I've joined a dozen other bloggers in posting this message simultaneously:
"We have all read recently about the threat of possible closure faced by the Boston Globe. A number of Boston-based bloggers who care about the continued existence of the Globe have banded together in conducting a blog rally. We are simultaneously posting this paragraph to solicit your ideas of steps the Globe could take to improve its financial picture.
"We view the Globe as an important community resource, and we think that lots of people in the region agree and might have creative ideas that might help in this situation. So, here's your chance. Please don't write with nasty comments and sarcasm: Use this forum for thoughtful and interesting steps you would recommend to the management that would improve readership, enhance the Globe's community presence, and make money. Who knows, someone here might come up with an idea that will work, or at least help. Thank you."
Senin, 06 April 2009
My Telepresence Experience
I returned to Boston from HIMSS to spend the day with my daughter on her 16th birthday. We had a great day cooking, hiking, and enjoying a fabulous Japanese meal as a family. However, I was also in Chicago for 2 hours, speaking with the press about the Stimulus Bill, Interoperability, and Decision Support.The press gathered at the Cisco booth on the floor of HIMSS and I welcomed them to my basement via Telepresence. We chatted for an hour with full life-sized 1080p real time video. Truly, there was no difference from sitting in a room together, other than the fact that my basement had a bubbling fish tank and 2 rabbits running around.
My Telepresence experience was different from traditional video conferencing in that it did not feel like a video conference. All the other units I've used in the past have had a small grainy picture with tinny sound, often displaying picture within a picture. Telepresence is just high definition video and audio with the feeling that you are in room with the other participants, not on a video conference.
All the eye contact, gestures, and common courtesy you'd use in an in person meeting are natural in Telepresence. I changed my body position, my eye focus and my voice direction as I spoke to various participants.
The technology worked perfectly over my home Verizon FIOS 20 megabit connection.
I really enjoyed using the technology to connect with HIMSS while being in Boston with my daughter. At 4am I'm heading back to HIMSS for a day of meetings with many stakeholders. I'm working on becoming 100% virtual, but our culture is not quite ready for that!
Jumat, 03 April 2009
The HIT Policy Committee Members
ARRA directed the Comptroller General to appoint 13 members to the HIT Policy Committee for terms of three years, although the members first appointed by the Comptroller General have staggered terms. An additional seven members will be appointed by the Secretary of Health and Human Services, the Majority and Minority leaders of the Senate, and the Speaker and Minority leader of the House of Representatives. The President can appoint other members as representatives of relevant federal agencies.
The 13 members the Acting Comptroller General has appointed across 10 different categories
are:
Advocates for Patients or Consumers
1. Christine Bechtel, Washington, D.C. (3 year term)
Vice President, National Partnership for Women & Families
2. Arthur Davidson, M.D., Denver Colorado (2 year term)
Denver Public Health Department; Director, Public Health Informatics; Director, Denver
Center for Public Health Preparedness; Medical epidemiologist; Director, HIV/AIDS
Surveillance, City and County of Denver
3. Adam Clark, Ph.D., Austin, Texas (1 year term)
Director of Research and Policy, Lance Armstrong Foundation
Representatives of Health Care Providers, including 1 physician
4. Marc Probst, Salt Lake City, Utah (3 year term)
Chief Information Officer, Intermountain Healthcare
5. Paul Tang, M.D., Mountain View, California (2 year term)
Vice President and Chief Medical Information Officer, Palo Alto Medical Foundation
Labor Organization Representing Health Care Workers
6. Scott White, New York City, New York (1 year term)
Assistant Director, Technology Project Director, 1199 SEIU Training and Employment
Fund
Expert in Health Information Privacy & Security
7. LaTanya Sweeney, Ph.D., Pittsburgh, Pennsylvania (3 year term)
Director, Data Privacy Lab, Associate Professor of Computer Science, Technology and
Policy, Carnegie Mellon University
Expert in Improving the Health of Vulnerable Populations
8. Neil Calman, M.D., New York City, New York (2 year term)
President and CEO, The Institute for Family Health, Inc.
Research Community
9. Connie Delaney, R.N., Ph.D., Minneapolis, Minnesota (1 year term)
Dean, School of Nursing, University of Minnesota
Representative of Health Plans or Other Third-Party Payers
10. Charles Kennedy, M.D., Camarillo, California (3 year term)
Vice President, Health Information Technology, Wellpoint, Inc.
Representative of Information Technology Vendors
11. Judith Faulkner, Verona, Wisconsin (2 year term)
Founder, CEO, President, Chairman of the Board, Epic Systems Corporation
Representative of Purchasers or Employers
12. David Lansky, Ph.D., San Francisco, California (1 year term)
President and CEO, Pacific Business Group on Health
Expert in Health Care Quality Measurement and Reporting
13. David Bates, M.D., Boston, Massachusetts (3 year term)
Medical Director for Clinical and Quality Analysis, Chief of General Internal Medicine,
Partners HealthCare/Brigham & Women’s Hospital
All are great choices and I look forward to working with these folks. They are the new "Board of Directors" for Healthcare IT in the US!
The 13 members the Acting Comptroller General has appointed across 10 different categories
are:
Advocates for Patients or Consumers
1. Christine Bechtel, Washington, D.C. (3 year term)
Vice President, National Partnership for Women & Families
2. Arthur Davidson, M.D., Denver Colorado (2 year term)
Denver Public Health Department; Director, Public Health Informatics; Director, Denver
Center for Public Health Preparedness; Medical epidemiologist; Director, HIV/AIDS
Surveillance, City and County of Denver
3. Adam Clark, Ph.D., Austin, Texas (1 year term)
Director of Research and Policy, Lance Armstrong Foundation
Representatives of Health Care Providers, including 1 physician
4. Marc Probst, Salt Lake City, Utah (3 year term)
Chief Information Officer, Intermountain Healthcare
5. Paul Tang, M.D., Mountain View, California (2 year term)
Vice President and Chief Medical Information Officer, Palo Alto Medical Foundation
Labor Organization Representing Health Care Workers
6. Scott White, New York City, New York (1 year term)
Assistant Director, Technology Project Director, 1199 SEIU Training and Employment
Fund
Expert in Health Information Privacy & Security
7. LaTanya Sweeney, Ph.D., Pittsburgh, Pennsylvania (3 year term)
Director, Data Privacy Lab, Associate Professor of Computer Science, Technology and
Policy, Carnegie Mellon University
Expert in Improving the Health of Vulnerable Populations
8. Neil Calman, M.D., New York City, New York (2 year term)
President and CEO, The Institute for Family Health, Inc.
Research Community
9. Connie Delaney, R.N., Ph.D., Minneapolis, Minnesota (1 year term)
Dean, School of Nursing, University of Minnesota
Representative of Health Plans or Other Third-Party Payers
10. Charles Kennedy, M.D., Camarillo, California (3 year term)
Vice President, Health Information Technology, Wellpoint, Inc.
Representative of Information Technology Vendors
11. Judith Faulkner, Verona, Wisconsin (2 year term)
Founder, CEO, President, Chairman of the Board, Epic Systems Corporation
Representative of Purchasers or Employers
12. David Lansky, Ph.D., San Francisco, California (1 year term)
President and CEO, Pacific Business Group on Health
Expert in Health Care Quality Measurement and Reporting
13. David Bates, M.D., Boston, Massachusetts (3 year term)
Medical Director for Clinical and Quality Analysis, Chief of General Internal Medicine,
Partners HealthCare/Brigham & Women’s Hospital
All are great choices and I look forward to working with these folks. They are the new "Board of Directors" for Healthcare IT in the US!
Cool Technology of the Week
I'm flying to HIMSS today to present a keynote with Senator Whitehouse about Health Information ExchangeI'll describe the work we've done in Massachusetts to create an appliance, using HITSP standards, that transports data for medication management, clinical summary exchange, administrative transactions, and quality reporting.
Over the past several years, I've been involved in many Healthcare Information Exchange projects for academic health centers, communities, and physician groups.
One interesting approach, that is my cool technology of the week, is OpenHRE(tm), Free and Open Source Software (FOSS) created and supported by Browsersoft. The goals of the OpenHRE project are
* to foster development, distribution and support of standard Record Locator, Health Record Exchange and Access Control services held as Free/Open Source Software
* to build a community to this aim
* to realize this goal via a self-sustaining business model and open collaboration among all stakeholders
The OpenHRE.org site is currently hosted as a collaboration among all interested parties including OpenHRE Community Contributors. These folks have implemented live data exchanges serving rural, metropolitan and State level initiatives in Tehachapi California, Franklin Louisiana, San Antonio Texas and throughout the state of Kansas.
The architecture is simple and is based on the Markle Foundation’s Common Framework that was implemented in the 2004-2005 Nationwide Health Information Network prototype projects. OpenHRE offers an open source record locator service (which provides community master patient index services), basic content exchange services using HL7 2.x and Continuity of Care Document standards, and a web-based clinical data viewer.
Importantly, they also provide a consent and information protection framework for easy control of clinical data flows. You'll find all the details in this manual provided by Gijs van Oort, from Healthcare Access of San Antonio , an OpenHRE Community Contributor.
They've developed these components, and their production exchanges, on small budgets using Linux, Java, and MySQL plus a great deal of volunteer time.
Their code is available at the OpenHRE site. Just click on "Downloads" in the Main Menu, and then click on "Software" to access the link to SourceForge. From this site you can download the software, submit to the support or developer forums, report bugs, and request new features.
An open source Health Information Exchange using standards, good policies, and a well thought out architecture.
That's cool!
Kamis, 02 April 2009
New Priorities for HITSP
Some of you may have seen the news alert from Modern Healthcare today "HITSP suspends activity for 90 days" and the followup article at Modern Healthcare's website "HITSP pauses use case work to focus on EHR stimulus requirements"
I've spoken with the author Joe Conn, shared my powerpoint presentation, and have been told that further clarification will appear in Modern Healthcare's Beyond the Headlines tomorrow.
The article notes that the HIT Standards Committee "is the apparent replacement of the current Healthcare Information Technology Standards Panel, which was created in 2005 as a private, not-for-profit organization but funded under a $3.3 million contract from HHS. "
The HIT Standards Committee will hopefully will be the evolution of NeHC. It is my hope and expectation that HITSP will now receive its priorities from the HIT Standards Committee, not be replaced by it.
I'd like to summarize my webinar message to the HITSP Panel today, which is about reprioritizing and accelerating our work, not suspending it.
The American Recovery and Reinvestment Act contains numerous technology and privacy provisions with aggressive timelines for completion.
Many of these ARRA milestones are related to standards and the work of the Healthcare Information Technology Standards Panel including
1. Technology to protect privacy and security
2. A nationwide health information infrastructure that supports exchange of health information
3. The use of certified health record for each person in the US by 2014
4. Technologies to account for disclosures of health information
5. The use of certified electronic health records to improve the quality of health care, such as by promoting the coordination of health care and improving continuity of health care among health care providers, by reducing medical errors, by improving population health, by reducing health disparities, by reducing chronic disease, and by advancing research and education.
6. Technologies that allow individually identifiable health information to be rendered unusable, unreadable, or indecipherable to unauthorized individual
7. The use of electronic systems to ensure the comprehensive collection of patient demographic data
8. Technologies that address the needs of children and other vulnerable populations
In order to meet these statutory requirements, HITSP must focus the energies of its volunteers, staff, and leadership on these areas for the next 90 days. This means that HITSP's products to date - 13 interoperability specifications - will be leveraged to create new streamlined electronically published standards guides organized around the ARRA EHR interoperability requirements . The end result will be much more compact, easy to implement, and flexible implementation guidance which supports the meaningful use of EHRs and protection of privacy.
This focus on ARRA will result in a re-examination and adjustment of the current HITSP work schedule for the next 90 days. Some efforts (e.g., SSA, Interoperability Showcase, Quality Measures, NHIN and CCHIT coordination, etc.) are expected to continue on a non-interference basis.
We've circulated our early thoughts about the work ahead to our technical committee chairs and encouraged them to discuss scope, time, and resource needs with their committee members.
I look forward to the great work HITSP will do together over the next 90 days. It will be like running a marathon, but it will be worth it!
I've spoken with the author Joe Conn, shared my powerpoint presentation, and have been told that further clarification will appear in Modern Healthcare's Beyond the Headlines tomorrow.
The article notes that the HIT Standards Committee "is the apparent replacement of the current Healthcare Information Technology Standards Panel, which was created in 2005 as a private, not-for-profit organization but funded under a $3.3 million contract from HHS. "
The HIT Standards Committee will hopefully will be the evolution of NeHC. It is my hope and expectation that HITSP will now receive its priorities from the HIT Standards Committee, not be replaced by it.
I'd like to summarize my webinar message to the HITSP Panel today, which is about reprioritizing and accelerating our work, not suspending it.
The American Recovery and Reinvestment Act contains numerous technology and privacy provisions with aggressive timelines for completion.
Many of these ARRA milestones are related to standards and the work of the Healthcare Information Technology Standards Panel including
1. Technology to protect privacy and security
2. A nationwide health information infrastructure that supports exchange of health information
3. The use of certified health record for each person in the US by 2014
4. Technologies to account for disclosures of health information
5. The use of certified electronic health records to improve the quality of health care, such as by promoting the coordination of health care and improving continuity of health care among health care providers, by reducing medical errors, by improving population health, by reducing health disparities, by reducing chronic disease, and by advancing research and education.
6. Technologies that allow individually identifiable health information to be rendered unusable, unreadable, or indecipherable to unauthorized individual
7. The use of electronic systems to ensure the comprehensive collection of patient demographic data
8. Technologies that address the needs of children and other vulnerable populations
In order to meet these statutory requirements, HITSP must focus the energies of its volunteers, staff, and leadership on these areas for the next 90 days. This means that HITSP's products to date - 13 interoperability specifications - will be leveraged to create new streamlined electronically published standards guides organized around the ARRA EHR interoperability requirements . The end result will be much more compact, easy to implement, and flexible implementation guidance which supports the meaningful use of EHRs and protection of privacy.
This focus on ARRA will result in a re-examination and adjustment of the current HITSP work schedule for the next 90 days. Some efforts (e.g., SSA, Interoperability Showcase, Quality Measures, NHIN and CCHIT coordination, etc.) are expected to continue on a non-interference basis.
We've circulated our early thoughts about the work ahead to our technical committee chairs and encouraged them to discuss scope, time, and resource needs with their committee members.
I look forward to the great work HITSP will do together over the next 90 days. It will be like running a marathon, but it will be worth it!
Infinite Growth in a Finite World
We're all aware of the Bernie Madoff Ponzi scheme. He used money from new investors to pay unreasonably high, consistent rates of return to his old investors.
Two recent articles by Thomas L. Friedman, The Inflection Is Near? and Mother Nature's Dow ask if we are engaged in a global Ponzi scheme of accelerating consumption and growth.
Most for-profit companies I've worked with as an advisor or Board member measure their success in quarter per quarter growth percentages.
In the economy of a bygone era, local businesses were considered successful when they made a high quality product, maintained the livelihood of a few employees, and built relationships with customers. There was a focus on service to the community rather than endless growth in value for shareholders.
Just as Bernie Madoff promised double digit returns, the US economy experienced rapid growth (likely unsustainable) via credit cards, speculation, and mortgaging our children's future.
If our resources are finite - we have a limited amount of fresh water, a fixed set of raw materials, and a cap to the population that can be sustained in the environment - infinite growth is not possible.
I believe that the era of "growth is good" is coming to an end. It is my hope that the era of quality, employee retention, customer satisfaction, and sustainability will replace it.
Call me old fashioned, but does it make sense for hedge fund managers, venture capitalists, and option traders to make such high returns without really contributing to society? Do they create new ideas, innovative products, or value added services? Or are they no better than sophisticated speculators in a global Ponzi scheme? The vast sums of money they make come from somewhere and we're all paying the price now for their creation of derivative investments that were based on the notion that home prices and businesses would have infinite growth in a finite world.
As I approach 50, my view of the world and my own needs have changed significantly. In my 20's I measured success by the amount of stuff I owned, the size of my house, and the speed of my car. Now I measure my success by the amount of stuff I do not have, the smallness of my house, and the carbon footprint of my car.
If we all endeavor to focus on the quality of life, the sustainability of our environment, and the future of our children rather than endless growth, the world will be a better place.
Two recent articles by Thomas L. Friedman, The Inflection Is Near? and Mother Nature's Dow ask if we are engaged in a global Ponzi scheme of accelerating consumption and growth.
Most for-profit companies I've worked with as an advisor or Board member measure their success in quarter per quarter growth percentages.
In the economy of a bygone era, local businesses were considered successful when they made a high quality product, maintained the livelihood of a few employees, and built relationships with customers. There was a focus on service to the community rather than endless growth in value for shareholders.
Just as Bernie Madoff promised double digit returns, the US economy experienced rapid growth (likely unsustainable) via credit cards, speculation, and mortgaging our children's future.
If our resources are finite - we have a limited amount of fresh water, a fixed set of raw materials, and a cap to the population that can be sustained in the environment - infinite growth is not possible.
I believe that the era of "growth is good" is coming to an end. It is my hope that the era of quality, employee retention, customer satisfaction, and sustainability will replace it.
Call me old fashioned, but does it make sense for hedge fund managers, venture capitalists, and option traders to make such high returns without really contributing to society? Do they create new ideas, innovative products, or value added services? Or are they no better than sophisticated speculators in a global Ponzi scheme? The vast sums of money they make come from somewhere and we're all paying the price now for their creation of derivative investments that were based on the notion that home prices and businesses would have infinite growth in a finite world.
As I approach 50, my view of the world and my own needs have changed significantly. In my 20's I measured success by the amount of stuff I owned, the size of my house, and the speed of my car. Now I measure my success by the amount of stuff I do not have, the smallness of my house, and the carbon footprint of my car.
If we all endeavor to focus on the quality of life, the sustainability of our environment, and the future of our children rather than endless growth, the world will be a better place.
Rabu, 01 April 2009
The Hive Mind
Over the past few years, I've radically redesigned my approach to learning. In the past, I memorized information. Now, I need to be a knowledge navigator, not a repository of facts. I've delegated the management of facts to the "Hive Mind" of the internet. With Web 2.0, we're all publishers and authors. Every one of us can be instantly connected to the best experts, the most up to date news, and an exobyte multimedia repository. However, much of the internet has no editor, so the Hive Mind information is probably only 80% factual - the challenge is that you do not know which 80%.
Here are few examples of my recent use of the Hive Mind as my auxiliary brain.
I was listening to a 1970's oldies station and heard a few bars of a song. I did not remember the song name, album or artist. I did remember the words "Logical", "Cynical", "Magical". Entering these into a search engine, I immediately retrieved Supertramp's Logical Song lyrics. With the Hive Mind, I can now flush all the fragments of song lyrics from my brain without fear.
My daughter asked me a question from her chemistry homework about calculating the mass of nitrogen gas gathered over water. I did remember the ideal gas law (PV=nRT), but I did not recall how to correct for the partial pressure of water using Dalton's Law. One quick search for "nitrogen collected over water" yield sample problem sets from colleges that refreshed my memory with all I needed to know.
While writing, I'm constantly looking up words, concepts, maps, and dates. I know how to look for them and where to find them.
There are a few times when the Hive Mind yields surprising results. I wanted to learn more about the Stimulus Bill's "Healthcare IT Standards Committee". I wanted to check out the "ARRA privacy timeline". Finally, I was looking for information about the "healthcare CIO". All three of these searches returned my own writing as the first hit. The blessing and the curse of Web 2.0 is that blogs are the news and personal opinions can become facts.
At the moment I have a balanced separation between my own mind and the Hive Mind. However, as we Twitter, Facebook, and LinkedIn, I wonder if the separation between our human mind and our network mind will blur.
I remember an Outer Limits episode Stream of Consciousness (actually, I found it in Wikipedia by searching Google for "outer limits episode stream") in which everyone in society is connected to the "Stream" and shares a network connected existence based on information, not knowledge. In the end, the Stream is destroyed and mankind has to re-learn how to think for themselves.
As the closing dialog of that episode notes
"We make tools to extend our abilities, to further our reach, and fulfill our aspirations. But we must never let them define us. For if there is no difference between tool and maker, then who will be left to build the world?"
Words to live by as we use the Hive Mind of the internet.
Here are few examples of my recent use of the Hive Mind as my auxiliary brain.
I was listening to a 1970's oldies station and heard a few bars of a song. I did not remember the song name, album or artist. I did remember the words "Logical", "Cynical", "Magical". Entering these into a search engine, I immediately retrieved Supertramp's Logical Song lyrics. With the Hive Mind, I can now flush all the fragments of song lyrics from my brain without fear.
My daughter asked me a question from her chemistry homework about calculating the mass of nitrogen gas gathered over water. I did remember the ideal gas law (PV=nRT), but I did not recall how to correct for the partial pressure of water using Dalton's Law. One quick search for "nitrogen collected over water" yield sample problem sets from colleges that refreshed my memory with all I needed to know.
While writing, I'm constantly looking up words, concepts, maps, and dates. I know how to look for them and where to find them.
There are a few times when the Hive Mind yields surprising results. I wanted to learn more about the Stimulus Bill's "Healthcare IT Standards Committee". I wanted to check out the "ARRA privacy timeline". Finally, I was looking for information about the "healthcare CIO". All three of these searches returned my own writing as the first hit. The blessing and the curse of Web 2.0 is that blogs are the news and personal opinions can become facts.
At the moment I have a balanced separation between my own mind and the Hive Mind. However, as we Twitter, Facebook, and LinkedIn, I wonder if the separation between our human mind and our network mind will blur.
I remember an Outer Limits episode Stream of Consciousness (actually, I found it in Wikipedia by searching Google for "outer limits episode stream") in which everyone in society is connected to the "Stream" and shares a network connected existence based on information, not knowledge. In the end, the Stream is destroyed and mankind has to re-learn how to think for themselves.
As the closing dialog of that episode notes
"We make tools to extend our abilities, to further our reach, and fulfill our aspirations. But we must never let them define us. For if there is no difference between tool and maker, then who will be left to build the world?"
Words to live by as we use the Hive Mind of the internet.
Langganan:
Postingan (Atom)