Whimsical Friday: The Green Thing

[Whimsical Friday is a light-hearted note on any technology that impacts our lives in some form or fashion.]

I received this email from one of my friends, I thought I would share....

In the line at the store, the cashier told the older woman that plastic bags weren’t good for the environment. The woman apologized to her and explained, “We didn’t have the green thing back in my day.”

That’s right, they didn’t have the green thing in her day. Back then, they returned their milk bottles, Coke bottles and beer bottles to the store. The store sent them back to the plant to be washed and sterilized and refilled, using the same bottles over and over. So they actually were “recycled.”

But they didn’t have the green thing back in her day.

In her day, they walked up stairs, because they didn’t have an escalator in every store and office building. They walked to the grocery store and didn’t climb into a 300-horsepower machine every time they had to go two blocks.

But she’s right. They didn’t have the green thing in her day.

Back then, they washed the baby’s diapers because they didn’t have the throw-away kind. They dried clothes on a line, not in an energy-gobbling machine burning up 220 volts – wind and solar power did the drying. Kids often got hand-me-down clothes from their brothers or sisters, not always brand-new clothing.

But that old lady is right, they didn’t have the green thing back in her day.

Back then, they had one TV, or radio, in the house – not a TV in every room. And the TV had a small screen the size of a pizza dish, not a screen the size of the state of Montana. In the kitchen, they blended and stirred by hand because they didn’t have electric machines to do everything for them. When they packaged a fragile item to send in the mail, they used wadded up newspaper to cushion it, not styrofoam or plastic bubble wrap.

Back then, they didn’t fire up an engine and burn gasoline just to cut the lawn. They used a push mower that ran on human power. They exercised by working so they didn’t need to go to a health club to run on treadmills that operate on electricity.

But she’s right, they didn’t have the green thing back then.

They drank from a fountain when they were thirsty, instead of using a plastic bottle or cup every time they had a drink of water. They refilled pens with ink, instead of buying new pens, and they replaced the blades in a razor instead of throwing away the whole razor just because the blade got dull.

But they didn’t have the green thing back then.

Back then, people took the streetcar and kids rode their bikes to school or rode the school bus, instead of turning their moms into a 24-hour taxi service. They had one electrical outlet in a room, not an entire bank of sockets to power a dozen appliances. And they didn’t need a computerized gadget to receive a signal beamed from a satellite 2,000 miles out in space in order to find the nearest pizza joint.

But they didn’t have the green thing back then!

Choosing the right Cloud Provider

Typically, the healthcare sector lags behind other industries when it comes to embracing new technologies. Ironically this industry is embracing cloud computing on par with other industries.

Nearly one-third of healthcare sector decision makers said they are using cloud applications, and 73% said they are planning to move more applications to the cloud, according to a recent report by Accenture. Those figures fall in line with findings about cloud adoption plans in other industries, according to the report.

What’s the attraction of cloud computing that has the healthcare industry adopting it at the same pace as other industries? Basically, smaller practices are finding it economical to do away with their own modest IT operations and rely on cloud service providers for electronic health record (EHR) services, while larger institutions are building internal, private health care clouds for easier accessibility.

However, before jumping to the cloud, healthcare providers should consider the following elements before choosing a cloud services provider:

An assessment of the associated risks and benefits should be taken. Evaluate all potential cloud computing service providers to understand key areas from compliance and data location to availability, recovery and viability. Ensure the service provider’s security, access, and control methods surpass, or at least equals, your current security measures. As I stated in a previous blog post (Due Diligene Is In, Google Health Is Out), perform due diligence on the provider. Even if the service provider is a well known multi-national firm don’t assume vendor due diligence isn’t needed.

As healthcare providers rapidly embrace this new technology, it’s important that they assess all of their needs and options so that the right solution and cloud computing partner is chosen.

A Week in Review, Aug 8

Best Practices For Selecting An EHR

[InformationWeek Healthcare] An in-depth analysis and exhaustive checklist from Huntington Memorial Hospital's Rebecca Armato. Rebecca Armato doesn't mince words. "Just as the right medical treatment is critical to a patient's survival, the right approach to EHR selection and adoption is critical to the health/survival of a physician's practice," she said. Read full story.


EHRs are easy prey, but all is not lost

[Network World] Wherever money and information flow, so do the bad guys. And with estimates that the Electronic Medical Record (EMR) and Electronic Health Record (EHR) market in the U.S. will reach $6 billion by 2015 -- according to the research and consulting firm MarketsandMarkets -- it's no surprise criminals are paying more attention. Also no shock is that as more records are digitized, there are many more breaches involving patient data. This is not unlike when vast credit card breaches quickly followed the rise of e-commerce in the early part of the previous decade. Read full story.


5 Considerations on Health Information Exchanges: What Your Hospital or Health System Needs to Know

[Hospital Review] Hospitals and health systems are scrambling to become meaningful users of certified electronic health record technology within their own entities, but what's the next step to share health information after that step? The answer for many organizations will be health information exchanges. Read full story.


How healthcare packaging professionals are using iPads for business

[Healthcare Packaging] Tablet computing has been around for years, but the category didn't take off until Apple launched the iPad in April 2010. A year and a half later, Apple has sold more than 25 million iPads. And that's nothing compared to what's to come. Millions and millions more will be sold over the next 12 months, by Apple and the slew of Android competitors being released. Read full story.

Whimsical Friday: Good Deal, Netflix New Pricing Model

[Whimsical Friday is a light-hearted note on any technology that impacts our lives in some form or fashion.]

By now everyone is aware Netflix changed their pricing model. What once cost $10 a month — online streams of movies plus one DVD by mail at a time — will now cost $16 a month. However, streaming only will remain $8 a month.

This price increase spurred complaints from thousands of Netflix customers on Facebook and other Web sites, some of whom said they may now rely less on physical DVDs and more on online options; and some saying they are dropping Netflix altogether.

I fit into the first category, “will rely less on physical DVDs and more on online options.” I’m converting my current Netflix account — unlimited streaming with 1 DVD, including blu-ray — for $12 a month to their streaming only option for $8 a month. I’ll rely on Redbox for those occasional evenings when I want a physical disc.

John Blackledge, an analyst at Credit Suisse Securities, states “Netflix must be pretty comfortable with the value of both services that they can break each out. At the same time, increasing the price for DVD-and-streaming customers may push more people into streaming-only plans.” Why would Netflix push their customers into a lower priced plan? Higher profit margins. To send a customer a DVD requires postage, inventory, multiple warehouses, trucks, envelopes, printing, and not to mention the labor that's involved (clerks, logistic personnel, etc.). All of which adds up to a fairly hefty expense. To stream that same movie requires only a small fraction of the DVD delivery cost because streaming is all computerized, no human intervention required per movie request, no warehouses, no trucks, no postage, no printing and no envelopes.

So if Netflix can increase their profits while potentially charging their clients less, more power to them. The ultimate question is when will Netflix's entire library be available for streaming? Currently only about 20 percent of Netflix’s library is available for streaming at any time, with some titles and studios coming and going. If Netflix doesn't address the gap between their DVD and streaming library soon this pricing model could become problematic.

In the mean time, Netflix just saved me $4 a month minus what I may spend monthly with Redbox, which is never more than $4 - 6 ANNUALLY. Sounds like a good deal to me. Redbox is probably saying the same thing.

Mobile Devices, a Security Risk?

Mobile devices are allowing health care workers 24-7 access to critical information from virtually anywhere. While mobile computing in health care is reducing costs and improving quality care, they pose huge security risks to patient information.

In less than two years, from September 22, 2009 through May 8, 2011, the U.S. Department of Health and Human Services Office for Civil Rights indicated that 116 data breaches of 500 records or more were the direct result of loss or theft of a mobile device, exposing more than 1.9 million patients’ PHI [Personal Health Information].

What's surprising about this report is that the biggest cause of breaches isn’t from hackers but from the theft or loss of mobile devices. The issue of data breaches isn’t a new one, but it is coming into greater focus with mobile devices increasing popularity.

Rick Kam, president and co-founder, ID Experts, gives a number of suggestions for protecting sensitive patient data. Among them:
• Whenever possible, don’t store sensitive data on wireless devices. If required, ensure the data is encrypted.
• Enable password protection on wireless devices, and configure the lock screen to come on after a short period of inactivity.
• Turn on the Remote Wipe feature of wireless devices.

Bottom line, to mitigate the loss when a mobile device has been stolen or lost a solid mobile device security plan must be in place.

A Week in Review, Aug 1

Why CompTIA Healthcare IT Technician?

[CompTIA] We all hear the buzz about healthcare – EHR/EMR, HIPAA, PHI and the other acronyms in the space. But what does it mean for IT professionals? What are the job opportunities? How do you show employers you have the unique skills required to work in IT in a healthcare setting? Read full story.


New Healthcare Technology to Save the United States $700 Billion

[Wall Street Daily] Thanks to the increasingly popular telemedicine trend, your home office could one day double as your doctor’s office.

It’s possible because telemedicine breakthroughs allow doctors to link directly with remote patients through its teleconferencing technology. Read full story.


EHRs Fall Short for Eye Doctors: Report

[eWeek] Ordinary electronic health record applications lack features that eye doctors require and therefore, these specialists have been slow to adopt the software, according to a report by the IT committee of the American Academy of Ophthalmology. Read full story.


Hospitals Boost IT Spending Plans

[InformationWeek Healthcare] The federal incentive program for Meaningful Use of electronic health records seems to be having its desired early effect by spurring healthcare organizations to adopt more than just basic EHRs, according to a new study. And many hospitals are making plans to spend more on other forms of IT in the next few years, suggesting that EHRs are becoming integral to the overall organizational strategy. Read full story.

A Week in Review, July 25

FDA proposes regulation of mobile healthcare apps

[LA Times] The Food and Drug Administration has introduced a proposal that would allow it to regulate smartphone and tablet apps that relate to health and medical needs. Read full story.


List of 'Most Connected Hospitals' Emphasizes Health IT Adoption

[iHealthBeat] On Tuesday, U.S. News & World Report released its "Most Connected Hospitals" list featuring 118 facilities, U.S. News & World Report reports. Read full story.

EHR, Cloud Computing

Cloud computing is becoming a standard method of software and hardware operation for many businesses. SearchHealthIT reported health care cloud adoption is on the rise, thanks in part to EHR systems.

Cloud computing advantages for healthcare are undeniable (especially for smaller providers), faster EHR implementation, low cost of ownership, and system access mobility. However, cloud computing risks should not be ignored when deciding to transition to a cloud-based system. Cloud computing risks include vendor dependency, security, data privacy and confidentially issues.

Because of the substantial cost savings associated with cloud-based systems, cloud computing is here to stay. However like any other IT project, appropriate steps should be taken to reduce and mitigate those risks. Seek out advice and guidance from cloud computing subject matter and legal experts to hammer out contingency plans, service level, data ownership, and security agreements in the event of system down time, security and privacy breaches.

A Week in Review, July 18

Healthcare IT booming but faces talent drought

[ZDNet] The healthcare IT sector is on a roll but the market's fast demand and growth is hindered by a lack of talent skilled with both clinical and IT know-how, note industry players, who add that clinical analysis, interface management and electronic medical records are some of the most sought-after skills in the industry. Read full story.


The Costs and Implications of EHR System Downtime on Physician Practices

[SYS-CON] Government funding incentives (ARRA HITECH Act) to implement electronic health record systems (EHR) are driving most physicians towards the selection and implementation of EHR applications that are appropriate to their practice. However, even though the average practice takes more than 120 days to select their EHR solution, 87% of practices spend no time evaluating the service levels and uptime associated with these installations, instead leaving this important criterion in the hands of the software provider. Read full story.


Do EHRs leave out your personal story? Social media response

[Healthcare IT News] The idea of a nationwide electronic health record system is brilliant. Patients could use their own personal health record to request prescription refills, schedule future appointments and evaluate their own test results. The record could live on thumb drives, mobile devices, personal computers, or in the cloud. Read full story.

Whimiscal Friday: Six Strikes, Anti-piracy Plan

[Whimsical Friday is a light-hearted note on any technology that impacts our lives in some form or fashion.]

Several major US Web providers, Cablevision, Comcast, Time Warner Cable and Verizon, and the entertainment industry developed a “six strikes” plan to combat, educate and punish people sharing copyrighted files online.

Matthew Decarlo reported for TechSpot that...

[this plan] officially called the "Center for Copyright Information" (CCI), the organization is being established jointly by the film, music and television industries along with the ISPs. As part of The Center, ISPs will issue "Copyright Alerts" to notify alleged pirates of their unsavory behavior. Warnings may begin as a formal letter or email to inform accountholders of the unscrupulous activity (this has occurred for years, so it isn't anything new).

Failure to heed those warnings will initiate another tier of alerts as ISPs begin to nag suspected offenders with pop-ups or by redirecting specific pages. If the accountholder refuses to comply, ISPs will progress to a series of "Mitigation Measures," including bandwidth throttling, redirection to a landing page until the subscriber contacts the ISP (it's unclear if this will block access to all sites), or "other necessary measures."

Regardless of how you feel about the RIAA or piracy in general, piracy is illegal and copyright holders should be compensated for their work. Unfortunately, the formulation of CCI is the beginning of legalized online monitoring. If you weren’t already convinced, anything, I mean ANYTHING, you do online is monitored and traceable, and now it can be legally reported to another party.

The question remains where does online monitoring by big brother stops? Since I constantly browse healthcare sites, will I start receiving targeted healthcare advertising because the ISP sold my online activity to marketers? Will an employee be terminated because their employer found out via the ISP the employee posted their resume on several job boards? Now that ISPs have legal standing to monitor “suspected” traffic, can they be trusted?

The Center for Copyright Information has the potential to be a slippery slope.

EHR Implementation Tutorial

Craig Byer with SearchHealthIT has written a good paper, EHR implementation tutorial: From vendor selection to maintenance, that succinctly conveys the EHR message, from why it needs to be done to vendor implementation. Byer's article can be used as a resource by organizations, practices and/or healthcare IT consultants to help articulate the EHR message and the process to transition from paper records to electronic records.

I find Byer’s resource particular useful for IT consultants in the trenches trumpeting the EHR horn. Getting medium to small-sized providers to grasp the importance of transitioning to electronic records can be an arduous task, especially if the practice is information technology adverse. Having additional third party information to assist in conveying the EHR message is never a bad thing.

A Week in Review, July 11

EMR by the Numbers – Video Infographic (GE Healthcare)



Delays Force Feds To Propose EHR Reporting Changes

[Information Week] The Centers for Medicare and Medicaid Services (CMS) said it plans to allow eligible professionals to attest in 2012 that they have used their electronic health records to collect data on clinical quality measures as part of the CMS criteria for "Meaningful Use" of EHRs. Read full story.


Personal Health Records to Thrive Despite the Demise of Google Health: Report

[eWeek] Despite the exit of Google from the personal health record market, the consumer version of electronic health records may have a future as part of an overall health care IT strategy, according to a report by research firm Frost & Sullivan. Read full story.


EHR Adoption Will Drive Health Care IT Stocks Through 2013

[TWST] Health care IT companies stand to benefit from the current move toward stage one meaningful use implementation of electronic health records by hospitals and physician offices through 2013, says Jamie Stockton, First Vice President at Morgan Keegan & Co., Inc. Read full story.

Whimsical Friday: $660 For A Brake Job?

[Whimsical Friday is a light-hearted note on any technology that impacts our lives in some form or fashion.]

“I hear this loud grinding noise while driving and it get’s louder when I apply the brakes”

“Mr. Henderson, my technician checked it out and you need a front brake job.”

“How much?”

“$660.00”

“$660.00 for a brake job? Put my car back together I’ll do it myself.”

This is the conversation I had last week with a national automotive service chain. I got caught up in the moment, because an automobile mechanic I’m not. Yeah, back in the day I changed my flats and my own oil, but I’ve never, again I say NEVER, done a brake job. During this era of AAA and the miniscule savings gained from changing your own oil, when it comes to automobile maintenance and repair I hardly do anything myself other than pump my own gas & wash it. I call AAA and/or fork over the cash for someone else to handle it. So for me to personally change the brakes on one of my vehicles is waaaaay out of my comfort zone.

Since there have been several technological automobile advances over the past few decades, i.e. rear view cameras, self parallel parking, air bags, etc. I was hoping this wasn’t the same tedious task I watched my uncle do about 40 years ago. Just maybe, after I removed the wheel there would be some type of touch screen hidden there with an app that I could run, or I could pull up the program source code to locate the runaway do-loop, or I could ping the network to see which host wasn’t responding. Unfortunately after I removed the wheel, I realized all of that was wishful thinking, no touch screen for me to play with.

I decided I needed help, so I called my brother in-law and my friend both of which live about 1000+ miles from me. Yeah, yeah, I needed assistance from two people, again, I have NEVER done a brake job before. Plus I could spread out my gazillion questions between them to keep from looking like a total klutz. In addition to my phone assistance, I watched several how-to video’s on YouTube which actually was a very good idea.

Needless to say, after 3 days of several trips back and forth to the automotive store, several phone calls and text messages to my instructors, I finally completed the brake job with new pads, rotors, and calipers all for about $200, take that!

This was my first, and my last, brake job. Until this can be done with a touch screen, I’m out of the automotive repair/maintenance business. Heck, I may stop pumping my own gas. Maybe not, some gas stations do have touch screens now.

Due Diligence Is In, Google Health Is Out

Google announced it’s pulling the plug on their Google Health personal health record (PHR). Developers that built connectors between their EHR and Google's PHR systems will be left out in the cold. The take-away from this shutdown is that, when choosing a third party partner, provider, and/or vendor due diligence must be performed, even if it’s a Fortune 100 company like Google. For instance, in addition to validating Google's ability to actually deliver the product, there were 4 other areas that should have been investigated also.

Financial: In 2010 Google had annual revenue in excess of $29 billion and roughly $8 billion in profits, so financial stability and resources were not a problem.

Capability: Over the past decade Google has been one of the most technically innovative companies around, i.e. Internet search, Android, etc., so Google’s technical capability was not an issue.

Support: Although Google was only founded about 13 years ago -- barring any illegal activity -- a multinational company with over 24,000 employees and several billion dollars in revenue doesn't disappear overnight. Google’s viability to provide long term support was strong.

Competence: Google is an Internet search company that hosts and develops a number of Internet-based services and products. However none (or very little) are federally regulated like EHR systems, this should have raised a few eyebrows. A healthy discussion should have occurred around Google’s inexperience and competency with developing federally regulated healthcare software. Unfortunately, entities that did perform due diligence and decided to proceed with Google's PHR development, Google's lack of experience was probably overshadowed by their very strong financial and technical positions.

Currently, both public and private entities have not settled upon health data standards and the execution of national health information exchange. According to former U.S. HIT coordinator David Blumenthal this could be a decade-long health IT construction project. Basically, Google did not have the stomach to tough it out. PHR development is not at the pace, and space, for a savvy, leading-edge, technical innovative company such as Google.

During my IBM days, I remember a CFO stating that no one loses their job for choosing IBM as a partner. For those healthcare IT executives that chose to hitch their wagon to Google’s PHR, hopefully none of them will lose their job for choosing Google as a partner.

A Week in Review, July 4

Capgemini eyes US healthcare acquisition

[Financial Times] Capgemini, the European IT services company, is looking for a string of acquisitions to bolster its position in the US market, with a particular interest in the healthcare sector. Read full story.


AAMI: Healthcare technology management dawns as a new profession

[CMIO] After an intensive two-day forum to better define the evolving role of clinical and biomedical engineering, industry leaders came to the conclusion that healthcare technology management is the new name for the profession, which was explained in a presentation at the Association for the Advancement of Medical Instrumentation (AAMI) conference & expo on June 26. Read full story.


Health IT grads to improve healthcare

[UPI] Nine U.S. programs in comprehensive management of health information are graduating their first classes, totaling about 500 students this summer, officials say. Read full story.


IBM study defines futuristic networked devices for healthcare

[Networkworld] IBM came out with a study this week that looks at what future healthcare applications and devices, be they PCs, tablet or smartphone might look like.

The study notes that medical device makers have in the past few years successfully targeted consumers who are extremely health or fitness conscious as well as those who need to be regularly monitored because of a serious health problem. But the IBM study says those devices and services could now go a step further and integrate mobile and home-based devices with web-based resources, electronic and personal health records to help people make more well-informed medial decisions and actually help manage their healthcare situation more proactively. Read full story.

EHR software market to exceed $6 billion

Markets and Markets reported the electronic health record (EHR) software market is poised to exceed $6 billion by 2015. In addition to government initiatives toward development of EHR, they also attribute the rising demand for healthcare cost containment and the need to improve the quality of healthcare services are driving the growth rate in this market. This is a huge jump as the EHR market was only about a $2 billion industry in 2009.

Not so surprising, they also noted that web-based EMR solutions or ASP models are gaining popularity with small-sized healthcare practices and physician offices. The popularity of web-based and ASP EHR solutions for smaller providers will force many smaller providers to upgrade their IT infrastructure, i.e. broadband access, hardware, LAN/WAN, software platform, etc. Therefore, IT opportunities should trickle down to smaller IT integrators and consultants.

A Week in Review, June 20

HITECH Act moves healthcare IT industry forward

[MedCity News] As I travel the world speaking about the Health Information Technology for Economic and Clinical Health (HITECH) Act, I’m often asked to present objective evidence that it is making a difference. Read full story.


Consumer confidence about health data safety is key to EHR adoption

[Government Health IT] As the healthcare system becomes more connected, it will increasingly become a breeding ground for risk to individual privacy, confidential information, data integrity and service availability, according to health IT security experts. Read full story.


Are Health Insurers Prepared for Healthcare Reform?

[Insurance & Technology] Countless papers have been written about the impact of healthcare reform on the insurance industry, but few look at these changes from the perspective of how these mandates will impact healthcare payers -- particularly, technology, people and processes. In the interest of bridging that gap, let's take a look some of the challenges health insurers face, and some solutions they might consider. Read full story.

Whimsical Friday: Bicycle Computers

[Whimsical Friday is a light-hearted note on any technology that impacts our lives in some form or fashion.]

The past few weeks I've been looking to upgrade my bike game, trying to find a fun activity to stay active, healthier, and have a better quality of life (well, that's what the cycling brochure said). In the past when I needed, and/or wanted, a new bike I would go to the nearest Walmart and purchase whatever bike that was on sale. Since I really wanted to do more than cruise the neighborhood I decided I would get a bike from my LBS (local bike shop).

Sticker shock aside, I was amazed at all the gadgets that were available for such a simplistic activity, gone are the days when you just buy a bike and a box of patches to repair the inner tube that would eventually blowout. The LBS had CO2, wedge packs, skinny seats, wide seats, platform pedals, clip pedals, front suspension, rear suspension, seatpost suspension, computers, yes computers and not to mention a whole line of clothing apparel. So much for my cutoff jeans and vintage University of Florida Gator tee shirt from 1984.

Since I’m a computer kind of guy, I decided to pushed the salesperson on the computer gadget to find out exactly what it did. "Does it calculate the wind resistance and the friction between the road and tires to adjust the tension in the crankset automatically? Or is it constantly monitoring the pressure in my tires to let me know when one of the tires is below the required PSI levels?" The salesperson replied, "No. It tells you your current speed, trip distance, and second-trip distance. And it’s all touch-screen." "What? A speedometer?" "Yes." "Why didn’t you just say that? Geez!"

I’m all for technology advancement, but just because a few LED’s, IC's, and a digital display were put into a speedometer, it’s still a speedometer. I suspect the name change was driven by dollars and cents, you can probably charge more by calling it a "computer" versus a speedometer. By the way, there’s an app for that!

So I jumped in my computer, I meant my car, and drove home without buying the bike. I’ll checkout Walmart this weekend to see what they have on sale.

Citrix Virtualization for the iPad

In my past few blog posts, I’ve discussed the rapid penetration of iPad’s by health care providers. Virtualization is another reason why iPad’s are being readily adopted in the clinical setting.

Citrix’s Receiver application is a free app available for the iPad which allows users to access their virtualized Windows applications. In addition, it let users access and view both Adobe Flash-and Microsoft Silverlight-based Web sites, which isn’t allowed through Apple’s Safari. With Citrix Receiver, the iPad can provide most of the functionality of a desktop, including an on screen keyboard.

Nick Volosin, ISS director of technical Kaweah Delta Health District in Visalia, CA stated “It [iPad] gets the physicians in the patient rooms more, if the physician is in the room charting-versus at the document desk—the patient feels that they’re present. The patient can ask questions. They don’t have to push the nurse call button as much.”

If your organization has Citrix servers already install, it would be prudent to do due diligence on allowing connectivity via their Receiver app for the iPad. If your organization doesn’t have Citrix but considering it, enumerate this feature as a pro for installing Citrix.

A Week in Review, June 13

Study: EHR, paper workarounds may lead to efficiencies

[CMIO] Workarounds identified during the outpatient consultation management process, first studied two years ago, continue to challenge EHR-based ambulatory consultation systems, according a study in the July 2011 issue of the International Journal of Medical Informatics. Read full story.

Small Practices, Individuals Practitioners Struggle More to Overcome EHR Costs

[Becker’s Hospital Review] Solo physicians and small physician practices find it harder to remain financially viable as they work to choose, implement and learn to use electronic health records, according to a Government Health IT news report. Read full story.


Patient involvement is critical to success of Meaningful Use program

[Healthcare IT News] One of the major purposes of the federal program for the Meaningful Use of electronic health records (EHRs) is to produce improved clinical outcomes for patients. Providing patients access to their personal health information and having that information available to their families, caregivers and healthcare providers anywhere at any time is another core requirement of the Meaningful Use program. Read full story.

Whimsical Friday: No More iPhone Activation

[Whimsical Friday is a light-hearted note on any technology that impacts our lives in some form or fashion.]

The Zeus of Apple, Steve Jobs, made three major software-based announcements this week at the 2011 Worldwide Developers Conference (WWDC), OS X Lion, iOS 5, and iCloud.

iOS 5 is the latest upgrade of Apple’s operating system for its mobile devices, iPhone, Touch, iPad, and Apple TV. Whereas OS X Lion is the latest operating system upgrade for its Macintosh desktop and laptop computers. iCloud is their cloud service offering to store music, photos, apps, calendars, and documents automatically and wirelessly push the stored content to all of your devices. There are too many features and enhancements involved in this announcement for me to discuss here, in addition you can find better sources on the Internet that discuss this announcement in greater details than I ever could.

The one feature that stood out as having a significant impact for consumers is computer-free iOS device setup and updating. Jeremy Horwitz of iLounge described it the best “as the single most important change in iOS 5—and the one that will impact not just existing iOS users, but the next generation of new Apple customers, too: you won’t need a computer any more to activate and start using your iOS device. The required “Connect to iTunes” activation step has always been a small hassle for some users and a major roadblock for others, particularly people who don’t own desktop or laptop computers (yes, they exist!) but want to enjoy the benefits of an iPhone, iPad, or iPod touch. These users have either had to find friends or family to lean on for initial activation, backups and/or software updates; some people haven’t purchased Apple’s digital media devices solely because they’ve been tethered to computers.”

Just in the past couple of years, I can think of three people that have used my computer to activate their Touch and/or iPhone. I’m finally free of being iPhone activation central!

iPad, Embraced By Health Care Providers

In one of my previous blog posts, Rapid Integration, I discussed the rapid adoption rate of tablet computers, iPads in particular, by physicians. One of my blog readers asked what were my thoughts on why the iPad was readily embraced by physicians?

Actually, healthcare providers have been using the iPhone for several years now for everything from voice recording to clinical data entry via the mass selection of apps that are available for this platform. So the rapid adoption rate of iPad by physicians really came as no surprise. However, I think there are a couple of characteristics that made the iPad even more attractive to health care providers.

First the price, for a few hundred bucks you can have the processing power of a desktop computer in your hands and/or lab jacket at a fraction of the weight and size. Secondly the apps, basically the iPad can run all of the apps available on the iPhone, and it can be used to enter data directly into EHR and CPOE systems. Thirdly the size, the iPad is about the same size as patient charts so carrying around an iPad is not awkward. Also the larger screen on the iPad makes it easier to obtain and enter information, and share this info with the patient.

Now if Jobs (Apple’s CEO) and Narayen (Adobe’s CEO) could settle their differences so the iPad can run Adobe’s Flash, this would open the iPad to many more applications.

A Week in Review, June 6

IBM Watson Beaten In Medical Diagnostics Race

[InformationWeek Healthcare] Sherlock Holmes would be proud of IBM's Watson computer. No longer the bumbling sidekick portrayed by Arthur Conan Doyle, the supercomputer has managed to master natural language skills, defeat Jeopardy contestants, and wow medical school professors with its potential to diagnose esoteric diseases. I suspect it would even make the late IBM President Thomas J. Watson, for whom the computer is named, proud. Read full story here.

Health Care Cloud Offers Some Risk, Endless Possibilities

[SearchHealthIT.com] Health care information technology, in many ways, trails other vertical markets. Contract attorney Diana McKenzie of HunterMaclean in Savannah, Ga. put it this way: When she first started practicing health IT law more than two decades ago, she found health care about eight years behind finance. Read full story here.

Verizon Enhances Security Programs For Healthcare Organizations

[InformationWeek Healthcare] Verizon has added new capabilities to two of its security programs, capabilities that should help health delivery organization strengthen security across their health systems and assess the security practices of partners they do business with. Read full story here.

Whimsical Friday: YouTube, Public Access Channel

[Whimsical Friday is a light-hearted note on any technology that impacts our lives in some form or fashion.]

As I familiarized myself with my latest toy, Verizon Fios television, I wondered was Public Access television (channels set aside for free by cable companies for use by the general public) still around and was it still a viable option for fledging artists, personalities, and technicians? Honestly, after fumbling around with Verizon’s glitzy television guide, and sifting through 300+ channels, I couldn’t tell which channels were public access versus the commercial ones, heck I had a hard time just trying to find TBS HD channel for the NBA playoffs.

Anyway, as I continue to think about Public Access television, I rationalized that YouTube is public access television. To get a show on YouTube all that is needed is a camera and means to upload your video, i.e. a cell phone purchased within the last 2-3 years with a camera would probably suffice. You can’t get more public access than that, right? Unlike cable’s Public Access television whereas most artists/personalities hope to get discovered to potentially cash in on their talents, with YouTube not only is the potential there to cash in if you get discovered but if one of your videos goes viral you cash in immediately.

I’ve taught myself several new skills by watching YouTube, i.e. how to apply an Invisible Shield to my iPod Touch, how to stain concrete, just to name a few. I've also watched some very entertaining videos of original content on YouTube at my leisure. Actually, Public Access television is still around, hopefully any person or persons still broadcasting their program on Public Access television are simultaneously posting their show on the other public access channel, YouTube. For the record, I've never self-taught myself anything from watching Public Access television.

IT Infrastructure for Telehealth

As baby-boomers continue to age, the demand on health services is set to double in the next 10 years. It’s not practical to believe the number of doctors and nurses, hospitals, and other healthcare providers will double also during this time, therefore, the industry will leverage technology to address these growing needs. Telephone and internet consultations will become increasingly more important as a method of providing and receiving healthcare advice.

Technology will be leveraged to provide care beyond the walls of hospitals and doctor’s offices, a routine trip to a doctor’s office could be replaced by a video, telephone, or even an internet consultation. Thereby free up time for the physician to spend with patients whose conditions require their full attention. In addition, healthcare providers will also increasingly need information systems to support non-collocated collaboration between clinicians.

The efficacy of telehealth requires the IT infrastructure to support this emerging remote physician-patient interaction; the infrastructure must connect and consolidate various imagining and clinical databases; and IT organizations must continually evaluate if and when SaaS and cloud computing is appropriate for their organization.

A Week in Review

Five Hot Trends in Healthcare Technologies

[ZDNet] The pace at which medicine and technology are converging is faster than most people realze. Today, point-of-care health technologies like tele-medicine and medical robots performing surgery in hospitals are common place. Apple iPads and other mobile devices have made their way into the exam room, and electronic medical record (EMR) vendors are following suit with compatible applications. Read full story here.


RealMed Facilitates Faster Payments by Embedding Claims Reconciliation Capabilities

[EMR and EHR News] RealMed, a leading provider of revenue cycle management solutions for health care industry, announced integration of its awarding winning capabilities with Epic. The integration provides Epic billing software clients with seamless access to RealMed’s powerful claims editing and error management tools from within the same interface used for processing claims today. Read full story here.


GlobalSign BIOWRAP Provides Healthcare, Pharmaceutical Industries with Security, Privacy and Compliance over all Digital Information

[SFGate] GlobalSign, one of the longest established Certification Authorities (CA) and specialists in online security, announced that its BIOWRAP Encrypted File system is now available to healthcare and pharmaceutical industry customers. Read full story here.

Whimsical Friday: My Favorite App

[Whimsical Friday is a light-hearted note on any technology that impacts our lives in some form or fashion.]

I’ve always been considered a music junkie (a termed coined by a fellow blogger, Chris Harris), and a self-proclaimed audiophile (albeit, an audiophile on a beer budget).  So I guess it comes as no surprise my favorite app is related to my passion of music and audio equipment, Apple’s Remote app.  Apple describes their app as “a free, fun, and easy-to-use app that turns your iPhone, iPad,or iPod touch into a remote control.  So wherever you are in your house, you can control your computer’s iTunes library....” 

What makes this app really cool is that I’m able to stream my iTunes library to my home audio system via Apple’s AirPort Express.   Of course the audiophile in me has my iTunes library digitize in a lossless format; a wired connection from my home server to the AirPort Express, none of that wireless stuff because I don’t want one bit dropping from the signal on its way to the AVR; and of course, the output from the AirPort Express to my Rotel Processor is via an optical digital cable. 

What does all of this means, at the touch of a screen I have access to my entire music library to play through my carefully crafted audio system from any location in my home and it sounds exactly as if I was playing the actual CD.  Audio nirvana!! Except for those days when I relax with my virgin vinyl pressing of Stevie Wonder’s Innervision LP on my B&O turntable with its ortofon cartridge and a Discwasher vinyl record cleaner.  What can I say, sometimes nostalgia trumps technological advances.

Rapid Integration

Apple’s iPad has made tablet computing a reality, easy and cool. The list of touch-screen tablets is constantly evolving and growing, i.e. Apple iPad, Samsung Galaxy Tab, BlackBerry Playbook, etc.

Not only have they become the must gadget to have, there’s a good collection of useful applications that are making life easier for both physicians and patients. Knowledge Networks reported in March 2011 that 27% of physicians in the United States had a tablet-style computer which is about 5 times the general public’s adoption rate.

This rapid adoption rate by physicians requires for healthcare IT professionals to be able to integrate these devices rapidly with their enterprise IT landscape. Long gone are the days where corporate infrastructure groups could take years before allowing new platforms into the enterprise. For instance, in 2006 a Fortune 100 company initially only allowed RIM’s BlackBerry mobile devices onto their corporate platform. As the iPhone grew in popularity, and apps, more employees and executives begin requesting to have the iPhone as part of the IT enterprise. Almost 4 years later, the infrastructure group finally granted approval to allow Apple’s iPhone and OS as part of the IT enterprise landscape. The problem is that Google’s Android mobile devices are now growing at an outlandish rate, so as you would probably guess, a significant amount of employees, and executives, are now clamoring to have Android devices approved. So not only is the company playing catch up with developing and integrating Apple OS apps with enterprise applications, they are also behind with Android development and integration.

In a healthcare IT setting, this slow speed of integration could very well be life or death for a patient. Particularly in the case of physicians in remote areas, where a significant amount of mobile apps have been developed to assist with providing more efficient and timely care. The bottom line, tablets and similar mobile devices have enough processing power to rival that of desktop computers. Because of open development, new apps are literally released everyday and are being developed to do what was once unimaginable. The impact and benefit of apps, and the high rate of adoption of tablet devices by physicians, requires healthcare IT organizations to make streamlining and integrating these new mobile technologies at a much more rapid pace than most other industries a top priority..

Whimsical Friday: Death of the Wristwatch

[Whimsical Friday is a light-hearted note on any technology that impacts our lives in some form or fashion.]

While out and about Saturday afternoon I asked my teenage son to tell me what time it was because I had forgotten to put on my watch. Instead of him looking at a wristwatch he pulled out his phone to give me the time. Just like my daughter, 7 years his elder, who told me 6 years ago she didn't need a wristwatch because she could always get the time from her phone and/or iPod, one of which will be in her possession at all times. For the next few days when I dropped off my son at school, I noticed there were only a few students actually wearing watches. Heck, on some days I would see no students with a wristwatch on. Do you think Timex, Swatch, and Rolex know that Generation Z aren’t wearing watches? When did this happen?

It’s easy to understand cell phones replacing pagers, two-way communication devices, and land line phones; and iPods replacing portable cassette and CD players, and even CD’s for that matter, but wristwatches? I should have realized this sooner when I was in NYC about 7 years ago, I remember making the observation that there were more street vendors selling DVD’s versus watches. However, I didn’t make the correlation that the wristwatch was actually being replaced by an emerging technology. I thought the street vendors had a higher profit margin in hawking bootleg DVD’s versus bootleg wristwatches, hence the change in products.

In any case, the wristwatch has been terminated seemingly from an unlikely technology, cell phones and portable music players, and the street vendors of NYC were the first to realize it.

The ONC Wants Your Feedback

Let your voice be heard, the Office of the National Coordinator for Health Information Technology Health IT Standards committee is requesting public comment about the temporary electronic health record certification for Stage 1 of the meaningful use program. One of the specific areas they are seeking input on is should it be required to test and certify that any EHR Module presented for testing and certification properly integrates with another EHR Module by a different vendor.

On some level, this debate boils down to a closed proprietary ecosystem-think Adobe’s Flash platform versus a more open ecosystem-think Apple’s app for their iPhone platform, basically, will interoperability among vendors be forced for certification? Even today with the examples I gave-which by the way is Apple’s point of view-there’s healthy dialogue among informational technology professionals on which system, Apple or Adobe is closed and/or more opened. These platforms have been out for decades with millions of users, and they still do not interact with each other.

EHR is too important and critical to let permanently defining the certification program of meaningful use drag on for decades. Take the discussion about EHR certification out of the break room, cubicle pod and conference room, and let the ONC officially hear your opinion by June 17.