As the landscape for Healthcare IT software and services continues to expand, the federal government has noted that security and data management will need some innovation and reinvention regarding the electronic medical record.  Approximately $60 million has been allocated to researchers for the following according to an article in HealthLeaders:

According to the article, funding for the four-year research period will target:

• Security of health IT research to develop security and risk mitigation policies and the technologies to build and preserve the public trust as health IT systems become ubiquitous.
• Patient-centered cognitive support research to align health IT with the day-to-day practice of clinicians as they provide care.
• Healthcare application and network platform architectures research to achieve electronic exchange and use of health IT securely, privately, and accurately.
• Secondary use of electronic health record data research to improve the overall quality of healthcare, population health, and clinical research, while protecting patient privacy.     —-The program is called SHARP, Strategic Health IT Advanced Research Projects.  Applications are due January 25, with awards anticipated in March 2010. Information about the SHARP program can be found at http://HealthIT.HHS.gov/ and at www.grants.gov.

John Goodman of the conservative Dallas based think tank National Center for Policy Analysis (NCPA) issued a “William Wallace-esque’ FREEDOM pitch today on his blog entitled Reforming Health Care the Right Way.

This is a man who previously claimed that there are no uninsured (from a health insurance point of view) in America; afterall he posits that everyone has access to the ER, so what are you complaining about? (paraphrased).

In his blog post today on the day after the historic Senate vote to advance the health care bill, Goodman opines on the right and wrong way to reform US healthcare.

What I find most insightful is the rebuttal comment proferred by Uwe Reinhardt as to the fantasy world this man, and unfortunately many other ideological predisposed converts, apparently inhabit. This industry defies over simplification, and disingenuous over simplification is the prima facie basis on which the opposition has stimulated emotive mis-understanding of the nature of the malady as well as it’s appropriate and quite comprehensive remedy.

Enjoy! And your comments are both encouraged and welcome whether pro or con…

Uwe Reinhardt Says:

December 21st, 2009 at 1:12 pm

I hear Richard Branson of Virgin Air is seriously exploring space travel as a commercially feasible project.

Once he has that done, I shall be able to book a flight to the distant planet on which John Goodman lives.

It is the planet on which all physicians always are purely the agent of their patients and do not have any economic conficts of interest — such as making money on tests they prescribe to anxious patients or from referring patients to imaging centers in which they have a state or to collegues with whom they play gold, and so on. Such conflicts of interest do not crop up on John’s planet, not because government forbinds them (there is no government on that planet), but because such conflicts of interest just don’t exist there somehow. Remember: it’s another planet!

On John’s planet it is also easy to have price competition among physicians, because all ill health on that planet can be cured with just one standard, well defined “unit of health care.” What that is I do not know, but John does, because he lives there. He’s probable consumed some, rationally, I wouold assume.

Contrast that with an earthbound hospital charge master with 20,000 itsems in it or the physician fee schedule with 7,000 items in it. How would one make diffenetials in the elements of those huge vectors understandable to patients?

John took on a new religion on that planet to where he actually immigrated — he once lived on earth. On earth he always boldly talked for decades about “Consumer Directed Health Care,” but neither he nor his entire think tanks (the NCPA) every did a stitch of work to help develop the user-friendly price information that patients as “consumers” would need to make rational choices in health care ex ante.

Once on the new planet, John realized that he sinned on earth and swore to do better there. Of course, on his new planet it’s easy: there is only one type of health care and one price. The redemption was a piece of cake.

All people on John’s planet have the same income — in fact, they all have John’s high income and all also have Ph.D.’s. or M.D.s So the problem with poor people not being able to afford high deductibles and therefore stiffing doctors and hospitals for it does not exist on John’s planet. Nor is there a problem with health illiteracry, because everyone on John’s planet has a Ph.D. or M.D. Every patient on John’s planet knows exactly what he or she needs before going to a doctor and simple shops around for a low price.

For the most part, an individual’s need for health care in a coming year on John’s planet is certain and predictable and thus not really insurable. Only the need for about 20% of all health care is stochastic and hence insurable.

On John’s planet, 50% of any large group of people account for 50% of all health spending — 80% of the people account for 80% of all health spending. Here on earth, 20% of the sickest account for 80% of all health spending, and much of that 80% will also be insured. It will be managed by some insurance clerk coming between doctor and patient.

Oh how I long to go to the planet where John Goodman lives, where life is so easy and so simple. I am so tired of the mess here on our planet. Aren’t we all?

Small wonder that John just up and left Mother Earth for a planet where all his theories actually work.

PeRSSonalized Medicine is an easy-to-use, free aggregator of quality medical information that lets you select your favourite resources and read the latest news and articles about a medical specialty or a medical condition in one personalized place.

Now here is the newest category, PeRSSonalized Pediatrics with all the quality news sites, blogs, peer-reviewed journals and web 2.0 tools focusing on pediatrics.

Some reasons why it is unique:

• You can search in the database. It means you will find medical information only from a quality selected portion of the world wide web.

• You can personalize any of the sections.

• You can also receive the newest Pubmed articles focusing on your search term. Just insert your field of interest, a therapy, a condition, etc. and click Search. Then you can add the newly created box to your personalized medical “journal”.

• It is a community-based project. Please let us know which quality resources should be added to the database.

• The increasing use of social media to recruit patients for clinical trials (Pharma Strategy Blog): There are more and more news ways for patients to find ongoing clinical trials and also for pharma companies to find interested patients.

• ResearchGATE and Its Savvy Use of the Web (BusinessWeek): The world’s biggest scientific community site has over 200,000 members and an official blog which I’m a co-author of.

• Buzzwords in Academic Papers (Flowing Data)

• 20 People Who Make Healthcare Better (Health Leaders Media)

• FDA Social Media Guidelines Best Done in Baby Steps (Pharma Marketing Blog)

• Are any of these the Web’s next big thing? (CNN)

• Hacked Wiimote Makes Super Scientific Sensor (Wired Science)

To gamers, $40 may seem like a steep price to replace a Wii remote controller, but to scientists, a hacked Wiimote is a steal compared to the pricey sensors needed for a lot of field research.

Inspired by videos of renowned hacker Johnny Chung Lee turning the Wiimote into a finger-tracking device and a touchscreen white board, physicist Rolf Hut of Delft University of Technology built a Wiimote wind sensor.

I’ve been organizing scientific events and medical conferences in the virtual realm of Second Life for years. Though it has some serious limitations.

• If you don’t have IT experience, it will be quite hard to download and install it.
• Costs a lot if you want to upload content.
• Creating slideshows is a complicated and long process.

In the last couple of months, I’ve been a consultant for a Hungarian team that developed Visuland which should be a perfect alternative for Second Life:

• Takes about 20-30 seconds to enter: You come up with the idea to organize an event and send the specific links to the potential attendants. They click on the link and get into your conference room in 20-30 seconds.
• No need of installation and registration
• Real-time voice communication
• Real time video-streaming on virtual screens (you can stream your presentation plus your face via webcam at the same time)
• Efficient presentation tool -> conferences, workshops, meetings
• Editable posters and textures -> personalized rooms, advertisements
• Any website, blog, forum can easily create its own virtual place
• Public and private chat, transcript can be saved
• Zero cost for not commercial users

Take a look at it yourself and see how fast you can enter Visuland. It has one major limitation, it only runs on Windows but will run on Macintosh as well in a few months.

It was the strangest headline this week. Let’s see a case study focusing on how to promote a device carefully and how to deliver false message about the use of online health information.

When Leroy Smith’s pregnant wife started going into labor, the desperate dad didn’t turn to the doctors, but to Google.

Unsure of what do when his wife, Emma Smith, began having contractions at their home, and fearing that the midwife wouldn’t arrive in time, the dad-to-be grabbed his Blackberry and Googled “how to deliver a baby.”

Leroy, a security guard, followed the step-by-step instructions he found on wikiHow, and successfully delivered his and his wife’s baby girl, Mahalia Merita Angela Smith.

First, people should contact online health information resources in severe situations only when there is no chance to get professional help. I saw myself how an operator could help deliver a baby by instructing the guy who made the call. I cannot imagine a situation where you cannot call professional help but can access WikiHow.

I gave an interview to one of the biggest Hungarian educational web portals, Felvi.hu about Webicina.com and Health 2.0. An excerpt:

Webicina.com is a freely accessible resource base for those who wish to read useful medical web pages, but cannot decide which ones are reliable and which ones are not. PeRSSonalized Medicine analyses the quality of Hungarian resources on health and diseases from a medical perspective, and presents them to the readers in a form that is easy to follow and does not require experience in informatics. The latest publications and posts in professional papers, medical blogs, news pages, video channels are made accessible on a surface that is as easy to handle as possible. We have collections categorised by diseases and professional fields, and we also have German, Portuguese, Dutch, Spanish and Hungarian collections, which means that the best up to date resources of the given language can be followed easily on a platform translated to the given language. Everyone can set the resources they wish to follow with a single click and without registration, creating, so to say, a personalised medical journal. This is where the name PeRSSonalized Medicine comes from.

Bart Collet, author of Zorgbeheer, published an interesting slideshow about non invasive health monitoring systems:

This week, we launched a new section of PeRSSonalized Medicine, an easy-to-use free aggregator of quality medical information that lets you select your favourite resources and read the latest news and articles about a medical specialty or a medical condition in one personalized place, every day and I thought we should publish the most interesting sections on Friday.

Now here are the newest categories, PeRSSonalized Pharma with all the quality news sites, blogs, peer-reviewed journals and web 2.0 tools focusing on pharmacology; and PeRSSonalized Pharma Companies that features the online presence including news, blogs, Youtube channels and Twitter accounts of the biggest pharmaceutical companies.

Some reasons why it is unique:

• You can search in the database. It means you will find medical information only from a quality selected portion of the world wide web.

• You can personalize any of the sections.

• You can also receive the newest Pubmed articles focusing on your search term. Just insert your field of interest, a therapy, a condition, etc. and click Search. Then you can add the newly created box to your personalized medical “journal”.

• It is a community-based project. Please let us know which quality resources should be added to the database.

I launched PeRSSonalized Medicine to help patients and doctors keep themselves up-to-date more easily without any kind of IT knowledge. It is an easy-to-use, free aggregator of quality medical information that lets you select your favourite resources and read the latest news and articles about a medical specialty or a medical condition in one personalized place.

Now here is the newest category, PeRSSonalized Dermatology with all the quality news sites, blogs, peer-reviewed journals and web 2.0 tools focusing on dermatology.

Some reasons why it is unique:

• You can search in the database. It means you will find medical information only from a quality selected portion of the world wide web.

• You can personalize any of the sections.

• You can also receive the newest Pubmed articles focusing on your search term. Just insert your field of interest, a therapy, a condition, etc. and click Search. Then you can add the newly created box to your personalized medical “journal”.

• It is a community-based project. Please let us know which quality resources should be added to the database.

I launched PeRSSonalized Medicine to help patients and doctors keep themselves up-to-date more easily without any kind of IT knowledge. It is an easy-to-use, free aggregator of quality medical information that lets you select your favourite resources and read the latest news and articles about a medical specialty or a medical condition in one personalized place.

Now here is the newest category, PeRSSonalized Psoriasis with all the quality news sites, blogs, peer-reviewed journals and web 2.0 tools focusing on psoriasis. What is psoriasis?

Psoriasis is a chronic, non-contagious disease that affects mainly the skin. It is currently suspected to be autoimmune in origin. It commonly causes red, scaly patches to appear on the skin, although some patients have no dermatological symptoms.

Some reasons why it is unique:

• You can search in the database. It means you will find medical information only from a quality selected portion of the world wide web.

• You can personalize any of the sections.

• You can also receive the newest Pubmed articles focusing on your search term. Just insert your field of interest, a therapy, a condition, etc. and click Search. Then you can add the newly created box to your personalized medical “journal”.

• It is a community-based project. Please let us know which quality resources should be added to the database.

I’m really proud that I can organize and run the world’s first university credit course focusing on Web 2.0 and medicine at a medical school. This was the third, and so far most successful, semester with 115 students who filled a survey before and after the course. I hope I can publish the results in a peer-reviewed paper soon with the help of real experts in this field.

In the final lecture, I used Prezi.com again and talked about the future of medicine as well as the results of the surveys. I’ve already got some invitations to do at least a part of the course at other international universities. What is sure is that the next semester will launch in February in Debrecen with assignments and tests because I would like to engage students even more. See you there!

Course material (semester 3)

• Week 1: Web 2.0
• Week 2: Medical Blogosphere
• Week 3: RSS and Twitter
• Week 4: Wikipedia and Medical Wikis
• Week 5: E-patients and doctors in social media
• Week 6: Virtual Reality in Medicine
• Week 7: Social Media in Healthcare
• Week 8: Education 2.0
• Week 9: Google Story and Medical Search Engines
• Week 10: Web 3.0, Web 4.0

I launched PeRSSonalized Medicine to help patients and doctors keep themselves up-to-date more easily without any kind of IT knowledge. It is an easy-to-use, free aggregator of quality medical information that lets you select your favourite resources and read the latest news and articles about a medical specialty or a medical condition in one personalized place.

Now here is the newest category, PeRSSonalized Stroke with all the quality news sites, blogs, peer-reviewed journals and web 2.0 tools focusing on stroke. What is stroke?

A stroke (sometimes called an acute cerebrovascular attack) is the rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain. This can be due to ischemia caused by thrombosis or embolism or due to a hemorrhage. As a result, the affected area of the brain is unable to function, leading to inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or inability to see one side of the visual field.

Some reasons why it is unique:

• You can search in the database. It means you will find medical information only from a quality selected portion of the world wide web.

• You can personalize any of the sections.

• You can also receive the newest Pubmed articles focusing on your search term. Just insert your field of interest, a therapy, a condition, etc. and click Search. Then you can add the newly created box to your personalized medical “journal”.

• It is a community-based project. Please let us know which quality resources should be added to the database.

On Tuesday, December 8th, 2009 I had the please of speaking with Bryan Vartebedian, MD, a pediatric gastroenterologist, active in the social media space via Twitter @Doctor_V, his personal blog 33Charts.com, and periodic contributor to Get Better Health.

We spoke via Blog Talk Radio on his calling to medicine, pediatrics in particular and more recently his attraction to the social media space. Doctor_V has both interesting and witty insights on the medium. Some of his more recent tweets are noteworthy:

When I mention SM to other physicians they just giggle and look confused

LinkedIn may be a good first step for socially retarded physicians

Social media is the fancy awning that hangs from a building; human interaction is the bricks & mortar (a re-tweet)

For more of ‘Doctor_V’s insight, wit and early ‘do’s and don’ts’ for physicians considering a social media presence, listen in to the full interview here.

I launched PeRSSonalized Medicine to help patients and doctors keep themselves up-to-date more easily without any kind of IT knowledge. It is an easy-to-use, free aggregator of quality medical information that lets you select your favourite resources and read the latest news and articles about a medical specialty or a medical condition in one personalized place.

Now here is the newest category, PeRSSonalized Multiple Sclerosis with all the quality news sites, blogs, peer-reviewed journals and web 2.0 tools focusing on multiple sclerosis.

Some reasons why it is unique:

• You can search in the database. It means you will find medical information only from a quality selected portion of the world wide web.

• You can personalize any of the sections.

• You can also receive the newest Pubmed articles focusing on your search term. Just insert your field of interest, a therapy, a condition, etc. and click Search. Then you can add the newly created box to your personalized medical “journal”.

• It is a community-based project. Please let us know which quality resources should be added to the database.

My good friends Kevin Clauson and Francisco Grajales published their fantastic slideshows focusing on how public health could benefit from social media and what the barriers are.

• The Cost of Getting Sick (Flowing Data): Click here to see the costs of different medical conditions in different ages.

• Data, data, data (Pharma 2.0)

Over 102 million people are using the Web to research prescription drug information.

The average physician now spends a full work day (eight hours) using the Internet for professional reasons – a substantial jump from only 2.5 hours in 2002.

• 10 Web trends to watch in 2010 (CNN)

• Health Hashtags: A Microsyntax for People and Machines (The Quantified Self)

• Medpedia Project Expands Platform Platform to Include Q&A, News & Analysis and Alerts

• Online pharmaceutical advertising: The FDA makes a move (Advertising and Health)

There is an interesting article in E-Health Europe about how patients try to contact doctors on Facebook, the popular social networking site, and how doctors shouldn’t respond to them. In my “Medicine and Web 2.0” university credit course, we cover this important issue several times and I try to provide students with useful pieces of advice about how to avoid such problems.

The Medical Defence Union said it was aware of a number of cases where patients have attempted to proposition doctors by sending them an unsolicited message on Facebook or similar sites.

The medical defence body said it would be “wholly inappropriate” to respond to a patient making an advance in such a way.

Dr Emma Cuzner, MDU medico-legal adviser, said the pitfalls posed to doctors using social networking sites and inadvertently breaching patient confidentiality had already been well documented but the dangers of patients using the sites to approach doctors were less well publicised.

In an anonymised case highlighted by the MDU a female GP was asked out for a drink by a patient as she left the surgery. When she declined the patient contacted the doctor via Facebook and sent her a bunch of her favourite flowers which he had found out about from her freely available Facebook page.

Kevin, MD has recently shared a video of Better Health’s Val Jones who is a fellow blogger of mine on Better Health Network, and who gave a presentation at the e-Patient Connections 2009 Conference. She used limericks to tell the stories of two e-patients. What is a limerick? Here is an example:

The limerick packs laughs anatomical

In space that is quite economical,

But the good ones I’ve seen

So seldom are clean,

And the clean ones so seldom are comical.

• ePatient2009: Voice of the Patient. (SixUntilMe): Kerri Morrone Sparling has recently talked at an epatient conference.

• An Interview of @EndreJofoldi of HealthMash (Phil Baumann)

• FDA regulations for e-marketing of Drugs

• First Keas DiabetesMine Health Plan Goes Live (!) on D-Blog Day (Diabetes Mine)

Today, I’ve got butterflies in my stomach, which usually only happens when I sit in the back seat of a moving vehicle. That’s not because it’s D-Blog day today, either, although I want to start out by sending lots of love to all my fellow diabetes bloggers, and you wonderful people who read our words and interact with us regularly. You have changed my life, for the better. So thank you all!

A few months ago, I wrote about the latest Pew Internet Research report that focused on online health information and the world of e-patients. I also shared excerpts:

61% of American adults look online for health information.

In 2000, 46% of American adults had access to the internet, 5% of U.S. households had broadband connections, and 25% of American adults looked online for health information. Now, 74% of American adults go online, 57% of American households have broadband connections, and 61% of adults look online for health information. We use the term “e-patient” to describe this group.

American adults continue to turn to traditional sources of health information, even as many of them deepen their engagement with the online world.

A majority of e-patients access user-generated health information.

Now Susannah Fox who is an Associate Director of the Pew Internet & American Life Project and principal author of the Project’s survey reports on e-patients and online health, published a fantastic and very useful guide for interpreting Pew Internet data dedicated to healthcare.

OK Tweeps in the movie ‘What the Bleep‘ do we know, the line transitioning to the theme of the flick proffers:

it’s time to get wise.

Well the same holds true with respect to the ‘resistance is futile’ health care borg aka ‘the tapeworm medical industrial complex’ economy. Our health care system is at risk of collapse; with 46 million uninsured, 25 million under-insured, primary care physicians bailing on the system daily, health care premiums sky rocketing, while benefits are being reduced and cost shifted from the plan to the employee. No one is happy with this status quo, quite to the contrary of some public opinion polls that tout we have the ‘best health care system’ in the world!

Surely we have the best high tech or ‘rescue care’ medicine that can be found. But when it comes to the ‘value proposition’ the story gets a little more complicated, and requires a bit more than sound-bytes or political grandstanding to get at the truth.

Money Driven Medicine is a primer for such a rational conversation. If we thought the Senate Finance Committee hearings followed by the debate of Chairman’s mark was exhausting, just wait for what’s in store from the special interests, and their ‘Quack-er’ proxies in the Senate during the impending floor debate of the merged bills.

So why not get current and be a part of the solution? Watch Money Driven Medicine and get WISE!

Ed Bennett has been updating a huge list of US hospitals that are engaged in social media. They manage a blog, or have Twitter, Youtube or Facebook accounts. Now there are 441 hospitals in the list and it’s still growing.

• 213 YouTube Channels
• 241 Facebook pages
• 323 Twitter Accounts
• 55 Blogs

The best medical blog out there, Medgadget.com, has recently covered the TEDMED 2009 conference and they have been sharing video interviews with us for weeks. One of the most interesting interviews is about Shareable Ink. It might make it easier for hospitals and practices worldwide to create electronic medical records systems while still using paper solutions. For example, in Hungary, in some cases doctors must print reports and sign those by hand because of the legal regulations.  But with Shareable Ink, it seems there is light in the tunnel.

Shareable Ink® delivers enterprise-grade digital pen and paper solutions for healthcare. In contrast to traditional keyboard-based systems, the Shareable Ink approach offers the fastest and most natural data input method without disrupting familiar workflows. Shareable Ink effortlessly captures all the information written on paper forms using a specialized ball point pen. As no software is installed onsite, Shareable Ink is suitable for any size organization, from the solo practitioner to the healthcare enterprise.