April 5th through April 8th:

• Headzoo » WP Anti-Wares - Now it looks like we have to worry about insecure wordpress themes, too.
• Electronic Prevention - washingtonpost.com - Nice writeup of the New York PCIP program. What the writer doesn’t realize, is that a patient portal is coming, so a visit isn’t always going to be required….
• Jack and Suzy Welch: Leader vs. Manager - ‘We’d wager it only comes into play when you don’t want to offend an employee who crosses t’s and dots i’s but couldn’t excite a busload of kids bound for Disney World. In such a case, what do you say? You got it. “You’re a good manager.”‘
• Generation Y’s Bad Rap - It’s not really that bad, according to Jack Welch. I agree.
• The National Physicians Alliance encourages all doctors to join our Unbranded Doctor Campaign — a national network of physicians committed to reducing the influence of pharmaceutical marketing on our profession. - NPA appears to be a grown up version of AMSA. They include consumers in their governance
• Macworld | Mac OS X Hints | Add more power to 10.5’s screen sharing - Economical screen sharing alternatives using Leopard
• Total Value, Total Return: Invest in Health Management Programs -
• Office 2004 for Mac Solution Center - Office 2004 downloads for Mac. Time to upgrade

A lot of stuff going on this week…

• Apple Digital Fitness Companion System? - Mac Rumors - It was/is only a matter of time. Hello Health2.0, courtesy of iPhone
• The computer will see you now | Economist.com - A nice biographical piece about Larry Weed, father of the problem oriented medical record.
• EMC, Partners collaborate on hypertension program - Daily Business Update - The Boston Globe - An employer that thinks about population health and sets up a PHR in concert with a health system. Interesting…..
• Subscribe to ringtones via iTunes - Easy way to get ringtones - a ringcast?
• Mashable?s Guide to Upcoming Web 2.0 Conferences - A plethora of get togethers to get up to speed on the latest in Web 2.0.
• leanblog.org | Lean Blog: The Waste of Handwritten Notes | Lean Manufacturing | Lean Healthcare | Toyota Production System - Yes, Leadership. From patients and their families too. The kind of leadership that brings the patient perspective into every conversation.
• Apple - Support - Downloads - MacBook, MacBook Pro Software Update 1.1 - Help with keyboard freezing issues caused by Leopard
• Healthcare 360 -
• GHI - GHI Medical Home Pilot - I think this is very promising for supporting EHR adoption and patient access to their own clinical information. Ties in very nicely with NYC’s PCIP project.
• Public health system struggles to reach gay ?hidden population? - Washington Blade - Another vulnerable population that could benefit from outreach - many are underserved even when well insured.
• Cocoa Programming for Mac OS X - The resource for programming on MacOSX, and iPhone as well

March 4th through March 6th:

• Steve Jobs speaks out - On his marathon Monday meetings (9) - FORTUNE - a weekly check and adjust at Apple
• S.F. equity firm launches health initiative with CalPERS, GE, others - San Francisco Business Times: - Maybe this will help California lead in Health IT.
• AMNews: March 10, 2008. Insurer finds EMRs won’t pay off for its doctors … American Medical News - Less health plans are requiring EHR adoption for P4P, and the AMA doesn’t have a policy requiring physicians to adopt them either.
• Virgin HealthMiles - As demonstrated at Health 2.0 - a pedometer program that includes a pedometer that uploads data to the Virgin HealthMiles website
• i2y - As featured at the Health 2.0 Conference. For the 68,000 GenX and GenY individuals who are diagnosed with cancer every year.

United Hospital Fund, Empire State Building, New York City

On our last day in New York City, Rachel and the United Hospital Fund arranged for a presentation on patient-centered health information technology to the New York Business Group on Health, at UHF-NYC headquarters in the Empire State Building.

As I do with most presentations, I started with a thought provoking question, and this day’s was “When was the last time you looked at your medical record?” The responses, as expected, were extremely varied. Most had never seen their medical record, or seen it in disconnected parts. There were some answers that went like this: “I have seen my claims data in a PHR, but not my medical record.” I thought it was interesting that people were able to differentiate between claims data and a medical record.

At the same time I said, “I wouldn’t be here talking about this if I didn’t think you could do it,” and I meant it. As I posted previously, New York is having great success implementing EHR’s through their PCIP project, and are about to add patient access to these systems. A strong purchaser community can bring the next level of integration - that of a wellness ecosystem.

Several audience members pointed out, accurately, that there are things that can be done in an integrated health system that cannot be done in a dis-integrated one. At the same time, there was sharing of some innovative projects that are happening in the health plan community as well as the purchaser community. I left as impressed with the possibilities as I was when I came.

When I looked out the window at the brewing snowstorm at the end of my talk, Rachel reminded me, “You’re still going to Queens.” Of course I was, and I’m glad I did. More on that in the next post.

I was fortunate to speak recently with Paul Grundy, MD, MPH, the director of healthcare technology and strategic initiatives at IBM, about the work he is driving as the chair of the Patient Centered Primary Care Collaborative. Through the magic of Web2.0, I first picked up word of Paul’s work via this post on the IBM HealthNext blog, and since then have participated (in one meeting last summer) and watched as the movement has gained traction.

I chose Patient centered health information technology as manageable scope for a sabbatical; the ultimate goal for a career is patient centered care that respects patients, their communities, and those who serve them.

Paul sent along his thoughts on patient-centered primary care, and I am reposting them here, for others to read. As I have listened to Paul and his colleagues and compared it to my own experience studying Informatics and process improvement methodology, I have become acutely aware of not just the value stream within health care. I am aware of the value stream for a person in society, which is to achieve their life goals through optimal health.

When I wrote about my visits to work sites, like Genie Industries in Washington (see: “Overwhelmed with Possibility,” DailyKaizen Blog, July, 2006) and the NUMMI Plant in California (see: “NUMMI, Fremont California,” DailyKaizen Blog, August, 2007 ), it has become clear that our role is as the support system for these individuals, who are providing for themselves and their families, and finding fulfillment in their lives, through optimal health. The medical center is just a stop on the journey, not the destination. Employers add this perspective to our work and can assist in having our health system reflect this ideal design.

Paul’s words are below. As usual, your comments are welcome.

Read the rest of this entry »

PCHIT links for December 24th:

• Life as a Healthcare CIO: Standards for Personal Health Records - To prove a point about portability, John Halamka, MD, posts his medical record on his blog, in unstructured and structured formats.
• Health Privacy - Health Privacy 101 - HPP Releases Best Practices for Employers Offering PHRs. A good primer on PHR practices for employers.

PCHIT links for November 26th through November 28th:

• Are Your Patients Ready for Electronic Communication? - October 2007 - Family Practice Management - Nice story about a practice that learns its patients are ready. Helpful survey included
• The Digital Office - Special edition on PHR’s, from HIMSS
• Society for Adolescent Medicine: Advocacy/Policy - Position paper on confidentiality / privacy for teens
• Pacific Business Group on Health - Page on Building Healthcare Value - nice summary from the purchaser perspective