A Health Information Exchange Conversation

Jon Udell:

Dr. John Halamka joins me for this week’s podcast. He’s a renaissance guy: a physician, a CIO, and a healthcare IT innovator whose work I mentioned in a pair of InfoWorld columns. Lots of people are talking about secure exchange of medical records and portable continuity of care documents. John Halamka is on the front lines actually making this these visions real. Among other activities he chairs the New England Health Electronic Data Interchange Network (NEHEN), which began exchanging financial and insurance data almost a decade ago and is now handling clinical data as well in the form of e-prescriptions. The technical, legal, and operational issues are daunting, but you’ll enjoy his pragmatic style and infectious enthusiasm.

A Lesson from Europe on Healthcare

David Leonhardt:

A few weeks ago, I wrote a column arguing that this country’s increased medical spending over the last half-century has, on the whole, been overwhelmingly worth it. Thanks to new treatments for everything from premature births to heart attacks, human life has continued to lengthen — defying expectations — even without major improvements in public health. Yet, strangely, we talk about medical spending as if it were nothing more than a drag on the economy, rather than an investment in the most important thing of all: our well-being.

I received about 500 e-mail responses from readers, and the most common reaction was a version of a simple question. “Why do Americans spend so much more than folks in most other developed countries while getting worse results?” as Sumati Eberstadt of East Greenwich, R.I., wrote.

In Greece, the government and individuals combine to spend about $2,300 per capita on health care each year, and the average life expectancy is 79 years. Canada, where the hospitals are probably cleaner, spends about $3,300, and people live to about 80. Here in the United States, we spend more than $6,000, yet life expectancy is just below 78.

Sharing Resources Worldwide

www.sharingresourcesworldwide.org:

It is our mission to make surplus and recycled medical supplies, durable medical equipment and related items/activities available to needy populations around the world in order to improve the health and quality of life of the recipients and to empower the recipients to live with increased dignity, independence, and hope.

This is how we Recycle Resources and Restore Hope… Around the world…..

Great local group.

Hackers Clone Human-implanted RFID Chip

DIGG:

This is the first time someone has cloned an human-implanted RFID chip The pair demonstrated the cloning process: Westhues held a standard RFID reader against an arm to register the chip ’s unique identification number. It actually has no security devices what-so-ever – VeriChip’s claims that its RFID chips can not be counterfited

Former Wisconsin Governor Tommy Thompson is (was) a director of Applied Digital Solutions, a firm that is promoting this technology.

Mute 19 Years, He Helps Reveal Brain’s Mysteries

Benedict Carey:

Mr. Wallis, 42, wears an open, curious expression and speaks in a slurred but coherent voice. He volleys a visitor’s pleased-to-meet-you with, “Glad to be met,” and can speak haltingly of his family’s plans to light fireworks at his brother’s house nearby.

For his family, each word is a miracle. For 19 years — until June 11, 2003 — Mr. Wallis lay mute and virtually unresponsive in a state of minimal consciousness, the result of a head injury suffered in a traffic accident. Since his abrupt recovery — his first word was “Mom,” uttered at the sight of his mother — he has continued to improve, speaking more, remembering more.

But Mr. Wallis’ return to the world, and the progress he has made, have also been a kind of miracle for scientists: an unprecedented opportunity to study, using advanced scanning technology, how the human brain can suddenly recover from such severe, long-lasting injury.

If It’s Good for Philip Morris, Can It Also Be Good for Public Health?

Joe Nocera:

“We don’t make widgets,” Steve Parrish likes to say, and that acknowledgment strikes me as a good place to start this story. Parrish, whose title is senior vice president for corporate affairs, is a highly paid executive at Altria Group, a New York-based holding company that is the 10th-most-profitable corporation in America. If the name of the company doesn’t strike you as terribly familiar, that’s because a few years ago the company changed its name. It used to be called Philip Morris, a name that still attaches to two of its holdings, Philip Morris USA and Philip Morris International. (Altria also owns Kraft Foods.) So, yes, let’s stipulate right up front: Steve Parrish represents the country’s leading tobacco company, whose best-known brand, Marlboro, is so dominant it accounts for 4 out of every 10 cigarettes smoked in the United States. Last year, Philip Morris USA alone made $4.6 billion in profits. What was it that Warren Buffett once said? “You make a product for a penny, you sell it for a dollar and you sell it to addicts.” They most certainly don’t make widgets.

Kraft is parent of Madison based Oscar Meyer Foods.

Clostridium difficile: Stalking the World

The Economist:

Ordinarily, the human colon harbours very few of the rod-shaped bacteria that cause Clostridium difficile associated disease or CDAD. But the guts of those people who are given antibiotics to prevent or treat infection during a stay in hospital are different. Antibiotics may rid the colon not only of harmful bacteria, but also of the beneficial ones that normally live there. This, in turn, can give C. difficile the chance to take hold.

Rates of the disease among patients in, or recently discharged from, American short-stay hospitals seem to have doubled between 2000 and 2003 and risen another 25% in 2004, the most recent year for which estimates are available. That translates into at least 225,000 new cases a year, according to the Centres for Disease Control, a government agency based in Atlanta, Georgia. As this number does not capture all of America’s hospitals and ignores its nursing homes, the real figure is probably at least 500,000 cases a year.

The full extent of the illness is unclear because American hospitals are not required to report it. Even when someone with the disease dies, his death certificate may not say he had it. Whatever the true numbers, about 20% of people infected have repeated bouts of the illness and some 1-2% of the stricken die; chiefly, but not exclusively, the victims are elderly people who are already in frail health.

Using Competition to Reform Healthcare

Michael E. Porter and Elizabeth Olmsted Teisberg:

The starting point for developing strategy in any field is to define the relevant business or businesses in which an organization competes. Health care delivery is no different. Health care providers do not think of themselves as businesses, but they are in the business of providing services to patients. (Those who are uncomfortable with the notion of businesses in health care can substitute the term service lines.)

The question “What business are we in?” is an important one because it guides an organization’s thinking about who its customer is, what needs it is trying to meet, and how it should organize. Implicit in every business definition is a view of how value is created. Aligning an organization’s view of value with actual value is a precondition for excellent performance.

In some fields, defining the relevant business is straightforward. In health care this is not the case, in part because of the way medicine has traditionally been structured and organized. Many hospitals, for example, see themselves in the “hospital” business or the “health care delivery” business, competing with other hospitals based on their overall service offering. An even broader definition of the business, “health care,” is common among experts in health policy. This leads them to favor large health systems, believing that health care is best organized by combining insurance and health care delivery into one vertically integrated, full-line system.