MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'information technology'. Sat, 03 Sep 2011 01:48:44 +0100 http://www.medworm.com/index.php?rid=5182342&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F09%2Ffuture-of-pathology-jim-harrison.html This is a guest blog note by Jim Harrison, M.D., Ph.D. He is a pathologist and Associate Professor at the University of Virginia. It's a repost of a document that he circulated on the Association for Pathology Informatics (API) listserv earlier in the year and is, in part, a compilation of input from other pathologists about anticipated changes in AP and CP. Earlier this summer I posted a request to the API list for thoughts about key changes that might occur in AP and CP within the next five years and how those changes might be best supported by IT. A similar request was passed around in CAP's informatics-related committees, and the results were compiled for distribution to the CAP Pathology Transformation project. I did receive several responses from this list, so I'm summari... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5182342 Fri, 02 Sep 2011 12:42:49 +0100 5182342 http://www.medworm.com/index.php?rid=5181974&cid=t_98042_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fhow-evaluate-hipaa-security-compliant-data-center If you host your healthcare data with a data center, certain administrative, physical and technical safeguards should be in place, as defined by the Health Insurance Portability and Accountability Act (HIPAA) Security Rule. Although all service providers tout their data centers as secure, how do you confirm it truly is HIPAA Security Rule compliant?  read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5181974 Thu, 01 Sep 2011 12:57:30 +0100 5181974 http://www.medworm.com/index.php?rid=5174713&cid=t_98042_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fend-beginning-and-launch-i2o When Dr. Farzad Mostashari, the national coordinator for health information technology, addresses more than 4,700 healthcare professionals at the Allscripts Client Experience in Nashville on Monday morning, Aug. 29, he’s likely to discuss one of the most exciting developments in healthcare today – and perhaps surprisingly, it won’t be the meaningful use of electronic health records.  read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5174713 Sun, 28 Aug 2011 16:48:46 +0100 5174713 http://www.medworm.com/index.php?rid=5159861&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Ffepic-beaker-ready-or-not.html There is going to be a lot of money made as the result of the potentially large-scale deployment of Epic's immature LIS called Beaker. One of the first in line to shake this money tree will be KLAS. Here is their announcement of a report on this topic by the company (see: Epic Beaker: Ready or Not?): The laboratory market typically sees little movement. Because of the expense and complexity from a laboratory system’s deep penetration into a hospital, laboratory systems are not changed frequently. If providers do change, it is rarely from a more sophisticated solution to a more immature one. One product that seems to be bucking that trend is Epic Beaker, Epic’s newly available laboratory solution. Of surveyed Epic hospitals currently using other laboratory solutions, over half are p... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159861 Fri, 26 Aug 2011 13:19:45 +0100 5159861 http://www.medworm.com/index.php?rid=5159862&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fdoes-epic-have-a-near-monoply-for-large-hospital-emrs.html Joseph Conn, who writes for ModernHealthcare.com, picked up on one of my blog notes about the Epic EMR dominance in larger hospitals (see: Not yet an Epic monopoly or conflict). Here is his note: Bruce Friedman, in a post on Lab Soft News says, "Epic has achieved a near monopoly of the (electronic health-record systems) installed in the largest U.S. hospitals." And writing in the Washington Examiner, Lachlan Markay, an investigative writer with the conservative Heritage Foundation's Center for Media and Public Policy, reveals that Epic Systems Corp. CEO Judith Faulkner not only has made campaign contributions to Democrats but also has served as a member of the federal Health Information Technology Policy Committee, which "holds in its hands the future of health informat... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159862 Thu, 25 Aug 2011 12:51:59 +0100 5159862 http://www.medworm.com/index.php?rid=5159863&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fapathology-informatics-2011-conference-only-six-weeks-away-1.html The second annual Pathology Informatics 2011 conference is only about six weeks away. It will be held in Pittsburgh on October 4-7, 2011. It's the merged version of two prior, long-standing informatics conference, APIII and Lab InfoTech Summit. You can review the entire conference schedule as well as register on-line. Three separate content tracks are being offered: Clinical Information Management, System Support and Connectivity, and Digital Imaging. The 3 1/2 day conference with a venue at the Pittsburgh Wyndham Grand offers an opening day with three workshops, included in the registration fee, 10 plenary lectures, and 27 track lectures. A total of 43 faculty members will participate. Also presented will be about 40 scientific presentations and 15 e-posters that have been selected fr... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159863 Wed, 24 Aug 2011 12:47:29 +0100 5159863 http://www.medworm.com/index.php?rid=5159864&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fepic-as-a-victim-of-its-own-success.html Katherine Rourke, who blogs over at Hospital EMR and EHR picked up on one of my recent notes about Epic (see: The Feasibility of Using the Epic EMR as a "Platform" to Extend Its Functionality) and posted the following note: Could Epic End Up The Victim Of Its Own EMR Success? Here is a copy of her commentary with a few minor edits. Boldface emphasis is mine: In essence, the [recent Lab Soft News] post makes three key points: Epic is implemented, or soon will be, in virtually every large U.S. hospital Epic keeps very close control of how its system is implemented and developed in an effort to control performance Given this desire for control, Epic isn’t likely to let other vendors create software to interoperate with its EMR If the Lab Soft News author has his facts right, Epi... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159864 Tue, 23 Aug 2011 12:46:33 +0100 5159864 http://www.medworm.com/index.php?rid=5159865&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fsix-major-disruptions-still-to-come-in-halthcare.html Predictions about strategic shifts in healthcare intrigue me. There is always the question in one's mind about whether you agree with the list. A recent article was labeled as a list of healthcare "disruptions" but otherwise caught my attention (see: 6 Major Disruptions Still To Come In Healthcare). Here's the list stripped of the accompanying brief explanations: Conversion of physicians to electronic health records. Removing the responsibility of records-sharing from the patient. The rise of the genomic signature as part of the medical record. Moving the responsibility [for] care and outcomes from the provider location to the consumer location. The rise of health avatars. The change in physician compensation from fee-for-service to fee-for-outcomes. What interested me... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159865 Mon, 22 Aug 2011 12:15:33 +0100 5159865 http://www.medworm.com/index.php?rid=5139951&cid=t_98042_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fannouncing-metadata-pilots-realize-pcast-vision Those of you keeping a close eye on the Office of the National Coordinator for Health Information Technology (ONC) and its activities might have noticed the advance notice of proposed rulemaking (ANPRM) that was published on Tuesday, August 9, 2011, requesting public input on a set of proposed metadata standards recommended to ONC by the HIT Standards Committee. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5139951 Thu, 18 Aug 2011 13:25:30 +0100 5139951 http://www.medworm.com/index.php?rid=5140317&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fthe-most-important-iphone-app-for-pathologists.html In response to a blog note about iPhone ecosystems (see: The iPhone Effect: Smartphones and Their App Ecosystems Have Changed Everything), a reader, Christopher Metts, asked the following question as a comment: If [you] wanted to create an app for a practicing pathologist, what do you think it should do? It's an interesting question and, for me, the answer seems to be obvious.  However, I need to qualify my answer. First, it will encompass all smart phones and not just the iPhone as well as tablets such as the iPad. Secondly. my response will include two broad functions rather than specific app products. Various apps with these functionalities do exist but I don't want to single out any of them. The two functional categories that come to mind for smartphone/tablets that will ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5140317 Wed, 17 Aug 2011 14:42:01 +0100 5140317 http://www.medworm.com/index.php?rid=5139748&cid=t_98042_88_f&fid=38153&url=http%3A%2F%2Fwww.ozemedicine.com%2Fblog%2F%3Fp%3D992 THE HON NICOLA ROXON MP Minister for Health and Ageing MEDIA RELEASE 15 August 2011 ACCENTURE TO BUILD AUSTRALIA’S PERSONAL EHEALTH SYSTEM Accenture, a world leader in IT, has been selected to lead the building of the IT infrastructure for Australia’s national personally controlled electronic health record (PCEHR) system in another major milestone for national health reform. “A consortium led by Accenture has been selected as the National Infrastructure Partner for the development of the PCEHR system,” Minister for Health and Ageing Nicola Roxon said. “Accenture will be responsible for designing and building the physical PCEHR system, which will be used by people to register for and view their eHealth record. “People will also use this system to allow their GP and other health ... Oz E Medicine - emergency medicine in Australia blogs http://www.medworm.com/rss/comments.php?id=5139748 Wed, 17 Aug 2011 06:51:28 +0100 5139748 http://www.medworm.com/index.php?rid=5131063&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fdeclining-autopsy-rates.html Discussion About Reinventing the Autopsy; Reinventing the Autopsy: CT Imaging as a Routine Part of the Procedure; NYT Highlights the "Virtopsy" Used for All Military Autopsies). The virtopsy would undoubtedly be more accurate than the classic autopsy. It also could be performed less expensively and more quickly. You can refer back to my previous notes for more details about its advantages. It is currently the norm for the U.S. military and also widely adopted in countries such as Switzerland. As noted in the excerpt above, one of the major reasons for the decline in the autopsy rate is that it's time-consuming and thus expensive. It's also an uncompensated hospital service. Needless to say, family members are also often reluctant to allow the procedure on relatives withou... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5131063 Mon, 15 Aug 2011 17:40:33 +0100 5131063 http://www.medworm.com/index.php?rid=5125830&cid=t_98042_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fhit-acos-need-part-i-analytic-data The Accountable Care Organization draft rule (http://edocket.access.gpo.gov/2011/2011-7880.htm) is out, and the political, clinical and technical trek to establishing these lynchpins of the Affordable Care Act and health reform is on. Community physicians and hospitals are jockeying for potential shares of the incentives that will be distributed via the ACO program. Health Information Technology has been so frequently cited as being a critical part of making ACOs successful that it is now de rigueur. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5125830 Fri, 12 Aug 2011 12:17:53 +0100 5125830 http://www.medworm.com/index.php?rid=5125758&cid=t_98042_88_f&fid=38153&url=http%3A%2F%2Fwww.ozemedicine.com%2Fblog%2F%3Fp%3D973 The hospital healthcare environment poses many important factors which impact upon the successful uptake of clinical software, these include: increasing staff dependence upon computers to document their clinical work and access timely patient information and clinical decision support. lack of physical space for additional desktop computers or computers on wheels to address the above point current laptops and Windows-based tablets are too heavy for carrying around by staff. this means we need wireless networks throughout hospitals and staff will increasingly use their Apple iPads, perhaps their iPhones and Android phones and other devices to help them manage the increasing pressures to find an available computer when and where they want it. the resultant need for high performing, rapid dat... Oz E Medicine - emergency medicine in Australia blogs http://www.medworm.com/rss/comments.php?id=5125758 Fri, 12 Aug 2011 02:00:00 +0100 5125758 http://www.medworm.com/index.php?rid=5119007&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fethical-questions-posed-by-office-emr-by-epocrates.html Epocrates is a very successful smartphone app for physicians. The company recently announced the availability of an electronic health record (EHR) (see: Epocrates electronic health record raises new possibilities and ethical questions). Below is an excerpt from an article about this new product that may raise some ethical concerns: ...Targeted to small and solo physician practices, the [Epocrates EHR product] is a web-based software-as-a-service platform which will be offered on a monthly-subscription basis. At launch , it includes a native iPhone app that appears to include access to patient records as well as e-prescribing functionality, with iPad support reportedly in the works. Epocrates EHR will also include support for billing/coding, data analysis and reporting, and an interesting t... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5119007 Wed, 10 Aug 2011 12:00:00 +0100 5119007 http://www.medworm.com/index.php?rid=5107559&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F08%2Fnhs-scraps-plans-for-centralized.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=5107559 Tue, 09 Aug 2011 13:33:00 +0100 5107559 http://www.medworm.com/index.php?rid=5107560&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F08%2Fare-electronic-medical-records-really.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=5107560 Tue, 09 Aug 2011 13:08:00 +0100 5107560 http://www.medworm.com/index.php?rid=5096268&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F08%2Fdoes-clinical-decision-support-in.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=5096268 Tue, 02 Aug 2011 11:55:00 +0100 5096268 http://www.medworm.com/index.php?rid=5069832&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fbetter-quality-services-when-doctors-manage-hospitals.html I have most commonly worked in hospitals where the CEO's major strengths were in financial management -- they were not MDs. Once, in the Army, I worked in a hospital where both the commander and deputy commander were physicians. My general impression has been that the former executives tended to stress the need for quality of care but often had little real understanding about the processes for achieving quality or the true cost of these processes. A recent article caught my attention and asks the question whether hospitals should be run by physicians (see: Should Hospitals Be Run by Doctors?), Below is an excerpt from it: The conventional wisdom is that doctors should focus on patient care, and managers with a business or administrative background are better suited to running the day-t... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5069832 Tue, 26 Jul 2011 18:15:43 +0100 5069832 http://www.medworm.com/index.php?rid=5062240&cid=t_98042_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhich-generation-of-physicians-uses-the-most-mobile-technology%2F2011.07.25 Smartphones and tablets have reached 80% of physicians across all practice types, locations and years in practice, and 25% of users are “Super Mobile” physicians who use both types of mobile devices. This is far beyond the general population’s 50% adoption of smartphones and 5% adoption of tablets. QuantiaMd, a free, online learning collaborative, released survey results that showed 44% of physicians who do not yet have a mobile device intend to buy one this year. While younger physicians have higher adoption rates than older ones, current use of mobile devices by physicians longest in practice is above 60%, the survey showed. Among physicians with 30 years or more of practice, almost 20% already use a tablet device for work, and another 25% say they are extremely likely ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5062240 Mon, 25 Jul 2011 18:00:00 +0100 5062240 http://www.medworm.com/index.php?rid=5062338&cid=t_98042_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fcertifications-do-i-need-one It is often asked today whether obtaining certifications in health IT is of benefit to a healthcare career path and/or will obtaining a certification guarantee securing employment? Well, first thing nothing is ever a guarantee in securing employment because so many variables play into that next career step. But to level set the certification question, various professional certifications are found in almost every industry of today. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5062338 Mon, 25 Jul 2011 12:46:43 +0100 5062338 http://www.medworm.com/index.php?rid=5051261&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fsmartphone-app-ecosystems-thrive.html I firmly believe that the iPhone "changed everything" by introducing us to what is now referred to as the smartphone app ecosystem (see: New Definition for "Apps": The Smartphone Market for Medical Software). Think about the rules of this ecosystem and how they differ from what we were accustomed to when using only PCs: (1) we shop for new apps online and many of the best ones are free; (2) we are promptly notified about operating system and app upgrades when they become available and can make these changes quickly and online; (3) the device easily fits in our pocket, giving us ready access to all of our apps including a rapidly improving camera and video recorder; and (4) most of the available apps are easy to learn and useful. A recent article discussed this iPhone ef... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5051261 Wed, 20 Jul 2011 15:38:08 +0100 5051261 http://www.medworm.com/index.php?rid=5051262&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Forchard-integrated-diagnostics.html Integrated diagnostics can be achieved by breaking down the sub-specialty silos in the diagnostic specialties like pathology, laboratory medicine, and radiology. The current standard of practice is to present the procedure and test-ordering clinicians with individualized reports from the various specialty labs (e.g., surgical pathology, immunology, microbiology) and radiology units like MRI and CT. This approach results from the super-specialization and subdivision of the diagnostics specialties. Under the integrated diagnostics mantra, the goal of integrating the diverse diagnostic reports is moved upstream and becomes the responsibility of the diagnosticians themselves rather than the clinicians. In my mind, the first major movement toward integrated diagnostics on the manufacturing side... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5051262 Tue, 19 Jul 2011 17:38:01 +0100 5051262 http://www.medworm.com/index.php?rid=5051263&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fa-different-paradigm-for-analyzing-the-competition-between-cerner-and-epic.html In a recent note, I discussed the competition between the Cerner and Epic EMRs and quoted another blog, Chilmark Research, to the effect that Cerner was moving in new strategic direction, emphasizing a network of services to provide communities of care (see: Cerner Fights Back in the EMR Market: A Community Network of Services + PHR). Such an approach is sometimes referred to as the development of a care coordination platform. I concluded that Epic's approach closely coincided with the business model currently favored by hospital executives and would probably continue to succeed in the market. Vince Kuraitis responded to my note with a comment that included a link to a lecture he had recently delivered titled Platform Wars (see: Platform Wars). The presentation can also be accessed at ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5051263 Mon, 18 Jul 2011 13:43:40 +0100 5051263 http://www.medworm.com/index.php?rid=5029239&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Ffemr-based-order-sets-as-a-locus-of-control-of-hospital-based-physicians.html In a recent note, I discussed the evidence-based physician order sets that were being deployed at the University of Kansas Hospital (see: Evidence-Based Order Sets Deployed at the University of Kansas Hospital). At the end of the piece, I commented on the very large number of them and speculated that many of them would probably never be used as a practical matter. Here is the specific quote: Here's what I don't understand about the deployment of standardized order sets. Why develop 240 when most physicians will use only a small number of them? In the current case, I am sure that Zynx Health wants to prove the worth of its product to the University of Kansas Hospital and it provides bragging rights to have 240 of them. Even differentiating them by type of patient, my guess is that p... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5029239 Fri, 15 Jul 2011 14:06:50 +0100 5029239 http://www.medworm.com/index.php?rid=5029240&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fcerner-fights-back-in-the-emr-market-network-of-services-for-a-community-of-care.html In my opinion, Cerner is facing a formidable competitor, Epic, in the high-end, larger hospital EMR space (see: Why Does Epic Keep Hammering Cerner? Mr. HIStalk's Opinion; Is Cerner Modifying Its EMR Business Model?). John Moore who blogs over at Chilmark Research recently posted a long piece suggesting that Cerner is crafting a new strategy in order to compete more effectively with Epic. He suggests, first, that It emphasizes support for "communities of care" (i.e, city, region, state, employer). Cerner also intends to provide a "PHR with an ecosystem of third party apps." This will serve as a replacement for the now departed Google Health product (see: Google Health Calls It Quits; Lessons Learned about PHRs or Not). Here is a link to John's note (see: Steppin... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5029240 Thu, 14 Jul 2011 14:02:53 +0100 5029240 http://www.medworm.com/index.php?rid=5008681&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fthe-epic-emr-as-a-platform-extending-its-functionality-with-other-products.html For a number of reasons, Epic has achieved a near monopoly of the EMRs installed in the largest U.S. hospitals (see: ShandsHealth Goes Live with Epic; Company Penetration of the Hospital Market; Why Does Epic Keep Hammering Cerner? Mr. HIStalk's Opinion). In my opinion, this trend poses a significant challenge for healthcare in general. Here's a quote from the first of these two notes describing the nature of this challenge: Epic...has a reputation of closely controlling the installation and development of its EMR software products. This is the basis for its record of successful system installations and part of the appeal of the product to hospital CEOs and CIOs. Furthermore, the evolution of clinical hospital systems (e.g., EMRs, LISs, RISs, etc.) is a critical element in the over... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5008681 Fri, 08 Jul 2011 13:31:58 +0100 5008681 http://www.medworm.com/index.php?rid=5008208&cid=t_98042_88_f&fid=38153&url=http%3A%2F%2Fwww.ozemedicine.com%2Fblog%2F%3Fp%3D960 I attended the EMA Course in New York last month and although IT systems were not directly part of the course, the topic did arise and the general feeling of the many US emergency physicians appeared to be that current commercial ED software in place in the USA is NOT efficient and comments such as “terrible” were not uncommonly expressed. It seems that the consensus was that for EP’s to be productive with such software they each need to have a personal scribe to ensure adequate timely documentation while allowing them to have adequate time at the bedside with the patients. Furthermore, it seems that the majority of prescibing mistakes are now because of software design issues and how the software interfaces with end users. Perhaps Australian administrators should be taki... Oz E Medicine - emergency medicine in Australia blogs http://www.medworm.com/rss/comments.php?id=5008208 Fri, 08 Jul 2011 01:59:42 +0100 5008208 http://www.medworm.com/index.php?rid=5008682&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fshould-diagnostic-test-scheduling-be-personalized.html I have posted previous notes about the need for periodic mammograms including the frequency of routine screening based on age (see: Shift to Digital Mammography Results in Increased Patient Recalls; Confusion Caused by Conflating "False Positive" and "Overdiagnosis" in Breast Cancer). Now comes news of research suggesting that mammogram screening should be personalized (see: Mammogram scheduling should be personalized, not based on age alone: study). The article caught my attention because of the use of the term personalized. Here is an excerpt from the article: Mammograms should not be done on a one-size fits all basis, but instead should be personalized based on a woman’s age, the density of her breasts, her family history of breast cancer and other factors includin... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5008682 Thu, 07 Jul 2011 16:12:55 +0100 5008682 http://www.medworm.com/index.php?rid=4984705&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fwupmc-patient-portal.html In a recent post, I speculated about some of the reasons why I thought that Google Health was exiting the personal health record (PHR) business (see: Google Health Calls It Quits; Lessons Learned about PHRs or Not). Shortly after posting this note, an article came across my desk discussing the success of UPMC's patient portal and the fact that it was now going mobile (see: UPMC's patient portal goes mobile). Below is an excerpt from the article: A health portal used by patients and doctors at the University of Pittsburgh Medical Center (UPMC) is now accessible on iPhones and iPads, thanks to the new mobile HealthTrak application. With its innovative approach to managing patient health - through technology like eVisits and tethered records - easy access to the portal is becoming mor... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4984705 Wed, 29 Jun 2011 13:11:10 +0100 4984705 http://www.medworm.com/index.php?rid=4976215&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fevidence-based-order-sets.html I am generally unenthusiastic about the term "evidence-based-medicine" (EBM) because it's often used synonymously with high-quality care. For the most part, however, I do see value for what are called "evidence-based order sets." The University of Kansas Hospital has recently gone live with 240 such order sets developed by Zynx Health’s clinical decision support unit. Here is an excerpt from the press release (see: The University of Kansas Hospital Goes Live with ZynxOrder and ZynxCare Integrated into EHR): ...The University of Kansas Hospital has gone live with 240 evidence-based order sets deployed via computerized provider order entry (CPOE)....The implementation of evidence-based order sets and plans of care within an EHR will enable The University of Kansas H... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4976215 Tue, 28 Jun 2011 13:12:07 +0100 4976215 http://www.medworm.com/index.php?rid=4976216&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fon-the-demise-of-google-health.html I am an unabashed fan of Google. However, if the company suffers from anything, it's a corporate sense of hubris. The founders think that almost any problem can be solved by their engineering mentality and their "search" business model. It turns out that launching a personal health record product was not that easy a nut to crack so the company is now withdrawing from the business (see: Google Shuts Down Medical Records And Health Data Platform). Here's Mr. HIStalk's take on the demise of Google Health (see: Monday Morning Update 6/27/11): Google predictably did what its know-it-all technology company predecessors have done over the years: dipped an arrogant and half-assed toe into the health IT waters; roused a loud rabble of shrieking fanboy bloggers and reporters...... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4976216 Mon, 27 Jun 2011 13:33:50 +0100 4976216 http://www.medworm.com/index.php?rid=4968921&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fpathology-resident-travel-awards-available-for-pathology-informatics-2011-conference.html The Association for Pathology Informatics is awarding a limited number of stipends of $1,500 to attend the Pathology Informatics 2011 Conference at the Pittsburgh Wyndham Grand hotel in Pittsburgh. The conference will take place on October 4-7, 2011. Awardees must be residents, post-doctoral students, or fellows in accredited teaching programs. This is the premier pathology informatics conference in the country with three workshops, three discipline tracks, multiple keynote plenary lectures, 44 participating faculty members, and more than 40 exhibitors. Last year's PI-2010 presentation marked the first of these events. The conference represents a merger of two long-standing pathology informatics meetings, APIII and Lab InfoTech Summit. The application deadline for awards is August 1, 2... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4968921 Thu, 23 Jun 2011 12:55:56 +0100 4968921 http://www.medworm.com/index.php?rid=4960336&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fpfizer-integrating-telemedicine-into-clinical-trials.html I have a special interest in clinical trials dating back to my five-year stint on the IRB (Institutional Review Board) at my hospital. I therefore read with some interest the news that Pfizer was integrating telemedicine (i.e., remote subject participation) into one of its clinical trials (see: Pfizer Integrating Telemedicine into Clinical Trials). Here is an excerpt from the article Pfizer is starting enrollment of its first ever investigational drug trial with remote patient participation. The trial, aptly named Research on Electronic Monitoring of OAB Treatment Experience (REMOTE), is a study to assess the safety and efficacy of Detrol LA (tolterodine tartrate), a treatment for overactive bladder. The main goal is to determine whether the results of the pilot REMOTE “virtual trial” ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4960336 Wed, 22 Jun 2011 14:59:22 +0100 4960336 http://www.medworm.com/index.php?rid=4953380&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fshands-installs-epic-interesting-facts-about-epic-coverage-in-the-us.html ShandsHealth is a large health system located in Gainsville and Jacksonville, Florida. Like many of the high-end and academic health systems with 500 beds or more, it is converting to the Epic EMR (see: Shands' new records system should simplify things). Here is a brief listing of the new features of this EMR as listed in the press release: Shands patients will no longer have to fill out their medical history and prescription information every time they visit a Shands hospital, faculty clinic or emergency room.... All Shands patient records are instantly available to all Shands health-care providers. Patients will no longer have to fill out their medical history and prescription information every time they visit a Shands hospital, faculty clinic or emergency room. Prescriptions are se... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4953380 Mon, 20 Jun 2011 13:32:33 +0100 4953380 http://www.medworm.com/index.php?rid=4945219&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Foffice-emrs-as-a-risky-investment-for-physicians.html Although some may view physician office EMRs and hospital EMRs as first cousins, I view them in a much different light. In previous notes, I discussed how community-based physicians and the professional societies that represent them are complaining to governmental bodies about the inadequacies and cost of office EMRs, particularly those for small practices (see: Cost of Deployment of EMRs in Physician Offices;  Barriers to the Deployment of Physician Office EMRs; "Usability Failures" of EMRs Frustate Physician Users). Here's a quote from my most recent post regarding physician office EMRs: It's no surprise to me that the "usability of [physician office] EMRs doesn't appear to be the focus of the federal government when establishing meaningful use standards ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4945219 Fri, 17 Jun 2011 12:08:48 +0100 4945219 http://www.medworm.com/index.php?rid=4945220&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fthomson-reuters-to-sell-its-healthcare-unit.html The healthcare unit of Thomson Reuters is up for sale. John Moore who blogs over at Chilmark Research has posted two blog notes about this news (see: Likely Suitors as Thomson Reuters Exits Healthcare; also see Additional Thoughts on Thomson Reuters). Here's an excerpt from the first of them: ...Thomson Reuters (TR) announced that it intends to sell off its healthcare unit. A logical first response is: What they heck, why would they sell right now when the healthcare market is so hot and shows no signs of letting up? Thomson Reuters is a well-respected brand in healthcare and as healthcare organizations (providers and payers) of all sizes look to more effectively run their operations, TR’s portfolio of healthcare solutions are well positioned. This isn’t the first time they have tr... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4945220 Thu, 16 Jun 2011 12:46:36 +0100 4945220 http://www.medworm.com/index.php?rid=4945221&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Falgorithms-as-the-next-generation-of-innovative-laboratory-and-clinical-tests.html I was somewhat surprised by a recent article suggesting that algorithms themselves will constitute a new type of medical test. The short article cited the work of Predictive Medical Technologies as a basis for this claim. The company software generates health predictions based on previous clinical data for ICU patients (see: Algorithms are the new medical tests; How data and algorithms help doctors make use of real-time data). Below is an excerpt from the article: Predictive Medical Technologies claims that it can use real-time, intensive care unit (ICU) monitoring data to predict clinical events like cardiac arrest up to 24 hours ahead of time. Effectively, the startup's algorithms are new types of medical tests that an ICU doctor can take into consideration when deciding on a course ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4945221 Wed, 15 Jun 2011 15:05:24 +0100 4945221 http://www.medworm.com/index.php?rid=4934486&cid=t_98042_114_f&fid=34646&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthCareBlogLaw%2F%7E3%2F3lERUzK0Rz8%2Fjp-morgan-healthcare-conference-hit.html If you follow health information technology and are interested in the future of health care take time and listen to this panel discussion on Innovation Opportunities for the Health Information Technology Market with Eric Schmidt, Chairman of Google, Aneesh Chopra, Federal CTO for the United States, Todd Park, CTO of HHS, and moderated by John Doerr, venture capitalist at Kleiner Perkins.The panel discussion was part of the Annual J.P. Morgan Healthcare Conference held in January 2011.To start off moderator, John Doerr has the audience rattle off a bunch of great questions for the panel to address. Just listening to the questions will make you want to listen to the panel discussion.Thanks to Susannah Fox and Claudia Williams for tweeting the link. Thanks to Brian Ahier (@Ahier) for posting ... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4934486 Sun, 12 Jun 2011 19:01:24 +0100 4934486 http://www.medworm.com/index.php?rid=4911482&cid=t_98042_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-dont-more-people-use-health-apps-for-iphones-and-droids%2F2011.06.08 I have been musing about why, despite our fascination with gadgets and timesaving devices, so few of us use the apps and tools that have been developed to help us take care of ourselves. The range of options is staggering – my iPhone coughed up 52 applications for medication reminders just now – but most of us don’t make use of the (often free) high-tech help available to us.  There are hundreds of websites and portals to help us monitor our diets, physical activity and blood sugar, talk to our doctors by e-mail and understand our test results.  Apps can help us watch for drug interactions, unravel our test results, adjust our hearing aids and track our symptoms.  Devices can monitor whether our mom is moving around her house this morning or continuously monitor our vital signs. I... Better Health blogs http://www.medworm.com/rss/comments.php?id=4911482 Wed, 08 Jun 2011 16:00:13 +0100 4911482 http://www.medworm.com/index.php?rid=4911833&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Ffda-gearing-up-to-regulate-apps-and-social-media-or-not-2.html I have gotten used to a degree of vacillation from the FDA regarding various lab regulatory issues. A  recent chapter in this drama was the agency's ambiguity about lab tests originally called IVDMIAs and subsequently referred to as laboratory developed tests (LDTs). Now comes news that the agency may, or may not, regulate medical smartphone/tablet (i.e., mobile) apps and the use of social media by pharmaceutical companies (see: FDA Reportedly Gearing Up to Regulate Apps). Below is an excerpt from the article: From a no less august source than American Medical News comes a report that the FDA is considering the regulation of medical apps.  See “FDA Signals it Will Regulate Medical Apps“.   The article quotes a source who relayed that at a town hall meeting h... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4911833 Wed, 08 Jun 2011 13:03:11 +0100 4911833 http://www.medworm.com/index.php?rid=4902700&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fweb-vido-chats-as-an-important-component-of-patient-care.html This article instead emphasizes the need for a "more equal dialogue between patient and clinician and improve the nature of the relationship."  Some patients tend to get overwhelmed in a formal medical setting and may not address all of their problems with  the physician. They may also think that "the doctor is too busy to bother with my petty complaints." With video chat, the patient remains on his or her home turf and hence the discussion may be conducted on a more equal footing. (Source: Lab Soft News) Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4902700 Mon, 06 Jun 2011 18:47:23 +0100 4902700 http://www.medworm.com/index.php?rid=4893452&cid=t_98042_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-arent-there-more-women-ceos-in-health-it%2F2011.06.03 The Health Tech 2011 Conference, held earlier this month in Boston, featured presentations from startup CEOs in the health and wellness space. The conference had nothing to do with gender issues or leadership per se. Yet the Twitter feed from the conference (#ciht11) contained this: @ml_barnett By my count, only 3 of 27 speakers are women. RT @taracousphd: where are the female entrepreneurs? It’s healthcare!!! taracousphd and @ml_barnett reminded us of a painful fact. There aren’t many female CEOs in Health IT. Why is this? Women certainly aren’t short on content knowledge in health care. In fact, they dominate men in this area. More than 40% of all practicing physicians and 50% of all medical school graduates are women. Women earn nearly 3 times more PhDs in psychology (useful cont... Better Health blogs http://www.medworm.com/rss/comments.php?id=4893452 Fri, 03 Jun 2011 14:30:14 +0100 4893452 http://www.medworm.com/index.php?rid=4893933&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fpseudo-certification-from-chime-is-anyone-taken-in-by-this.html Mr. HIStalk reports on the CHIME CIO credentialing program (see: News 5/27/11): CHIME reports that 109 individuals have earned Certified Healthcare CIO designation since the credentialing program was launched in July 2009. I said it was a dumb idea then and I’ll stand by that opinion now. Obviously the credential hasn’t exactly gone viral if only 109 out of thousands of hospital CIOs have signed on over two years, voluntarily jumping onto the hamster wheel of spending hospital money on renewals and going to CHIME meetings to earn CE. To each his own, but I’d be embarrassed to use a non-educational  credential earned by passing a multiple choice test of job-specific knowledge (designed by asking CIOs what they do on the job, then testing them to see if they theoretically know ho... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4893933 Thu, 02 Jun 2011 19:06:55 +0100 4893933 http://www.medworm.com/index.php?rid=4893462&cid=t_98042_88_f&fid=38153&url=http%3A%2F%2Fwww.ozemedicine.com%2Fblog%2F%3Fp%3D952 Last year Microsoft stunned the programming world when they announced that .NET and Silverlight is no longer their preferred cross platform technology, and instead, the focus of cross platform application development is now on HTML5 and javascript technologies. Likewise, their SOAP/XML technology is rapidly becoming replaced with an emphasis on REST/JSON technologies. Microsoft itself avoided using .NET for its main Windows applications such as Office. Today, Microsoft unveiled early version of Windows 8 – and is promoting that it will be designed for two main types of apps – current Windows apps and yes, you guessed it, HTML5/javascript cross-platform apps. Seems all that hype over the last decade of the supposed benefits of .NET is coming to an end. I am not sure where that w... Oz E Medicine - emergency medicine in Australia blogs http://www.medworm.com/rss/comments.php?id=4893462 Thu, 02 Jun 2011 09:39:33 +0100 4893462 http://www.medworm.com/index.php?rid=4893934&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fwhy-steve-balmer-of-microsoft-is-doomed.html Microsoft seems to me to have lost its edge as an IT innovator and industry leader (see: The Decline of Microsoft: The Clues Seem to Be Obvious). Although the company's profit picture is still rosy, the stock price has languished in recent years. A recent article speculated whether all of this will have an effect on Steve Ballmer's tenure as the CEO of the company (see: Microsoft’s Steve Ballmer Conundrum). Below is an excerpt from the article: Revenue and profits aren’t the only things the CEO of a major public company has to consider, though. He or she is also responsible for improving shareholder value by increasing the company’s stock price and market capitalization. In that respect, Ballmer has failed....At its peak in 2001, Microsoft was worth approximately $400 billion... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4893934 Wed, 01 Jun 2011 12:23:32 +0100 4893934 http://www.medworm.com/index.php?rid=4872495&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fincidentalomas-revisited-revisited.html I recently posted a note about so-called incidentalomas, lesions often "accidentally" discovered during CT scans that have been ordered on the basis of other diagnostic concerns. You may want to refer to it to refresh your memory about the topic (see: How to Avoid the Risks of a CT Incidentaloma). Dr. Mark Pool who blogs over at The Daily Sign Out has posted a a well-thought-out note that extends this discussion in some interesting ways (see: Incidentalomas revisited). Below is an excerpt from it: Dr. Bruce Friedman posted a thoughtful blog on Lab Soft News recently concerning "incidentalomas" ....This post happened to coincide with a new working committee at my hospital commissioned with developing a virtual clinic for following patients who have incidental lung nodule... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4872495 Thu, 26 May 2011 23:24:39 +0100 4872495 http://www.medworm.com/index.php?rid=4862947&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fcomplexity-of-emrs-frustates-hospital-users.html The fact that EMRs have been failure prone is no secret (see: The Causes of EMR System Implementation Failure). The cause of such failures is multifactorial. Lab Soft News has also covered this topic in the past (see: EMR Failures and a Recipe for Their Avoidance in the Future; Modeling the Costs of IT System Failures Globally). However, I firmly believe that physicians, like most professionals, will avidly embrace any type of information technology that will improve their productivity. This is particularly true these days when healthcare reform requires physicians to work more efficiently. It follows that a large part of the rejection of EMRs by clinicians is based on the fact that they are not well designed. A recent article discusses this issue (see: Complexity of EMRs discourages new u... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4862947 Wed, 25 May 2011 13:20:01 +0100 4862947 http://www.medworm.com/index.php?rid=4862948&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fshould-hospitals-set-up-private-social-networks-to-server-their-patients.html A recent article about how Toyota is setting up a private social network for its customers stimulated my thinking about how this idea might apply to hospitals and their patients (see: Toyota Owners To Get a Private Social Network). Below is an excerpt from it: Toyota has teamed up with Salesforce.com to create Toyota Friend, a private social network for owners of Toyota cars. The network will be accessible through PCs, tablets and smartphones, giving Toyota customers the ability to connect with their dealerships, cars and Toyota itself. For example, your car could send you an alert when its battery needs recharging, and you would be able to connect to your dealership to get maintenance tips and service information. Toyota Friend will primarily be a private network for Toyota car owners, bu... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4862948 Tue, 24 May 2011 13:57:59 +0100 4862948 http://www.medworm.com/index.php?rid=4841999&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fthe-true-cost-of-implementing-an-emr-or-lis.html Mr. HIStalk came up with another gem of a observation recently: software license fees are often nearly irrelevant to overall project cost, especially on the often-forgotten cost of internal labor (see: Monday Morning Update 5/16/11). Below is his exchange with a reader: From Former CIO: “Re: high price of Epic. In my experience, the price of Epic software is competitive with others (at least the big guys). The difference is that they drive the customer to look at the true cost of implementation and plan for the resources, internal and external, training, etc. The other vendors hope you won’t actually add it all up until you sign the software contract. This is the best part about Epic since it gets the organization to accept the budget, even if difficult. If you are not prepared to spen... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4841999 Thu, 19 May 2011 12:00:00 +0100 4841999 http://www.medworm.com/index.php?rid=4829329&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fmanage-raw-data.html A recent article I came across examines how the mining and analysis of "raw data" in various industries will provide an opportunity for innovation (see: New Ways to Exploit Raw Data May Bring Surge of Innovation, a Study Says). Below is an excerpt from it: Math majors, rejoice. Businesses are going to need tens of thousands of you in the coming years as companies grapple with a growing mountain of data. Data is a vital raw material of the information economy, much as coal and iron ore were in the Industrial Revolution. But the business world is just beginning to learn how to process it all. The current data surge is coming from sophisticated computer tracking of shipments, sales, suppliers and customers, as well as e-mail, Web traffic and social network comments. The quantity of ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4829329 Mon, 16 May 2011 13:54:52 +0100 4829329 http://www.medworm.com/index.php?rid=4821173&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fphysicians-and-the-two-screen-revolution.html In a recent note, I discussed the two-screen revolution that seems to be gaining traction (see: iPad Helping to Launch a "Two-Screen Revolution"). The basic idea is that many of us we will soon be operating with two screens, the large one being a TV or PC monitor and the small one being a tablet computer such as an iPad for simultaneously browsing the web. The large screen provides generalized, standard content and the smaller one provides customized, complementary information. I have been thinking about how this computing model relates to physicians and I think I can now describe how it may work in a hospital or large clinic. Consider the process that occurs when a physician accesses the electronic medical record of a patient using a computer monitor. He or she, using an iPad, c... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4821173 Fri, 13 May 2011 12:58:48 +0100 4821173 http://www.medworm.com/index.php?rid=4813681&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fipad-launching-the-two-screen-tech-revolution.html I have been using "two-screen technology" frequently since I acquired my iPad. In my particular case, this use-case could be called "independent two-screen technology." When I am watching, say, a Netflix movie on my television, I will frequently search for more details about the film (e.g., reviews) on the web using my tablet device. However, the two-screen revolution involves a more integrated approach and was described in a recent article (see: Is the iPad Launching the Two-Screen Revolution?): iPad owners are starting to see more and more apps that encourage the use of the device in conjunction with other screens. I’m not talking about remote desktop apps that allow the iPad to act as a mirror of other machines; I specifically mean apps that allow the iPad to act a... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4813681 Wed, 11 May 2011 14:04:21 +0100 4813681 http://www.medworm.com/index.php?rid=4794912&cid=t_98042_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F05%2Ftop-ten-things-you-need-to-know-about.html The Institute for Health Technology Transformation is a US based organisation that brings together private and public sector leaders to foster the effective use of technology across the healthcare industry.Their report, "Top Ten Things You Need To Know About Engaging Patients' is a compilation of what key health IT experts from across the U.S. think are the most important things to know about engaging patients in the digital age along with four key recommendations for practical action.Mostly common sense. Doctors just need to ask a simple question - How would you like your lawyer to communicate with you ? Use the same principles to open as many communication channels with your patients, so it's easy for them to connect with you ! (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4794912 Sat, 07 May 2011 05:25:00 +0100 4794912 http://www.medworm.com/index.php?rid=4795066&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fmarketing.html In previous notes, I argued that it was largely useless to complain about the loss of privacy and confidentiality in this digital era because the horse was already out of the barn (see: On the Privacy of Health Information: The Horse Is Already Out of the Barn; Despite HIPAA, the Privacy of Our Health Records Is Largely a Myth). Instead, one needs to help prevent further erosion of our rights. A recent article reinforced this idea. It showed how life insurance companies are now using readily available marketing data about individuals to assess their health status and therefore risk (see: Insurers Test Data Profiles to Identify Risky Clients). This approach will be in lieu of, or in addition to, the lab testing and health questionnaire that the companies have used for many years. Below is a... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4795066 Fri, 06 May 2011 14:41:00 +0100 4795066 http://www.medworm.com/index.php?rid=4780329&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F05%2Fimplementation-for-implementations-sake.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4780329 Tue, 03 May 2011 10:30:00 +0100 4780329 http://www.medworm.com/index.php?rid=4775448&cid=t_98042_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F05%2Fit-drives-patient-education.html " In an earlier column, I complained that IT spends a lot of time providing electronic tools for clinicians--electronic health records (EHRs), computerized physician ordering systems (CPOS), etc.--but not enough time developing tools to improve patient education. I was wrong. Digging deeper into this area has convinced me that there are all sorts of practical technology-based resources to help patients understand their treatment and how to comply with their doctors' advice. Computer-generated questionnaires, medication resolution programs, and sophisticated videos are making a difference in patient care. "India can be a market leader in this space ! (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4775448 Mon, 02 May 2011 12:07:00 +0100 4775448 http://www.medworm.com/index.php?rid=4775417&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F05%2Ffda-report-on-hit-safety-problems.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4775417 Mon, 02 May 2011 10:21:00 +0100 4775417 http://www.medworm.com/index.php?rid=4775418&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F05%2Fcpoe-accounted-for-most-near-misses.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4775418 Mon, 02 May 2011 10:05:00 +0100 4775418 http://www.medworm.com/index.php?rid=4768261&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Fmedical-students-as-emr-scribes.html In two recent posts, I have reported on the growing use of EMR scribes in hospitals (see: Shift of Hospital EMR Data Entry Tasks from MDs to Scribes; Medical Students Recruited to Serve as EMR Scribes in Toledo). It makes no sense to use physicians and nurses as data entry clerks for the EMR. The user interfaces of these systems are still too awkward for these personnel to perform the necessary tasks quickly and efficiently. Hence, hospitals associated with medical schools are turning to medical students to serve as EMR scribes. These students bring to the job some knowledge of medical nomenclature and benefit from the early exposure to the patient care environment. Other hospitals are turning to college students or other suitable candidates in the community after some training. A Google s... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4768261 Fri, 29 Apr 2011 12:00:00 +0100 4768261 http://www.medworm.com/index.php?rid=4758819&cid=t_98042_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Ffailure-information-exchange As part of its response to the PCAST report, the Office of the National Coordinator for Health Information Technology (ONC) charged a review committee to analyze the PCAST recommendations. The President's Council of Advisors on Science and Technology (PCAST) called for greatly accelerated health information exchange and development of an increased focus on population health objectives. The report also recommended technologies for a Universal Exchange Language (UEL), Data Element Access Services (DEAS) and granular access controls. No sticky read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4758819 Wed, 27 Apr 2011 18:41:25 +0100 4758819 http://www.medworm.com/index.php?rid=4753978&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Fexhibitors-sought-for-pathology-informatics-2011-october-4-7-in-pittsburgh.html We are seeking exhibitors for the Pathology Informatics 2011 conference that will take place at the Wyndham Hotel in Pittsburgh on October 4-7, 2011. This conference resulted from a merger of two previous pathology informatics conferences, Lab Infotech Summit and APIII. The inaugural merged conference was held in Boston last September. A total of 41 exhibitors participated in that event with about 250 paid registrants in attendance. A total of twenty-five companies have signed-up thus far to participate in Pathology Informatics 2011. They are the following: Aperio, Apollo PACS, ARUP Laboratories, Aurora Interactive, Beckman Coulter, Cerner, Dawning Technologies, Definiens, Elekta, General Data, Haemonetics Software Solutions, Halfpenny Technologies, McKesson Corporation, Milestone Medical,... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4753978 Tue, 26 Apr 2011 15:07:51 +0100 4753978 http://www.medworm.com/index.php?rid=4747908&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Fradiology-job-market-trends-downward-blame-technology-and-reimbursement.html Here are summaries of three conversations that I have had recently: A newly graduated physician tells me that her colleagues widely understand that the radiology job market is lousy with the exception of interventional radiology (IR), for which there are plenty of openings. A mid-career, highly specialized  academic radiologist tells me that there would be few, suitable positions available for him if we were to change positions. A very senior radiologist in a large, midwest hospital tells me that he is working twice as hard to simply maintain his expected income; he cites digital pathology and PACS as the enabling technologies that allow him to ramp-up his personal efficiency and effectiveness. All of this caused me to search the web for some further discussion of the current radio... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4747908 Mon, 25 Apr 2011 12:12:55 +0100 4747908 http://www.medworm.com/index.php?rid=4747701&cid=t_98042_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F04%2Fwhat-american-health-care-system-can.html " In Denmark, we’ve developed communication thus far for almost all IT systems in the health sector. We have implemented all prescription and medication information, and all discharge letters and summaries from hospitals. This also includes outpatient notes, injury reports, x-ray reports, lab reports and lab orders. Reimbursements from health insurance have been made electronic, along with referrals to hospitals and private specialists, and referrals to psychologists. All private physicians have electronic health records today so they can communicate and transfer documents electronically, as well.From the beginning it was a grassroots effort; we thought it was a good idea to exchange information electronically. And now it has become mandatory that you must communicate electronically. The... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4747701 Mon, 25 Apr 2011 05:02:00 +0100 4747701 http://www.medworm.com/index.php?rid=4734680&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Fweb-search-algorithms-as-a-type-of-journalism.html Google executives have continuously emphasized that the company is in the search business and not in the content business. This assertion positions it as a neutral, valueless arbiter of efficient web search. However and with the growing sophistication of search algorithms, their role now appears to be much less neutral. The "values" mediated and executed by the invisible, Google search algorithms are commented on by Jonathan Stray in his blog (see: The editorial search engine). Below is an excerpt from his note. Read the whole thing it you have time -- it's worth the effort. It’s impossible to build a computer system that helps people find or filter information without at some point making editorial judgements. That’s because search and collaborative filtering algorithms ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4734680 Thu, 21 Apr 2011 11:35:27 +0100 4734680 http://www.medworm.com/index.php?rid=4719959&cid=t_98042_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fmostasharis-onc-wont-be-easy-run-blumenthals Farzad Mostashari, the newly-appointed and fourth leader of the Office of the National Coordinator for Health Information Technology (ONC) is going to face some stiff challenges his predescessor David Blumenthal did not have to face. No sticky read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4719959 Fri, 15 Apr 2011 12:53:06 +0100 4719959 http://www.medworm.com/index.php?rid=4709428&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Ftypes-of-cloud-computing.html I have been commenting about the feasibility of cloud computing for more than three years. The technology has now reached a state of maturity such that CIOs, at least outside of healthcare, are seriously considering deploying this architecture. Healthcare computing tends to trail that in most other fields so most hospitals continue to run their own "machine rooms" with dedicated servers. A recent article provides some useful definitions of the various types of cloud computing (see: Here's Why Cloud Computing Is So Hot Right Now). Below is an excerpt from it: What is cloud computing? At its simplest, cloud computing means that users are connecting to applications that run on a set of shared or pooled servers, rather than running on a single dedicated server. This is a subtle b... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4709428 Wed, 13 Apr 2011 12:14:23 +0100 4709428 http://www.medworm.com/index.php?rid=4704588&cid=t_98042_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F04%2Ffool-computer-bigger-fool.html As a blogger, I often receive obviously machine-generated spam generously offering to allow me to post links to the wisdom of others.Some of the time, the "wisdom of others" is related to medicine.Often it is not. It is often just bizarre.Examples:From: Kristen McneillSent: Thursday, April 07, 2011 3:39 PMSubject: Ham radio resource suggestion for www.ischool.drexel.eduHi!My name is Kristen McNeill, I am a high school teacher, and I have been using your page: http://www.ischool.drexel.edu/faculty/ssilverstein/biography.htm in my class for a while now, I hope you don't mind, it is a wonderful resource and has a lot of great information on it!I also wanted to let you know of a nice resource on ham radios one of my students stumbled across: [I redacted a link about dating ham radio operators ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4704588 Tue, 12 Apr 2011 16:45:00 +0100 4704588 http://www.medworm.com/index.php?rid=4704967&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Ftighter-integration-of-cvs-minuteclinic-with-chicagos-advocate-health-care.html There has always been some challenges associated with the business model for walk-in clinics located in retail pharmacy chain stores. Commonly staffed by nurses, they were only prepared to deal with minor health problems and routine procedures. This approach often did not generate enough business. Therefore, some began to place physicians in these clinics who were then able to treat more significant health problems. Once some of these clinics started in this direction, it made sense to contract with local hospital systems to both provide physicians and also to integrate the clinic records with those of the health system. This provided a referral network for the more seriously ill patients who were being turned away from the nurse-staffed clinics. The Cleveland Clinic was an early participa... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4704967 Tue, 12 Apr 2011 14:08:34 +0100 4704967 http://www.medworm.com/index.php?rid=4696963&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Fmedicare-billing-rife-with-fraud-need-open-access-to-claims-database.html How badly do we want to reduce the cost of Medicare? For me, one of the most important steps will be to provide public access to the Medicare claims database and use it to root out fraud. This is the goal of two senators who have introduced some new legislation (see: Senators Push to Open Database on Medicare). Below is an excerpt from the Wall Street Journal article about this topic: Two senators have introduced legislation to overturn a 1979 court injunction that bars the government from revealing what individual physicians earn from Medicare. That information is stored in the Medicare-claims database, widely considered one of the best tools for finding fraud and abuse in the $500 billion federal health-insurance program for the elderly and disabled. Soaring Medicare costs threaten to ov... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4696963 Mon, 11 Apr 2011 13:03:48 +0100 4696963 http://www.medworm.com/index.php?rid=4677125&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Ftumore-on-zite.html Last Thursday, I posted an enthusiastic note about an iPad app called Zite. It enables you to create a customized e-magazine to read on your device (see: Zite as an Example of the Future of E-Magazines). In response, Mike Lougee posted this comment: It appears that some of the big publishers, from whom Zite is using news content, are so unhappy that they're sending cease-and-desist letters to Zite. Presumably the smaller, non-commercial publishers that are described in this post are happy to be displayed via Zite. Mike's alert was helpful and timely. Here's an excerpt from an article that provides more information of this issue (see: Note to Media: Don’t Fight Zite, Learn From It): In an entirely too-predictable development, a group of media outlets has sent a cease-and-desis... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4677125 Tue, 05 Apr 2011 11:48:06 +0100 4677125 http://www.medworm.com/index.php?rid=4670106&cid=t_98042_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatients-dont-want-to-communicate-with-their-doctors-on-facebook%2F2011.04.03 Patients may not want to discuss clinical matters via social media, but they’d gladly set pay their bills when reminded. Social media’s value in communicating with patients is limited to the administrative aspects of it. Americans still want traditional ways of communication when they need a clinical consult. A survey finds 84% would not use social media or instant messaging channels for medical communication if their doctors offered it, according to the communications firm Capstrat. Respondents were more favorable toward conferring with the doctor via e-mail (52%) than they were by Twitter and Facebook (11%), chat or instant messaging (20%) or a private online forum (31%). Even among those 18 to 29 years old, 21% said they would take advantage of an online forum if their docto... Better Health blogs http://www.medworm.com/rss/comments.php?id=4670106 Sun, 03 Apr 2011 15:00:00 +0100 4670106 http://www.medworm.com/index.php?rid=4670200&cid=t_98042_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fimho-google-dropping-google-health-just-rumor There is a rumor out there that Google is planning on dropping Google Health, its personal health record platform. I’m going to go out on a limb here, and say it is highly unlikely the rumor is true, in my honest opinion (IMHO). And here's why.  read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4670200 Fri, 01 Apr 2011 20:30:28 +0100 4670200 http://www.medworm.com/index.php?rid=4664487&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F04%2Ffthe-web-of-information-evolves-to-a-web-of-things.html A recent blog note contained a powerful idea. The current web (i.e., internet) is evolving into a larger network that will allow participation by "things" by which is meant inanimate objects such as roads, bridges, or even the door to your house (see: How the Internet of Things is Changing the Way We Work). Below is an excerpt from it: Several years ago, before the Web had become as ever-present as it is now, Wal-Mart was the shining example of a future where inanimate objects communicated, aka the Internet of Things. The company had a plan to implement RFID tags to better optimize its supply chain. The problem? The RFID technology could not be programmed to exchange data. In the past few years, we've seen the emergence of the application programming interface, or API. APIs h... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4664487 Fri, 01 Apr 2011 14:24:47 +0100 4664487 http://www.medworm.com/index.php?rid=4653612&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Ftugreater-clarity-on-the-googleandroid-business-model.html A recent blog note about the Google/Android business model was one of the best I have ever read on this topic (see: The Freight Train That Is Android). These ideas will have great relevance for medical and healthcare apps which currently are dominated by Apple under its mobile operating system, iOS. Below is an excerpt from the piece: Despite all that has been written about Android, as well as its unquestionable early success, the world at large still doesn’t fully appreciate the raw power of this juggernaut....One of Warren Buffet’s most famous quotes is that “In business, I look for economic castles protected by unbreachable ‘moats’.” An “economic castle” is a great business, and the “unbreachable moat” is the strategy or market dynamic that heightens the barriers-to-... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4653612 Tue, 29 Mar 2011 16:06:22 +0100 4653612 http://www.medworm.com/index.php?rid=4642739&cid=t_98042_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fonc-seeks-public-comment-federal-health-it-strategic-plan-2011-2015 Providing strategic leadership to public and private sector efforts to improve health and health care through the use of information and technology is a key responsibility of the Office of the National Coordinator for Health Information Technology (ONC). read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4642739 Mon, 28 Mar 2011 14:06:13 +0100 4642739 http://www.medworm.com/index.php?rid=4643005&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Ffwhy-and-how-hospitals-should-market-themselves.html For the most part and in my opinion, hospitals don't don't do a very job of marketing themselves. This is not surprising given that most of them are non-profit and most such organizations do not seem to be proficient in this area. However, the use of social media for marketing is free of cost and relatively simple to engage for this purpose. According to a recent study, even here most hospitals don't always get their message out (see: Study: Hospitals' Facebook use is poor). Below is an excerpt from the article: U.S. hospitals are not taking advantage of the opportunities Facebook creates to better engage patients, build healthcare communities or develop their hospital brands, according to a new study....According to the study, only a few hospitals across the the country ar... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4643005 Mon, 28 Mar 2011 13:04:31 +0100 4643005 http://www.medworm.com/index.php?rid=4627026&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Ftuentrepreneurs-rescue-valuable-data-from-the-hidden-web.html The deep or hidden web can be defined in the following way: web content that is not part of the surface web which is indexed using standard search engines (see: Exploring the Deep or Hidden Web with WebMynd). Exposing and utilizing hidden web content has been a goal of computer scientists and entrepreneurs since web search using Google and other search engines became commonplace. A recent article explains a new facet of this quest (see: This Data Isn’t Dull. It Improves Lives). Below is an excerpt from it regarding previously hidden "governmental" information: Take data that you and I have already paid a government agency to collect, and post it online in a way that computer programmers can easily use. Then wait a few months. Voilà! The private sector gets busy, creating Web s... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4627026 Wed, 23 Mar 2011 15:58:50 +0100 4627026 http://www.medworm.com/index.php?rid=4696593&cid=t_98042_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fhow-academic-boneheads-kill-people.html I'm already receiving comments that, regarding Prof. Jon Patrick's detailed exposé of the dangers of ill-suited-for-purpose ED EHR's, Patrick's observations are:... not really valid because they're not peer reviewed; they're just anecdotal. Only an egghead could pen such words.I always get hives immediately after eating strawberries. But without a scientifically controlled experiment with all the right peer review, it's not reliable data. So I continue to eat strawberries every day, since I can't tell if they cause hives.I'd already written about anecdotalist refrains at my Mar. 7, 2011 post "Australian ED EHR Study: Putting the Lie to the Line "Your Evidence Is Anecdotal, Thus Worthless" Used by Eggheads, Fools and Gonifs." In that essay I cite Dr. Patrick himself on "anecdotal evidence"... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4696593 Tue, 22 Mar 2011 14:05:00 +0100 4696593 http://www.medworm.com/index.php?rid=4611009&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Ffhp-unveils-new-business-strategy-cloud-and-business-analytics.html If I were an investor in HP, I would be discouraged to learn that the new CEO has only now discovered that software has a higher profit margin than software and also that there's money to be made in the cloud. Here's a report of his remarks about these topics (see: Hewlett-Packard Chief Unveils Strategy for Expansion) Léo Apotheker, chief of Hewlett-Packard, said Monday that the company would expand its software business and venture into cloud computing. He finally unveiled his strategy to investors on Monday, saying that H.P. would build out its tiny software business and expand into the cloud — a term used to describe products and services delivered online. Mr. Apotheker’s plan is not so much to reinvent H.P., but to help it evolve. Mr. Apotheker said he planned to use the c... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4611009 Fri, 18 Mar 2011 10:58:39 +0100 4611009 http://www.medworm.com/index.php?rid=4600803&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Foffice-based-specialists-abandon-hospital-call-responsibilities.html The inexorable transition toward more salaried, hospital-based physicians, hospitalists, is accelerating. Many physicians favor these positions because they can avoid the burden of managing an office practice. They are also seeking a more tolerable, and predictable, work-week. Hospital executives like to hire hospitalists because this allows them to exercise more control over the physicians on the hospital staff (see: The Emergence of the Surgicalist). One of the consequences of this shift is that many office-based physicians are losing their ability to perform various medical procedures. This void is being filled by proceduralists in hospitals (see: The Emergence of the Proceduralist in Hospitals; Two Definitions for the Physician Proceduralist). All of these changes are resulting in a ma... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4600803 Wed, 16 Mar 2011 11:53:08 +0100 4600803 http://www.medworm.com/index.php?rid=4592704&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Ffcreating-the-i-patient-bedside-diagnostic-skills-continue-to-deteriorate.html According to one prominent physician, Dr. Abraham Verghese, electronic records and our sophisticated diagnostic tools are causing physicians to increasingly focus on the electronic records and diagnostic images (i.e., the iPatient) and ignoring their flesh-and-blood patients (see: Treat the Patient, Not the CT Scan). Put another way, we are treating the iPatients rather than the physical patient. Below is an excerpt from the article: [The expanding reliance on electronic medical records] creates what I call an “iPatient” — and this iPatient threatens to become the real focus of our attention, while the real patient in the bed often feels neglected, a mere placeholder for the virtual record. Imaging the body has become so easy (and profitable, too, if you own the machine). When I was ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4592704 Tue, 15 Mar 2011 21:19:45 +0100 4592704 http://www.medworm.com/index.php?rid=4575252&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Ffsituational-versus-ambient-information-overload.html Let me say at the outset that the condition of information overload has never been a problem for me personally except in my medical school years. It existed at that time for two reasons: I had no control over the information flow presented to me and I also understood that much of it (e.g., gross anatomy) was largely useless. Clay Shirky launched the idea in 2008 that there is no such thing as information overload but rather a situation that can be easily managed by the use of information filters. I agree with him. Nick Carr recently presented a new slant on this question (see: Situational overload and ambient overload). Below is an excerpt from his blog note: Information overload actually takes two forms, which I'll call situational overload and ambient overload, and they need to be tr... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4575252 Fri, 11 Mar 2011 18:47:15 +0100 4575252 http://www.medworm.com/index.php?rid=4566347&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Fmmmunderstanding-platforms-and-apples-platform-strategy.html The definition for an "IT platform" seems to have changed somewhat over the years. I was under the impression previously that it referred mainly to hardware (e.g., the PC as a platform for Windows) but today it seems to encompass primarily software. A recent blog note by Aleem Bawany about this topic struck me as right on target and also provided some keen insights into the Apple strategy (see: Apple’s Ultimate Platform Strategy). Below is an excerpt from it: I have written about the Platform Strategy before, a remarkably potent strategy if you can get it right. Linux and Microsoft Windows are both platforms because they allow others to build on top. The web browser is also a platform. Facebook became a platform when it decided to allowed third-party applications to be built on... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4566347 Wed, 09 Mar 2011 13:15:15 +0100 4566347 http://www.medworm.com/index.php?rid=4560612&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Fhimss-booth-fees.html There is no question that the HIMSS annual conference is a huge cash-cow for the organization. With about 30,000 registrants and 1,000 vendors, it's generally a mandatory appearance for all but the smallest HIT companies. Want to know what it costs a company to participate?. A recent guest blog by a vendor representative on HIStalk spells out some of the details (see: More HIMSS Wrap-Up 3/2/11). Below is an excerpt from it: First, we vendors pay a fortune to exhibit at these shows. At more than $33/square foot for just the footprint (a small 20 x 20 booth is over $13k), plus between $15,000 and $1,000,000 for the booth construction, the tab is just beginning. Don’t forget all the rental furniture, phones, and $1,500/day for Internet hookup (can you believe that?). Shipping each booth... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4560612 Tue, 08 Mar 2011 13:35:36 +0100 4560612 http://www.medworm.com/index.php?rid=4560204&cid=t_98042_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fis-that-foul-odor-of-dity-socks-im.html We at Healthcare Renewal have had experience with the corporate sock puppets. They are shills, a person working on behalf of a company, attempting to use distraction, ad hominem, misdirection and other psyops tactics to attack points of view they don't like. They also plant memes their sponsor finds desirable.They are universally anonymous in their postings.One got careless and got nailed via IP forensics, as at my Jan. 2010 post "More on Perversity in the Healthcare IT World: Is Meditech Employing Sockpuppets?" and my semi-satirical followup post a few days later, "Socky the Meditech Sockpuppet on Vacation?" after he/she disappeared after exposure.A Healthcare Renewal reader with an MBA at that time non-anonymously related the following (emphases mine):In reading this thread of comments I... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4560204 Tue, 08 Mar 2011 04:48:00 +0100 4560204 http://www.medworm.com/index.php?rid=4560309&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F03%2Fmalpractice-risk-and-emr.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4560309 Mon, 07 Mar 2011 18:58:00 +0100 4560309 http://www.medworm.com/index.php?rid=4560388&cid=t_98042_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2FYrKGAWy5afw%2F The policy journal Health Affairs has just put out a media advisory noting that the March issue, which comes out tomorrow, will have at least three articles devoted to health IT. From the advisory (verbatim): Studies on EHR: Neil Fleming and colleagues shed light on the financial and nonfinancial resources a small practice needs to implement an EHR system. Using data from  a physician network in north Texas, the authors estimate that the average cost to implement EHRs is $46,659 per physician. Use of EHRs will be accelerated because more than four in five office-based doctors are eligible for federal “meaningful use” incentives, says Brian Bruen of George Washington University and colleagues. Their analysis also highlights gaps in eligibility that must be addressed to further incre... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4560388 Mon, 07 Mar 2011 18:49:09 +0100 4560388 http://www.medworm.com/index.php?rid=4560613&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Fblood-bank-personnel-serving-as-epic-consultants-is-this-a-good-idea-.html In a recent note, I discussed the idea that Epic is providing incentives for larger hospitals to serve as hosting sites and consultants for smaller ones (see: Epic Helps Convert Its Large Hospital Customers into Epic Hosting Sites/Consultants).The overarching strategy is obvious for hospital CEOs/CIOs -- it binds the smaller hospital to the larger one. Healthcare reform is stimulating many such mergers/realignments (see: Hospital Executives Search for the Formula for an Accountable Care Organization). However, the question should to be raised whether there are any unanticipated surprises when entering into such relationships. Below is an on-point item copied from a lab/pathology web forum (see: Epic (Beaker) Lab Module): THintz: At our facility we use Epic for our HIS and Sunquest for our ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4560613 Mon, 07 Mar 2011 13:03:11 +0100 4560613 http://www.medworm.com/index.php?rid=4554611&cid=t_98042_88_f&fid=38153&url=http%3A%2F%2Fwww.ozemedicine.com%2Fblog%2F%3Fp%3D948 This news article about NSW’s troubled implementation of Cerner’s FirstNet EDIS is in response to a review of it by Professor Jon Patrick. “Sally McCarthy, president of the Australasian College for Emergency Medicine, said the review by Professor Jon Patrick confirmed that the system, loathed by doctors and nurses, is unsuitable for its purpose” But then, NSW ED staff have been complaining about it ever since it was introduced, and still it seems Cerner has not fixed its problems. (Source: Oz E Medicine - emergency medicine in Australia) Oz E Medicine - emergency medicine in Australia blogs http://www.medworm.com/rss/comments.php?id=4554611 Sun, 06 Mar 2011 23:23:18 +0100 4554611 http://www.medworm.com/index.php?rid=4545259&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Fthepic-converts-its-academic-health-system-customer-into-franchisees.html I had not heard anything about this before but Mr. HIStalk alerts us to a new strategic initiative on the part of Epic's CEO and founder, Judith Faulkner (see: News 3/2/11). Below is a Q and A exchange posted recently: From HISJunkie: “Re: Texas Health Resources offering HIT consulting services (see: Texas Health Resources offering HIT consulting services). Epic is doing what IBM did 35 years ago, turning every client into a hosting site (see SHAS circa 1975). Epic is allowing / encouraging the large medical centers to distribute its app on a host basis to almost any remote client (particularly if they are under 150 beds) without incurring a new acquisition or license fee. Just add more work stations and pay a small seat license increment and you can buy them in ‘bulk’. I spoke t... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4545259 Thu, 03 Mar 2011 13:57:16 +0100 4545259 http://www.medworm.com/index.php?rid=4536026&cid=t_98042_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fcommittee-on-patient-safety-and-health.html In my Jan. 2011 post "Institute of Medicine Committee on Patient Safety and Health Information Technology, and Thoughts on Social Aspects of Health IT Evaluation" I wrote that:The U.S. National Research Council of the National Academy of Sciences issued a report in early 2009 on the state of health IT. That study's report, led in part by pioneers in Medical Informatics G. Octo Barnett and William Stead, was entitled "Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions" (pre-publication PDF available free at this link). The report was announced under the following header:CURRENT APPROACHES TO U.S. HEALTH CARE INFORMATION TECHNOLOGY ARE INSUFFICIENT The insufficiencies were largely in the areas of difficulties with data sharing and integration, deploy... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4536026 Wed, 02 Mar 2011 02:40:00 +0100 4536026 http://www.medworm.com/index.php?rid=4532579&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F03%2Fsee-drugmakers-create-mobile-phone-apps-to-track-diabetes-cancer-drugmakers-led-by-novartis-ag-and-merck-co-boosted-in.html This article highlights three major reasons why Big Pharma is starting to invest in smartphone apps. If patients are non-compliant, the various drugs that are being prescribed for them may be judged to be non-efficacious in retrospective, post-market studies. This non-compliance problem has arisen in response to pressure from government-run health plans. The article provides two more reasons for companies to invest in the development of smartphone apps. The FDA is breathing down their necks about direct-to-consumer (DTC) ads on television (see: It's Time for the FDA to Prohibit Direct-to-Consumer Advertising by Pharmaceutical Companies). If and when such ads are banned, the companies will have another trick up their sleeves -- drug marketing via smartphone apps. However, there is a dow... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4532579 Tue, 01 Mar 2011 14:45:25 +0100 4532579 http://www.medworm.com/index.php?rid=4532580&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Fpublic-health-alerts-to-physicians-via-office-emrs.html The objective is to identify episodes of food born illness by assessing symptoms recorded in EMRs and then alert physicians via these same systems. Below is an excerpt from the article: The Centers for Disease Control and Prevention (CDC), GE Healthcare and the Alliance of Chicago Community Health Services are collaborating on a project that aims at testing the efficacy of actionable health alerts, delivered instantly to a physician's electronic medical record. Officials made the announcement at [the recent] HIMSS and said the project will begin with a six-month prospective study, seeking to determine if the alerts are triggered often enough or too often, and if doctors take the advice displayed within the alerts. As a foundation, the study will utilize GE Healthcare's densely popu... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4532580 Mon, 28 Feb 2011 15:00:06 +0100 4532580 http://www.medworm.com/index.php?rid=4522303&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Fmultiple-privileges-extended-to-hospital-cios-at-himss.html I have been running conferences for nearly thirty years and my mantra has always been the following: no special privileges for any particular subset of registrants regardless of their status. Obviously, HIMSS does not operate under this same principle; CIOs are routed to the short lines and offered special refreshments and quiet rooms to escape the crowds. Here's a Q and A exchange just published on HIStalk about the ongoing HIMSS conference (see: From HIMSS 2/22/11): From Another CIO: “Re: VIP lines. My title is CIO, but it isn’t worth the ink to print it if all of our staff aren’t working together to accomplish everything that needs to get done.  To this end, I am literally embarrassed to hear about a ‘VIP Line’ at the HIMSS conference and wouldn’t be caught dead in... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4522303 Fri, 25 Feb 2011 13:00:00 +0100 4522303 http://www.medworm.com/index.php?rid=4517191&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F02%2Fwould-you-tolerate-those-occasional.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4517191 Thu, 24 Feb 2011 19:10:00 +0100 4517191 http://www.medworm.com/index.php?rid=4517193&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F02%2Fdocs-attitudes-about-emrs.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4517193 Thu, 24 Feb 2011 15:12:00 +0100 4517193 http://www.medworm.com/index.php?rid=4517359&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Fsmart-dictators-dont-quash-the-internet.html I deviate from the normal topic matter of Lab Soft News because of the importance of this topic.  ---BAF Social media such as Facebook have been much in the news lately in connection with the revolution in Egypt, Libya, and other Middle Eastern countries. A recent op-ed piece in the Wall Street Journal could serve as a playbook for dictators who want to use the social media to serve their own purposes (see: Smart Dictators Don't Quash the Internet; registration required). The author, Evgeny Morozov, makes some very important points and suggests that the IT-savvy young revolutionaries living under oppressive regimes may need to change some of their tactics. Below is an excerpt from it: The Egyptian experience suggests that social media can greatly accelerate the death of already d... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4517359 Thu, 24 Feb 2011 13:00:00 +0100 4517359 http://www.medworm.com/index.php?rid=4501818&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Ffederal-emphsis-on-emr-funding-hurts-ancillary-system-market.html A recent article on the web emphasizes the effect of ARRA funding for EMRs on the market for ancillary systems -- RISs, PACSs, and CVISs (see: ARRA FUNDING TO HAVE A SIGNIFICANT NEGATIVE EFFECT ON THE PACS, RIS, AND CVIS MARKET THROUGH 2013). The article did not include LISs or Pathology PACSs in the list of affected ancillary systems but I will assume this to be true. Below is an excerpt from the it: According to Millennium Research Group (MRG)..., the 2009 American Recovery and Reinvestment Act (ARRA) will continue to shift the focus of hospital healthcare IT budgets away from picture archiving and communication systems (PACS), radiology information systems (RIS), and cardiovascular information systems (CVIS), and toward Electronic Medical Records (EHR). This will result in a continued d... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4501818 Mon, 21 Feb 2011 15:28:19 +0100 4501818 http://www.medworm.com/index.php?rid=4489991&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Frationale-for-the-increasing-tempo-of-physician-practices-by-hospitals.html One consequence of the recent federal healthcare reform initiative has been the purchase of physician-owned private practices and specialty clinics by hospitals (see: Physician Private Practice Declines; the Last Barrier to Emergence of "Big Medicine"; Health Systems Use Their Regional Dominance to Muscle Insurance Companies). I have attributed this trend to the greater access to capital by hospitals, the increasing paperwork required from accountable care organizations (ACOs) (see: Hospital Executives Search for the Formula for an Accountable Care Organization), and the interest of hospitals in beefing-up their ambulatory care programs. Below is an excerpt from a blog written by a physician commenting on the purchase of physician practices (see: Dr. Manoj Jain: Hospitals taking ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4489991 Thu, 17 Feb 2011 17:09:06 +0100 4489991 http://www.medworm.com/index.php?rid=4482977&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Fa-pathologist-recounts-his-experience-with-a-demonstration-of-epics-beaker-lis.html An anonymous academic pathologist describes below, as a guest blog note, his experience with Epic and its LIS, Beaker. A number of previous notes have been posted in Lab Soft News about Beaker (see: Introducing the Epic Laboratory Information System (LIS); It's Called Beaker; An Update on Epic's LIS, Called Beaker, from HIStalk; More Information about Epic's Beaker LIS and Its Sibling; Assessing the True Cost of Serving as a Beta Test Site for the Beaker LIS; Details about Epic's Beaker LIS, Supplied by the Company). Over the last several months, there have been a few posts in Lab Soft News which have shed some light on a relative newcomer to the LIS party that goes by the name Beaker. Beaker, as you may recall from the earlier stories, is the latest development from Epic. ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4482977 Wed, 16 Feb 2011 13:42:08 +0100 4482977 http://www.medworm.com/index.php?rid=4482802&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F02%2Femr-facilitates-higher-coding-what-does.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4482802 Wed, 16 Feb 2011 13:03:00 +0100 4482802 http://www.medworm.com/index.php?rid=4482852&cid=t_98042_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fehrs-age-government-controlled-internet-kill-switches Egypt's crisis has raised alarms about national security and economic impact for Americans if regime change leads to an anti-US government controlling a strong ally in the Middle East.  This crisis raises another more personal concern for Americans that has been overlooked by the national media: The security and availability of your electronic medical records in the event of a government-imposed "kill switch" for the Internet. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4482852 Tue, 15 Feb 2011 17:03:26 +0100 4482852 http://www.medworm.com/index.php?rid=4459953&cid=t_98042_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FR1hfmzvterw%2F By Jane Sarasohn-Kahn. In February 2011, 1 in 10 jobs in the U.S. is in health care employment; nearly 14 million people in the U.S. work in health care employment, with health care representing 10.7% of all jobs in America. The growth rate of health care jobs rose 1.2 percentage points since the recession kicked in late 2007. Since the start of the recession, health employment grew 6.3%; the number of non-health jobs fell by 6.8%. The chart starkly illustrates this story (click the chart to enlarge for easier reading). Altarum Institute has crunched the health job numbers from the Bureau of Labor Statistics (BLS) and published their analysis in Health Sector Economic Indicators, published February 9, 2011. Altarum’s top-line: health care employment has reached an “all-time high�... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4459953 Thu, 10 Feb 2011 16:54:40 +0100 4459953 http://www.medworm.com/index.php?rid=4460190&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Fthintroducing-the-eicu-what-is-it-and-why-is-it-now-being-introduced.html I recently stumbled upon a successful example of telemedicine about which I was unaware -- the enhanced intensive care unit (eICU). Provena Health, with six hospitals in Illinois, has a web page explaining the concept which I quote from below (see: eICU - enhanced ICU): Initially one of only a handful of health systems to implement eICU technology, the Provena eICU Connection is one of 43 eICUs of its kind in the country, which collectively monitor approximately 10 percent of ICU beds nation-wide and lead the way in innovative patient care....It's a revolutionary service that utilizes enhanced computer software and physiology monitoring technologies to get immediate critical care physician and nurse input about any change in a patient's condition....eICU technology adds to current ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4460190 Thu, 10 Feb 2011 13:02:49 +0100 4460190 http://www.medworm.com/index.php?rid=4450526&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Fontario-ges-omnyx-establish-digital-pathology-center-of-excellence.html GE has announced an agreement to establish its first Global Pathology Imaging Centre of Excellence in Toronto, Ontario. GE and its digital pathology joint venture, Omnyx, will invest $7.75M along with a $2.25M grant from the Health Technology Commercialization Program created by HTX (Health Technology Exchange) and funded by the Ontario Ministry of Research and Innovation. Planned collaborative research and development partnerships will bring an additional $7.2M, for a total investment of $17.2M over the next 3 years (see: GE and the Government of Ontario Establish First Global Digital Pathology Centre of Excellence to Improve Patient Care). Three facts were listed at end of the press release that provided some insight for me about why the Canadian government was interested in jump-startin... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4450526 Tue, 08 Feb 2011 13:19:14 +0100 4450526 http://www.medworm.com/index.php?rid=4429234&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F02%2Fdetails-about-epics-beaker-lis-supplied-by-the-company.html I have published previous notes about Epic's Beaker LIS (see: Introducing the Epic Laboratory Information System (LIS); It's Called Beaker; An Update on Epic's LIS, Called Beaker, from HIStalk; More Information about Epic's Beaker LIS and Its Sibling). Because of the popularity of the Epic EMR, extensive pressure is being placed on pathology departments to install Beaker as a component of the enterprise solution that Epic offers and many CIOs seem to lust after (see: Why Does Epic Keep Hammering Cerner? Mr. HIStalk's Opinion; Are You an Enterprise or Best-of-Breed CIO? Access to Cash May Make the Difference). It's important for pathology personnel to understand the relative immaturity of this product and that key components are lacking (see: Assessing the True Cost ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4429234 Wed, 02 Feb 2011 14:33:32 +0100 4429234 http://www.medworm.com/index.php?rid=4429036&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F02%2Felectronic-health-technologies-gap.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4429036 Wed, 02 Feb 2011 12:57:00 +0100 4429036 http://www.medworm.com/index.php?rid=4424261&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F02%2Fis-hitech-next-on-republican-chopping.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4424261 Tue, 01 Feb 2011 12:33:00 +0100 4424261 http://www.medworm.com/index.php?rid=4424262&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F02%2Fhuge-ambulatory-study-finds-no-impact.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4424262 Tue, 01 Feb 2011 12:31:00 +0100 4424262 http://www.medworm.com/index.php?rid=4419460&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Fepic-employee-turnover-keeping-up-with-the-huge-number-of-new-contracts.html In a recent note, I quoted Mr. HIStalk describing how Epic manages its sales process (see: Some Details about the Epic Sales Force and Sales Process). In the same blog note that I linked to, he also cites the recent success of Epic in writing new EMR contracts (see: Monday Morning Update 1/24/11) Until 2009, Epic was making just 10-15 new sales a year and many of those were just for ambulatory or inpatient alone, but the percentage of enterprise sales has increased each year. In 2010, they supposedly made around 40 new sales .... Continuing on in this same vein regarding Epic staffing and personnel issues, Mr. HIStalk responds to a query for a reader, QPFC, about some sour grapes from ex-employees on the web (see: News 1/26/11): From QPFC: “Re: Epic. On Glassdoor.com, ex-employees have s... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4419460 Mon, 31 Jan 2011 12:58:51 +0100 4419460 http://www.medworm.com/index.php?rid=4419165&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F01%2Fis-emr-slowing-you-down-hire-scribe.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4419165 Mon, 31 Jan 2011 11:14:00 +0100 4419165 http://www.medworm.com/index.php?rid=4406041&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2F23andme-builds-online-sarcoma-research-community.html Here's an interesting development. 23andMe, the online, consumer-oriented genomic testing site, is developing a sarcoma research community (see: 23andMe Achieves Milestone in Building Sarcoma Research Community). This strikes me a very novel idea that may serve as a forerunner to similar online projects. Below is an excerpt from the article explaining the concept in more detail: 23andMe’s sarcoma research efforts are well underway with collection of both phenotypic and genetic data from 500 individuals diagnosed with sarcoma already completed. The company is half way towards its goal of building a sarcoma research community of more than 1,000 individuals.... Sarcomas are a rare group of cancers that arise in connective tissues ...or in bone. It is estimated that there are approximate... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4406041 Thu, 27 Jan 2011 14:10:41 +0100 4406041 http://www.medworm.com/index.php?rid=4382956&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Fhow-healthy-is-e-health.html Here's a definition for e-health from Canada: {A]n overarching term used to describe the application of information and communications technologies in the health sector. It encompasses a range of purposes from purely administrative through to health care delivery. This definition seems to me to provide a good start but, in my opinion, is insufficient. It doesn't touch on the notion of health information acquisition by consumers via the web, which is one of the most far-reaching aspects of e-health. This pursuit of knowledge by healthcare consumers is critical because it it allows them to educate themselves and prepares them to take more responsibility for their own health. Keeping all of this in mind, I now want to turn to a recent article that raises the issue of the "health&... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4382956 Fri, 21 Jan 2011 14:43:39 +0100 4382956 http://www.medworm.com/index.php?rid=4382787&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F01%2Femr-dogma.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4382787 Fri, 21 Jan 2011 11:35:00 +0100 4382787 http://www.medworm.com/index.php?rid=4372253&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Fus-supreme-court-to-review-prescription-privacy-laws.html The days of the "detailing" of physicians by sales personnel from the pharmacy companies are numbered (see: How E-Detailing May Lead to Greater Knowledge by Physicians about Drugs; E-Sampling: Another Blow to the Future of Pharma Sales Reps). Nevertheless, an important case is now before the U.S. Supreme Court relating to access by pharmacy reps of the prescribing history of the physicians whom they call on (see: Prescription Privacy Laws Get U.S. High Court Scrutiny). Below is an excerpt from the story: The U.S. Supreme Court accepted a case that pits medical privacy interests against speech rights, agreeing to consider whether states can limit how drugmakers use data about the prescription-writing practices of doctors. The justices ...will review a Vermont law being challenged ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4372253 Wed, 19 Jan 2011 14:20:18 +0100 4372253 http://www.medworm.com/index.php?rid=4372070&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F01%2Fmedical-apps-for-smart-phones.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4372070 Wed, 19 Jan 2011 12:47:00 +0100 4372070 http://www.medworm.com/index.php?rid=4361315&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Fis-meditech-dooomed-becasue-of-lack-of-robust-ambulatory-product.html Until about ten years ago, there was only minimal interest in IT support for ambulatory care. Successful EMR vendors such as that of Cerner were focused on inpatient care although their forward-looking "vision" statements always included ambulatory care. In terms of their major product focus, however, they were following the lead of the hospital executives who derived the bulk of their revenue from the inpatient side of the hospital. Many physicians shared this view at this time. Academic surgeons, for example, operated on mainly inpatients and then saw them as outpatients mainly to ensure that the surgical incisions were healing. All of this is now changing. Epic, for example, initially focused on IT support for ambulatory care. We all know how this has ended up (see: Why Does E... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4361315 Mon, 17 Jan 2011 15:19:55 +0100 4361315 http://www.medworm.com/index.php?rid=4349706&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Fwhats-shakin-in-verona-wi.html Verona, Wisconsin, a short drive from Madison and the home of Epic, has a lively newspaper. It's called the Verona Press. It turns out that whenever Mr. HIStalk links to an Epic story published by the Verona Press, the interest stresses their web server. Mr. HIStalk informs us about the clout his blog exercises in a recent note (see: News 1/12/11): HIStalk links to Epic-related stories provided so many incoming hits to website of The Verona Press that its top stories of 2010 had to be separated into Epic and non-Epic lists. They nicely mentioned HIStalk specifically. Epic articles outdrew other big news stories about deer season, a sausage factory fire, and bear sightings. I want to assure you that I am not going to resort to any cheap shots relating to local Wisconsin wildlife or the ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4349706 Fri, 14 Jan 2011 15:02:59 +0100 4349706 http://www.medworm.com/index.php?rid=4343347&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Ftu.html I had previously heard about Google Goggles but do not have the app on my smartphone -- I don't have an Android phone. However, I may consider one in the future. It turns out that the app can perform a new trick that astonishes me (see: Android Google Goggles Adds Barcode Scanning, Sudoku Cheats). Below are the details: Google's latest version of Google Goggles is apparently powerful enough to beat a Sudoku champ at her own game....Google announced Goggles 1.3 client for Android, featuring instant barcode scanning and print ad recognition. And as an added bonus, Goggles 1.3 can also help you cheat on Sudoku. First released on Android phones in December 2009 and on iOS in October 2010, Google Goggles is a visual recognition app that allows users to photograph objects and receive rel... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4343347 Thu, 13 Jan 2011 12:48:54 +0100 4343347 http://www.medworm.com/index.php?rid=4331251&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Fhow-valid-is-some-criticism-of-clinical-software.html Anecdotal information is defined as being based on personal experiences or, alternatively, on reports of individual cases rather than more rigorously acquired data. With regard to the selection of a new information system such as an LIS, it is nearly impossible to obtain detailed side-by-side comparisons of competing systems in the market. I personally pay no attention to the KLAS rankings (see: Mr. HIStalk Comments on KLAS). In order to make an informed decision when replacing an LIS, is it therefore necessary to perform a rigorous request-for-proposal (RFP) (see: More Ideas about Developing and Refining an RFP, Assessing the True Cost of Serving as a Beta Test Site for the Beaker LIS). It's also very important make a number of telephone calls to current users of the system. Mr. HISta... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4331251 Tue, 11 Jan 2011 13:51:34 +0100 4331251 http://www.medworm.com/index.php?rid=4318553&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F01%2Fcerner-lowering-lis-prices.html This article on Idaho hospital EMR projects describes Cerner, being implemented at North Canyon Medical Center for $2 million, as “an economical system that works well for smaller rural hospitals.” Syringa Hospital (a strangely satisfying hospital name) paid $1.3 million. What? The Cerner EMR as “an economical system that works well for smaller rural hospitals.” I, like Mr. HIStalk, was surprised by this description and had to think about the idea for a while. Then some of my thoughts started to come together. First of all, and as I noted in a previous note, Epic is winning most of the contracts for the highest-end hospital contracts, which was one of Cerner's sweet spots (see: Why Does Epic Keep Hammering Cerner? Mr. HIStalk's Opinion). Also, and as suggested in a previous... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4318553 Thu, 06 Jan 2011 14:19:00 +0100 4318553 http://www.medworm.com/index.php?rid=4313969&cid=t_98042_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F01%2Finstitute-of-medicine-committee-on.html The U.S. National Research Council of the National Academy of Sciences issued a report in early 2009 on the state of health IT.That study's report, led in part by pioneers in Medical Informatics G. Octo Barnett and William Stead, was entitled "Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions" (pre-publication PDF available free at this link). The report was announced under the following header:CURRENT APPROACHES TO U.S. HEALTH CARE INFORMATION TECHNOLOGY ARE INSUFFICIENT The insufficiencies were largely in the areas of difficulties with data sharing and integration, deployment of new IT capabilities, large-scale data management, and lack of cognitive support by health IT for busy clinicians.One might reasonably conclude such deficits could affect... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4313969 Wed, 05 Jan 2011 15:25:00 +0100 4313969 http://www.medworm.com/index.php?rid=4309644&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F01%2Fusing-emr-to-reduce-ventilator.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4309644 Tue, 04 Jan 2011 14:05:00 +0100 4309644 http://www.medworm.com/index.php?rid=4309612&cid=t_98042_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmaking-2011-meaningful%2F2011.01.03 Today, $27 billion in incentives begin for using electronic medical records, as office- and hospital-based providers begin to register for meaningful use criteria. Providers must use a certified system according to Centers for Medicare and Medicaid meaningful-use guidelines for 90 consecutive days within the first year of the program to qualify. Eligible professionals can receive up to $44,000 over five years under the program. There’s an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area. To get the most money, Medicare-eligible professionals must begin by 2012. By 2015, Medicare-eligible professionals and hospitals that do not demonstrate meaningful use get punished. (more…) *This blog post was originally publis... Better Health blogs http://www.medworm.com/rss/comments.php?id=4309612 Mon, 03 Jan 2011 20:00:00 +0100 4309612 http://www.medworm.com/index.php?rid=4298804&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Fprediction-for-2011-apps-go-corporate.html In an end-of-the-year article discussing IT trends, the WSJ tucked-in what I consider a highly significant and insightful prediction under the "apps" category (see: The Rise of Apps, iPad and Android; subscription required). I copy it below: Coming next: Apps go corporate. AT&T, business-software developer SAP AG and other companies are working on apps that can help their employees track sales, monitor systems or check-out customers without being tied to their stations. The quick adoption of tablets by business users is helping fuel the trend. I have posted a number of notes about the usefulness of smartphones in healthcare delivery and health education. I have also discussed previously the type of programs that run on smartphones -- generally referred to as apps (see: New De... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4298804 Wed, 29 Dec 2010 16:25:21 +0100 4298804 http://www.medworm.com/index.php?rid=4295005&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Ftop-.html I tend to be a sucker for the various "top ten" lists and they are common at this time of year. I tend to always read them, mainly to see if I agree with the list. Hence my interest in the "top 11" technology innovations of the past ten years published by the IEEE (see: The top 11 technology innovations of the last 10 years, from the IEEE). IEEE is an organization that bills itself on its web site as "the world’s largest professional association dedicated to advancing technological innovation and excellence for the benefit of humanity." Why the top eleven? I suspect that there were some ties and controversy near the end of the list and they settled on eleven rather than ten. Here's their list: Smartphones. Social Networking. Voice over IP. LED Lighting... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4295005 Tue, 28 Dec 2010 14:46:39 +0100 4295005 http://www.medworm.com/index.php?rid=4295006&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Ftwitter-valued-in-billions-according-to-new-study.html I have been fascinated by Twitter for at least a couple of years. The service can be defined as a free, one-to-many social networking system. Messages are confined to 140 characters but allow embedding in messages of links to web resources, thus expanding the information content of the tweets. Twitter provides value in different ways for its subscribers. I carefully select people and organizations to follow who then provide me rapid and easy access to breaking healthcare and medical science news. I "unfollow" those who post personal data that I find irrelevant and distracting. Many of my blog posts are based on ideas that I first discover on Twitter. Here's an extract of an article discussing the rapid growth of the growth and estimated value of the company (see: Twitter valu... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4295006 Mon, 27 Dec 2010 15:53:57 +0100 4295006 http://www.medworm.com/index.php?rid=4285199&cid=t_98042_87_f&fid=39187&url=http%3A%2F%2Fscienceroll.files.wordpress.com%2F2010%2F12%2Fhealthmash_iphone_app_screen_shot2.png HealthMash, WebLib’s next-generation semantic health search engine, will release an iPhone application in January. It utilizes proprietary natural language processing and semantic technology tools and resources in order to find highly relevant, reliable, and recent health information from the most trusted sources and facilitate user exploration and discovery. *This blog post was originally published at ScienceRoll* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4285199 Thu, 23 Dec 2010 20:00:26 +0100 4285199 http://www.medworm.com/index.php?rid=4281554&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Fhealth-insurance-companies-jump-into-healthcare-software.html Mr. HIStalk comments below on the recent acquisition of Medicity by the health insurance company Aetna (see: Healthcare IT From the Investor’s Chair 12/9/10). Medicity is an HIE (health information exchange) company. Speaking from my usual perch in the peanut gallery (as I’ve done work for neither company), I’m fairly astounded by the price [of Medicity’s acquisition by Aetna]. Rumor has it that $500 million (twice what Ingenix paid for Axolotl) is approaching 8x revenues, a princely multiple that dwarfs, say, Allscripts’ purchase of Eclipsys for 2x revs or even Ingenix’s purchase of Picis for 3x revs. Medicity appears to be the leader in its space, with over 750 hospitals and 125,000 physicians using its system. Still, it’s a huge bet on the HIE market that’s not quite eme... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4281554 Wed, 22 Dec 2010 13:00:00 +0100 4281554 http://www.medworm.com/index.php?rid=4266286&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Fdifference-between-software-born-in-the-cloud-and-software-moved-to-the-cloud.html I have posted a number of notes about cloud computing but have not paid particular attention to differences between applications born in the cloud as opposed to those that are moved to the cloud. Luckily, the Forbes blog Quicker, Better, Tech has reprinted a column on this topic by Aaron Levie who is the co-founder and CEO of Box.net. Below is an excerpt from his musings (see: The Open Social Enterprise). Read the whole thing if you have time. It's worth the effort. When Steve Ballmer declared that Microsoft was “betting the company” on cloud computing earlier this year, he cautioned that “the goal can’t be to throw out all the world’s software and start again.” Microsoft and the other enterprise technology behemoths may be embracing the cloud, but in many cases they’re d... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4266286 Thu, 16 Dec 2010 14:07:04 +0100 4266286 http://www.medworm.com/index.php?rid=4259217&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Fhospitals-said-to-withhold-clinical-data-from-phrs.html It may strike you as sour grapes that the president of a personal health record (PHR) company, is griping about hospital CEOs holding hostage the clinical data that they control. Mr. HIStalk recently published the following tidbit, quoting Colin Evans of Dossia (see: News 12/8/10): Colin Evans, president and CEO of PHR vendor Dossia says ...HHS and the FTC need to make big providers and health plans stop holding the medical information of their patients hostage and using liability or privacy concerns as an excuse. He says they refuse to share patient information even when patients request it, hoping to forestall competition based on service, price, and quality. He also points out that lots of them are selling the data of their patients anyway or are using PHR information to display targete... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4259217 Tue, 14 Dec 2010 14:13:24 +0100 4259217 http://www.medworm.com/index.php?rid=4258873&cid=t_98042_88_f&fid=38153&url=http%3A%2F%2Fwww.ozemedicine.com%2Fblog%2F%3Fp%3D934 Just thought I would bring your attention to Houston Neal’s blog where he groups iPhone apps for doctors and medical students as I am sure many of the readers of this blog would be very interested. Check out his blog here. (Source: Oz E Medicine - emergency medicine in Australia) Oz E Medicine - emergency medicine in Australia blogs http://www.medworm.com/rss/comments.php?id=4258873 Tue, 14 Dec 2010 03:39:16 +0100 4258873 http://www.medworm.com/index.php?rid=4225675&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Fhuntsman-gay-purchases-sunquest.html It looks like Sunquest is in play again, having now been purchased by Huntsman Gay Global Capital, a private equity fund (see: Huntsman Gay Buying Laboratory Software Company: Moody’s). It was held for only three years by its previous owner, Vista Equity Partners. Below is an excerpt from the press release: Huntsman Gay Global Capital LLC, an upstart buyout shop working through a $1.1 billion debut fund, is leading an investor group expected to pay $208 million for a 51 percent stake in Sunquest Information Systems Inc., a provider of laboratory, radiology and pharmacy software products to hospitals and commercial laboratories.....Details of the complex transaction remain sketchy. But according to Moody’s Investors Service, the company would simultaneously borrow $655 million as part o... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4225675 Fri, 03 Dec 2010 14:37:30 +0100 4225675 http://www.medworm.com/index.php?rid=4225676&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F12%2Fmore-information-about-googles-chrome-os.html In a previous note, I began to address the Chrome browser/operating system (see: The Decline of Microsoft: The Clues Seem to Be Obvious). A recent NYT article begins to fill in some of the white space concerning this product (see: For Google, the Browser Does It All). Below is an excerpt from it: ....Chrome stores everything that people have on their computers — like documents, photos and e-mail — online, or in tech parlance, in the cloud. In Google’s vision of a world where all computers run on its Chrome OS, anyone can walk up to any computer with an Internet connection and gain access to all their information....It is all the more confusing because Google already has a Web browser named Chrome. And Google already has an operating system, called Android. Google says it will become ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4225676 Thu, 02 Dec 2010 20:42:46 +0100 4225676 http://www.medworm.com/index.php?rid=4225429&cid=t_98042_114_f&fid=34646&url=http%3A%2F%2Fwww.wvhin.org%2FPrivacy_and_Security%2FDocuments%2FPrivacy%2520and%2520Security%2520Policies%2520for%2520Public%2520Comment%2FPatient%2520Consent%2520-%2520General.pdf The West Virginia Health Information Network (WVHIN), West Virginia's health information exchange, has issued proposed privacy and security policies and is seeking public comments on the proposed policies from December 3, 2010 through January 3, 2011. The WVHIN is a public/private partnership created in 2006 under W.Va. Code 16-29G-1 et seq. and is charged with building a secure electronic health information system for the exchange of patient data among physicians, hospitals, diagnostic laboratories, other care providers, and other stakeholders.The proposed privacy and security policies that are available for review and comment are as follows:Patient Consent - GeneralPatient Consent - Permissible Purpose Patient Consent - Sensitive Health InformationUser AuthorizationUser AuthenticationPat... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4225429 Thu, 02 Dec 2010 15:02:03 +0100 4225429 http://www.medworm.com/index.php?rid=4214127&cid=t_98042_88_f&fid=38153&url=http%3A%2F%2Fwww.ozemedicine.com%2Fblog%2F%3Fp%3D896 Their 5 golden rules for social media use by doctors: Don’t discuss patients Don’t defame colleagues Don’t ‘friend’ patients Maintain a professional image – eg posting images, joining certain groups, making comments etc Be aware of who’s accessing your details – eg patients and employers See their guidelines here (Source: Oz E Medicine - emergency medicine in Australia) Oz E Medicine - emergency medicine in Australia blogs http://www.medworm.com/rss/comments.php?id=4214127 Tue, 30 Nov 2010 11:52:14 +0100 4214127 http://www.medworm.com/index.php?rid=4207511&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F11%2Fma-fresh-look-at-epic-from-a-financial-and-strategic-perspective.html The financial health and strategic goals of Epic are of great interest to those large healthcare systems that are totally dependent on the company for their EMR software (see: How to Avoid Software Vendor Lock-in and Account Control). Mr. HIStalk alerted me in a recent blog note to coverage of the company in a Milwaukee newspaper (see: Monday Morning Update 10/18/10). Here's his take on the company: The Milwaukee newspaper profiles  Epic with some interesting facts, with the most interesting one being confirmation of our June report that Aurora is dumping its $150 million Cerner system for Epic, which will cost them an additional $100 million. A quarter billion dollars seems like a lot for an EMR considering that Aurora showed a $50 million loss two years ago and a $116 million l... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4207511 Mon, 29 Nov 2010 12:20:57 +0100 4207511 http://www.medworm.com/index.php?rid=4197375&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F11%2Fhow-labs-can-avoid-the-dreaded-vendor-lock-in-.html People new to the field of lab computing may be unaware of the risk of vendor lock-in and account control in their purchase of software. According to the Wikipedia, vendor lock-in, also known as proprietary lock-in or customer lock-in, makes a customer totally dependent on a single vendor for products and services and unable to use other products without substantial switching costs. A recent article discussed how to avoid such a situation (see: How to Protect Against Vendor Lock-In). Below is an excerpt from it: It appears that Oracle CEO Larry Ellison is aggressively either buying or putting out of business potential competitors. SAP and HP look to be his latest targets on the latter path and his goal appears to be total account control, that is, a situation in which one vendor single-han... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4197375 Tue, 23 Nov 2010 12:01:12 +0100 4197375 http://www.medworm.com/index.php?rid=4183562&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F11%2Fnew-malamoma-detection-device-narrowly-apporoved-by-the-fda.html MelaFind, a device designed for use by dermatologists for in-vivo detection of suspicious pigmented skin lesions, has been narrowly approved by an FDA advisory panel. Here is an excerpt from the article (see: Panel Splits over Skin Cancer Detection Device): An FDA advisory panel has voted 8-7, with one member abstaining, to recommend approval for an experimental skin cancer detection system called MelaFind. A vote so close generally is not considered an endorsement in the eyes of FDA officials, who have the final say in whether to approve the device. The FDA does not have to follow the advice of its advisory committees, but it often does. Some panelists on the [committee] were concerned that relying on a device to detect melanoma could lead to unnecessary biopsies, or worse: missed skin ca... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4183562 Fri, 19 Nov 2010 17:06:09 +0100 4183562 http://www.medworm.com/index.php?rid=4175980&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F11%2Fhimss-virtual-conference.html HIMSS seems to be up to one of its revenue-generating, marketing, and sleight-of-hand tricks according to a report by Inga who blogs with Mr. HIStalk (see: News 10/29/10). Here's her account about registration for one of its virtual conferences: HIMSS is hosting another virtual conference November 3-4. I “attended” the first one two or three years ago, mostly because I was curious about the virtual format. The conference is free for “qualified” participants and $99 for “non-qualified” HIMSS members. I can’t find anywhere on the HIMSS site that clarifies what it takes to be qualified, but I can say that when I tried to sign up for a conference a year ago, I didn’t have the secret requirements. I am mildly amused because my status must have recently changed, having receiv... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4175980 Wed, 17 Nov 2010 13:00:00 +0100 4175980 http://www.medworm.com/index.php?rid=4134276&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F11%2Fwthe-decline-of-microsoft-the-clues-are-obvious-to-the-informed-observer.html Despite recent impressive profits (see: Microsoft's huge Q1: profit up 51%, revenue up 25%) and the continuing robust sales of its cash-cow operating system Windows, the future for Microsoft seems unfavorable, at least in the opinion of Paul McDougall who referred to it recently as an end-stage company (see: Microsoft Looking Like An End-Stage Company). Below is the key quote from his recent column: Microsoft's defenders, and Microsoft itself, point to the company's lock on the PC operating system market (more than 90%) as proof it's still a dominant player that controls a bunker from which it can generate piles of cash and withstand reversals in other segments. But that's just whistling past the graveyard, spouting a tune written from backward-looking data not pa... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4134276 Wed, 03 Nov 2010 12:00:00 +0100 4134276 http://www.medworm.com/index.php?rid=4119739&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F10%2Fthipad-as-the-owner-manual-for-hyundai.html I picked up, by chance, on a recent reference to the fact that a "free" iPad is delivered with each Hyundai Equus, substituting for the normal hardcopy user manual for the vehicle. Here is an excerpt from the article (see: A Week In The High-Tech Hyundai Equus Super Sedan): There’s enough technology within the driver’s (and backseat passenger’s) reach to require a few trips to the manual, which just so happens to be an app on the included iPad. Yep, this is the car that comes with an iPad as the user manual. It makes sense, too. Instead of following a series of step-by-step instructions to, say, change the audio settings, you can just refer to the app for a quick demonstration. It’s genius from a user experience and marketing standpoint. OK, OK! This is a car with a $96,0... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4119739 Thu, 28 Oct 2010 16:45:25 +0100 4119739 http://www.medworm.com/index.php?rid=4097933&cid=t_98042_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-survey-1-in-10-cell-phone-users-have-health-or-medical-apps%2F2010.10.24 A new survey from the Pew Internet & American Life Project shows how the proliferation of smart mobile devices is causing a shift in the way users are accessing data and information on health. Some of the most interesting findings are related to the substantial number of users who actually have applications that help them manage and track their health. Some key findings from the survey: *17 percent of cell owners have used their phone to look up health or medical information on the Internet; 29 percent of cell owners ages 18 to 29 have done such searches. *9 percent of cell phone owners have apps they use to help track and manage health. *The heaviest use of health or medical related apps was by young adults: About 15 percent of those ages 18 to 29 have such apps, compared to 8 percen... Better Health blogs http://www.medworm.com/rss/comments.php?id=4097933 Sun, 24 Oct 2010 13:00:07 +0100 4097933 http://www.medworm.com/index.php?rid=4086527&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F10%2Fmanaging-workflow-as-the-secret-sauce-in-diagnostic-information-systems.html Have you ever wondered why pathologists and radiologists would be unable to manage their daily work without their LISs, RISs, and/or PACSs whereas many clinicians balk at using hospital EMRs? One of the primary reasons for this difference is that these former systems manage professional workflow in the diagnostic services whereas clinical EMRs largely record the results of workflow decisions previously made by physicians and nurses. Because workflow support is not broadly integrated into the clinical EMRs, physicians understand that they may be able work more efficiently without them. This is one of the reasons why scribes are now being hired in some hospitals to enter data into clinical EMRs (see: Shift of Hospital EMR Data Entry Tasks from MDs to Scribes). Such an action, to the best of ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4086527 Wed, 20 Oct 2010 15:59:18 +0100 4086527 http://www.medworm.com/index.php?rid=4031513&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F10%2Fmin-search-of-an-accountable-care-organization.html Mr. HIStalk, in his Monday Morning Update 10/4/10, highlights a YouTube animated video entitled In Search of an Accountable Care Organization. As most of you will know by now, an ACO or Accountable Care Organization is a key requirement in the recent healthcare reform legislation. Hospital executives are searching for the secret sauce about how to transform their organizations into one. Information technology, and particularly EMRs, are critical elements in the recipe. Watch this short video -- very enlightening and uncomfortably funny. KevinMD, a well-known and highly respected blogger about health issues, has this to say about ACOs: Somewhere in the Obama Administration, there is an elitist central cabal that operates with the support of the highest organs of our central government....Mu... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4031513 Mon, 04 Oct 2010 12:31:47 +0100 4031513 http://www.medworm.com/index.php?rid=4027186&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2010%2F10%2Fdiagnosispro.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4027186 Mon, 04 Oct 2010 10:59:00 +0100 4027186 http://www.medworm.com/index.php?rid=4023144&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F10%2Fmobile-phr-not-the-answer.html I came across an article recently about the relationship between mobile devices such as smart phones and healthcare and the word conflation immediately came to mind (see: Deloitte Report Finds Major Role for Mobile Devices in Health Care). It can be defined in the following way: conflation occurs when the identities of two or more individuals, concepts, or places, sharing some characteristics of one another, become confused until there seems to be only a single identity — the differences appear to become lost. Read the extract below and see if you agree with me: The Deloitte Center for Health Solutions has released a report showing how mobile technology can improve people's health and reduce health-care costs....Considering that treating chronic disease accounts for more than 70 perc... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4023144 Fri, 01 Oct 2010 14:14:31 +0100 4023144 http://www.medworm.com/index.php?rid=4018199&cid=t_98042_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2010%2F09%2Fcpoe-patient-safety-dogma-is-gradually.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4018199 Thu, 30 Sep 2010 10:01:00 +0100 4018199 http://www.medworm.com/index.php?rid=3999307&cid=t_98042_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2010%2F09%2Fassessing-the-true-cost-of-being-a-beta-test-site-for-beaker-lis.html I have been trying to keep abreast of the news relating to the Beaker LIS, given that Epic is closing most contracts in high-end hospitals and their labs are sure to get caught up in this process (see: Introducing the Epic Laboratory Information System (LIS); It's Called Beaker; An Update on Epic's LIS, Called Beaker, from HIStalk; More Information about Epic's Beaker LIS and Its Sibling). I have been told that Beaker is now live in a a number of physician offices labs and a few hospitals with the 500-bed Sanford Health in Sioux Falls, SD, as one of the major show sites. Two hospital systems are now considering the installation of Beaker, Allina and OHSU. The latter, previously running GE's Ultra LIS, is apparently seeking a replacement for this system with some degree of u... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=3999307 Fri, 24 Sep 2010 13:53:51 +0100 3999307