Denise Silber's eHealth

Digital economy: France invests for the future #health20fr

Nathalie Kosciusko-Morizet, the French Minister of the Digital Economy, is the motor behind a recent French law proposing a 4.5 B Euro budget,to "create wealth for future generations" via digital initiatives. This  begins by a public consultation ongoing til July 7. The envelope is divinded into two main categories: 2B for infrastructure and 2.5 B for services. There are 9 priority areas: cloud computing, digitization of content, digital technologies, smart grids, ehealth, network security, intelligent transport systems, digital city, e-education. The French government will invest and participate in co-financing of those projects that are the most advanced. Initial ongoing consultation is for the purpose of collecting and understanding "needs" before holding a public bidding on projects. ROI will be a determining factor.

 

Certification of EMR's: one or many standards bodies? #health20fr

Chris Thorman, The author of an interesting blogpost on the standards bodies related to EMR's contacted me and asked that I encourage my network to vote on his survey. Please read his post and vote!

Chris's question regards the future of the CCHIT, who used to be the single certifying body, designated by the Department of Health and Human Services, and now finds itself one amongst many both private and public. 

In August 2009, the "National Coordinator for Health IT, said that it would be in the best interest of the healthcare industry to have multiple entities certifying EHR software." So, what will happen to CCHIT?

Chris also points out the handy Health IT standards and testing site for those of you who are interested in the subject: http://healthcare.nist.gov/index.html

The subject is also interesting, because we've been complaining about the existence of a variety of standards bodies in the field of health care web site quality and how debilitating that has been for momentum. But EMR standards and web site quality are two different fields...To be continued.

Dermatology at a distance saves time, gets results #health20fr #health20

Dermatology studies showing that distance is as good, if not better than in person consultation are certainly not rare.

This Norwegian photo shows us Dr Schopf, who along with Dr Bolle, published a study demonstrating that consultation time dips from 20 to 5 minutes or less in 60% of cases, when the consult is prepared by a patient and handled online.

 Partners in Boston also published yet another study showing that results are equivalent at a distance in dermatology. In this study, patients learned how to take an appropriate photo and send them to their physician. There are many other  favorable dermatology at a distance studies.

Of course, we are not saying that all dermatology consultations should be done from a  distance, but undoubtedly far more than at the present time if we want to make good use of patients', physicians', and system resources.

Online consultation in US: reimbursement is becoming more common #health20fr

As the latest NYTimes article tells us, American patients are ready for online consultation, but it won't take off until doctors get paid for it. Take a quick look at the numbers

Crowdsourcing at the VHA: 26 Winning IT Innovations #health20fr #health20

Continuing in the crowd-sourcing, 2.0 mode, Silber's Blog is  particularly pleased to post this information about a completed crowd-sourcing competition at the VHA, who  remain near and dear since my mission to Tulsa and Washington DC a few years ago.

 The employees at the VHA submitted 26 winning ideas between February and May 28th when the contest winners were announced. 

These run the gamut from search engines to a  suicide hotline and a touchscreen device for nurse support.

6500 ideas were submitted. Then a  web-based voting method narrowed the submissions to a smaller group of finalists that were then judged by a panel.  

The panel consisted of 24 department employee and other distinguished participants, including Craig, the founder of "the" list, Dr. Harvey Fineberg, president of the Institute of Medicine; Dr. Robert Kolodner, health IT consultant (and former VHA CTO person); Dr. Mehret Mandefro, White House fellow; Dr. Stephen Ondra, VA’s senior policy advisor for health affairs; Peter Levin, VA’s chief technology officer; and, Todd Park, chief technology officer for the Department of Health and Human Services.   

Click for the 26 best of the 6500 !

Crowdsourcing : the Health 2.0 Developer Challenge! #health20fr #health20

Health 2.0 is proud to announce The 2010 Health 2.0 Developer Challenge, with support from the Department of Health and Human Services (HHS) and the Community Health Data Initiative (CHDI).

With newly opened government data sets and lightweight frameworks for rapid application development, we have a unique opportunity to participate in an ecosystem of data “suppliers” and “appliers” to build innovative tools to improve personal and population health.

Who can participate?
Government agencies, community organizations, foundations, healthcare and technology companies, software developers, UI designers, subject matter experts – all backgrounds welcome!

Organizations working on related efforts will be able to join the Challenge Consortium to share resources and success stories. For example, the National Library of Medicine (NLM) will be convening a community roundtable around their datasets, API, services, and user experience that will be incorporated into the Health 2.0 Developer Challenge.

How it works
Through a series of formal and informal “code-a-thons”, multi-disciplinary teams will work on specific solutions within priority areas identified in advance. The teams will compete in a stimulating environment to build real applications. And yes, there’ll be prizes (and food to keep you going)! A calendar of events will be available soon.

When and Where?
Health 2.0 will host a series of events leading up to the final Challenge during the Health 2.0 Annual Conference October 6-9, 2010, the culminating event of Health Innovation Week, October 3-10, in San Francisco CA.

How to get involved!
Stay tuned for an announcement of the Challenge Guidelines and a formal Call for Participation – but in the meantime we want to hear from you. To find out how to sponsor a challenge or join a development team, contact Health 2.0

French Ministry of Health Examining Adoption NHS Direct in France

While all the world's health systems share the same objectives of improving the health of their population, the regulation and organization of care is national and reflects many local factors (demography, genetics, environment, diseases, culture, resources, history of public policy...). Nonetheless, as many developed economies hit up on the same challenges of insufficient resources, budget deficits, unequal quality of care, benchmarking is becoming more common? The recent Health 2.0 Europe conference is a case in point of the potential synergies amongst European health innovators.

The May 20th edition of the French daily Le Figaro   explains a recent benchmarking development;  the French Health Minister is considering establishing a single govermental portal with a national telephone answering service akin to NHS Direct. The dual program would have several goals a)  to ensure the provision of quality information b) to reduce the inequality of population access to quality information c) to reduce unprogrammed visits to emergency rooms, thanks to nurse/patient phone conversations, distance medical consultations, and an appointment service,  d) to reduce the overconsumption of medications. 

But there are many factors to take into consideration.

The May 20th edition of the French daily Le Figaro   explains a recent benchmarking development;  the French Health Minister is considering establishing a single govermental portal with a national telephone answering service akin to NHS Direct. The dual program would have several goals a)  to ensure the provision of quality information b) to reduce the inequality of population access to quality information c) to reduce unprogrammed visits to emergency rooms, thanks to nurse/patient phone conversations, distance medical consultations, and an appointment service,  d) to reduce the overconsumption of medications. 

But there are many factors to take into consideration.

Cleveland Clinic #12 of Top 100 Creatives (Fast Company) with Dr Martin Harris

FastCompany

published its new top 100 creatives list, headed by  Lady Gaga, in case your wondering. Anyhow, it's a serious exercise and the first health care listing is none other than the director of the Cleveland Clinic, Dr Martin Harris,  number 12.

Dr Harris has worked with Google Health and Microsoft and let's not forget to mention recently with the stimulus package, thanks to the Obama White House..

I always like to point out the worldclass health information system at the Cleveland Clinic, its 6 million files, its scorecard for physicians approach, and of course its wonderful  social media policy with quite a few successes. Thank you @johnsharp for bringing Cleveland Clinic to our attention in this light. 

Health 2.0 Europe - European governments are moving ahead (report on the keynote session Fr, NL, DK) #health2eu

Is a keynote speech necessarily the highpoint of the conference for the audience? When the speaker is an international celebrity, if nothing else, the audience will have had the pleasure of seeing the speaker in person. But in healthcare where there are few global celebrities, the keynotes can be just as boring as elsewhere. Not so at Health 2.0 Europe, where you could hear a pin drop during the session.

As the organizer, I of course felt that we were proposing an exciting selection  with  Etienne Caniard from France, Pieter Vos of the Netherlands, and Morten E Petersen of Denmark. We would be taking the audience on a journey from a country that is just starting to recognize the important of Health 2.0, France, to the Netherlands that has finished a public consultation on the subject and even translated its report to English so that others can benefit from it around the world, and finally to one, Denmark, whose citizens can already access their electronic health record and exchange on a national portal, without knowing about the 2.0 movement.

However, I didn't realize just how well the chemistry would work amongst the speakers who had not previously appeared together....Read on for analysis, testimonials, slides the DUTCH REPORT on HEALTH 2.0 in English, and what is happening in the state of Denmark !

Health 2.0 Europe Paris: Denise's takeaway messages Part 1 #health2eu

Whether you attended the Health 2.0 Europe conference in Paris or not, if you're interested in the movement, whatever the name you use for it, you've been waiting to hear the results of the conference. In this first article, we'll look at  the takeaway messages. What did people learn? Well, this very much depends on what they knew going in. But we'll take a stab at answering nonetheless. Click for the important takeaways that the program could provoke. And come back soon for the next blogpost, where we'll work our way through the agenda. 

2001 Lancet article interview with Mark Bard, Denise Silber foresaw today's Health 2.0 sector

In preparing my notes for the Health 2.0 Europe conference in Paris April 6,7, I came across a 2001 article in which Marilyn Larkin interviewed Mark Bard and myself.

The article was written just after the crash of the first internet bubble.

If you read Mark Bard's and my comments, you will see that we both spoke of a second stage, where web sites woud go beyond content to practical applications

We were in fact predicting the arrival of Health 2.0

I in particular spoke of the "rise and fall and rise" of the internet health sector.

OK, so I wasn't expecting it would take 9 years to reach the level of interest we see today...But as they say in French, when you love, who's counting?

PS I'm sorry I'm printing this article from Lancet...But it is 9 years later...and for a good cause!  Téléchargement Silberlancet-page

A 2.0 Interview of Miguel Cabrer, MEDTING founder and ex digital hospital CIO

Miguel Cabrer founder of MEDTING, a global site for the exchange of  medical information and images, will be a panelist at Health 2.0 Europe in Paris. Formerly CIO of Hospital Son Llatzer, the first digital hospital in Europe (European Commission eHealth Award in 2004) and eHealth Coordinator for the Balearic Islands Health Department,  Miguel Cabrer is now an independent eHealth Advisor, Member of the HIMSS EMEA Governing Council and Member of the IMIA Web 2.0 taskforce workgroup.  Our Health 2.0 Regional Ambassador to Spain, Miguel even found the time to be interviewed!  

 

Denise says: Please tell us the main reason for a physician to use Medting?  

Miguel says: Physicians use Medting to share a clinical case with a colleague from anywhere in the world.  They also store images and videos, build clinical cases, and access content for research and learning purposes. Content can be restricted to invitees only.  A hospital or other organization can create its own extranet with the Medting Enterprise platform.  

Denise says: How did you get the idea that there was a need for these different functionalities?  Was it something you would have wanted  when you were working in a hospital?  

Web 2.0, BMJ, Braillon, Silber - Act 2

You recall that I learned about a French colleague's unfortunate "sacking" through a Dutch colleague's tweet of an article by a French author in BMJ and wrote about it on this blog and my French blog. This all led to broad 2.0 relaying of the story in France.

Chapter 2 is a somewhat happier story. Braillon and SIlber responded jointly this weekend to an article that Alain Braillon had noticed. And sure enough it was published online the same day and discouvered thanks to  a Google alert received this morning

Our response explained why we think that the FDA should not suddenly be recommending that patients fill in  lists of x-rays taken on a separate form, given the many alternatives for a relatively complete file online, not to mention the "meaningful use" incentive.

In any event, given how fast 2.0 communication is going, what are you waiting for? Isn't there something you need to publish?

(video) Health 2.0 Europe speaker : Mohammad Al Ubaydli Patients Know Best

Catch Dr Mohammad Al Ubaydli speaking about electronic health records. Meet him in person at Health 2.0 Europe.

Improving patient care with the EPR - Mohammad Al-Ubaydli from Mohammad Al-Ubaydli on Vimeo.

PHR's : 1 up, 1 down -- Microsoft HealthVault, Revolution

So, it's a big week in PHR-land.

• Revolution Health stops theirs for lack of users.
• Obama doesn't mention health IT in his State of the Union address.
• Microsoft Health Vault goes off to test European waters via Siemens in Germany.

Good thing the weekend is almost upon us...But that doesn't mean the news will stop. On the contrary, with all the tweeters, bloggers, etc, we're all having to tweet and blog, faster and faster to keep our platforms current.

Who can predict the physionomy of the PHR market? All I can say, is that it is sure to be hybrid. No big new national programs that ultimately bite the dust, despite Denmark's success. Long live innovation...We're waiting for the breakthrough and if we don't continue to innovate, phr's will remain imperfect for quite some time.

Microsoft HealthVault to launch in Belgium?

While  the definition of "meaningful use" is occupying some of the finest minds in official EMR-land in the US, things are also moving in Belgium, and Microsoft HealthVault may be approaching roll-out, according to the Francophone website of a patient association. The site reports that patients must partake in the pending debate on this subject. Here is the link to the  article in French by the president of the association.  And an extract from the article:

"Even though all of this seems to contribute to the centralization of medical data by the patient, who is the only one to decide to share the data with the entity of his or her choice, Microsoft HealthVault could represent a danger for Belgian patients. ... We think we should participate in the debates concerning Microsoft HealthVault to preserve the freedom of choice for patients (freedom to change vendors, suppliers, health management system...). Let us hope that Microsoft will guarantee the associations the right to follow the studies that may one day enable Microsoft to participate in the improvement in our country of the transmission of objective non commercial information about patients and their providers.

 Lucio Scanu

Personal health records are indeed progressing in many ways, shapes, and forms, in parallel to physician-initiated electronic medical record systems. Public and private organizations are venturing in many interesting directions.   Personal health records in Europe will be demoed and discussed with representatives from several significant initiatives from the US, UK, France, Netherlands at Health 2.0 Europe, Paris, April 6-7, 2010.Should you be attending, exhibiting, covering the conference? Contact me.

Terminology : EHR, EMR, PHR

Electronic health record, electronic medical record, personal health record -- We decided to see how frequent the use of the term has been over the past 50 years, with an advanced Google timeline search.

  

 

Communicate (animated film on you, your health, and the internet)

Free Wiki handbook on Medical Informatics and more: just out on Wikipedia in time for New Year's

The Wikipedia Handbook of Biomedical informatics is itself a gem "published" today, thanks to the wonderful new Web 2.0 world in which we live and in particular to the organizational  efforts of Pr Renato Sabbatini in Brazil. Read on for  the reasons to not miss out on this one!

Health 2.0 in Europe: Quotes & Testimonials

We've been reaching out and  collecting statements regarding Health 2.0 Europe from health care's finest in Europe.  Etienne Caniard from the National French Health Authority and Ségolène Aymé from OrphaNet, speakers at the conference raise some interesting points in this post. Click also for our Regional Health 2.0 Ambassadors from Europe.

Health 2.0 in Europe: Couldn't? Wouldn't? Does!

(first published on the Health Care Blog)

They said it couldn’t happen in Europe, that social media and online tools wouldn’t catch on, because the healthcare context was soooo different from the US. They said that Europeans don’t worry about access and cost, that they aren’t looking for information online because they they trust their doctors utterly and fully, and that European doctors don’t go online, except if they're Scandinavian. Well, it just isn’t so!

Adam Bosworth's Keas : most read article in NYTimes health section

 Keas the new health site that lets consumers set up personalized coaching plans was the most read article in the NYTimes health section on October 6/7, 2009.

The coaching is decision-oriented, ie decide to increase your exercise, stop smoking, change your diet, get a screening exam.

Keas starts with some solid assets: a well-known and respected founder, Adam Bosworth; the choice of the service which is the hot topic of participatory medicine, Esther Dyson and other investors, top flight partners:

--Google Health and Microsoft Health Vault, to automate the personal health record piece,
-- Quest Diagnostics for lab results,
--known content vendors

The business plan will evolve; the  free beta period will be followed by consumer subscriptions and purchase of expert advice from ... experts.

Can this service be globalized ? Here are some of the challenges:

Getting lab results online

Google Health and Microsoft Health Vault are not yet really implanted outside the US,

And here's another big one: the need to localize the healthcare information. The articles can't be simply translated. It would probably be cheaper to purchase existing local content and work from that.

And of course, varying privacy rules and legal requirements,

And finally, I'd venture to guess Keas will be busy enough in the first couple of years ensuring success in the US.

CHAM 2009 (Chamonix) : Text of Dr Ken Kizer's interview by Denise Silber

CHAM 2009 - Interview with Kenneth W. Kizer, MD, MPH, former Under Secretary for Health, U.S. Department of Veterans Affairs, and architect of the transformation of the Veterans Health Administration.

Robert Kolodner's farewell message: satisfaction in Health IT?

Robert Kolodner's farewell is a happy one, not a usual thing for those working in largescale health IT. But it is surely the satisfaction of a job well done and a concrete largescale result (the VHA system)

So, congratulations to Robert and fare thee well. Click for the text

Health 2.0 is going European with a conference in Paris : April 6/7 2010

At  last, a wish come true: you can attend a Health 2.0 Conference without leaving Europe. Save the date :  April 6 and 7, 2010 in Paris. The conference will be in English with French translation. Speakers will be European, American, and global... Health 2.0 has joined forces with Basil Strategies to produce this event.. So, don't be shy. Contact Denise Silber  about participation, speaker possibilities, volunteering, sponsorship. Earlybird opportunities now available. Click also for further details:

Tablet Mac was patented in 2004; medical applications soon to come?

The tablet mac was patented in 2004 but the blogosphere is just now buzzing with rumors about a tablet mac with EMR applications. One blogger in Texas Houston Neal, started the recent rumors by an interesting April post reflecting on the combination of iPhone touch keyboard and Mac technology and their potential for medical application.

Health 2.0: PHR & ODL (observations of daily living)

Health 2.0 Accelerator presentation #2 is about PHR's and ODL's: Rethinking the Power and Potential of Personal Health Records. One of the consequences of Health 2.0 is the realization that Personal health records (PHR's) should and will be more integrated. Why?  Because of the usefulness of ODL's (observations of daily living), since medical things don't happen during medical appointments, but in fact they happen all the time. The question is how to seamlessly integrate them into the clinical work flow. So, this is one of the emerging trends in the US. Research grants are available on this subject.

Health 2.0 Accelerator: Role of AHRQ in health IT explained by Matt Quinn

Matt Quinn, Health IT Expert at AHRQ is speaking at the Health 2.0 Accelerator in Boston.  AHRQ's mission is "improving quality, security, effectiveness, efficiency of healthcare for all Americans." Click for key points.

EMR in France: relaunch announced by Minister Bachelot April 9 2009, within the framework of a greater health IT program.

On April 9th, France's Health Minister, Madame Bachelot announced the relaunch of France's EMR or DMP (standing for Personal or Shared Medical Record; there is no term implying that it is digital, but it is). In 2009, various pilot projects are to be rolled out in different regions, to test value-added services including: a patient summary, follow-up for diabetes patients, cancer emr, electronic prescription, digital xray records, EMR for children. This is to be followed by a national roll-out in 2010. Not an easy task. Madame Bachelot explained a broader Health IT Strategy.