Ramblings: Losing Data can be painful

Something sad and painful happened yesterday – I accidentally wiped out all contacts and calender entries in my Dopod.


And to make things worst, I also deleted the backup.

Double Ouch.

So now I’ve trying to reconstruct items but its not going to be easy. I can already foresee alot of phone numbers gone forever. The calender part will be less tricky.

Losing data can be painful.

First ‘meaningful use’ definition proposed

Ladies and Gentlemen, may I present this article from Healthimaging.com on the first ‘meaningful use’ defination proposed.

The ultimate goal of an EHR that exemplifies meaningful use is to enable significant and measurable improvements in public health through a transformed healthcare delivery system, according to the Meaningful Use Work Group, which presented its first recommendations today on the evolving definition to the Health IT Policy Committee.

Members of the work group–including John Glaser, PhD, group chair and senior special adviser to the Office of the National Coordinator for Health IT (ONC) and co-chairs Paul Tang, MD, and Farzad Mostashari, MD–presented a draft description of meaningful use to the Health IT Policy Committee, chaired by David Blumenthal, MD, national coordinator for health IT, for full discussion and consideration.

A public comment period on the recommendations and discussion the meeting starts today, after which the Centers for Medicare & Medicaid Services (CMS) will spearhead the final rulemaking process. The public comment period will be open through the close of business on Friday, June 26. Instructions on how to submit public comment can be found at http://healthit.hhs.gov.

“This is the beginning of a conversation that is going to last for sometime,” Blumenthal said. “There is a long way to go before we get to a formal governmental posture on the definition of meaningful use.”

Blumenthal also noted that the definition of meaningful use must be ambitious and implementable in the 2011/2014 timeframe.

“We want a definition that is simple enough to be understandable, but specific enough to be meaningful,” he said. The work group’s hope with this first definition is to focus on where “we want to get to and how the definitions that we take into account today could get us there in the allotted timeframe.”

2011 objectives

The group focused on five categories of criteria and objectives when thinking about meaningful use in 2011:
1. improving quality, safety and efficiency and reducing healthcare disparities;
2. engaging patients and families;
3. coordinating care;
4. raising the health status of the population and
5. maintaining privacy and security of systems and data.

Specifically, under each category, the work group recommended that the key objectives for demonstrating meaningful use in 2011 are to:

Improve Quality, Safety, Efficiency

  • Capture data, such as problem list, active medication list, vital signs, patient characteristics, in coded format
  • Document progress note for each encounter (outpatient only)
  • Use computerized provider order entry (CPOE) for all order types; and
  1. Use of e-prescribing for permissible Rx
  2. Implement drug-drug, drug-allergy and drug-formulary checks
  • Manage populations
  1. Generate a list of patients by specific conditions (outpatient only)
  2. Send patient reminders per patient preference

Engage Patients and Families

  • Provide patients with an electronic copy of or electronic access to clinical information per patient preference
  • Provide access to patient specific educational resources
  • Provide clinical summaries for patients for each encounter

Improve Care Coordination

  • Exchange clinical information among providers of care
  • Perform medication reconciliation at relevant encounters

Improve Population and Public Health

  • Submit electronic data to immunization registries
  • Submit electronic reportable lab results to public health agencies
  • Submit agencies according to applicable law and practice

Ensure Privacy and Security Protections

  • Comply with HIPAA rules and state laws
  • Comply with fair data sharing practices set for in the National Privacy and Security Framework

Meaningful use framework

The group’s ultimate vision of an EHR is for all patients to be fully engaged with their care, and for providers to have real-time access to medical information and tools that ensure the quality and safety of the care provided, while affording improved access and the elimination of healthcare disparities.

“This ‘north star’ must guide our policy objectives, advance care processes needed to achieve them and lastly, enable the specific use of IT to produce the desired outcomes and our ability to monitor them,” the group noted.

They presented a meaningful use framework that is divided into three parts:
1. improved outcomes;
2. advanced clinical processes and
3. data capture and sharing.

“Health IT adoption and the collection of information is not the end in and of itself, it is simply the enabling mechanism for achieving the outcomes,” said Mostashari. “The largest contribution we can make with meaningful use is to provide an information infrastructure for healthcare reform, whether in clinical quality measurement for outcomes or care coordination to reduce readmissions.”

For example, demonstrating improved performance and reduced disparities in blood pressure control among diabetics that will require a host of new care processes for many outpatient providers, e.g., monitoring medication adherence, use of evidence-based order sets, clinical decision support tools at the point of care, as well as patient outreach and reminders. To use the tools that undergird these processes and monitor progress toward improved outcomes, information such as vital signs, problem lists, medications, procedures and lab tests must be digitized, queriable and trendable.

The goal is achieve continuously measurable results, in order to continuously improve the state of U.S. healthcare, said Tang, who is also chief medical information officer at Palo Alto Medical Group Objectives.

The group hopes to achieve that goal through a series of steps, including, “shifting from capturing data in a coded format and sharing it among those who need it, including patients, and toward using that platform to change our advanced care processes so that we are really focused on the patient and the patients’ needs. Finally, with that infrastructure in place, we will have the ability to measure and constantly improve our system.”

Transforming assessment metrics

“The journey to a transformed health system requires meaningful use of transformation-capable health IT,” Tang said.

While there are number of quality measures currently available, the vast majority are based on billing or claims data–which are limited in terms of accuracy and reliability, Tang noted. Instead of using these claims-based measures, the group has proposed to move some of them as being defined by clinical data out of an EHR.

“There are certain measures that we can take the definitions and change them into quality measures derived from an EHR,” he said, citing examples of the percentage of diabetics with A1c under control or the percentage of aspirin prophylaxis for patients at risk for a cardiac event.

“This is not only a system change, but a cultural change on the part of the provider,” he said. By changing the measures from claims-based to health IT-based, reporting on them “implicitly means you are using an EHR.”

Ramblings: So I took another course – Writing a non-fiction book in 30 days

Yup, I’ve enrolled in another course – “Writing a non-friction book in 30 days”. (I’m an educational junkie, I want to do a freelance journalism diploma next).

So what was I thinking of when I enrolled in this course? Do I want to write a book? Oh yeah 🙂

In case you have not noticed (or you are reading this blog the first time), I like to write. Although the most extensive pieces Ive ever done so far are articles, white-papers and my Master thesis, I’ve always wanted to write a book.

So has the opportunity finally arrived for me to write a book? Maybe 🙂 (more details in the near future).

Also, I reckon I can use the knowledge obtained from this course to help me in my doctorate thesis (that’s right, I’ve not given up on that goal yet, again more details in the near future).

So “writing a non friction book in 30 days”, maybe I’d  publish my book soon 🙂

AMA, Microsoft collaborate for patient-physician communication

This in my humble opnion, is an indication of “things to come”, the American Medical Association (AMA) is working to have patients and physicians exchange healthcare information by connecting via HealthVault, an application developed by Microsoft to store and maintain health and fitness information.

According to this article, the collaboration will allow physicians to access self-reported patient health information at the point of care, while enabling patients to access information that has been entered by the physician’s office.

With patient consent, physicians will be able to access a patient’s HealthVault record through a new physician Web-based portal that the AMA is developing with Covisint, a subsidiary of Detroit-based Compuware. The AMA portal, which is currently in beta testing, will provide physicians access to practice-related products, services and resources in a single location. The AMA said it plans to launch the portal in early 2010.

“Through Microsoft HealthVault’s connection to the AMA portal, patients will be able share personal health information with their physicians, who can make more informed decisions for improved coordination of care,” said David Cerino, general manager of the consumer health solutions group at the Redmond, Wash.-based Microsoft.

The AMA has been developing its portal for more than a year. The effort is aimed at helping physicians better meet their practice-related needs. Primary offerings will include: clinical resources, practice and revenue management tools, e-prescribing applications, EHR applications and professional development resources. The association said its portal will allow for personalized content, search capabilities and learning and networking opportunities that will not require great technological expertise to implement.

Ramblings: So I ‘cave in’ and got BlackBerry Connect on my Dopod

That’s right folks, I finally turned over to the Dark Side – I activated BlackBerry Connect on my Dopod 838Pro.

Was it due to my Managing Director’s constant nagging for the past two years? Partly.

Was it due to my business / personal needs? Partly.

Well, the fact is, I’ve been coping well for the past 2 years without a BlackBerry because I check my emails whenever I can (if I’m not sleeping at 2 a.m. in the morning, I’ll be checking my emails). However, there are times when I can’t get access to the Internet or the VPN server (for work), especially when I’m travelling or on the road, it can get difficult for work. Interestingly, I still reply more emails than most BlackBerry carrying staff who usually stays put in Singapore only.

However, in view of the potential in increasing productivity and an upcoming role change, I foresee a renew need to get my emails promptly (the burden of greater responsibilities) so I ‘cave in’ and got it activated.

So why not a BlackBerry Phone? Well for starters, I run tons of stuff off my Dopod 838Pro (E.g. Skype, a GPS) as well as write articles (well, the draft) with the OfficeMobile that comes with it so it does not make sense for me to swap it. (besides, the Dopod 838Pro is not really a phone, it’s a mini mini PC).

I do get asked alot on why I did not ‘upgrade’ to a new PDA phone (especially when the company policies state that they will pay for it). Well for starters, the Dopod 838Pro still serves me well. I bought the gadget in 2007 (more than 2 years ago) at SGD $1200, now at that time, the price of a decent netbook is lower, that’s how expensive this little ‘brick’ cost me (I paid it with my own money).

Over the years, the Dopod 838Pro has not only served me well but far exceeded my ‘usage capabilities’, for example, I almost never use the MP3 and MP4 player, video cam etc. In other words, its still ‘current’ for me, besides, it is bulid like a ‘tank’. I’ve dropped it several times from ‘great heights’ and aside from some scratches, it’s still working very well. Granted there are lots of new models with tons of fancy (and cool) features, the question I always ask myself is – “Do I need this feature?” (and this rule of thumb will serve you well when you evaluate healthcare informatics solution). Another good reason is Green Computing (need I say more?).

So am I not worried that I’d end up checking my emails even more often and hence, spending whatever little time (that is left) on unstoppable incoming emails? Well, the good thing about the BlackBerry Connect is that as with all applications running off WindowsMobile, it can be turned off, try doing that with a BlackBerry Phone 🙂

P.S. Turning the BlackBerry Connect does drain the battery out pretty fast. Ah well, one can’t have it all 🙂

Ramblings: My next (three) speaking slots are..

So life has been busy for… well, everyone (no exception for me) but lack of time is never really an excuse of a Certified Project Manager right 🙂 Of course, there are times when its beyond “human capabilities” but I usually pull things off (thankfully).

I received another invitation to speak for a conference in late July so I thought I’ll post up my next speaking slots;

  1. College of Radiology (Academy of Medicine, Malaysia) on the 25th June.
    The topic is not decided yet but its going to be on new technologies in PACS (radiology theme)
  2. HL7 Singapore’s Sharing Session on the 30th June 2009
    My topic is “Health IT Standards in the Enterprise – Effective Adoption for Workflow Optimization”
  3. E-health Conference in Singapore on the 31st July.
    The topic is not decided yet but the theme is ‘workflow solutions in e-health’

I also need to write a few articles (I got so much materials and topic on mind) but I reckon I first need to define my “Project Plan” first. If you need a speaker on healthcare informatics and related topics (be it in Singapore or not), just drop me a mail.

Ramblings: Philippine Heart Association 40th Annual Convention

Alright, its time to provide an update on the Philippine Heart Association held its 40th Annual Convention & Scientific Meeting. The convention took place on 27th – 29th May 2009 and the venue was the Edsa Shangri-La Hotel in Mandaluyong City, Manila Metro (which as you  can guess, is a beautiful hotel) . The event was well attended by over 2000 cardiologists (and some nurses).

The convention not only boosts a well-designed scientific program but also exudes distinctive Filipino culture, marked with colorfully costumes, refreshing entertainment and generous hospitality (the entertainment factor is definitely a score of ten!). 

As mentioned in my previous blog entry, I presented a lecture titled “Cardiology Informatics: An Enabler of Workflow Efficiency” at a corresponding lunch symposium and I really feel the interest from delegates on how effective implementation of imaging informatics can help improve their workflow and operational efficiency. This ‘ hunger of information’ was also felt throughout the entire convention. Although the initial reaction when they realise that its an ‘IT Solution’ was more of fear of the uncertainty but after sharing on the benefits and possibility of cardiology informatics, the intelligent questions starts flowing in.

Tons of opportunities emerged during this trip and I look forward to implementing some ideas in the Philippines (did I mention that its a beautiful country?)