Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Thursday, May 21, 2009

International News Extras For the Week (18/05/2009).

Again there has been just a heap of stuff arrive this week.

First we have:


public health, university priorities, patent failure


More than 20 years after medical expert systems were first developed, the USPTO issued two patents simply on the concept of using a computer to help physicians choose medical treatments. A company that purchased these patents claims that “the diagnosis and treatment of most chronic diseases will fall under the claims of these patents.” Already it has filed patent infringement suits against seven companies in three years and it threatened to sue a university for hosting a freely available HIV database. Perhaps most startling of all, that same university — where much of the seminal research on expert systems took place — entered into a licensing agreement intended to limit the use of the HIV database, which had been created by one of its own faculty.

Who should care?

  • If you use the freely available Stanford HIV Drug Resistance Database and want to continue to use it without restriction - you should care.
  • If you are developing a medical expert system and do not want to pay licensing fees to a company claiming a monopoly on many such systems - you should care.
  • If you are a diagnostic company, diagnostic service provider, or therapeutic manufacturer - you should care.
  • If you are dismayed by undeserved obvious patents and abusive patent litigation - you should care.
  • If you are concerned about how the dense web of licensing and cross-licensing raises the cost of health care - you should care.

Much more here with links :


Go here and start getting very upset indeed. Patenting the concept of clinical decision support is just a nonsense – especially since it has been actually operational and in use for decades before the patient was lodged. Read and weep.

Second we have:

Meadows Slices ER Wait Times

Meadows Regional Medical Center has cut in half the length of time a patient stays in its emergency room by embracing the lean manufacturing practices first implemented in the automotive industry. But the hospital, unwilling to rest on that achievement, put in place in April a system to reduce ER wait times even further.

The 122-bed facility in Vildaltia, Ga., has reduced ER stays from 247 minutes to 125 minutes, which is making it possible for the department to treat more patients. Where, two years ago, the unit saw 60 patients a day, it now treats 100 or more people daily.

"It's been an incredible success," says Matt Haynes, a health care efficiency specialist who works with a group at Georgia Tech that consulted with Meadows on how it could improve its operations.

A key piece of Meadow's "lean hospital" effort is its emergency department information system from T-System Inc., Dallas. The system automates and coordinates critical ER tasks such as triage, patient tracking, and documentation, among others. The EDIS was installed in the second half of 2005.

But, as in the case of lean manufacturing, which is designed to drive out waste and inefficiencies while also instilling a sense of continuous process improvement, the hospital is looking to do even more. In April, Meadows upgraded its EDIS with a computerized physician order entry system, which it hopes will lead to an additional 30-minute reduction in ER patient stays.

Much more here:


This is a nice practical example of the value of Health IT in improving patient flow, service levels ad reducing costs.

Third we have:

More healing for the dollar

Tom Lynn

Hospitals exchanging information on emergency visits

By Guy Boulton of the Journal Sentinel

The patient arrived at Columbia St. Mary's emergency department in Milwaukee complaining of chest pains, and normally Howard Croft, an emergency physician, would have admitted him to the hospital and ordered multiple tests.

The patient's chart, though, showed he had been given a full cardiac work-up at another hospital only a week earlier. Croft estimates the information saved $8,000 to $10,000 in duplicative and unneeded care.

It's just one example of how the Wisconsin Health Information Exchange is helping emergency departments provide better care and save money.

"It clues me in early on that information is available that could be helpful," Croft said.

The exchange provides basic information on visits to emergency departments and some other clinical information that can help emergency physicians make better decisions.

The project, now in its second year, is gathering information electronically from 14 hospitals and is in use at 10 emergency departments. It also is the first step in the enormously complex task of building a system for exchanging medical records among hospitals and clinics throughout the Milwaukee area - and, ultimately, the state and the country.

The exchange someday could be an essential component of the health care system and as basic to the area's infrastructure as its highways. For now, it is still in its infancy. In addition to emergency department admissions, the exchange provides information on pharmacy claims for people in state health programs, such as Medicaid, and in some cases information on hospital admissions and office visits.

That may not seem like much, but it can be valuable information for doctors. Froedtert Hospital was added in March. Christopher Decker, an emergency physician and medical director of emergency services at the hospital, said the exchange already has enabled him to avoid ordering several costly CT scans that had been done recently at other hospitals.

Reporting continues here:


This is a nice simple example of how even small amounts of e-Health networking can make a difference and save a little money. Well done to all involved in getting this far!

Fourth we have:

Telemedicine helps experts treat stroke from afar

By Robert Preidt, HealthDay

Examining stroke patients via videoconferencing (telemedicine) is as effective as a bedside exam and can increase patient access to stroke specialists, says a scientific statement released this week by the American Heart Association.

Stroke patients require rapid assessment in order to determine if they're eligible for time-sensitive treatments such as tissue plasminogen activator (tPA), which can save brain function and reduce stroke-related disability, the AHA explained in a news release.

These patient evaluations often need to be done by stroke and brain imaging specialists, but there are only about four neurologists per 100,000 people in the United States, and not all neurologists specialize in stroke, according to the statement.

Telemedicine — which uses interactive videoconferencing via webcams connected to a computer or television screen — enables distant stroke experts to see and hear patients, family members and on-site health care providers. Telestroke technology along with teleradiology allows distant doctors to review a patient's brain images.

This technology offers a cost-effective and time-efficient method of extending the reach of neurologists.

More here:


This is really good news – again e-Health making a positive difference.

Fifth we have:

W.Va. saves money on electronic medical records

By TOM BREEN , 05.08.09, 01:51 PM EDT

Doctors and hospitals in the U.S. worry about costs as they switch over from paper patient records to electronic systems, but West Virginia's seven state-run health care facilities have found a cost-friendly solution.

Using open-source software based on the system in Veterans Administration hospitals, they're avoiding millions of dollars in licensing fees.

More importantly, officials say, the system streamlines administrative processes and lets doctors and nurses spend more time working with patients and less time hunting for paperwork.

"A paper medical chart could be at any one of eight or 10 places within a facility at any one time," said Jerry Luck, director of facilities system administration for the state Department of Health and Human Resources.

"A doctor wanting to review a chart no longer has to search it out," he said. "Whenever it's convenient for them, they can pull it up on the computer at any time and people in different departments can be working on the same chart at the same time."

The system - called OpenVista, and provided by Carlsbad, Calif.-based Medsphere Systems Corp. - is now in place at John Manchin Sr. Health Care Center in Fairmont, Lakin Hospital in West Columbia, Pinecrest Hospital in Beckley and Hopemont Hospital in Terra Alta.

Much more here:


It is good to see continuing deployments of OpenVista. This will certainly help foster innovation throughout the Hospital Information System space.

UC hacking leaves thousands at risk of ID theft

Henry K. Lee, Chronicle Staff Writer

Saturday, May 9, 2009

Overseas hackers gained access to confidential information belonging to tens of thousands of students and alumni at UC Berkeley and Mills College after breaking into computer databases at the Berkeley campus' health services center, officials said Friday.

The databases contained 97,000 Social Security numbers, health insurance information and non treatment medical information, such as immunization records, names of doctors whom people may have seen and dates of medical visits, said Shelton Waggener, UC Berkeley's associate vice chancellor for information technology and its chief information officer.

What remains unclear is whether the thieves were able to create an entire identity for fraudulent purposes. Many people's personal data were housed in different areas of the computer system, and investigators don't know whether the hackers were able to match up the different types of data - such as a name with a Social Security number.

No students have reported being the victims of identity theft, officials said.

University officials stressed that hackers had not obtained medical records - including diagnoses, treatments and therapies - because they are stored in a separate system.

More here:


This sort of thing just seems to keep happening. A bit of a worry when it happens over the internet to a major university health facility.

Seventh we have:

White House budget makes HIT a priority

May 08, 2009 | Diana Manos, Senior Editor

WASHINGTON – The White House has released President Barack Obama's expanded fiscal year 2010 budget, with a continued commitment to advancing healthcare IT as a way to cut healthcare costs and save lives.

Obama's $3.4 trillion federal budget, expanded in detail from the outline he presented to Congress 10 weeks ago, includes $879 billion for the Department of Health and Human Services, an estimated $63 billion increase over fiscal year 2009.

The Agency for Healthcare Research and Quality (AHRQ) is expected to receive $372,053,000 to conduct research on comparative effectiveness, prevention and care management, value research, health information technology and patient safety. In addition, the AHRQ will use the funding to support research it conducts with other agencies.

The president's budget for AHRQ will be in addition to the $1.1 billion allotted for comparative effectiveness research under the stimulus package.

Obama's plan calls for $635 billion over 10 years as a "downpayment" toward health reform. In a press conference Thursday afternoon, Health and Human Services Secretary Kathleen Sebelius called it "a smart investment."

"No one should underestimate President Obama's commitment to getting healthcare reform this year," she said.

"This budget sends a clear message that we can't afford to wait any longer if we want to get healthcare costs under control and improve our fiscal outlook," she added.

The budget calls for improving efficiencies and bringing down costs in Medicare and Medicaid through reform, as well as cracking down on fraud.

More here:


It seems the Obama administration is really moving forward at an amazing speed to get Heath IT happening!

Eighth we have:

Quality, safety champion Clancy leads doc-exec list

By Andis Robeznieks / HITS staff writer

Posted: May 11, 2009 - 11:00 am EDT

If the promise of health information technology is to improve the quality, safety and efficiency of healthcare, the Agency for Healthcare Research and Quality will probably have something to do with IT keeping that promise.

As the person in charge of the agency tasked with such matters, AHRQ Director Carolyn Clancy can have a significant impact on health IT reaching its potential—even if she lacks the budget and regulatory power that would allow her to force it to happen. This fact was recognized by the readers of Modern Healthcare and Modern Physician who voted Clancy 2009’s most powerful physician-executive.

“AHRQ is a unique organization because our goal is to improve the quality, safety, efficiency and effectiveness of healthcare,” says Clancy, who finished 27th in last year’s voting and 10th in 2007. “We don’t provide care like the VA, we don’t pay (providers) like the CMS, or regulate like other agencies of HHS. That makes us very good conveners and helpful partners.”

AHRQ advocates have been lobbying for the agency’s budget to be “billionized,” but for the past seven years or so, its budget remained stagnated in the low $300 million range.

Clancy has also seen her agency’s budget get siphoned off to provide operating funds for the Office of the National Coordinator for Health Information Technology.

Recently, however, AHRQ’s budget has seen a surge. For fiscal 2009, almost $326 million had been requested, which would have equaled a 2.7% budget cut of $8.9 million. Instead, AHRQ’s 2009 budget was increased to just over $372 million, plus an additional $300 million was appropriated in the American Recovery and Reinvestment Act of 2009, which AHRQ will use to fund comparative-effectiveness research for a two-year period. Since 2005, AHRQ’s budget for such research equaled $15 million a year.

Long full article here (registration required) :


Dr Clancy and her agency are very important players in the US E-Health story and need to be watched very closely indeed over the next few years.

Ninth we have:

Press, 5/10).

Make Sure Your Facility Measures Up

Vol. 18 •Issue 13 • Page 18
The first HIPAA security audit was performed more than a year ago, and more are on the way. Is your facility ready if the auditors come knocking?

Little more than a peep has been heard about the first HIPAA security audit at Piedmont Hospital in Atlanta. Computerworld magazine obtained a list of 42 items that the Department of Health and Human Services (HHS) queried the 481-bed private, not-for-profit, acute-care tertiary facility about, but mostly, the audit was done quietly. Early this year, the Centers for Medicare and Medicaid Services (CMS) said that it signed a 1-year contract with accounting and consulting firm PriceWaterhouseCoopers (PWC) to conduct HIPAA security reviews in 10-20 hospitals across the nation. The first reviews will take place in hospitals that CMS received a security complaint on, and then the reviewers will move on to larger hospitals, Tony Trenkle, director of CMS' Office of e-Health Standards, told Government Health IT.

It's a day your facility has undoubtedly been preparing for since before HIPAA was even implemented, but would you be ready if those contractors came to visit? We look at ways you can be ready if the reviewers come calling, examine areas that might be targeted and point out the reasons that HIM professionals must be involved in the process.

Much more here:


This is an interesting article discussing how the US is going about making sure health information is being handled in a way that conforms with US law. We will need similar mechanisms here I believe.

Tenth we have:

Open source viewed as aid to Philippines e-health goals

Ronald James Panis

11.05.2009 kl 15:55 | IDG News Service

Emphasizing on how electronic health records (EHRs) can give healthcare in the Philippines its much-needed shot in the arm, several speakers of the first Philippine eHealth and Telemedicine conference and exhibition highlighted the efficacy of Free Open Source Solutions (FoSS) in bolstering the delivery and organization of this critical digital medical information.

Emphasizing on how electronic health records (EHRs) can give healthcare in the Philippines its much-needed shot in the arm, several speakers of the first Philippine eHealth and Telemedicine conference and exhibition highlighted the efficacy of Free Open Source Solutions (FoSS) in bolstering the delivery and organization of this critical digital medical information.

In one of his talks during the recent two-day event held in Ortigas, director of UP Manila – National Telehealth Center and International Open Source Network Southeast Asia Dr. Alvin Marcelo stressed on how FoSS can liberate hospitals from the limits and costs that come with proprietary systems usage.

Comparing FoSS to a car with a hood that can be opened, letting owners examine and fix the engine, Marcelo meanwhile depicted proprietary systems as having that hood welded shut. Owners have no choice but to ask the manufacturers for assistance, which is guaranteed to be pricey.

More here:


News of this sort of work in the developing world is very welcome indeed.

Eleventh for the week we have:

Stakeholders to Obama: We're Ready to Cut Costs

Five health care associations and a union have sent a letter to President Obama committing to support his effort to cut the annual health care spending growth rate to save at least $2 trillion over the next decade.

Those savings would come by slowing the annual growth rate by an average of 1.5 precentage points during the next 10 years. But details are scarce. The associations, for instance, pledge to implement "common sense improvements in care delivery models, health information technology, workforce deployment and development, and regulatory reforms."

In addition to the letter, the groups met with Obama on May 11 at the White House. Signers of the letter include the Advanced Medical Technology Association, American Medical Association, American Hospital Association, America's Health Insurance Plans, Pharmaceutical Research and Manufacturers of America, and Service Employees International Union. Following is text of the letter to President Obama, dated May 11:

"We believe that all Americans should have access to affordable, high quality health care services. Thus, we applaud your strong commitment to reforming our nation's health care system. The times demand and the nation expects that we, as health care leaders, work with you to reform the health care system.

"The annual growth in national health expenditures-including public and private spending-is projected by government actuaries to average 6.2% through the next decade. At that rate, the percent of gross domestic product spent on health care would increase from 17.6% this year to 20.3% in 2018-higher than any other country in the world.

"We are determined to work together to provide quality, affordable coverage and access for every American. It is critical, however, that health reform also enhance quality, improve the overall health of the population, and reduce cost growth.

More here:


Sadly this is no where enough to make the US Healthcare system sustainable – and worse is probably an attempt to prevent moves by the Obama Administration to move to much greater health system efficiency at the cost of the profits and conditions of many making the offer.

Twelfth we have:

HIT policy committee sets agenda with work groups

By Joseph Conn / HITS staff writer

Posted: May 11, 2009 - 11:00 am EDT

The Health Information Technology Policy Committee, a federal advisory panel created under the American Recovery and Reinvestment Act of 2009, met this morning in Washington for the first time and boiled down its initial work activities to three areas.

After batting around ideas for creating as many as six work groups, the panel in the end settled on initially forming only three.

One was a work group to come up with an initial set of criteria for the “meaningful use” standard that healthcare providers must meet under the stimulus act to receive federal subsidies for the purchase and use of health IT systems. The act provides an estimated $34 billion for healthcare IT provider subsidies through Medicare and Medicaid.

A second work group would focus on requirements of IT system certification. The stimulus act also requires that providers use systems that are certified in order to be eligible for reimbursement. Later, this work group would also embrace the need for the government to assist in the adoption of health IT systems.

A final work group would address workforce development needs.

More here:


This is pretty important stuff. I especially note the establishment of a workgroup to address workforce issues.

Thirteenth we have:

Digital medical records push exposes potential side effects

By Carolyn Y. Johnson, Globe Staff | May 11, 2009

The push for electronic medical records, fueled by $19 billion from the federal stimulus package, seems urgent and clear; such technology will cut costs and save lives, backers say. But a growing body of research illustrates the potential challenges - from getting doctors to use the safety-enhancing features the systems offer, to the patchwork of privacy regulations in different states.

"Attention nationwide will continue to focus on adoption, and needs to focus on adoption," said Dr. Steven Simon, a professor of ambulatory care and prevention at Harvard Medical School. "Close on the heels, we have to turn our efforts to ensuring these systems are robust and have the capabilities that we think will improve safety."

Simon is coauthor of a study on electronic medical record adoption that surveyed Massachusetts doctors in 2005 and 2007. Over that time, he found, electronic medical record adoption jumped to 35 percent of practices, from 23 percent.

But he also found that over the same time, there was little change in the use of many of the system features thought to increase the safety and efficiency of medicine. For example, reminders for tests or appointments - such as mammograms or Pap smears - were not available in all doctor's offices that had electronic medical record systems installed. And when they were available, many doctors reported that they didn't use them, reported the study, to be published in the Journal of the American Medical Informatics Association.

The one exception was the increased use of electronic prescriptions, which were more widely used and available.

Another new study examined how state medical privacy laws affect adoption of electronic medical records.

Much more here:


A well researched article that explores some issues that are still live and still need to be addressed for e-Health to have maximum positive impact.

Fourteenth we have:

Conficker worm infects medical devices

By anne

Created May 9 2009 - 2:14pm

Well, here's a piece of malware that's pulling a particularly vicious trick--infecting medical devices at hospitals around the world. The Conficker worm has infiltrated many critical medical devices, including MRI machines. To date, no patients seem to have been harmed, but no one's sure what's next.

In March, researchers monitoring Conficker discovered that it had colonized medical devices, when they noticed that an imaging machine put a call out over the Net, something a standard imaging device would never do. As it turned out, Conficker was researching out for instructions that cause it to rewrite itself, making the infection worse.

Once researchers discovered the anomaly with the imaging machine, they looked further, and found more than 300 similar devices at hospitals around the world that had been infected. What's more, thousands of other machines, including personal computers and medical devices within hospitals, were apparently networking with the central Conficker machine. At the peak of the infection, a working group estimates, there were more than 10 million devices infected worldwide.

Much more (with link) here :


Certainly a worry!

Fifteenth we have:


Slovenia goes for eHealth

15 May 2009

The Health Insurance Institute of Slovenia is set to rollout a new eHealth insurance card system throughout the country.

The new system, based on IBM technology, enables healthcare providers to check a patient’s health insurance status and enables health claims to be processed online.

The nationwide rollout follows in the footsteps of a pilot a programme that was held at the Dr Franc Derganc General Hospital in the Nova Gorica region of Slovenia.

Since the completion of the pilot in March 2009, the new system has been extended to more than 100 healthcare institutions in the Gorenjska and Primorska regions. IBM says the new system is planned to be fully operational by January 2010, and will be used by approximately 30,000 health professionals and more than two million patients in health institutions across Slovenia.

More here:


Seems it is just happening everywhere!

Sixteenth we have:

Comparative-effectiveness group talks big money

By Andis Robeznieks / HITS staff writer

Posted: May 15, 2009 - 5:59 am EDT

When you add $1.1 billion to what was once a $15 million a year enterprise, you get a lot of suggestions on what to do with that money. To ensure that not all those suggestions were coming from Washington insiders, 11 members of the new 15-person Federal Coordinating Council for Comparative Effectiveness Research traveled on Wednesday to Chicago for a listening session.

Attorney Neera Tanden, who currently serves as HHS “counselor for health reform,” led the session and said it was an attempt to “get outside the beltway” to hear other opinions and suggestions on how to spend the $1.1 billion allocated for comparative-effectiveness research in the American Recovery and Reinvestment Act of 2009. To that end, the session was successful as the panel received an earful from the more than 20 speakers.

There were calls for transparency, to fill specific research gaps and to look at broad, silo-crossing strategies. Arturo Bendixen, vice president for programs and partnerships for the AIDS Foundation of Chicago, spoke of the improvements that could be made if the systems in place to help the homeless and to provide healthcare for the poor worked together.

Scott Wallace, former president and CEO of the National Alliance for Health Information Technology, suggested that comprehensive health registry population databases be included in any comparative-effectiveness program.

Very much more here:


This is a really worthwhile article indeed. Well worth a browse for the ideas on how to show care should be evaluated.

Seventeenth we have:

Senate Bill Targets Critical Care

May 13, 2009

Legislation introduced in the Senate would authorize millions of dollars to support specific programs to optimize the delivery of critical care and increase its workforce.

The bill, for example, calls for spending $5 million annually from 2010 through 2015 to expand use of telemedicine technologies to enable clinicians in rural facilities to remotely consult with critical care specialists.

More here:


Being an old ICU doc – sounds good to me!

Fifth last we have:


Wednesday, May 13, 2009

After Weeks in Limbo, It's Full Speed Ahead Now for Health IT

by George Lauer, iHealthBeat Features Editor

After several weeks of limbo following the signing of the American Recovery and Reinvestment Act, it appears now to be "full steam ahead" for the Obama administration's health IT agenda.

Two key committees officially were launched last week, and both are scheduled to embark this week on ambitious journeys with relatively tight timetables. The Health IT Policy Committee met Monday and zeroed in on three areas of concentration in the coming weeks. The Health IT Standards Committee, the second advisory panel created under the HITECH portion of the stimulus package, is scheduled to meet for the first time Friday.

Following more than 10 weeks in neutral with no one at the helm, many in the health IT community welcome the shift to high gear.

Lots more here (with links):


Well worth a browse – the ramp up is happening!

Fourth last we have:

Hospital Implements Handheld Medication-Administering Device

LEONARDTOWN - 5/15/2009

St. Mary’s Hospital has taken yet another step toward patient safety with the implementation of CareMobile — a handheld scanning device designed to prevent medication errors.

“Patient safety is our top priority here at SMH,” said Liz Schaeffer, director of Nursing Resources for St. Mary’s Hospital. “CareMobile is our latest technology implementation that will enhance our patient care by providing safer administration of their medications.”

Nurses on the second and third floors of the hospital began using the device on February 17. CareMobile, offered to the hospital by the Cerner Corporation, is a software solution used on a Personal Digital Assistant (PDA). It is used for medication distribution, although it can be used for other functions such as documenting vital signs, intake and output. When a nurse administers medication, he or she will scan the barcode on his or her employee badge, scan the wristband of the patient and scan the barcode on the medication. This process links the nurse to the patient’s chart and will provide alerts to tell the nurse if the medication dose, or route, such as pills or liquid, are correct.

More here:


This is certainly the way to go – the full closed circle of information flow from prescription to actual patient administration with checks all the way!

Third last we have:

Obama's emerging IT agenda could mean big changes

  • May 14, 2009

Experts assess the potential ramifications of the president’s IT agenda

As a presidential candidate, Barack Obama’s vision for technology was off the charts of anyone’s prior expectations.

A self-confessed Blackberry addict, Obama personally understood the power of connectivity. A relentless campaigner, he realized that social networking technology was unmatched in its ability to influence public opinion and rally supporters. A “change candidate,” he saw technology as an integral component of his strategy to rein in the cost and improve the effectiveness of major government programs.

Of course, now the stakes have changed entirely, because Candidate Obama has become President Obama. Instead of running a campaign, he is running the federal government, so his vision for technology must be filtered through legislation, regulations and commonplace bureaucracy. Faced with these realities, many a candidate promising big change has opted, as president, to settle for much less.

Just four months into his administration, it is too soon to tell how Obama will fare. Nonetheless, through a variety of venues, including speeches, blogs sites and policy documents, the president has continued to talk up his IT agenda and herald the new era of Government 2.0.

But does it all add up? We asked FCW staff writers Doug Beizer, Alice Lipowicz and Matthew Weigelt to talk with experts around the community to take measure of Obama’s ambitions for IT in five areas featured prominently in the president’s IT agenda: Web 2.0, health information technology, transparency, acquisition reform and workforce improvement.

Much more here:


This is a useful review of the overall approach to IT in general – including Health IT – being adopted by the new Administration.

Second last for the week we have:

May 12, 2009, 12:42 pm

Sweating the Details on Health Technology Policy

By Steve Lohr

Some of the nation’s fine minds in medicine and technology have huddled, attended hearings and produced position papers in the last few weeks that focus on the definition of “meaningful use.”

The Obama administration’s health technology plan, which is part of the economic recovery package, includes incentive payments for adopting electronic health records — more than $40,000 per physician and up to several million dollars for hospitals. The payments are based on “meaningful use” of such records, although Congress left defining that term to the Department of Health and Human Services.

It may seem arcane and nit-picky, but how the government defines and measures meaningful use will determine whether the $19 billion in incentives is a significant step in reforming American health care or a high-tech fiasco.

The professional organization of people responsible for putting electronic health records to use, the Association of Medical Directors of Information Systems, is wading into the discussion on Tuesday with — appropriately enough — a Web site, www.meaningfuluse.org.

More here:


The work goes on – and the final outcome is hardly yet guaranteed. I suspect that the people who got to the Moon in a decade can get there however..despite some bumps in the road!

Last, and very usefully, we have:

The Machinery Behind Health-Care Reform

How an Industry Lobby Scored a Swift, Unexpected Victory by Channeling Billions to Electronic Records

By Robert O'Harrow Jr.

Washington Post Staff Writer

Saturday, May 16, 2009

When President Obama won approval for his $787 billion stimulus package in February, large sections of the 407-page bill focused on a push for new technology that would not stimulate the economy for years.

The inclusion of as much as $36.5 billion in spending to create a nationwide network of electronic health records fulfilled one of Obama's key campaign promises -- to launch the reform of America's costly health-care system.

But it was more than a political victory for the new administration. It also represented a triumph for an influential trade group whose members now stand to gain billions in taxpayer dollars.

A Washington Post review found that the trade group, the Healthcare Information and Management Systems Society, had worked closely with technology vendors, researchers and other allies in a sophisticated, decade-long campaign to shape public opinion and win over Washington's political machinery.

With financial backing from the industry, they started advocacy groups, generated research to show the potential for massive savings and met routinely with lawmakers and other government officials. Their proposals made little headway in Congress, in part because of the complexity of the issues and questions about whether the technology and federal subsidies would work as billed.

As the downturn worsened last year, advocates helped persuade Obama's advisers to dust off electronic records legislation that had stalled in Congress -- legislation that the advocates had a hand in writing, the Post review found.

Their sudden success shows how the economic crisis created a remarkable opening for a political and financial windfall: the enactment of a sweeping new policy with no bureaucratic delays and virtually no public debate about an initiative aimed at transforming a sector that accounts for more than a sixth of the American economy.

"It was perhaps a once-in-a-generation opportunity to make something happen," said H. Stephen Lieber, the trade group's president. Obama "identified the vehicle that he could use to move his policy agenda forward without the crippling policy debate."

Obama and some of his advisers had been thinking about health-care reform for years before they made it a top campaign issue. Some advocates have talked about improving use of health information technology for decades.

Much more here:


I think we need something like this in OZ! – Nothing else seems to have worked so far. However there are caveats to this approach – which I explore in another blog this week

There is an amazing amount happening. Enjoy!


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