Health IT in the Latino Community–From Concept to Practice January 24, 2012
Posted by gonzalezloumiet in American Recovery and Reinvestment Act of 2009, Health Care, HIT, Interoperability, Stimulus Plan, Technology.Tags: Health IT, HIMSS, Latino
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If you are planning to attend HIMSS 2012, make sure to stop by the HIMSS Latino Community Workshop.
Learn more here
New Statewide Health Data Network Will Improve Patient Care December 13, 2011
Posted by gonzalezloumiet in Data Integration, EMR, Health Care, Interoperability, NHIN, open source, Stimulus Plan, Technology.Tags: BBRHIO, Direct, FHA, FHDN, FMA, NwHIN, Uber Operations
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TALLAHASSEE, Fla. – Florida healthcare patients soon will receive more collaborative and streamlined care with improved safety, outcomes, privacy and efficiency thanks to the launch of a new, secure, cloud-based, statewide health information exchange (HIE) network.
Leaders from a new Florida company, HIE Networks, the Florida Hospital Association and the Florida Medical Association joined forces at a news conference to announce the creation of the Florida Health Data Network (FHDN), which will make patient medical records easily accessible to authorized healthcare providers.
FHDN is a statewide network developed, solely funded and operated by HIE Networks LLC, a private, physician-owned, national provider of integrated digital medical records technology. Based in Tallahassee, Fla., HIE Networks grew out of its co-founders’ successful piloting of the Big Bend Regional Healthcare Information Organization (BBRHIO), a health information exchange network serving nine counties in North Florida which has been nationally-recognized as one of the top 12 regional HIEs in the country.
“One of the greatest challenges to providing efficient, cost-effective, high-quality health care is access to patients’ medical history by health care providers,” said Dr. Dan Kaelin, co-founder and Chief Medical Officer of HIE Networks. “The Florida Health Data Network will change that forever.”
FHDN can connect hospitals, physicians, laboratories, pharmacies and insurers without geographic boundaries using “cloud” technology that allows for the networking and sharing of patient clinical records in a secure, fully integrated, health information exchange, said Allen Byington, co-founder and CEO of HIE Networks.
“The core HIE technology allows for providers, hospitals and communities to avoid bearing the high capital cost of acquiring and maintaining the initial technology, requiring only a modest monthly service fee,” said Byington. “Leveraging the FHDN technology, providers only have to fund their Electronic Medical Record (EMR) vendors’ interface cost and a small staff-training fee. Our goal is to significantly reduce the capital barrier to HIE adoption nationally.”
“By exchanging patient clinical records in a robust HIE network, physicians can eradicate inefficiencies, duplication of services and medical errors,” said Kaelin.
“Hospital emergency rooms can better provide prompt diagnosis and treatment. Pharmacists can be certain that a new prescription doesn’t conflict with an existing one. Lab and radiology results can be shared and accessed instantly for prompt evaluation and treatment. Patients have more knowledge and control of their treatments and procedures. Elimination of duplicative testing and elimination of waste will help streamline treatment, reduce delivery costs, reduce errors and, most importantly, improve outcomes and save lives.”
“Another unique aspect and value of the FHDN,” said Byington, ”is that it is community-based, local-provider-driven and compatible with other local groups and networks – including BBRHIO and the Gulf Coast Health Information Exchange based in Manatee County – united under HIE Networks’ core HIE technology umbrella.”
The HIE Networks’ endorsements by the Florida Hospital Association (FHA), the Florida Medical Association (FMA) and other provider affiliations will help provide a trusted roadmap and pathway for providers to confidently address their HIE needs, says Byington. HIE Networks is the only endorsed HIE vendor for FHA and FMA.
“The Florida Hospital Association supports local-provider-driven health information exchange based on national standards,” said FHA President Bruce Rueben. “Hospitals, physicians and other healthcare providers collaborating to leverage health information exchange improve the coordination and quality of care for patients. FHA is pleased to collaborate with HIE Networks and the Florida Medical Association in the expansion of patient-focused health information exchange.”
“The FMA conducted an exhaustive search among dozens of international, national, regional and local health information exchange vendors with the primary intent to identify and qualify a health information exchange solution that would preserve physician stewardship of sensitive personal health information for the benefit of our patients,” said Dr. Chris Pittman, chairman of FMA’s Health Information Technology Committee. “The FMA identified several excellent vendor finalists; however, HIE Networks prevailed for several reasons: HIE Networks enjoys a multi-year track record as a proven and sustainable community-wide health information exchange model, has demonstrable and deployed solutions that meet physician and patient needs at the point of facilitating high-quality care, an ability to transmit electronic patient information at low cost to both physicians and patients and they are committed to local, provider-driven HIE that promises to preserve the time-honored physician-patient relationship.”
Byington stressed that security and privacy issues are paramount with FHDN.
“Robust HIE actually improves patient privacy by reducing unauthorized access to patient data,” said Byington. “With HIE, we can prevent records from being faxed to the wrong locations and know exactly when and who accessed a patient record.
“The key is that we’re not a monolithic statewide HIE organization, but a unifier, integrator and consolidator of local providers and HIE organizations,” added Byington. “We connect any provider or organization and build uniformity, consistency and accessibility as needed to share information across communities, regions and, ultimately, states. We’ve also added Direct-enabled, secure messaging to FHDN; however, unlike other Direct messaging platforms, FHDN-facilitated messages can be automatically integrated as a part of the patient HIE clinical record rather than as a stand-alone, non-relational communication.” Direct is a national, secure-messaging platform used by some physicians and other medical providers. “With this capability, a single provider login is all that’s needed to access patient clinical records and send secure communications to those not yet participating in an HIE.”
HIE Networks’ FHDN currently has records for nearly one million unique Florida patients representing about 5 percent of Florida’s population. In addition, FHDN already processes more than 32 million messages and responds to more than 800,000 user queries. Current community commitments are expected to increase FHDN’s records to about 12 percent of the state’s population by second quarter 2012. “We expect that percentage to grow exponentially over the next year and beyond,” said Byington.
Nationally, the concept of an interconnected, private and secure electronic medical record (EMR) system is getting more attention, thanks in part to the 2009 American Recovery & Reinvestment Act (ARRA, also known as the stimulus bill) which set aside more than $20 billion for incentives to health care providers to deploy and use such systems. During the past year, many more providers have come on board the EMR train, says Byington, and many more are finally starting to see the benefits of HIE.
HIE Networks’ strategic partnership with Über Operations – also a Tallahassee-based company – will address the large-scale integration requirements needed to program EMR interfaces of providers statewide and beyond. “Über Operations’ existing work with the Florida Department of Health and healthcare organizations throughout the nation position the FHDN to streamline the on-boarding and interfacing process for providers and trading partners,” said Byington.
“For the past seven years, we have focused on providing expert and innovative data integration services to both public and private healthcare organizations throughout the nation,” said Eduardo Gonzalez Loumiet, Managing Director of Über Operations. “With this new network, we will be in a position to implement state-of-the-art technology to connect local providers, ultimately improving the health care of millions.”
HIE Networks grew out of the Big Bend Regional Healthcare Information Organization, which was profiled in a recent report on leading HIEs by the National eHealth Collaborative (NeHC). In response to news of the launch of FHDN, Kate Berry, CEO of NeHC, said, “Today’s announcement is an impressive example of continued innovation in HIE with a relentless focus on what’s best for the patient. The Big Bend team and its broader HIE Networks company are leveraging technology to bring low cost solutions to the market that will benefit patients by improving safety, quality, care coordination, and achieving cost savings.” To view the NeHC report, go to www.nationalehealth.org/secrets-hie-success-lessons-leaders.
For more information about the Florida Health Data Network and HIE Networks, go towww.HIEnetworks.com, call (850) 702-0365 or email zach@HIEnetworks.com. For more information about Big Bend RHIO, go to www.BigBendHealth.com.
About HIE Networks, LLC
HIE Networks is a leading provider of local health information exchange (HIE) services, with secure, standards-based exchanges that create and operate efficient, effective and sustainable health information networks at the local and regional levels. By acting as a region’s single reference point for patient records, HIE Networks allows hospitals, physicians and medical practices, laboratories, pharmacies and insurers to collaborate and streamline patient care, thereby improving the safety, outcomes, privacy and efficiency of healthcare services in their local communities. The HIE Networks service mix includes practice consultation, social architecture, legal structure, hardware support, software implementation, networking, integration, training and support.
About Big Bend RHIO
Big Bend RHIO is a federally-recognized 501(c)(3) not-for-profit that has deployed BigBendHealth.com, a first-of-its-kind health resource that brings with it economic benefits, a connected workforce, improved medical care and a breakthrough in exchange of clinical records. It serves as an essential communication resource for health care in the Capital region, with many resources offered in one place. BigBendHealth.com is the largest active regional HIE in Florida with millions of records for over 500,000 unique patients in the system and processing over 600,000 new clinical messages a month. BigBendHealth.com initiatives involve every major component of North Florida’s local healthcare system from physicians’ offices to HMOs to hospitals, laboratories and pharmacies. BigBendHealth.com is a partner in the delivery of safer, more cost-effective healthcare, placing its community at the head of the line for federal and state research dollars and making Tallahassee a model for other communities seeking to control the cost and improve the quality of local healthcare. BigBendHealth.com is anchored in Tallahassee, Fla., and serves nine counties in the Big Bend area of the Florida Panhandle, including Gadsden, Franklin, Jefferson, Leon, Liberty, Madison, Wakulla, Taylor and Dixie counties.
About Über Operations
Founded in 2004 in Tallahassee, Fla., Über Operations is a leading provider of health care IT services. They have provided integration services for well-known organizations, including the Florida Department of Health, Texas Department of State Health Services, Mercy Hospital of Miami, National Cancer Institute, Trinity Health, Association of Public Health Laboratories, and the University of Washington. Über Operations’ team members are experts in various technologies, such as Rhapsody, Cloverleaf, Mirth, PHINMS, Direct, and NwHIN CONNECT, to name a few. Über Operations is nationally recognized by the Association of Public Health Labs (APHL) and the CDC as their choice to architect, develop, host, and support the PHLIP RnR health information exchange hub. Über Operations was named “Health Innovators” by Florida Trend Magazine in 2011. For more information on Über Operations please visit www.UberOps.com
Team Member Profile: Linda Nelson December 12, 2011
Posted by gonzalezloumiet in Data Integration, EMR, Health Care, HIT, Stimulus Plan, Team Member Profile, Technology, Uber Operations.Tags: FDOH, Florida, Linda Nelson, Tallahassee, Uber Operations
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Linda Nelson joined Uber Operations a little over a year ago. Linda Nelson’s experience includes executive, program management, policy development, technical, leadership, commercial, and governmental roles throughout her highly successful career. Her diverse resume includes commercial, local, state, and national expertise in management and consulting in organizational development, health care, telecommunications, information technology, education, infrastructure development, and statewide and national safety.
She has served as Chief Information Officer (CIO) of the Florida Department of Health, Management Services and the Palm Beach County District Schools, the State of Florida Telecommunications Director, Executive Director of the Florida Distance Learning Network, and Director for Center for Educational Technology for the Department of Education.
Linda has presented internationally, nationally, and at the state and local levels on areas as diverse as infrastructure development, FCC deregulation, economic development, telemedicine and electronic health records, bio-terrorism, privacy, security, and product and service development for emerging markets.
Specific areas of expertise include information management (security, user access controls, data integrity and integration), data and system integration, telecommunications (data, voice, video, image, and Internet protocols), and infrastructure (hardware, software, e-business systems/software), regulatory compliance, quality management (LEAN, Six-Sigma), public policy, strategic project and program management, enviro-consulting, sustainability (SPARK/SCORE, LEED, DSM), and strategic business/project development.
Linda is a graduate of Leadership Tallahassee Class 24 and founding member of College Leadership Tallahassee. She is a Board Secretary of Rotary International, Tallahassee Sunrise Chapter. She is Vice-Chair for the Board Directors for Big Bend Community Based Care (corporation), Secretary and Executive Board Member Early Learning Coalition, President of the Board of Directors for the Office of Public Guardian, President of Big Bend Crime stoppers, and President and CEO of EarthSTEPS, LLC. She is an appointed member of the Leon County Schools External Audit Committee and serves/or has served on a variety of other committees including the 2007 Community Human Services Partnership committee. She is a Team Member at BCMPros. Linda volunteers for many community based initiatives including providing meals for the local homeless shelter. She continues to serve on national workgroups and presents on related Information Technology, Privacy and Security, Health, Social Service and Environmental issues.
At Uber Operations, she is currently working on a project for Hillsborough County, Florida.
Linda on LinkedIn.
Health IT is set to grow – and consolidate April 6, 2009
Posted by gonzalezloumiet in American Recovery and Reinvestment Act, Health Care, Stimulus Plan.add a comment
Mon Apr 6, 2009 4:21pm BST
By Debra Sherman – Analysis
CHICAGO (Reuters) – As interest in the health information technology sector swells ahead of government funding to modernize the U.S. healthcare industry’s record-keeping system, consolidation cannot be far behind.
The U.S. stimulus package includes $20 billion to create computerized systems that can easily communicate with one another, replacing reams of disparate, paper records.
Both large and small companies are likely to join forces to increase the scope of their offerings, while others are looking to enter this potentially lucrative business.
Some 225 companies are exhibiting for the first time at the annual Health Information Management Systems Society meeting this week, which has drawn more than 23,000 health IT professionals.
“You can’t dangle billions of dollars in front of an industry and not expect more people to try and get involved,” HIMSS Chief Executive Stephen Lieber told Reuters.
From the Chicago meeting site, Lieber said he expected some of the bigger players, which include the healthcare arm of General Electric Corp (GE.N), Siemens (SIEGn.DE), McKesson Corp (MCK.N) and Cerner Corp (CERN.O), to acquire smaller companies to broaden their scope.
“You may see a lot of the smaller ones merging,” he added.
More partnerships are also likely.
On Monday, computer maker Dell Inc (DELL.O) announced an alliance with Perot Systems (PER.N) to provide desktop, storage, server and electronic medical records systems for physician’s offices, hospitals and other healthcare providers.
Dell also said its EMR and Clinical Practice Management package to help small medical practices cut paperwork would be available at Wal-Mart’s (WMT.N) Sam’s Club stores.
“If we want massive adoption, it has to be inexpensive,” said Paul Bell, President of Dell Public, which helps healthcare, government and other public organizations improve their use of information technology.
Dr. James Coffin, general manager of Dell Healthcare and Life Sciences, estimated the market for electronic medical records would reach $20 billion globally over the next few years, from a tiny fraction of that amount now. He declined to predict how much of this market Dell can capture.
THE WAL-MART EFFECT
Lieber noted that about half of U.S. physicians practice alone or in groups of three or less, which makes distribution of Dell’s EMR product through Sam’s Club’s broad retail network potentially transformational.
“Wal-Mart has the potential to do to healthcare what it did to retail,” he said.
And last week, GE and Intel Corp (INTC.O) said they would invest $250 million in the field over the next five years to develop devices to help doctors monitor patients remotely, an area they said could grow into a multibillion-dollar business.
GE is working on electronic medical records as well, and the conglomerate’s CEO, Jeff Immelt, said the stimulus program could “tangentially” benefit the project with Intel by stimulating investment in healthcare technology.
Kaiser Permanente and the U.S. Veterans Administration have the most advanced electronic medical systems.
Kaiser, the largest nonprofit U.S. healthcare organization, invested $4 billion to computerize its system and created 10 million electronic medical records in three years time. Even in the project’s early days, the company has seen cost savings and efficiencies, a reduction in medical errors and better care as a result, Chief Executive George Halvorson told Reuters.
Halvorson, a keynote speaker at the HIMSS conference, cited Kaiser’s Colorado pilot program that linked coronary artery disease patients with teams of primary care physicians, nurses and pharmacists, and created an electronic care registry. By providing more information to caregivers, the program cut cardiac deaths by almost two-thirds, he said.
For its part, HIMSS, whose 20,000 members include doctors, nurses, IT professionals, financial specialists, insurance representatives and corporations, is embarking on a public awareness campaign to explain how electronic medical records improve health outcomes.
“Automating documentation and electronic records takes some of the art out of medicine and puts more science in medicine,” Lieber said. “That shouldn’t be a problem. I want more science in medicine.”
(Editing by Lisa Von Ahn)
New law helps open source April 2, 2009
Posted by gonzalezloumiet in EHR, HHS, HIT, Mirth, open source, Stimulus Plan.add a comment
• By John Moore
• Mar 30, 2009
The economic stimulus law mentions health information technology dozens of times, establishing an agenda to promote electronic health records, form standards committees and work out health information privacy and security impasses.
However, the $20 billion package also contains a more obscure provision that has buoyed hopes among advocates of open-source technologies projects that have struggled to gain acceptance in the health IT marketplace.
Tucked away in the law is a call to explore open-source technologies in the healthcare setting. The provision directs the Health and Human Services Department to conduct a report on the “availability of open-source health information technology systems.”
The study will look into the availability of heath IT open source systems and compare its total cost of ownership to proprietary systems. Congress must report on the progress of the study by Oct. 1, 2010. Although a relatively minor provision, open-source advocates consider it significant.
“This is first actual piece of federal legislation that explicitly uses the term open source,” said Richard Li, product marketing director for healthcare at Red Hat, an open source software company. Sen. Jay Rockefeller (D-W.V.) sponsored the amendment that set up the open-source study. His staff could not be reached for comment.
Li said Rockefeller was especially interested in open source as a way to serve small, rural healthcare providers. Consequently the amendment has a rural slant, calling on HHS to consider the circumstances of “healthcare providers located in rural or other medically underserved areas.” “Small rural providers don’t have large enough health IT budgets and little internal expertise,” Li noted. Red Hat worked with Senate and House members to support the open source study and other health IT provisions.
Cost is a huge consideration in heath IT adoption, particularly for underserved communities, said Kiki Nocella, chief executive officer of Believe Health, a health consulting firm. Nocella cited her work with a rural regional health information organization in Tehachapi, Calif., which took the open-source route.
“On the whole, the open source approach was less expensive when we did our RFP process than the proprietary approaches,” she said.
Open source allows for greater customization, an important feature for underserved communities, Nocella said. Smaller, rural communities are not smaller versions of urban centers, she noted, but have requirements that might be unique to the community. In contrast, a vendor of proprietary systems tends to scale their offerings to fit the price point of rural customers. But that method can eliminate important health IT features.
Although the ARRA study might mark a greater federal interest in open source, projects such as Tehachapi’s were already on Washington’s radar. Over the course of the project, its team met with officials from the federal Office of the National Coordinator of Health IT. “Part of what they found intriguing was the efficiency” of using open source to build the project, Nocella said.
Deborah Bryant, public sector communities manager at Oregon State University’s Open Source Lab, said the HHS study reflects growing interest in open source as an opportunity for health IT.
“I don’t believe this study would have been funded if there wasn’t already an awareness that there are many projects out there that are already underway,” she said.
About the Author
John Moore is a freelance writer based in Syracuse, N.Y. You can reach him at editor@govhealthit.com.
SOURCE: http://govhealthit.com/articles/2009/03/30/arra-open-source.aspx
Public health IT grant seekers flood CDC program April 2, 2009
Posted by gonzalezloumiet in CDC, Centers of Excellence, Dr. Scott McNabb, NCPHI, Stimulus Plan.add a comment
Stimulus bill, economic downturn generate overflow of applications for CDC’s informatics program grants.
* By Maureen McKinney
* Mar 31, 2009
Officials at the National Center for Public Health Informatics at the Centers for Disease Control and Prevention are expecting a deluge of applications for its latest round of Centers of Excellence grants based on early signs of interest from funding seekers.
During a March 30 conference call, potential applicants for the informatics “incubator” grants jammed phone lines. “We’ve received lots of interest from a range of organizations,” said Dr. Scott McNabb, NCPHI’s associate director for science, who added that NCPHI had already received 40 letters of intent to apply.
The response forced NCPHI to schedule a second call for those who were unable to get through.
“The stimulus bill obviously focuses a lot on health IT and I think there’s a lot of interest in it right now,” McNabb said. “The other factor is that these institutions are being forced to tighten their belts and they’re looking for new ways to save resources.”
The Centers of Excellence in Public Health Informatics grant program was created in 2005 as a way to spur innovation in health IT for grid infrastructure, public health decision support, statistical and health surveillance, and other informatics tools.
According to NCPHI, the centers were originally conceived as “incubators for transformational public health informatics research.”
Spurred by the success of the first five research centers – two of which received awards in 2005 and three in 2006 – NCPHI has extended the program and will designate a new group of organizations.
The CDC intends to commit $5.5 million in 2009 to fund four or five new centers, he said. The average award amount will be $1 million per center for the first 12 months, and McNabb estimates that the total cost of the five-year program will be $27.5 million.
The strongest applications, according to McNabb, will have a well-defined goal and will clearly demonstrate how their results could practically apply to public health informatics and the everyday practice of public health.
NCPHI provided applicants with several examples of appropriate research projects. Among the suggestions were developing a low-cost open source model to simplify data exchange and data access, and examining evidence-based public health decision support systems.
“We did include examples of projects, but it is important to stress that these are just examples,” McNabb said. “We’re really hoping that applicants are creative and think outside the box because we think that’s where the best ideas will come from.”
Funding for the five existing Centers of Excellence in Public Health Informatics runs out this summer, and although they will be able to apply for the latest grants, they will have no advantage over first-time applicants, McNabb said.
The CDC posted the request for applications Feb. 9 and interested organizations must apply by April 10. The scientific peer review process will begin in May, and McNabb is hopeful that NCPHI will announce the award winners by the end of the fiscal year in late September.
About the Author
Maureen McKinney is a freelance writer based in Chicago, Ill.
SOURCE: http://govhealthit.com/articles/2009/03/31/cdc-program.aspx
Open Sourcing Healthcare One Patient at a Time April 2, 2009
Posted by gonzalezloumiet in Health Care, Obama, open source, Stimulus Plan.1 comment so far
By Jack M. Germain
LinuxInsider
04/01/09 4:00 AM PT
The billions in federal stimulus funds directed toward the development electronic health records may help modernize the system, but it will likely be a slow process. Meanwhile, New York Lawyer Patrick Donahue is taking the initiative by launching the Sarah Jane Brain Project. His efforts are aimed at jump-starting innovative treatment for pediatric brain injuries using open source methods.
Open source healthcare IT solutions are just beginning to become acceptable alternatives to proprietary software systems. As is happening in other fields, open source medical projects are getting noticed as cost-saving alternatives to proprietary vendors.
The battle for supremacy between the two marketing strategies may gain national political attention as President Obama’s administration drives toward the creation of a national electronic health records (EHR) network built on standards for interoperability and affordability. The US$20 billion in health IT funding incorporated into the economic stimulus package is bolstered by the Health Information Technology for Clinical Health (HITECH) Act of 2008. That legislation calls for a national, interoperable network of electronic health records through open source standards.
The stimulus package will pave the way for hospitals to adopt electronic health records (EHRs). The federal funds will help the health records industry solve the lingering financial barriers that hindered health IT adoption in recent years. However, it’s still unclear whether the government will push for open source projects over a specific proprietary software developer.
Meanwhile, a new open source organization called TheBrainProject.org is seeking both government and private funding for what its founder, New York Lawyer Patrick Donahue, claims is the first-of-its-kind open source platform dedicated to uniting the medical profession in a battle against Pediatric Traumatic Brain Injury (PTBI).
“It’s a very fractured field out there. It is reminiscent of what the computer science industry went through in the 1950s and 1960s where you had brilliant people all over the world working but nobody knew what everybody else was doing,” Donahue told LinuxInsider.
Industry Skirmishes
Elsewhere in the open source medical records field, a still quiet fight is waging between supporters of open source software modeled after the U.S. Department of Veterans Affairs’ VistA EHR and commercial vendors. Currently, VistA contains roughly 2.1 billion clinical documents, 2.76 billion orders, and 1.51 billion images. Commercialized versions of VistA, such as MedSphere’s OpenVista, are vying for selection by hospitals, clinics and integrated delivery networks.
Parallel to this controversy, Donahue for the last two years has been pulling together a crusade to create another type of open source medical records project. This data repository would accumulate medical records on pediatric head injuries and research on the disparate treatments for victims of Pediatric Traumatic Brain Injury (PTBI).
To that end, Donahue last October launched the Sarah Jane Brain Project. His efforts were aimed at jump-starting innovative treatment for brain injuries similar to the one his three-and-a-half-year-old daughter suffers. They spawned a nationwide upswell of sponsors to press for federal funding and international medical interaction for all victims of PTBI and Pediatric Acquired Brain Injuries (PABI).
What began as the Sarah Jane Foundation is now modeled on the same strategies that drive open source communities. The TheBrainProject.org, headed by Donahue, is guided by a national advisory board.
“I saw a parallel in how all the breakthroughs in computer science came from sharing knowledge and community-driven activities,” said Donahue about what led him to travel the open source route for his medical records public warehouse.
Foundation’s Incubation
Sarah Jane is Patrick’s three-year old daughter. Her nurse shook her when the infant was five days old, resulting in Pediatric Traumatic Brain Injury or PTBI. The infant’s injures included three broken ribs, a broken collar bone and severe brain injury. The nurse is currently serving a 10-year prison term.
That incident is what introduced Patrick Donahue to the leading cause of death and disability for children under 15 years of age in the United States. PTBI causes more than 5,000 deaths annually. It causes permanent disability to more than 17,000 children annually, and some 1 million children are hospitalized each year from it, according to Donahue.
PTBI includes all brain injuries caused by trauma from falls, motor vehicle accidents, assaults, sports incidents, gunshot wounds and bicycle accidents.
However, its definition as a children’s death threat is misleading. Some PTBI victims are actually military veterans returning from Iraq and Afghanistan. Since most children’s brains do not fully develop until age 21 or 22, many of the traumatic brain injuries actually qualify as pediatric brain injuries, said Donahue.
Related to this is Pediatric Acquired Brain Injuries (PABI). These are caused by brain injuries, brain tumors, strokes, meningitis, insufficient oxygen, poisoning, ischemia and substance abuse.
The Mission
Patrick’s goal was to create a model system for children suffering from all Pediatric Acquired Brain Injuries. He envisions the project becoming the most collaborative medical project ever put online.
Doctors told him that if he presented just one head injury case to a panel of 20 medical experts, he would get 20 different treatment approaches. His response was to put all of his daughter’s medical records online under General Public License (GPL) and invite doctors and researchers to access them.
“This is scary stuff,” he said upon learning about the fragmented knowledge left untracked in the medical field. His own research quickly showed him that there was no organized set of data on the injuries or treatments for PTBI. He recognized that medical science is just barely scratching the surface on brain injuries.
The commonality with all head trauma victims’ families is constantly having to reinvent the wheel. There is no standardization of care, according to Donahue.
“It’s a crap shoot from state to state,” he noted.
Fractured Funding
Donahue also learned from medical practitioners that the problem he faced in setting up a pediatric brain injury model system is political support and funding for the pediatric treatment.
No stranger to the worlds of politics and fund-raising in his home state, Donahue knew that politicians listen to victims and victims’ families. He sought the creation of a PBI Act in Congress. He delivered a letter to President Obama at the onset of his administration pleading the case for federal support for his infant foundation.
To maximize his chances for widespread acceptance, doctors and supporters he worked with suggested that Donahue expand the scope of his medical records repository to include Pediatric Acquired Brain Injuries. That larger victim group is now the focus of his efforts.
“The medicine and the science goes where the money is,” Donahue said.
If We Build It …
The concept behind creating an open source medical repository of data on PTBI and PABI victims will bring truth to the old saying, “If we build it, they will come,” according to Donahue.
The exposure of medical records includes the complete medical and therapy records on Sarah Jane. In addition, the records of other children suffering from PABI are available to doctors, researchers, other parents and caregivers, therapists, students and the general public through the project’s Web site.
The project uses the GNU open source principle to empower the medical community. Donahue hopes that licensing the medical records and going about the discovery process in the same way that software communities work will jump-start more effective treatments.
The End Game
Donahue admits he is not a patient man when it comes to the welfare of his daughter. He expects the open source medical records project will accelerate the progress of medical research for head injuries. Traditional boundaries will not slow down that progress. “Some medical researchers might pore over one or more reports in the middle of the night instead of looking at football results,” he explained. They’d better — it’s the only way the project will succeed in cramming 50 years of progress into the next five.
SOURCE: http://www.linuxinsider.com/story/Open-Sourcing-Healthcare-One-Patient-at-a-Time-66688.html
Questions surround health IT money March 23, 2009
Posted by gonzalezloumiet in FBI, HHS, HIT, IBM, Obama, Standards, Stimulus Plan.add a comment
By ERICA WERNER – 10 hours ago
WASHINGTON (AP) — Here’s the best-case scenario for the government’s plans to spend $19 billion on computerized medical records: seamless communication among doctors and patients, and far fewer mistakes.
And the worst-case: $19 billion goes down the drain.
The medical industry is hoping for the first outcome, even while some fear the second, as the Health and Human Services Department tries to get hundreds of thousands of doctors to quit using paper files and join the digital age.
The money for the massive undertaking is in the economic stimulus bill that President Barack Obama signed into law last month.
“We need to get this right,” said Dr. David Kibbe, a senior adviser at the American Academy of Family Physicians. “Adoption of information technology for its own sake really is not the end game.”
The end game, Kibbe and others say, is for doctors’ offices and hospitals to be able to easily share patient information, something the vast majority can’t do today. That would cut down on mistaken and unnecessary procedures and give doctors faster access to more accurate information about patients’ medical histories and drug regimens.
The government’s history of undertaking major technological upgrades isn’t entirely encouraging.
The FBI spent four years and $170 million trying to modernize its paper-based case system, only to kill the project in 2005. Before that, the Federal Aviation Administration wasted more than $1 billion trying to overhaul the air traffic control system.
For advocates of the health technology transformation, the biggest fear is that the money could pay just for making paper records electronic, without giving doctors and hospitals much greater ability to connect.
“It’s not going to improve the decisions that either providers of care or patients make unless we get that information to move from the existing stovepipes,” said Zoe Baird, president of the Markle Foundation, which works to improve health care and national security.
The U.S. lags behind many other countries in adoption of electronic health records. A report in the New England Journal of Medicine, based on surveys from 2007 and 2008, found that 4 percent of physicians had extensive, fully functional electronic records systems, while 13 percent had more basic systems.
Typically, many systems aren’t connected to other physicians or hospitals. Dozens of vendors compete to sell proprietary systems that often cannot communicate with each other. Installation costs are prohibitively expensive for some doctors, particularly those in small practices.
Lawmakers and the Obama administration say they are aware of those problems and tried to write the stimulus legislation to address them. The bill envisions new standards to drive development of systems that are better able to communicate, and requires doctors and hospitals to show they’re going to be able to put those systems to “meaningful use.”
Computerizing records will “save money, improve the quality of care for patients and make our health care system more efficient,” HHS spokesman Nick Papas said. “We will move quickly and carefully to help implement this technology.”
But important details are missing from the legislation. A health secretary is not yet on the job, and other important officials are not in place. Just on Friday, the administration named the official who will serve as national coordinator for health information technology — Dr. David Blumenthal, a former Harvard Medical School professor who advised Obama during the presidential campaign and once worked for Sen. Ted Kennedy, D-Mass. Kennedy is chairman of the Senate Health, Education, Labor and Pensions Committee.
The stimulus bill specifies that $17 billion is to be spent in incentives through Medicare and Medicaid to nudge doctors and hospitals toward electronic record-keeping beginning in 2011. In 2015, financial penalties will start for doctors and hospitals if they haven’t done so.
What systems will be deemed acceptable? How will doctors and hospitals be able to show they will put such systems to meaningful use? Those questions remain largely unanswered.
Preliminary technological standards are due at the end of this year. That doesn’t give doctors, hospitals or technology companies much time to get systems up and running by 2011.
The bill also contains $2 billion for items such as health technology grants, training initiatives and state programs. The uncertainty surrounding this money has touched off heavy lobbying from interest groups hoping for a piece.
“The devils are in the details and we don’t know the details,” said Janet Marchibroda, head of the eHealth Initiative, a nonprofit that advocates for health improvements through technology.
Still, many health care professionals are optimistic about the prospects for a more connected health care system ahead.
“It will take time to get there,” said Tom Romeo, IBM’s vice president for government health care. “But everything’s in place to really make a huge jump forward now like it never has been before.”
Copyright © 2009 The Associated Press. All rights reserved.
Health care experts warn of challenges for IT adoption March 19, 2009
Posted by gonzalezloumiet in American Enterprise Institute, EMR, HIT, nationwide health information exchange, Obama, Standards, Stimulus Plan, Trinity Health.add a comment
by Stephanie Condon
WASHINGTON–President Obama has called health information technology the “low-hanging fruit” of health care reform, but implementing the use of electronic medical records nationwide will be incredibly difficult, experts warned Wednesday, especially without larger health care reforms.
The Congressional Budget Office estimates that the use of electronic medical records could save the nation $12.5 billion over 10 years, and other analyses give more optimistic figures.
At a forum here on Wednesday, hosted by the conservative think tank the American Enterprise Institute, health care providers and buyers attested to the improved quality of care and efficiencies that can result from the use of properly implemented electronic medical records. Yet without new policies to incentivize the use of health IT systems, the stimulus funds may go to waste, they said.
“We have an incredibly complex industry that doesn’t necessarily want to change,” said Joseph Swedish, president and CEO of Trinity Health, a nonprofit health care provider that includes 44 hospitals in its network. “I think the stimulus can prime the pump, but we have to recognize the daunting task ahead of us.”
TheTrinity Healthdirects health care providers to electronically record patients’ health information for “biosurveillance and public health” and “medical and clinical research” as part of a “nationwide system for the electronic use and exchange of health information.”
However, Swedish and other health care experts said providers will be reluctant to share data–or even use health IT systems in the first place–because of the pay-for-service structure and other institutional characteristics of the health industry.
Coordinators of a federal health care IT initiative have said developing a national health IT network will be extremely difficult and slow going because of the endless number of varying standards for medical health records applied in different states and localities.
Yet Benjamin Sasse, an assistant professor at the University of Texas at Austin, said Wednesday that providers themselves–not a lack of consistent standards–are the biggest roadblock to a nationwide health information exchange.
“The standards problems are absolutely real, but if you want a sticky patient, why would you ever make a patient portable and available to your competitor?” he asked. “Most of the reasons we don’t have (health) IT have nothing to do with IT.”
“There are a lot of complexities with the sharing of data…I don’t envision in the near term being able to work with others.”
–Joseph Swedish, president and CEO of Trinity HealthTrinity Health, along with Kaiser and the U.S. Department of Veterans Affairs, has one of the nation’s largest integrated, single-platform data management systems and is using its repository of information to adopt more evidence-based treatment. However, Swedish said, Trinity is not sharing data with Kaiser or other providers.
“There are a lot of complexities with the sharing of data,” he said. “I don’t envision in the near term being able to work with others.”
Trinity rolled out its health IT network in 2000 and incurred operational costs that greatly exceeded estimates, Swedish said, but also achieved more benefits than anticipated. Its hospitals, for instance, administer emergent medications 40 percent faster, and Trinity’s nurses have increased their bedside attendance of patients by 8 percent now that they spend less time on paperwork.
“We have witnessed lowering costs and what we believe is better quality,” he said. “We believe the investment is absolutely the right thing to do in the modern world we live in today.”
Still, he said, the process took years to implement, the benefits would not have been possible with just the IT–a change in culture and staff processes was also necessary.
The economic structure of the health industry does not only deter providers from sharing information, but also from simply adopting health IT in the first place, Sasse said.
“Health IT is (part of) a much larger debate around payment reform that would provide much higher care than the fee-for-service system does today,” he said.
SOURCE: http://news.cnet.com/8301-13578_3-10199405-38.html
