paid millions to air the following commercial during the Super Bowl:

There you have it, the definition of irony. Either that, or yet another reason to believe PHRs in their current state are mostly vaporware.

February 27, 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.

Computers, the future of healthcare

ORLANDO, Fla.—Here’s a clip showing the great potential of computers for reducing the paperwork burden on nurses and other hospital workers—from 1966. Note that the computers didn’t even have video displays back then; they simply printed out the pertinent information. (So much for reducing paperwork.)

Thanks to AMDIS Chairman Dr. Bill Bria for alerting me to this exciting breakthrough. He showed this video during his presentation to the HIMSS Physician Symposium on Sunday.

February 25, 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.

Podcast: HIMSS CEO Steve Lieber

ORLANDO, Fla.—Here’s a podcast that’s been a year in the making. Actually, it was a year plus an hour and a half. Last year in New Orleans, I had a lively, hour-long conversation with HIMSS President and CEO Steve Lieber that was supposed to be for a podcast, but the recording didn’t work.

On Saturday, I showed up at the appointed hour for another sit-down with Lieber, and realized I’d forgotten my recorder back at my hotel, so we rescheduled for about 90 minutes later. Well, the third time was a charm, and the result is this podcast, a lively, half-hour-long conversation with Steve Lieber, just ahead of the opening of the annual HIMSS conference.

Podcast details: Interview with Steve Lieber at HIMSS ’08. MP3, mono, 64kbps, 13.8 MB. Running time 30:10.

0:30 Expected attendance of 27,000+
1:15 Greater attention on technology in healthcare
1:45 Growth on clinical side
2:50 More interest from non-IT executives
4:00 E-prescribing as an example of IT crossing disciplines
5:45 Multiple opportunites for improvements in prescribing and medication administration
6:30 Continuing problems with access to capital
8:50 Prospects for Medicare payment reform
10:07 Health IT in the presidential campaign
11:15 Health IT debate remains largely nonpartisan.
12:40 Progress among private payers in reimbursement for quality
14:00 More focus on disease management than quality per se
14:40 Slow adoption of personal health records
15:42 Suitability of PHRs for chronically ill
17:30 Kids may be first major PHR constituency in general population.
18:05 Google, Microsoft and Revolution Health in healthcare and HIMSS keynotes from Eric Schmidt and Steve Case
20:00 Movement toward home health
20:40 HIMSS strategic interest in medical devices
21:40 HIMSS branching out as an association
22:30 Interoperability of financial and administrative information
23:10 Working for universal set of quality measures
23:35 Globalization of HIMSS
26:00 Standardization beyond the U.S., e.g., Snomed
27:00 Highlights of HIMSS conference: Interoperability Showcase
28:00 Public meetings at HIMSS, including AHIC
29:03 International registration

I Written By

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

Dude, this sucks!

Paper medical records suck. You and I have known this for a long time. But it’s confirmed this month in “Wired,” which has a cover story called, “Why Things Suck! 33 Things That Drive Us Crazy.”

Among them is this entry:

Why Things Suck: Medical Records
By Erin Biba Email 01.18.08 | 6:00 PM

Most medical records are about as orderly as an ER on Saturday night. Because they’re mainly confined to paper, they can’t be easily transferred from one physician or hospital to another. And because they’re not subject to any standards (or even legibility requirements), they’re nearly impossible to compare and combine.

Improving the system is possible, but it would take the cooperation of a bunch of interest groups that have no interest in working together. The Health Insurance Portability and Accountability Act, passed by the federal government in 1996, was supposed to fix things, but massive lobbying turned it into porridge. For example, HIPAA lets states make their own rules; now some states say doctors should keep records for 20 years, some for two.

You’d think electronic records would solve the problem, but no. Because the software vendors selling electronic record-keeping systems are competing, their systems are proprietary and incompatible. Oddly, that’s OK with many physicians. Another name for an all-knowing, all-seeing, all-compatible electronic system is database, and physicians don’t want people mining theirs — not because of patient-privacy concerns, but because the info could be used for doctor-on-doctor performance stats. Plus, docs already hate filling out charts; you think they want to learn data entry?

A fix may be on the way. Google and Microsoft are both working on software that will appeal to physicians and patients alike. (Kind of gives new meaning to “blue screen of death,” don’t it?) But a word of advice: Pressure your docs into accepting a more transparent system. If you don’t understand your chart, ask. You want some surgeon to cut the wrong leg off of you someday?

So finally a publication that fancies itself as cutting-edge gets it. Are Microsoft and Google the fix? Well, that remains to be seen. Last week, Microsoft re-branded its healthcare products as Amalga, replacing the Azyxxi and Hospital 2000 names. Today, the Redmond Empire announced plans to publish the source code for HealthVault XML interface protocols and other open-source projects.

HealthVault chief architect Sean Nolan explains the open-source initiative on his blog. Michael Zimmer, the 2007-08 Microsoft Resident Fellow at Yale Law School’s Information Society Project talks about some of the privacy issues HealthVault is trying to address on his blog today, while open-source guru and Microsoft critic Fred Trotter cautiously lauds Zimmer for a fair assessment of the issues.

As for Google, CEO Eric Schmidt is delivering a keynote at next week’s HIMSS conference, and actually is holding a 30-minute press conference afterwards. The Internet search giant also is throwing a cocktail party next Tuesday, with the theme, “Home is Where the Heart Is.” The invite says, “Come meet the health team at Google and learn more about what we’re working on.” About all I expect to learn from the secretive company is who actually works for Google (I know a couple of people already) and whether the bartender can mix a dry vodka martini.

Back to the “Wired” spread. Medical records are not the only “things that suck” in healthcare. The list also includes prescription drugs, hearing aids, infertility treatments and knees and backs, not to mention the all-encompassing science itself.

I can’t say for certain that personal health records suck, but that could be an addition to the list if someone doesn’t figure out a way to make someone other than health plans use them. You may recall that back in December I declared a personal moratorium on PHR stories until I saw proof that doctors and patients were actually using PHRs in any sort of volume.

After I got a pitch from one payer-owned PHR vendor on Jan. 29, I wrote back with a terse, “I’m not doing any more PHR stories until someone shows me evidence that more than a handful of patients and doctors are actually using the things.” I’m still awaiting a response.

February 20, 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.

Health Wonk Review

This week’s Health Wonk Review is up, over at David Williams’ Health Business Blog.

My favorite item there is from Fard Johnmar, who writes in his Health Care Vox blog that technology, marketing and social media are more likely to transform healthcare than any politician.

I see I’m not the only one who noticed that we’re now on our third Congress since the Bush administration challenge of 2004, and I recall exactly one significant health IT bill passed, the one that formalized the Office of the National Coordinator for Health Information Technology. Am I forgetting anything else?

Meanwhile—and this is not from Health Wonk Review—new Leapfrog Group CEO Leah Binder has been added as a keynote speaker for the Integrated Healthcare Association‘s 2008 National Pay for Performance Summit. That event is set for Feb. 27-29 in Los Angeles. You know, right during the HIMSS conference in Orlando, where I and the rest of the health IT universe will be. Nice planning.

February 7, 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.


What would my blog be without a random item from weeks ago? On Tuesday I discovered a news story from Dec. 31 about an e-health strategy in Rwanda. The U.S. Centers for Disease Control and Prevention reportedly is helping to fund the installation of Internet links between the three major hospitals in the Central African country, known in these parts mostly for its brutal, 1990s civil war.

According to the story, lack of high-speed Internet is holding back a national e-health strategy, “meant to help Rwandan medical experts exchange health information with their overseas counterparts.” Those overseas counterparts included “two U.S. universities of George Washington and New Jersey.” So George Washington University in Washington, and, I presume, the University of Medicine and Dentistry of New Jersey? (Anyone know for sure? I’m too tired to hunt down that information.)

So, basically, U.S. taxpayers are financing international interoperability testing in a country with limited health infrastructure of any kind, but we can’t find more than $100 million or so (counting various HHS offices) in a $3 trillion federal budget for health IT at home? Interesting.

Yes, President Bush did discuss electronic health records in his State of the Union again this year, and yes, Sen. Hillary Clinton did give a pretty lengthy argument in favor of EHRs during last week’s Democratic presidential debate in Los Angeles, but are we really getting more than empty election-year posturing? Prove me wrong, politicians, prove me wrong.

And while we’re pondering interoperability conundrums, here’s a good one from Tim Dotson, my editor at Inside Healthcare Computing. In the Feb. 4 issue of that newsletter, he asks: “Why can’t somebody figure out a way for hospitals to share clinical decision support rules that will work on any vendor’s system instead of letting those systems go to waste because hospitals never develop their own rules?”

Good question. I suppose that’s why Cerner sold off Zynx Health a couple of years ago, but the issue is a lot deeper than one set of rules being tied to one vendor. Collaboration sure is hard, isn’t it?

P.S. Is anyone arriving at HIMSS early? I may come in as early as the Friday, Feb. 22, just because I hate 6 a.m. flights. Drop me a line if you’ll be in Orlando before Sunday.

February 5, 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.