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RFID EMR Pioneer Says “RIP”

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By MICHAEL MILLENSONVerichip_tiny

When Harvard Medical School and CareGroup CIO Dr. John Halamka agreed to place his medical  information on an RFID chip and have it implanted it in his arm, he triggered an instant global spotlight on this unusual form of portable electronic medical record. The decision, made in December 2004 and disclosed in early 2005, captured worldwide attention from places a diverse as Fox News, the BBC and the New England Journal of Medicine (where Halamka contributed a commentary ).

As recently as 2007, a debate over chip privacy and safety versus having critical medical data instantly at hand (as it were) was featured in a PLoS Medicine exchange.  In it, Halamka asserted, “Implantation of RFID devices is one tool, appropriate for some patients based on their personal analysis of risks and benefits, that can empower patients by serving as a source of identity and a link to a personal health record when the patient cannot otherwise communicate.”

Two years later, Halamka’s chip remains under his skin but he’s ready to turn over the idea that he’s a trendsetter to the undertaker. The technology “has been adopted by no one,” Halamka told me at a meeting on Patient-Centered Computing sponsored by Partners HealthCare’s Center on Information Technology Leadership. “As a technology it’s dead. Use the network, use the cloud to store your personal health records. Or in a pinch, use a USB drive. But the implanted RFID chip is not as a society where we’re going.”

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Defining “Meaningful Use” of Health IT

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By STEVE BELLER

The federal government’s $20 billion stimulus programs for health IT (HIT) is on its way. Called Hitech—for Health Information Technology for Economic and Clinical Health Act—it will fund the development of innovative HIT and use a “carrot & stick” financial approach to encourage clinicians to use HIT in meaningful ways. A debate now raging is how to define “meaningful use.”1

A Definition

Meaningful use, to me, means using HIT in ways that are of great value to the patient and other healthcare consumers. It doesn’t matter what types of software tools are used, what communication infrastructure is used, what standards are used, or what certifications are used. It just means that the using HIT should result in ever more effective and efficient (i.e., ever greater value) care delivery.

Increasing care value is unlikely unless clinicians obtain information and guidance assisting them in answering difficult questions, making tough diagnostic and treatment decisions, collaborating effectively, and taking competent action. In addition, healthcare consumers (patients, clients, customers, etc.) would benefit from assistance in selecting the most cost-effective treatment options for existing conditions, and in managing their own health in ways that prevent illness, control chronic conditions, and increase their wellbeing.

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MedicExchange

MedicExchange does product reviews for radiology and HIT products.  We have a thriving community of 50,000 decision makers who use the site to network, read customer reviews and research products for RFP’s.   We are bringing transparency to the industry and trying to minimize ‘buyer confusion’ with a goal to help buyers make the right decisions.  Our product showcase platform offers vendors and manufacturers a unique way to show off their products by using video, instant messaging and other tools to communicate with buyers and existing customers.  We really think we are onto something but we want to hear what you think, register for free on www.medicexchange.com and network and research products with other decision makers.

The Health IT Stimulus and FQHCs — Don’t Forget About Us!

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By JAMES KAHN

James Kahn There is a critical element in the American Recovery and Reinvestment Act (ARRA) that targets funds for Federally-Qualified Community Health Centers (FQHCs).  An FQHC is an organization defined by the Medicare and Medicaid statutes that receives funding under Section 330 of the Public Health Service Act.  FQHCs provide primary care services for all age groups and provide preventive health services on site to some of the country's most vulnerable populations, and they are an important part of this country's primary care delivery system.  Among services that FQHCs must provide directly (or by arrangement with another provider) include: dental services, mental health and substance abuse services, transportation services necessary for adequate patient care, hospital and specialty care.  There are more than 16 million Americans who are served by FQHCs.

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Op-Ed: Cost-Reduction Strategies Help Hospitals Weather Economic Uncertainty

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By DAVID MARKOSKI

David Markoski In today’s current economic climate, many hospitals are reducing staff to cut costs and balance their budgets. An even greater number are trying to reduce administrative costs to save money for the difficult days ahead and retain their employees.While reducing staff may help the bottom line, it may threaten a hospital’s long-term success by jeopardizing quality patient care and its reputation. Cutting non-salary costs, meanwhile, may save as much—or more—while kick-starting organizational recovery when the economy improves. Since these cost reductions do not compromise patient care or the level of support hospitals provide to their physicians, they create long-term efficiencies that will serve the hospitals into the future.Employee compensation accounts for the single largest item on a hospital’s budget, but the aggregated costs of goods and services are greater. These costs represent dozens of money-saving opportunities—from supply chain management and physician-preference items to service contracts and pharmacy—that can impact the bottom line without affecting patient care.

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Andy Hurd, CEO, CareFx

By MATTHEW HOLT

Matthew is away in Peru sampling the delights
of the Andes this week. He had a very busy month with conferences
in Hawaii, HIMSS in Chicago, WHCC in Washington DC, and of course
Health 2.0 Meets Ix in Boston. Lots and lots of video was taken during
all those trips, and we gnomes back at THCB are taking the opportunity
to show you some of it. This week we're presenting all the interviews Matthew had at HIMSS in Chicago that haven't already been shown.

Andy Hurd, CEO, CareFx, talks about his company, which provides a way
of viewing disparate systems, by sharing views into different hospital
departmental systems quickly and relatively cheaply. It's a fix for the
messy "different systems don't talk to each other" problem, and it's
catching on in the big hospital market, with explosive growth last year.

Luis Machuca, CEO, Kryptiq

By MATTHEW HOLTLuis Machuca, CEO, Kryptiq explains how his secure email solution is
mixing and matching data between different providers.

Of Healthcare and Toilets

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By TOBIAS GILK

Tobias Gilk “Any system produces exactly the results it was designed to produce,” or so goes the saying. If we don’t like the results we get, we need to re-examine the system and not simply individual inputs.

In the US, healthcare’s systemic complexity has gone from that of a grandfather clock to nuclear reactor over the course of the past 100 years. If we really wish to improve the results of US healthcare, we need to look at the totality of the system, the multitude of inputs and outputs.

EMR’s, reimbursement rates, pre-authorizations, universal coverage and each of the many hot-button topics swirling around the question of healthcare reform are all important inputs that effect quality, cost, access, but I’m very much a hands-on person and I want to know what these have to do with the physical points of distribution of healthcare… our doctors’ offices and hospitals?

We know that a hammer sees every problem as a nail. And I concede that my predisposition as a recovering architect is to see the problems inherent in the physical instruments of our healthcare delivery… namely hospitals.

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The Stimulus Package and Health Data Exchange

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By DAVID HANSEN

CapitalObama’s stimulus package allocates
tens of billions for healthcare IT, and that much expenditure by the 
Feds won’t happen twice; thus, we should ensure these stimulus funds
address key health information infrastructure needs. The package dangles
incentive payments in front of hospitals and physician offices to adopt
electronic medical records (EMRs) by 2011, as well as penalties if they
fail to use them by 2016. Providers will hopefully benefit from EMRs
through improving effectiveness and efficiency within their organization.
For the health system as a whole, however, the promise goes beyond gains
within practices to encompass improved teamwork among providers and
with patients. It is on this latter promise—system improvements through
sharing medical records—that I’d like to focus here.

The vision is for a community-wide
information system that allows Marie, a diabetic who is allergic to
penicillin, to show up unconscious at any emergency room, yet get care
from doctors who know her special medical needs.  Further, Marie’s
treatments in the ER are known immediately both to her family physician
and to her specialists. The full team—primary through tertiary care—have
access to complete medical records available in real time, integrating
their separate decisions through shared information. This vision promises
improved care quality through comprehensive and transparent information,
and it will reduce redundant diagnostic testing.

Does the stimulus package adequately
promote this vision? What we’ve seen so far disappoints.

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Calendar: Project HealthDesign

The Robert Wood Johnson Foundation (RWJF) has announced a new call for
proposals for Project HealthDesign: Rethinking the Power and Potential
of Personal Health Records, a $10-million national program to stimulate
innovations in personal health information technology.  Project
HealthDesign will host the second of its informational web seminars for
potential applicants on
May 7th.  For more information and to register: http://www.projecthealthdesign.org

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