Health IT


Alice Lipowicz

Health IT

By Alice Lipowicz

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HHS Open Government Plan deserves a visit

I have to give the Health and Human Services Department credit for its Open Government Plan. The plan was bursting at the seams with lots of new ideas for government transparency and accountability, mostly in the form of new dashboards and datasets. So kudos to HHS for promoting open government!

Let’s talk about some of the details. For example, the new FDA-Track project has 40 online performance management dashboards; that’s right, 40. That is both impressive and, possibly, unwieldy; It takes quite a bit of scrolling around to get the full picture.

Looking over a few of the FDA-Track dashboards (which are still in beta mode), I read through many of the performance measures. Some were useful; others a bit esoteric. One of the performance measures for the Information Management Office is the percentage of IT outages resolved in three hours. I don’t know about the FDA but, at my house, the question of how quickly a power outage is resolved is beyond my control and in the hands of the utility companies. So it is not immediately clear to me how it is in the FDA IT department’s control to resolve power outages quickly. That’s a small quibble that is not meant to detract from what looks like one of the largest open government initiatives I’ve seen.

Next, I checked out the Centers for Medicare and Medicaid Services (CMS) dashboard after an FCW reader asked me to write about it. Well, after 10 minutes, I’m still trying to decipher the first three charts I looked at. It does not help that the charts are sprinkled with acronyms and jargon. It seems to me that the CMS dashboard is very ambitious in scope and designed for people with some familiarity with these datasets. I may come back to visit later, when I have more time.

Third, I visited the newly published list of HIPAA breach notifications from the HHS Office for Civil Rights. Technically, this is not part of the open government plan, but shouldn’t those principles apply across the board? It’s great that the breach list is published. But as for easily finding if there were breaches in my state, or with my own health plan, that wasn't possible. A simple chart format would have solved that problem.

Posted on Apr 20, 2010 at 7:25 PM0 comments


Food safety legislation may ladle IT money to FDA

Senate legislation that would boost the Food and Drug Administration’s capabilities to prevent, identify and respond to foodborne illnesses is expected to come to the floor within days. If the bill becomes law, does that mean there will be more money for FDA information technology systems? Most likely so, but you might have to read between the lines on that.

The House passed a food-safety bill last July. The Senate bill, sponsored by Sen. Dick Durbin (D-Ill.) had been waiting in the wings during the health care reform debate, but now is in line for a Senate vote. Durbin’s FDA Food Safety Modernization Act would give the FDA new authority, tools and resources, according to an April 11 statement from Durbin’s office.

“Today, FDA is working within the constraints of outdated laws, inadequate staff and not enough funding,” said Durbin. “The agency has been set up to react to outbreaks of contamination. My legislation would take the FDA to a new level by empowering the agency to prevent outbreaks. The bill gives FDA the resources and authority to quickly trace food borne illnesses back to their source.”

It also increases FDA surveillance of foodborne illnesses, access to testing records and results and FDA authority to do recalls.

According to a copy of Durbin’s bill posted in the Library of Congress database, standards will be set for the information, format and time frame for people to submit records about foodborne illnesses to the FDA. The legislation refers to use of “technologies, including existing technologies, that enhance traceback and trace forward.” It also refers to use of surveillance systems to improve the collection, analysis and reporting of data on foodborne illnesses, and increased participation in federal information-sharing in networks for that purpose.

However, the bill also is careful to say that “nothing in this section shall be construed as giving the secretary the authority to prescribe specific technologies for the maintenance of records.”

Later on, the bill states that increased capacity of FDA systems is aimed at “working toward automatic electronic searches”-- and that is about as close as it gets for a description of what types of FDA systems might be expanded under the bill. The legislation does not mention fancy new IT applications and IT system expansions—which might have scared off the small farmers that already are complaining that the legislation brings in too much new regulation and raises their expenses—but if you search for IT in the bill, you can find something.

Posted on Apr 14, 2010 at 7:25 PM0 comments


The emergence of the e-patient

 The National Library of Medicine wants to be part of the conversation on “e-patients.” So it made sense to Dr. Donald Lindberg, director of the library, to co-sponsor an e-patient conference on April 6 and April 7 on the National Institutes of Health campus in Bethesda. The event brought in experts and patients who are using social media tools and other health IT applications to help manage their care.

“I was struck by the patients going after the information on the Internet. They deem themselves e-patients,” Lindberg told me. “Call if chat groups or whatever, the patients get helpful information from each other.”

The focus of the e-patient conference was on personal health records and personalized health care, Lundberg said. The national library can help with developing technical and vocabulary standards in those areas, he said.

What else should government do? I asked him.

“It should stand back,” Lindberg said.

I could not help noticing that relatively few vendors appeared to attend the event, in contrast to other recent well-attended health IT conferences. I asked Dr. Andrew Balas, board member of the Friends of the National Library of Medicine, also a co-sponsor of the event, whether vendors were more interested in electronic health records (EHRs), rather than personal health records (PHRs).

EHRs are used by doctors’ offices and institutions, while PHRs are used by patients to access their own records. The bulk of the $20 billion in economic stimulus law funding goes for EHRs.

Balas said personalized health care covers more than just PHRs. It is a set of technologies, including genomics, that allows for personalized care. And there also is some convergence with PHRs and EHRs, he added.

“You can talk about PHRs, or EHRs, or about patient access to EHRs,” Balas said.

Posted on Apr 08, 2010 at 7:25 PM1 comments


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