HIMSS Preemptively Publishes "Meaningful Use" Definition

Feds are about to meet to delineate a 'meaningful use' standard for EHRs (electronic health records).

These will be weighty words...upon this definition hinges a company/provider's ability to secure funding (or lack thereof) from the ARRA and HITECH pot of stimulus dollars.

The gospel of 'meaningful use' according to HIMSS includes 4 main provisions:

1. EHR is CCHIT (Certification Commission for Healthcare Information Technology) certified (oh boy - here we go...we're putting one pseudo-agency in charge of universal certifications?)...

2. "Demonstrate abilities to exchange clinical and administrative patient data." Ok. Sounds good. But where is the patient's ability to modify, contest, or add to administrative data that may be erroneous, such as the upcoding found in @ePatientDave's BIDMC/Google Health PHR transfer?

3. ePrescribing (awesome. No argument here...)

4. "Electronically report quality and safety data." Ok. But what data sets? And to whom? Where is my clinical and administrative data going? To insurers? What if this loophole enables people to deny claims or insurance based on faulty information like upcoding? Oh wait, that's already happening with our current paper-based system. It will be interesting to see how HIMSS believes a change in the transmission method alone can improve quality and safety for each patient.

This bears watching folks. And if you're part of a healthcare reform group (read: ePatients PLEASE jump on this), I'd recommend releasing your own recommended "meaningful use" standard.

Bet you $50 bucks the AMA and potentially the AARP release one in the next 48-72 hours....

Posted via web from Jen's posterous


HealthCampBoston Review, Going Veggie!

Check out this website I found at katemgilbert.com

Thanks Kate for the great HealthCampBoston writeup!

If you're the health/tech type who's not on Twitter (gasp!) or prefer to read event-related tweetstreams in aggregate, check out the great conversations from HealthCampBoston by searching for #HCBOS.

My favorite session? Of course I can't pick one, so grand prize is a two way tie between @healthblawg and @lostonroute66/@mikekirkwood.

@healthblawg talked about HIPAA, social media, PHRs, updated legislation and requirements as a result of ARRA and HITECH (read: stimulus bill, $), and all things ridiculously over-interpreted in healthcare.

Excellent audience comments, questions by @rdale and @williamcrawford. Plenty of heckling from @lostonroute66 and I, cozied up with our Macs in the front row.

Just after the @polarwisdom case study (which gets more and more difficult each time I do it rather than easier due to some super-charged subject matter), @lostonroute66 present the NIH's kick-a%$ pillfinder app, which is in semi-stealth beta.

This baby is a BEAUT.

David's put in the time, effort, money, and research to make this one some of the juiciest HIT I've seen in quite awhile. He wants to bust out an open API after finishing development. They're looking for funding, so if you're a VC (or know one) ping me and I'll put you in touch, or tweet @lostonroute66.

After David's presentation, Polka.com's @mikekirkwood did an interactive session, where he asked the audience how they could see this being used. The semi-service design brainstorm yielded some very interesting suggestions, including matching pill color to the Pantone deck (from @christinekraft).

Excuse my relative lack of verbosity - this week is packed with chewy health innovation goodness. Posting language may be a bit terse and parsed because lots of glial power is going towards after-convention mumbo jumbo with @epatientdave, @carlosrizo, et. al.

Today Health 2.0 begins. My schedule kicks off with a limited edition Hello Health/Myca Deep Dive lunch, which I hope has vegetarian options.

See, I'm at healthcare events. All. The. Time.

And, ironically, they're usually really unhealthy times. Lots of caffeine, very little sleep, not enough water, high stress, junk food, and that's not counting the happy hour(s).

Today's Earth Day, and I suck at recycling. What does this have to do with healthcare, or HealthCampBoston? I'm trying to save the planet, but figured I'd make a pledge. I'll be taking more aggressive steps to protect my personal biosphere.

That means step 1 - more sleep. Got 6 hours last night, but I'm going to catch a 30 min catnap before heading over the #health2con shindig.

Step 2 is the go big or go home goal though - I'm going vegetarian. I rarely eat meat, so this is far less of a sacrifice than it may seem. I'll continue to ingest milk, cheese, eggs (mostly egg whites) and shellfish.

It's Health 2.0 time, people. Instead of just sitting around nodding your heads at the latest brilliant utterances and concepts, what will YOUR health, version 2.0, look like?

Mine just got a whole lot greener.

Posted via web from Jen's posterous


The Health Care Blog: Jay Parkinson, Hello Health & Myca, talks about the new release

Please. San Francisco, DC next!

Dr. Jay, I want Hello Health to be as accessible as the Jamba Juice or Subway franchises.

See you in Boston...

Posted via web from Jen's posterous


"Another Contender Emerges: Posterous Takes On TwitPic With New API"

Much love to the Posterous team (w00t Garry and Sachin!) for this TechCrunch article.

Those of you in healthcare following me on Twitter (@jenmccabegorman, @polarwisdom) know I'm completely infatuated with the platform, which lets me post content via email and autopublish to Twitter, Facebook, my 'old school blog' Health Management Rx (via Blogger) and even Flickr.

With the pic API Posterous is making another dream come true. I love Posterous because it lets me extend multiple 'tentacles' of communication without any extra time or effort.

My sites, my content, should be extensions of my online 'self,' and this is exactly what Posterous enables - one me (or one 'meme') indivisible under www.

At Kaiser's Garfield Innovation Center in Oakland, CA Thursday (via an invite for Tech 'Speed Dating' Day from Mike Kirkwood, @mikekirwood, Polka.com), we were asked to share our favorite innovation.

Some folks mentioned fitness activities, like Pilates, running, and the treadmill (albeit as an excellent clothes hanger).

Some folks mentioned relaxation tools like the hills of New Zealand (!), red wine, and chocolate.

Four folks mentioned Blackberries, while two mentioned iPhones.

My answer? Communication, enabled by Twitter and Posterous.

Innovate away guys. Thanks for keeping it real. And simple.

Posted via web from Jen's posterous


Demand? Check. Supply? Nope: 42% WANT Personal (Participatory) Health Records

Health bloggers will be all over today's release of the Deloitte Survey of Healthcare Consumers.

You can read the lengthy, packed release here (and tighter, more op-ed commentary elsewhere).

Major conclusion: People want PHRs. We want increased online health capabilities, access, and services. We STILL want to use these to connect with our brick-and-mortar care providers (don't fear the rogue e-patient - work WITH us, not against us). 

For once, I'm going to stick with the numbers. They're plenty powerful enough to stand alone:

  • 4,001 people surveyed from October 2-10 2008 using WEB BASED QUESTIONNAIRE 
  • Age of all participants = 18+ (participants all over 18, which creates interesting conundrum - voice of young health consumers?)
  • 9% of consumers report having an electronic personal health record (PHR) - almost 1/10 have a PHR? REALLY?) - this is much higher than 2% of hospitals that have 'comprehensive' EHRs...
  • 42% are "interested in establishing PHRs connected online to their physicians" (bivalve PHR anyone? Couldn' resist...)
  • 55% want their doc available via email ("exchange health info" and "get answers to ?s")
  • 57% want to schedule appointments, buy Rxs, and 'complete other transactions'
  • 57% like the idea of integrated billing/payment systems
  • 38% "very concerned" about privacy AND security of personal health information (PHI) - NOTE: These are two separate issues. ALSO NOTE: Despite these concerns, more than 4 in 10 of us WANT a PHR. 
  • MOST INTERESTING FINDING: 24% don't give a hoot about privacy and security ie "had no reservations about it." 
  • Who's in that 24%? Women over 65(!) and men 18-24 were LEAST RISK AVERSE to sharing PHI online.
  • 6/10 want Uncle Sam to establish standards (here comes CCHIT with a bang). 
  • 4/10 think Uncle Sam should cough up $ to support docs, hospitals, and health plan adoption of EHRs, but HALF THAT NUMBER oppose this funding (2/10). Gen Y supports this (44%), Gen X too (43%) and let's not be guilty of ageism - seniors support this in SAME PERCENTAGE as Gen X. Can we please, please, please STOP assuming younger folks are 1. healthy all the time and 2. thus don't give a s&*^ about healthcare spending and policy?
  • Margin of error in the study: "+/- 1.6 percent at the .95 confidence level"

Report: 2009 Survey for Health Care Consumers (www.deloitte.com/us/2009consumersurvey)

Overview: Deloitte Center for Health Solutions (www.deloitte.com/us/healthsolutions)

Yesterday's healthcare advocate radicals are today's mainstreet majority. The people have spoken. Who's listening?

Posted via web from Jen's posterous

Sometimes, What it Feels Like to Be a Patient...

Amazing photography from mladen penev.

Themes include isolation, independence, journeying.

Note the determined stance, the covered face with only contours visible.

Still, the subject stands strong, shoulders squared.

But she's also very, very alone in the wilderness.

What I'd like to tell her: "Not for long. Don't worry. The drought WILL end."

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Technology Review: Blogs: arXiv blog: Why ET's genetic code could be just like ours

In 3-5 years we will look back on this study as one of the most valuable announcements in life science's recent history.

Mark the day.

If you haven't read up on panspermia and the RNA world theory, you have some significant catching up to do.

Posted via web from Jen's posterous

Health 3.0 Rx Roundup: CVS, Google Health Expand Partnership

Read all about it:

"CVS/pharmacy customers the ability to securely download their prescription and medication histories to their Google Health Account. Consumers filling prescriptions at CVS/pharmacy stores can now add their medication history to their online medical record directly from CVS.com."
Source: http://uk.sys-con.com/node/909038

Note: CVS has been a Google Health partner for just under a year (May 2008).

Why you should care:

1. Content! Coherence! Commerce! Health 3.0!!! (#sarcasm)
2. This deal pushes responsibility for updating Google Health records right over to the patient end of the balance sheet. Consumer responsibility! Huzzah!

Let's take a quick look at what news outlets (and early blogs) are saying about the deal:

Theme: Google Health needs work, lots of it (as does the space in general) but this integration = c00l

"Google Health, the SaaS approach to Health Care records by Google Inc., received a boost today with the addition of CVS pharmacy to the list of pharmacies they support. I am a great sucker of online health records and, even though I was not greatly impressed, I had a neutral opinion about Google Health in its early stages. In fact, Zoli has covered both Google Health and Microsoft’s HealthVault here at Cloud Avenue and he was not at all impressed with them...Like Zoli, I am also unimpressed with the progress on the Health 2.0 front. Both Microsoft and Google are relatively quiet about their plans. But today’s announcement by Google offers some hope that we will eventually get there. The integration with CVS allows more than 100 million people in US to access their records through Google Health by importing your data from the pharmacy and also in managing the prescriptions through it. Though it is not a big leap, it is a solid tiny step towards Health 2.0 and towards helping to lower the health care costs."
Source: http://www.cloudave.com/link/google-health-gets-a-boost-with-the-addition-of-cvs-pharmacy

Theme: Consumer-facing EHRs = w00t! If you use 'retail' or 'quick' clinic branded by CVS (MinuteClinic), you can export records to your PHR at Goog Health

"Patients who receive treatment at MinuteClinic, the retail-based health clinic subsidiary of CVS Caremark, can also securely import their visit summaries into their Google Health Accounts."
Source: http://uk.sys-con.com/node/909038

Theme: Privacy, security = sticky. CVS requiring separate site enabling, login/verification

"In order to maintain patient privacy, the consumer making the request for information will need to be authenticated on the cvs.com Web site before any data is shared with Google Health."
Source: http://uk.sys-con.com/node/909038

Theme: Power to the patients....wonder if that last sentence will come back to bite Goog at some point if/when they try to monetize our data, or just use internally for semantic search/NLP R&D?

"Typically, Google has pushed for the democratization of such medical records, in keeping with its “open source” philosophy in many other areas, such as public domain book, painting and photograph publishing. "Google Health puts you in charge of your health information,” the company says on its web site, adding that “you always control how it’s used.”"
Source: http://www.bizjournals.com/sanfrancisco/stories/2009/04/06/daily11.html

Now, I'm a CVS customer (no current Rxs), but I'm not a Google Health PHR user. Wonder if this capability is available for any other EHR/PHR, or if this'll be an other walled garden with 2 hedgerows...

Posted via web from Jen's posterous


Hello my little pre-cambrian creature!

If you spend 2 mins tricking out your new Razer bluetooth mouse to look like a Trilobita Xandarella fossil from the Burgess Shale (using a wire twisty tie):

1. You might be a geek. Seriously. And way too easily amused.

2. You might need a vacation. Seriously x2.

3. You might want to put down the technologies and run out to buy a TV and watch more, ah, American Idol or something. Or maybe buy a copy of Cosmo.

Inspiration = "Wonderful Life: The Burgess Shale and the Nature of History" by Stephen Jay Gould, circa 1989

It's a disgusting shade of Pepto-Bismol pink, and too much of a pain to ship back - what the heck else was I gonna do with it?!

Posted via web from Jen's posterous


IBM, Mayo Form Open-source Health IT Consortium - PC World

Check out this website I found at pcworld.com

Health tweets, coders, haxors, developers working in HIT, consultants, media wonks, policy folks, academics, docs, patients, etc...

Why you should care about the IBM/Mayo partnership forming an open source Health IT consortium called Open Health Natural Language Processing...

Watch an elementary demo here (from Mayo - thanks to @LeeAse for source URL): http://dl.getdropbox.com/u/190048/MayoIBM/mayo_clinic_v4.swf

1. Have to start with the geekery....They posted it on SourceForge. SourceForge!!! For HEALTH IT! I cannot contain myself.

*For non-coders (self included) this means anyone can grab and work with the code and post suggested changes. ANYONE. SourceForge accounts are free. My username = jenmccabegorman.

2. Mayo and IBM each contributed a pipeline based on Apache's UIMA framework, which is downloadable from Apache.

3. This is the 'crowdsourcing clinical cases' we've been tweeting about for the last little while. The OHNLP platform pipelines will help providers and researchers index and search electronic medical records so "physicians are not reliant solely on their own clinical experience in analyzing a problem." Forget the walled garden analogy - medicine has been practiced in a vacuum. Imagine having millions of cases scrubbed for similar data and results returned within seconds (maybe milliseconds). That's what we're talking about here.

4. NLP (natural language processing) systems in health are responsible for the throughput of data generated when providers enter text (lab values, CPT codes, SOAP notes, family history data) about caring for patients. A larger repository of terms = faster search for relevant cases that may have bearing on how docs are for you. Think Google for medical record search (eventually...we're a loooong way off).

5. The project has 4 dedicated admins. If I ever meet these developers the drinks are on me. This could go all Linus Torvalds on us, quick fast and in a hurry.

Complete deets for developers:

Project Admins : isominsky, james_masanz, jpzheng, tanenblatt
Developers : 4
Development Status : 3 - Alpha, 5 - Production/Stable
Intended Audience : Science/Research
License : Apache License V2.0
Programming Language : Java
Topic : Bio-Informatics, Medical Science Apps.
Project UNIX name : ohnlp
Registered : 2009-03-06 19:31
Activity Percentile (last week) : 99.18
View project activity statistics
View list of RSS feeds available for this project

Relevant deets for non-developers:

"Mayo Clinic and IBM released their clinical NLP technologies into the public domain. The site http://www.ohnlp.org will allow the approximately 2,000 researchers and developers working on clinical language systems worldwide to contribute code and further develop the systems."

Posted via web from Jen's posterous


Dying is a 5-Letter Word: 39 Minutes on Why Americans' "Dying Does Not Go Well"

From NPR's Fresh Air series: "The Ethical Way to Heal American Health Care"

Podcast with Dr. Robert Martenson, author of "A Life Worth Living: A Doctor's Reflections on Illness in a High Tech Era"


Dr. Martenson on default care in the US "biomedical industrial complex":

"One must keep doing things unless the patient or the patient's surrogate tells you in advance to not do things...things keep happening...aggressive interventions..."

"Nobody stands back and says 'This patient is dying."

Of course they don't, Dr. Martenson. 

Dying is a 5-letter word. 

I want my doctors to talk with me about living. To discuss this fully, and develop a participatory, choice-aware plan of care that lets me opt in or out, we *must* talk about dying.

It's the height of ridiculousness that we make most of our decisions in life only after fearfully stepping around the conversation about death.

Healthcare will be on the road to recovery when we can say this to each other, as a part of the patient-provider care conversation...

"There are only two certainties in this life - birth, and death. Since you're here today, one has already happened, and the other is waiting. Now - let's talk about how you want to live (well) until the other time comes."

Posted via web from Jen's posterous

Sower&Seed - Starting an Eco-Mow Biz in Blacksburg, VA

Who says all new startups have be hightech?

My brother-in-law Jon Bluey just started his new human-powered mowing co. near Virginia Tech.

Sister Kate is helping with some of the business arrangements, legal docs, reg, etc.

I'm trying NOT to consult :).

Jon's not the first in the family to do the outdoors thing.

Uncle Craig's got Ruppert Landscape (and Nurseries, and Properties, and Ventures).

Cousins Char and Soph and Julie Ruppert have Ruppert Sisters Pumpkins.

And who could forget the McRuppert cousins early lemonade ventures ("add more water! That'll make it last longer!") and charging $0.25 per person for admission to basement talent shows we ran with a keyboard, 'costumes,' and poor attempts at cartwheels (thank God there was no YouTube back then).

We didn't seem to care that we always had to rope the family into coming with fancy flyers, sweet smiles, and arm-tugging, and we got very, very good at it.

Earlier this year I asked my Uncle Craig whether entrepreneurs are born or made. "Born" he said.

Me: "Ok, then how do you know if you are one?"

Craig thought a minute: "You're an entrepreneur if you'll do anything to succeed."

Welcome to the wide world of owning your own time Jon, where managing your own trajectory becomes the sum and total of your work. (Also, wave bye bye to naptime!)

May many lawns await you...

Posted via web from Jen's posterous