In a new report from the Pew Internet & American Life Project, Internet access for individuals with lower household income and educational attainment is in the range of 61 percent. It’s interesting to note that until recently, this was the overall Internet penetration rate for all Americans (it’s now at 76 percent). The former percentage for all Americans (63 percent) was enough for many health care organizations to pursue connectivity with patients in higher education and income brackets. Now that everyone has reached this plateau, perhaps this access should be universal across health care.

The report also includes useful insights into the role of libraries in our communities. There is a great opportunity to integrate libraries into our health care system as a key agent of Information Therapy applications.

The low-access (no access or Dial-up only) group is potentially a core group of customers for the nation’s public libraries. Although they are less likely in general to use the the library than the high-access group (39 percent vs. 61 percent), those with low-access are equally likely to turn to the library for help with their problems (health care, paying for health care, and government benefits).

Prior to my move to Washington, DC, I did some work with Seattle Public Libraries (see A Dialogue at the Public Library about Internet-enabled Care). The ground is fertile for this collaboration.

This is a short paper produced by the Information Technology and Innovation Foundation about the state of health care, health care information technology, and recommendations for the future.

I have been following a growing movement to prioritize health information technology before health information exchange (”HIT before HIE” - see my link cloud here). This paper adds to the conversation by making a bold statement:

The strategy of build the network from the bottom up by establishing many regional health information organizations (RHIOs) throughout the country is not working.

The overall tone of the article is not negative, though, which is what I liked about it (as any glass 3/4 full person should). Beyond the statement, there’s a nice summary of HIT efforts to date including the postulated improvements in access, quality, and cost. There’s a discussion of what leading edge organizations are doing, such as Kaiser Permanente, along with information about smaller practices, which I thought was well balanced. Finally, a discussion of the possibilities offered by health record banks is included. These provide a different strategy, one which I have been interested in for some time. Given that we now have organizations that are regularly sending aggregate data from their EHR systems to public health departments to improve disease surveillance, there may be a model for consumers to direct their data to the trusted bank of their choice.

I think this is a balanced read that’s pretty informative. I think the fact that it’s written from outside the health care industry makes it more useful to experienced and novice informaticists.

PCHIT links for December 29th through December 30th:

• News Release: Electronic Health Records Still Not Routine Part of Medical Practice, Says New Study - Link to RWJF Report with best estimates of EHR adoption. No word on PHR adoption, but good framework for considering adoption of PCHIT, too.
• The Information Technology & Innovation Foundation: Mind the Gap - A very nice set of slides looking at differences in broadband and Internet use by income, ethnicity, gender and education.
• Oncologist Communication About Emotion During Visits With Patients With Advanced Cancer — Pollak et al. 25 (36): 5748 — Journal of Clinical Oncology - Oncologists infrequently responded with “continuers” when presented with empathetic opportunities by ill patients. How could the availability of a PHR impact this - what could an anlalysis of pre-visit/post visit secure e-mail show in terms of continuers for empathetic moments?

I’m starting to track the disruption of other industries, like music and real estate….

December 29th through December 31st:

• The Fleecing of the Avatars - The downsides of virtual worlds are starting to match the physical world.
• The Battle for Radio Royalties - Picture two dinosaurs. Both are wounded. And both are grappling with climate change that has weakened their ability to compete. Once they coexisted. Now they’ll do whatever it takes to survive?even if it means turning on one another.
• The RIAA Will Die in 2008 - Forecasting hard times for this industry protector.
• Number of Jobs Held, Labor Market Activity, and Earnings Growth Among the Youngest Baby Boomers: Results From a Longitudinal Survey Summary - Individuals born from 1957 to 1964 held an average of 10.5 jobs from ages 18 to 40.
• 12 Filtering Tips for Better Information in Half the Time | The Blog of Author Tim Ferriss - Nice overview of information management tools from the guru of efficiency. Tim Ferriss’ blog.