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Gates Foundation to fund global informatics training

The American Medical Informatics Association will announce today that it has received a $1.2 million grant from the Bill and Melinda Gates Foundation to promote health informatics and biomedical education and training worldwide, particularly in developing countries.

This will be the first project of a new program called 20/20, in which the International Medical Informatics Association
and its regional affiliates, including AMIA, will attempt to train
20,000 informatics professionals globally by 2020. This is an outgrowth
of the AMIA 10×10 program to train 10,000 people in informatics in the U.S. by 2010. IMIA will present details of 20/20 this week at the Wellcome Trust in London.

AMIA
will use the Gates Foundation money to develop "scalable" approaches
to e-health education, including a replicable blueprint for training
informatics leaders, including physicians, medical records
professionals, computer scientists and medical librarians.

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Confessions of A Physician EMR Champion, Part 2: Empowering Health IT for the Connected Medical Home

In a post here three weeks ago, I explained that I am engaging physician audiences in a conversation about participatory medicine, using a talk and presentation entitled "Confessions of a Physician EMR Champion.”

I “confess” my own misplaced hope in the EMR movement, and that I’m finally embracing the reality that most investments in health IT have not met expectations.

My broad message is that the key lesson of this failure has been that adoption of health IT without understanding the fundamental interactions between people, business process, and technology wastes both human and economic capital.

To be successful, the adoption of health IT by physicians, nurses, and staff must extend communication and health data exchange beyond their practices and bill payers to include the patient and family members, the patient’s team of health and wellness professionals, and ancillary service providers such as pharmacists and lab technicians in the community.

Health IT must be able to support coordination and continuity of care, as well as accountability for doing the right things for patients. I now realize most EMRs are not sufficient to this task, and I was wrong to think they would evolve in this direction.

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A glimpse of what might have been: Palin announces Alaska health goals

PalinAlaska Gov. Sarah Palin announced plans last week to improve Alaskans’ health.

Palin supports expanding Denali Health, the State Children’s Health Insurance Program, to families earning twice the federal poverty level. Expanding the program would make an additional 1,300 children and 225 pregnant women eligible for coverage, The Anchorage Daily News reported.

Palin’s plan also includes creating a Web site  called "Live Well Alaska" "to offer suggestions in
such health-related areas as diet and exercise as well as tips to quit
smoking."

The hockey mom governor also wants to dedicate an additional $2 million in preschool, $250,000 toward early diagnosis of autism, and establishing a state health commission to further work.

The Daily News says Palin has some "good ideas," but should go further toward universal coverage and recruiting additional primary care doctors to Alaska.

Now, Sleepless in San Francisco

Having returned from Seattle, the persistent itching from the sand-fly bites of Roatan has awakened me at 5 a.m. So I’m commenting on three pieces of news, which I’ve commented on before here and at Spot-On.

First, United HealthGroup has introduced two new things this week. One is is a consumer portal/WebMD competitor called myOptumHealth, which gave a sneak preview (and was a sponsor) at the Health 2.0 Conference in October.

At first blush I like the look of what they’ve pulled together, although the about us section doesn’t exactly tell you much about who owns Optum! But the really interesting product United launched this week was aimed right at me. It’s an option to repurchase your individual health insurance without being re-underwritten and rejected.

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Moving up the health care value chain

Last week, I participated in a very cool live podcast with the ReadWriteWeb editor Richard Macmanus. While I am finishing up my commentary based on that experience, I did want to comment on another post by Richard who is one year into his diagnosis of Type I Diabetes. He mentioned that his favorite Health 2.0 application was MyMedLab.

In full disclosure, I serve as an advisor to
the company as well as a participant on the call that was conducted. I
became involved with MyMedLab while conducting my own survey of
promising Health 2.0 companies, tools, and technology. I was intrigued
by their Health 2.0 delivery model of leveraging the internet to remove
inefficiencies of time, location, and physician approval for routine
wellness laboratory testing.

I became convinced after using the service for myself. Since I
hadn’t ordered lab test since my medical school entrance physical exam,
and I was preparing for an upcoming physical, I ordered the baseline
wellness tests I knew my primary care provider would want (conveniently
organized by “profiles” – individual tests that are grouped together to
provide disease or organ system specific information
). I wanted to
maximize my time with my doctor and come prepared with as much
information to review during our appointment as I could.

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Using real-time, real patient data to guide medical evidence

The NYTimes had a recent article on real world testing of drugs. This raises questions, such as how are consumers to be informed today? 

There are limited head to head
trials, and almost all of the data comes from highly selected groups of
individuals under conditions that are nearly impossible to replicate in
the real world. Ivory tower medicine indeed, giving us the best case
scenarios only…but far from the outcome impact for all the spend and
utilization occurring in very different ways out in the real world.

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Fibroid Tumors: What You Need to Know

In her just published 8th book on women's health, Biologist Winnifred
Cutler takes the terror out of fibroid tumors.  In HORMONES AND YOUR
HEALTH: A SMART WOMAN'S GUIDE TO HORMONAL AND ALTERNATIVE THERAPIES FOR
MENOPAUSE
, she writes:

     "Fibroids are about as common as freckles.  They are benign and
occur in more than 70% of reproductive-age women."  ***Fibroids should
not be confused with cancer or a risk of developing cancer.

Dr. Cutler recognizes that unwanted bleeding caused by fibroids
understandably alarm women and scare some to rush into surgical removal
of the fiborids, or worse, of the entire uterus i.e. an  unneeded
hysterectomy (which Dr. Cutler generally opposes.)

Importantly her new book alerts women to the "turf battles" among
various medical specialists competing for the business of fibroid
treatment and the 4 effective treatments if they are causing problems.
She shows women which specialists are trained to perform which
procedures.

An important theme throughout her book is encouraging women to:
-Take Command

If you having a problem with fibroids, I hope you will seriously study
the information presented here. Your informed, dignified command of the
facts can profoundly affect the solutions you seek and find. Don't be
in a rush to get the process over with. Every surgery provides fodder
for future medical problems. Surgery is dangerous. Reject the attitude
of, "when in doubt, cut it out."

To learn more read  Hormones and Your Health: The Smart Woman's Guide to Hormonal and Alternative Therapies

     ************

Leading medical experts praise this book:
"Winnifred Cutler's message is clear, precise and correct that women
have choices as far as hormone therapy is concerned and they are in
charge."

-Dr. Alan De Cherney, MD., Editor in Chief of the medical journal Fertility and Sterility.


"Excellent"

Dr. John Sciarra, MD, PhD, past president International Federation of Gynecology and Obstetrics

We hope you will visit the Athena Institute for Women's Wellness website to learn more about Dr. Cutler's new book and research;

http://www.athenainstitute.com/hormonesandyourhealth.html http://www.athenainstitute.com/mediaarticles/moremag2.html

The Benefit of the Doubt

Valjones

By

Today a dear friend of mine told me a horror story about her recent trip to a hospital ER. She has kidney stones, with rare bouts of excruciating pain when they decide to break off from their renal resting place and scrape their way down her ureters.

My friend is a stoic person who also doesn’t like to cause trouble for others – so when she was awoken at 4am with that same familiar pain, she decided not to call an ambulance but rather drive herself to the ER. She also chose not to call her doctor out of consideration for his sleep needs.

She managed to make it to the triage desk at her local hospital and was relieved to see that the ER was quite empty. There were no ambulances in the docks, no one in the waiting area, and no sign of any trauma or resuscitations in the trauma bay. She approached the desk trembling in pain and put her health insurance card, driver’s license, and hospital card on the desk and let the clerk know that she was in incredible pain.

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Sleepless in Seattle

In a 36 hour span I left the mountains of Copa Ruinas in Western Honduras, had dinner in South Beach, Miami and after stopping off to see that Health 2.0 central in SF hadn’t collapsed, ended up in Seattle. I woke up early (had to get that in there to match the title) and hustled off to the main symphony hall because it’s the 25th anniversary of the Group Health Center for Health Studies. (The research arm of Group Health Cooperative of Puget Sound)

There the question of the day is, why haven’t integrated group practices (like Group Health & Kaiser) spread across the nation? And is there something that the new Administration can do to help make it so?

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