Electronic Health Records and your privacy

Electronic Health Records has been a hot topic ever since Obama's inauguration and the inclusion of $20b for EHR in the proposed stimulus bill. However, the patient privacy is issue is far from settled as yet and for the EHR to gain widespread adoption and result in the kind of healthcare cost savings that are being promised, it is imperative that the privacy issue is addressed at the earliest. I think the three key determinants here are:


1. A government willing to regulate and effectively enforce privacy laws
2. Heavy deterrent action against a few major privacy offenders

3. Putting in technology to address privacy


EHR does promise to be the largest IT initiative on the horizon and like many in the IT industry, I am rooting for it. But it's not only for selfish business reasons. As a healthcare consumer, I see the ridiculousness of the current system - doctors requesting other doctors for patient's records over the phone, records being sent out by fax (not the best way of ensuring privacy), no way of making sure you have the most recent records. We've lost a decade on this issue - EHR would have been big in the early part of this decade had it not been for the diversions that most of us regret now.

Your E-Health Records

As part of the stimulus package, $20 billion will be pumped into the health care system to accelerate the use of electronic health records. The goal is both to improve the quality and lower the costs of care by replacing cumbersome paper records with electronic records that can be easily stored and swiftly transmitted.
The idea is sound, but it also raises important questions about how to ensure the privacy of patients. Fortunately, the legislation would impose sensible privacy protections despite attempts by business lobbyists to weaken the safeguards.
With paper records the opportunities for breaches are limited to over-the-shoulder glimpses or the occasional lost or stolen files. But when records are kept and transferred electronically, the potential for abuse can become as vast as the Internet.
Electronic health records that can be linked to individual patients are already protected by laws that apply primarily to hospitals, doctors, nursing homes, pharmacists, laboratories and insurance plans. The stimulus bill that has passed in the House, and a similar bill awaiting approval in the Senate, would strengthen the privacy requirements and apply them more directly to “business associates” of the providers, like billing and collection services or pharmacy benefit managers, that have access to sensitive data but are not readily held accountable for any misuse.
The potential for harm was spelled out by the American Civil Liberties Union in a recent letter to Congress. Employers who obtain medical records inappropriately might reject a job candidate who looks expensive to insure. Drug companies with access to pharmaceutical records might try to pressure patients to switch to their products. Data brokers might buy medical and pharmaceutical records and sell them to marketers. Unscrupulous employees with access to electronic records might snoop on the health of their colleagues or neighbors.
The bills pending in Congress would go a long way toward preventing such abuses. They would outlaw the sale of any personal health information without the patient’s permission, mandate audit trails to help detect inappropriate access, and require that patients be notified whenever their records are lost or used for an unauthorized purpose. They would also beef up the penalties for noncompliance and allow state attorneys general to help enforce the rules — a useful backup in case the federal government falls down on the job. The House version would also encourage the use of protective technologies, like encryption, to protect personal medical information that will be transmitted.
Health insurance plans and some disease management groups are complaining that the new requirements would impose administrative burdens that could actually impede the use of electronic records and interfere with coordination of care. They want to ease the marketing restrictions, notify patients only if security breaches are harmful, and keep the attorneys general out of the enforcement role.
It should be possible through implementing regulations to fine-tune the privacy requirements so that they do not disrupt patient care. Congress must make every effort to ensure that patients’ privacy is protected.

New stimulus bill contains complete health IT act

The latest in HITECH is not what you think it is - it is the Health IT for Economic and Clinical Health Act. The act is part of the economic stimulus bill expected to be signed into law this February. It provides for a whopping $20 billion in health information technology spending - I realize a billion isn't what it used to be given all the numbers floating around in the current economic mess, but it still is more than pocket change :-)

The cornerstone of this Act is the emphasis on widespread use of Electronic Health Records (EHR) by doctors, hospitals, and payers. And for once it seems like even the privacy advocates like ACLU and others are lending support.

Read more here.

Technorati Tags: Electronic Health Records, EHR, EMR, HITECH, Health Information Technology

Solar Panels on White House

Wow! That was quick - less than one day since Obama's been in the White House and there are solar panels on the roof of the West Wing already!

Well, actually this picture is almost 30 years old - Jimmy Carter installed these back in 1979 - only to have these taken down by Ronald Reagan in 1986 (click here). Makes you wonder - what if? What if we had persisted with Energy Independence as the top priority? What alternate energy sources would we be using today? Would there  be much lesser pollution, lower cancer rates and decrease in other diseases, fewer wars fought over oil, .....

What if? That's such a potent thought.

Coffee Beans As The Next Great Auto Fuel?

Not only will the fuel be cheap, but the exhaust will also produce the wonderful aroma of coffee.

Scientists at the University of Nevada, Reno, researching the prospect of extracting oil from used coffee grounds report that the process is not that difficult. The cheap and environmentally friendly biofuel is abundant enough to potentially manufacture several hundred million gallons a year to power cars and trucks.
The idea was formed by accident says the chief researcher. “I had left my coffee out one night, and the next morning, I noticed that there was a kind of oil around the edge of the cup,” Mano Misra, a professor of engineering said. “Every cup of coffee has it. I decided to do some tests on the oil.”
The analysis proved that the grounds contained roughly 10 to 15 percent oil by weight. The researchers then extracted the oil with standard chemistry techniques and converted it to biodiesel.
For the study, the team collected leftover grounds of espressos, cappuccinos and other coffee preparations from the Starbucks coffee chain.
Being that the process is not particularly energy intensive, the researchers estimated that biodiesel could be produced for about a dollar a gallon.
According to the Department of Agriculture, the world’s coffee production is more than 7.2 million tons per year.
The study was first reported toward the end of last year in The Journal of Agricultural and Food Chemistry.

Fill 'er up with an unleaded cappuccino?

The resulting coffee-based fuel –which smells like java– is more stable than traditional biodiesel due to coffee’s high antioxidant content, according to the researchers.
“We have found that biodiesel created from spent coffee grounds is stable over a longer period of time than other forms of biodiesel that have been created from feed stocks such as soy and corn,” Misra said. “Biodiesel from spent coffee grounds is a low-cost ‘green’ form of fuel that shows a significant reduction of carbon dioxide emission. It’s an excellent source for biodiesel.”
One hurdle, Dr. Misra said, is in the organized collection of the spent beans. Therefore, the researchers plan on setting up a pilot operation this year using waste from a local bulk roaster.
It won’t be a complete fix for reducing America’s dependence on oil, but it can be a help while at the same time providing a nice aroma for those in the vicinity. The researchers report that the exhaust actually smells like coffee.
“It won’t solve the world’s energy problem,” Dr. Misra said of his work. “But our objective is to take waste material and convert it to fuel.”

Stimulate Manufacturing, Not Consumption

I love this quote from Joel Kotkin's article, "we have deluded ourselves into believing that a small number of "creative" alchemists--software engineers, hedge fund managers, urban developers--could transform code, cash and condos into limitless pots of gold. The huge winnings of these few would then allow the rest of us to spend like teenagers on a borrowed credit card, consuming everything made by the hard-working fools abroad."

Read on...
http://www.forbes.com/2008/12/29/manufacturing-productivity-stimulus-oped-cx_jk_1230kotkin_print.html





New Geographer
Stimulate Manufacturing, Not Consumption
Joel Kotkin 12.30.08, 12:01 AM ET

As store earnings plunged last week, the National Retail Federation proposed that the country create the mother of all sales by suspending taxes on all purchases. These tax holidays would occur in March, July and October and be national in scope.

The bill, they suggested, should be picked up by--who else?--the federal taxpayer, who would make up for the lost local revenues even for the five states without sales taxes. The rationale, suggests the Federation's chairman, J.C. Penney Chief Executive Myron Ullman III, in a letter to President-elect Barack Obama, would be "to help stimulate consumer spending as one of the first priorities of your new administration."

Now I can understand the manager at the local Target, Macy's or Nordstrom feeling a bit neglected as money pours out to prop up financial institutions and the Big Three. This proposed subsidy for mallrats, however, makes the previous somewhat-dubious bailouts look like good policy.

In fact, if there is one thing Americans do not need, it is yet another incentive to spend money they do not have. This has become a fixture of stimulus-think under the Bernanke-Bush regime. Remember the tax rebates earlier in the year? That was a big help, wasn't it?

Sadly, this "shop 'til you go bankrupt" strategy is being adopted by the new kingpins in Washington as well. Already you can hear Barney Frank, chair of the House Financial Services Committee, talking about a big stimulus to "prop up consumption."

This quick-fix approach has become a new genus of bipartisan madness. Like "the best minds of my generation ... looking for an angry fix"--to recall Allen Ginsberg's Howl--politicians and policymakers seem to feel we need some quick high to restore our battered economy.

Like a bad drug habit, reckless stimulation may make us feel better in the short term, but it could leave us shaky later on. To be effective over time, a stimulus plan must first address some fundamental challenges that have haunted the American economy for a generation.

Of course, there are countries that should be spending more. Places like China, Germany and Japan have gotten fat off our consumption. Now their beggar-thy-neighbor policies are backfiring as shopaholic nations, most notably the U.S., rein in their spending.

In contrast, our economy's failing stems from not producing nearly enough in goods and services to pay our bills. Our long-term weakness stems not from a shortage of consumer credit--the main obsession of Wall Street and both parties--but from the decline in manufacturing, growing dependence on imported fuel and deteriorating basic infrastructure.

Our consumption patterns--coupled with disdain for production--explain how our deficit in goods-related trade alone has soared over the past two decades from roughly $100 billion annually to over $800 billion. In the process, we have created an enormous shift in currency reserves to countries like China, Russia, India, Korea, Brazil and Taiwan. They produce and save too much; we consume and borrow too much.

Reversing this dangerous disequilibrium does not necessitate the end for American-style capitalism--as suggested recently by France's president, Nicolas Sarkozy--but instead a paradigm shift within it.

First, we need to swear off our addiction to hype-driven bubbles, seen first in technology and more recently in real estate. The fact that the government may be about to start yet another--this one colored "green"--suggests bad habits are hard to break.

Of course, bubbles certainly benefit some individuals and companies, most notably the financial sectors, who can best take advantage of wild speculative swings. The financial sector's share of profits more than doubled as a percentage of national income since the 1980s.

However, this pattern has not worked so well for most Americans, who have seen their wages stagnate or even fall. Most of us would benefit far more from robust growth that stems from productive industries like energy, fiber, food, logistics and manufacturing. Parts of the industrial Midwest, Texas and the Southeast have enjoyed expansions in these fields--until the onset of the recession, at least.

More important, productive economic growth creates demography far more egalitarian than the Namibia-like bifurcation that characterizes bubble centers like Manhattan and San Francisco. In fact, notes University of Washington demographer Richard Morrill, areas with greater concentration of these kinds of industries tend to suffer less inequality and offer better prospects for the average middle class worker.

Concerns over income equality should persuade Democrats--the supposed party of the people--to focus primarily on the basics of economic growth. This is precisely what we have not been doing for over a generation.

Just think of the billions sunk into convention centers, yuppie condos, performing arts centers and other ephemera. These produce some high-wage short-term construction and architecture jobs, but after that, they offer largely low-paying service work. Meanwhile the Chinese and other competitors dredge new harbors, build high-speed rail systems, new freeways and fiber-optic lines--the keys for pushing their economies to the next stage.

Sure, you can say, the Chinese are also hurting from this financial crisis. But at least they can pay for their own stimulus. The Germans, Russians and Japanese, for now, can also dip into their dollar reserves to pay for new infrastructure investment. In contrast, we will have to beg the money for our stimulus like some busted-up small-town bookie.

More serious yet, the real problem may be whether we even want to make the changes necessary to boost our economy. Americans were once masters of both innovation and production, but we have begun to fall behind on both counts.

Indeed, our policies no longer focus on such things as manufacturing and energy production, deeming them beneath our dignity. As early as the mid-1980s, the New York Stock Exchange issued a report baldly stating that "a strong manufacturing economy is not a requisite for a prosperous economy."

At the same time, we have deluded ourselves into believing that a small number of "creative" alchemists--software engineers, hedge fund managers, urban developers--could transform code, cash and condos into limitless pots of gold. The huge winnings of these few would then allow the rest of us to spend like teenagers on a borrowed credit card, consuming everything made by the hard-working fools abroad.

By now we should know better. Americans possess no monopoly on "creativity." Our suppliers abroad are using the billions made from selling us everyday stuff to help finance future moves up the value-added scale. You can see it in every critical field from aerospace, steel and pharmaceuticals to software services, fashion design and entertainment.

Americans can meet this challenge but not by goading the family to spend more at Wal-Mart. Instead, we need to remember what actually drives economic growth. The ultimate fate of the economy will not be determined in the malls, but in the mines, oilfields, farms, factories, design shops and laboratories of a more productive economy.

Joel Kotkin is a Presidential Fellow in Urban Futures at Chapman University and executive editor of www.newgeography.com. He is finishing a book on the American future and writes a weekly column for Forbes.com.

Technorati Tags: economy, manufacturing, consumption, bailout, stimulus, china, india, software, hedge funds