TeleMedicine Now

Do Medical Records Belong Online? New York Times Today.

Re “Your E-Health Records” (editorial, Feb. 1):

While it’s true that patient privacy and prurient commercial objectives can disastrously collide in electronic health records, the specter of doom camouflages other issues that demand consideration.

What about the outrageous cost of our health care system and the 45 million uninsured Americans? And the foreclosures and bankruptcy caused by medical bills? And let’s not forget that an estimated 100,000 lives are lost each year because of medical errors, and that there are large discrepancies in access to quality care across economic and geographic strata.

Electronic health records and patient privacy are not mutually exclusive. We cannot let concerns about privacy morph into paralysis. The stimulus package’s financing for electronic records will bring us technology innovation and job creation, better-educated patients, improved health outcomes and advances toward affordable personalized medicine.

Brent Gendleman
Reston, Va., Feb. 3, 2009

Link to New York Times Article

Obama Weighs into Electronic Health Records (EHRs)

Privacy Issue Complicates Push to Link Medical Data

New York Times

By ROBERT PEAR

Published: January 17, 2009

WASHINGTON — President-elect Barack Obama’s plan to link up doctors and hospitals with new information technology, as part of an ambitious job-creation program, is imperiled by a bitter, seemingly intractable dispute over how to protect the privacy of electronic medical records.

Representative Edward J. Markey said strong privacy protections were needed to prevent “a nightmare for consumers.”

Rahm Emanuel, the White House chief of staff-designate, said it was “essential” to protect personal health information.

Lawmakers, caught in a crossfire of lobbying by the health care industry and consumer groups, have been unable to agree on privacy safeguards that would allow patients to control the use of their medical records.

Congressional leaders plan to provide $20 billion for such technology in an economic stimulus bill whose cost could top $825 billion.

In a speech outlining his economic recovery plan, Mr. Obama said, “We will make the immediate investments necessary to ensure that within five years all of America’s medical records are computerized.” Digital medical records could prevent medical errors, save lives and create hundreds of thousands of jobs, Mr. Obama has said.

So far, the only jobs created have been for a small army of lobbyists trying to secure money for health information technology. They say doctors, hospitals, drugstores and insurance companies would be much more efficient if they could exchange data instantaneously through electronic health information networks. Consumer groups and some members of Congress insist that the new spending must be accompanied by stronger privacy protections in an era when digital data can be sent around the world or posted on the Web with the click of a mouse..

NYTimes - SlashDot

“Health information technology will succeed only if privacy is protected,” said Frank C. Torres, director of consumer affairs at Microsoft. “For the president-elect to achieve his vision, he has to protect privacy.”

Senator Sheldon Whitehouse, Democrat of Rhode Island, and Peter R. Orszag, director-designate of the White House Office of Management and Budget, said electronic medical records could be more secure than paper records.

“If the files are electronic,” Mr. Whitehouse said, “computers can record every time someone has access to your medical information.” But, he said, the challenge is political as well as technical.

“Until people are more confident about the security of electronic medical records,” Mr. Whitehouse said, “it’s vitally important that we err on the side of privacy.”

The data in medical records has great potential commercial value. Several companies, for example, buy and sell huge amounts of data on the prescribing habits of doctors, and the information has proved invaluable to pharmaceutical sales representatives.

“Health I.T. without privacy is an excellent way for companies to establish a gold mine of information that can be used to increase profits, promote expensive drugs, cherry-pick patients who are cheaper to insure and market directly to consumers,” said Dr. Deborah C. Peel, coordinator of the Coalition for Patient Privacy, which includes the American Civil Liberties Union among its members.

Electronic Medical Records today - where are we at ?

Found on Slashdot today

09/01/18/0451249 storElectronic Medical Records, the Story So Far- StupidPeopleTrick writes

"After the executive order signed in 2006, states are making strides with privacy breach notification but are struggling with enacting privacy laws and finding funding.
With looming deadlines to move to e-records and e-prescribing, where will the money and the privacy standards come from?"

"While the federal government is trying to coordinate the development of a National Health Information Network, state legislatures and governors have begun crafting innovative statewide health information exchanges, mandates, funding mechanisms, and privacy laws to move from a paper-based to an electronic health system.

The best thing about state governments' willingness to experiment is that their successes can be replicated by other states. For instance, in 2007, California passed a privacy bill that extended its financial data breach notification to the healthcare realm. Now, if there is a breach of health data anywhere in the state, healthcare providers must notify patients. The law also made clear that the data breach notification rules apply to personal health record vendors such as Microsoft and Google." David Raths

Find the nearest Hospital based on your Address

From LifeHacker.

Web site US Hospital Finder is a Google Maps mashup that finds the nearest hospital based on your address. Frankly, at first glance the results of the Hospital Finder don't net you all that much more information than searching for "hospital" on Google Maps proper. If you click on a specific hospital, though, you're greeted with an overview of all kinds of fascinating information, like mortality rates, number of beds, and patient ratings. It may not be a web site you'll use every day, but it's certainly interesting to learn more about your current hospital, and it may be worth a look next time you need to pick a new hospital.

US Hospital Finder: Find and search Hospitals

America's Best Hospitals 

Google Health not HIPAA Compliant

In my regular day I am constantly viewing various RSS feeds using Google's iGoolge page. So the irony of this is pretty exquisite.

One of the main feeds I troll on a regular basis is Slashdot, and just now I found a very interesting and relevant post regarding Google Health, which has been featured on this blog now for a few weeks. LINK to the original Slashdot article.

"Security researcher Robert 'RSnake' Hansen discusses numerous concerns with Google's new Google Health application, which aims to integrate user's medical records online. We discussed Google Health's opening to the public earlier this week. RSnake mentions that Google has found a loophole allowing them to provide this service without having to follow HIPAA regulations, which, combined with Google's track record of having numerous flaws leading to private information disclosure, draws serious concern.

The referring site is ha.ckers.org in which they bring attention to the fact that Google has left itself a legal out from the industry standard HIPAA protocol, which does not bode well for Google fanboys, like myself. I am hoping that this new scrutiny via the huge readership of the Slashdot will  focus attention to this very important  issue, if not stopping people from blindly putting up their medical information, at least  causing Google to re-examine it's position.

"Security researcher Robert 'RSnake' Hansen discusses numerous concerns with Google's new Google Health application, which aims to integrate user's medical records online. We discussed Google Health's opening to the public earlier this week. RSnake mentions that Google has found a loophole allowing them to provide this service without having to follow HIPAA regulations, which, combined with Google's track record of having numerous flaws leading to private information disclosure, draws serious concern.

LINK to the post on ha.ckers

Google Health Opens !

Google Health opened up to the public today after several months of private beta testing. The long-anticipated health records project now allows Google users to manage their doctor records, prescriptions, and test results, as well as find out information about drug interactions and search for new doctors. All you need is a Gmail account and a healthy dose of trust to get started with Google Health, although some are still skeptical about the terms of service.

Signing into the service is extremely simple. If you already have an account with Google (already required in order to use Gmail, Google Docs, Google Calendar, and the like), then you have already skipped a major step. This is also one of Google Health's possible downfalls, however, as it is now exceedingly easy for a hacker to discover someone's universal Google login (which, by the way, has no minimum requirement for secure passwords) and not just access their e-mail but their health records too.

Still, logging in and using the site is easy—"Google easy," one might say. Using easy-to-find links on the landing page or in the left-hand column, users can add their own personal information (such as date of birth, height, and weight), list out their existing medications and allergies, and, most importantly, import their medical records.  LINK to Ars Technica article

WebMD to merge with parent HLTH Corp.

Health information corporation HLTH Corp. has announced it will merge into its subsidiary WebMD Health Corp. in a deal valued at $2.31 billion.

Upon completion of the merger, HLTH shareholders will own about 80 percent of WebMD, based on the shares currently outstanding at HLTH and WebMD.

The transaction is expected to close in the second or third quarter of 2008.

WebMD's senior management team is expected to continue to lead the organization under president and CEO Wayne Gattinella.
Meanwhile WebMD Health Corp. posted 2007 results stating earnings of $48.3 million, or 81 cents per share, compared with $6.0 million, or 10 cents per share, a year ago.

The company, which provides health information through its Web site, said profit soared in the fourth quarter on a hefty tax gain and strong demand for online services.

WebMD's revenue for the fourth quarter and full year excluded about $1 million and $4 million, respectively, related to its offline professional medical reference and textbook publication business, which was sold on Dec. 31.

Patients' Health Records to be Stored by Google

SAN FRANCISCO (AP) - Google Inc. will begin storing the medical records of a few thousand people as it tests a long-awaited health service that's likely to raise more concerns about the volume of sensitive information entrusted to the Internet search leader.
 

The pilot project to be announced Thursday will involve 1,500 to 10,000 patients at the Cleveland Clinic who volunteered to an electronic transfer of their personal health records so they can be retrieved through Google's new service, which won't be open to the general public.

Each health profile, including information about prescriptions, allergies and medical histories, will be protected by a password that's also required to use other Google services such as e-mail and personalized search tools.

Google views its expansion into health records management as a logical extension because its search engine already processes millions of requests from people trying to find about more information about an injury, illness or recommended treatment.

But the health venture also will provide more fodder for privacy watchdogs who believe Google already knows too much about the interests and habits of its users as its computers log their search requests and store their e-mail discussions.

Prodded by the criticism, Google last year introduced a new system that purges people's search records after 18 months. In a show of its privacy commitment, Google also successfully rebuffed the U.S. Justice Department's demand to examine millions of its users' search requests in a court battle two years ago.

The Mountain View-based company hasn't specified a timetable for unveiling the health service, which has been the source of much speculation for the past two years. Marissa Mayer, the Google executive overseeing the health project, has previously said the service would debut in 2008.

Contacted Wednesday, a Google spokesman declined to elaborate on its plans. The Associated Press learned about the pilot project from the Cleveland Clinic, a not-for-profit medical center founded 87 years ago.

The clinic already keeps the personal health records of more than 120,000 patients on its own online service called MyChart. Patients who transfer the information to Google would still be able to get the data quickly even if they were no longer being treated by the Cleveland Clinic.

"We believe patients should be able to easily access and manage their own health information," Mayer said in a statement supplied by the Cleveland Clinic.

The Cleveland Clinic decided to work with Google "to create a more efficient and effective national health care system," said C. Martin Harris, the medical center's chief information officer.

Google isn't the first high-tech heavyweight to set up an online filing cabinet in an effort make it easier for people to get their medical records after they change doctors or health insurance plans.

Rival Microsoft Corp. (MSFT) last year introduced a similar service called HealthVault, and AOL co-founder Steve Case is backing Revolution Health, which also offers online tools for managing personal health histories.

The third-party services are troublesome because they aren't covered by the Health Insurance Portability and Accountability Act, or HIPPA, said Pam Dixon, executive director of the World Privacy Forum, which just issued a cautionary report on the topic.

Passed in 1996, HIPPA established strict standards that classify medical information as a privileged communication between a doctor and patient. Among other things, the law requires a doctor to notify a patient when subpoenaed for a medical record.

That means a patient who agrees to transfer medical records to an external health service run by Google or Microsoft could be unwittingly making it easier for the government or some other legal adversary to obtain the information, Dixon said.

If the medical records aren't protected by HIPPA, the information conceivably also could be used for marketing purposes.

Google, which runs the Internet's most lucrative ad network, typically bases its marketing messages on search requests and the content on Web pages and e-mail contained in its computers.

It's not clear how Google intends to make money from its health service. The company sometimes introduces new products without ads just to give people more reason to visit its Web site, betting the increased traffic will boost its profits in the long run.

Google begins testing health records system with Cleveland Clinic

Google plans to begin testing its long-anticipated health records project this week by partnering with an Ohio hospital group over the next couple of months. The pilot will involve transferring the health information of between 1,500 and 10,000 patients who have records at the Cleveland Clinic, which already has over 100,000 records stored in its own digital database. Patients will then be able to have access to their own records online, wherever they go (with an Internet connection), which Google thinks will help reduce conflicts in diagnoses and prescriptions between doctors.
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The pilot project is expected to last six to eight weeks, Google health VP Marissa Mayer told The New York Times, with a public launch expected sometime later this year. Patients will be able to approve the secure transfer of any number of records—from lab results to known allergies to other medical conditions—to Google's system, allowing them to take the records to another doctor or have them available while traveling. One doctor pointed out to the Times that many Cleveland Clinic patients are retirees that travel for nearly half the year, so the clinic's own digitized system isn't very helpful during that time. If the records are accessible through Google's system, patients won't have to worry as much about keeping accurate records on hand in the case of an emergency.

Google isn't the first company to dip its toes into the online health records pool. Microsoft managed to beat Google to the punch by launching a beta of its own health records system, HealthVault, last October. The system allows users to manage records for not only themselves, but also spouses, children, relatives, guardians, patients, and even pets. Information can be transferred directly from a healthcare provider like Google is doing with Cleveland Clinic, but it can also be uploaded directly from a PC, entered by hand, or transferred from a device (such as a glucose monitor).

Google did not give any indication as to whether its health records database would be tied into the same Google login required to access Gmail, Google Calendar, Google Docs, and other Google services. Hopefully it will not (or at least require an additional level of security), as privacy and security have become major sticking points for companies attempting to launch online health record systems. Microsoft's system requires both a Windows Live ID and a HealthVault account that are tied together and require complex passwords, and the company has a strict privacy policy about who can have access. That is, no one has access to your health records unless you specifically grant them permission, and Microsoft makes an effort to ensure that you know exactly what you're doing when you do so.

There is another issue that has skeptics doubtful that such an initiative could ever take off. The level of freedom allowed in Microsoft's HealthVault means that patients can enter (or omit) anything they want, meaning that any healthcare provider that bases diagnoses on what they find on HealthVault is taking a serious risk—the data available there is no more reliable than a patient survey at the doctor's office. We observed in October that a system that restricts write access to doctors, with patients being granted read-only access and the ability to request changes if they find inaccuracies, would be much more reliable.

There are not enough details about Google's system to know whether it will be implemented like HealthVault, though. From the description of what's happening with Cleveland Clinic, it sounds as if records will only be transferred by healthcare providers and not by patients themselves—if that's the case, then doctors can have a little more confidence in the information there. But with several months to go before Google's public launch, anything can change.

Cardiocom - preventive solutions

MINNEAPOLIS, MN — Cardiocom® Multi-Disease Management, an industry leading developer and manufacturer of remote patient monitoring equipment and disease management software, announced that it has entered into a relationship with Heritage Provider Network, Inc., a Management Service Organization (HPN, Inc.) extending over Central and Southern California service areas.  The two partners will combine the benefits of well-managed Medical Group/IPA networks, which offer value-added clinical resources to community-based physicians, with the innovative and cost-effective technology of an experienced telemonitoring company.  The overall goal is to improve the care and clinical outcomes of Heritage Provider Network patients.

            

“The Heritage physician groups are committed to providing quality clinical programs that empower patients to actively participate in the management of their clinical diseases in an effort to improve their health and life,” says S. Ian Drew, M.D FACP FRCP FACEP, Executive Vice President, Clinical Affairs of Heritage Provider Network, Inc.  “By using the flexible Cardiocom technology-based management solutions, we can offer new benefits to help people improve their self-management skills, remain in constant communication with their treating physician and reduce unnecessary emergency room visits and in–patient hospitalizations.” 

            

The Cardiocom Telescale® and Commander equipment are placed in the homes of HPN Network patients. The sophisticated software system provided by Cardiocom allows nurses at remote locations to monitor daily vital signs and health status of patients.  Nurse case managers intervene to provide education and coaching designed to assist HPN patients with the management of their chronic conditions.  The telemonitoring system enables physician groups to provide high quality care that follows national practice standards.