Ramblings: I seriously have to resume writing my book

I was working on a book (read blog post here) but it has been put on hold for some months now as I was busy with my day job.

As with all things with a deadline – it catches up so I reckon its time to resume writing the book, besides, I’ve only got 3 outstanding chapters before draft 1 is completed (after that, I have to ‘rewrite’ it).

The tough part is finding a ‘writing spot’. I initially thought I could use the office (of my day job)  after working hours but it would seem to be a non-viable option (still assessing the situation).

So thats the new goal for April and May – finish the book.

Wish me luck~

Ramblings: I was supposed to write an article today…

I blocked off some time (after 7pm) to write an article today and I did get started – with only 2 lines.

Do not get me wrong, I really wanted to deliver an article but a colleague (yes, I was still in the office) from another department walk over, pulled a chair, sat down and played ’50 questions’ (which on hindsight, he has been asking the same old 50 questions every other day (occasionally a few times a day) over more than a month now, I think I was sub-consciously getting  irritated for having to answer them (out of politeness) again and again and again and again and again and again and again and again and again and…… you get the idea.

Interestingly, he also posted a few interesting questions which when put in context, was quite amusing, the first being – “why do I list my qualifications and CV in my ‘blog’, am I ‘selling’ myself”.

The first thing that came to my mind was – is the layout of  binaryhealthcare that bad? Granted that it’s not the ‘sexiest’ web portal around but it still  shouldn’t come across as a ‘blog’ (it was actually quite demeaning), and for ‘selling’ of oneself, one should use Linkedin.

So to set the record straight, this web portal is an information and  web-presence for a Social Enterprise named BinaryHealthcare which also performs consulting services (mostly for free as a form of contribution to a noble cause) as well as serving as a collaboration platform (including consultancy firms, professional societies, other social enterprise of similar goals, educational institutes etc) and as with other thought-leadership providers, one would place a simple biography online to demonstrate credibility.

The other interesting question posted was that shouldn’t I exercise caution since I ‘proclaim ownership’ of Project CLEO (for my ‘day job’) given that in the  event that the project is not awarded, my personal reputation would take a hit  (see old post here – which I don’t think I ‘proclaimed ownership’ but rather shared that I am very excited to be part of this excellent opportunity).

Personally, I do not share the same thoughts because as the Business Manager of the Healthcare BU of my current day job, I will take full initiative to try and secure the bid from all possible angles and we all know that in the fair game of tenders, nothing is guaranteed – the best technology doesn’t always get implementation (maybe due to price) and the lowest price doesn’t always secure the bid (maybe due to technology), of course there are many more factors at play but I am quite amuse that the perception of one being possibility ‘stigmatize’ due to such reasons because a tender bid is the work of the entire bidding team and most importantly – if the pro-offered solution is a suitable fit in comparison to other bidders).

So there you have it – no article was written although the time was allocated  and ‘spent’ but I promise that if a similar situation happens again, I will politely ask the colleague  to ‘go away’.

Now to clear some emails 🙂

Dell announces new data archiving system

I chanced upon this from healthcareitnews.com, it is basically ‘yet another’ medical storage device.

ROUND ROCK, TX – Healthcare IT is booming. But one of the biggest challenges facing hospitals in the adoption of new technology is finding storage capabilities for the growing profusion of data from EMRs and ever more sophisticated medical imaging. Not to mention meeting regulatory requirements that dictate how that data is managed and archived.

“Hospitals expect a 20 to 50 percent growth in storage [needs] over the next two years,” says James Coffin, VP and GM of Dell Global Healthcare, in an interview with Healthcare IT News.

“The problems are getting exacerbated,” he adds, “not only by new modalities but also by things that are coming down the pike, like genomics and proteomics, and also areas like digital pathology. Hospitals do between hundreds and thousands of studies a day in radiology — but in areas like pathology they do tens of thousands of slides a day. Having to store that data digitally is going to be a huge challenge going forward.”

On Wednesday, Dell announced a solution to enable hospitals to better manage this flood of data that, Coffin says, is a “new storage model for healthcare.”

Dell’s object-based Medical Archiving Solution, which is based on the upcoming Dell DX Object Storage Platform, allows healthcare organizations to efficiently access, store and distribute data while meeting regulatory guidelines.

This is accomplished via:

  • Intelligent, policy-driven storage that uses metadata to automatically manage the length and location of content storage, reducing IT overhead and helping to avoid human error.
  • Open, industry-standard access protocols that allow organizations to choose their preferred independent software vendor platform.
  • A self-managing, highly available “nearline” archive for medical content, engineered to provide seamless integration of future storage technology.
  • Alignment of data with the appropriate storage to help lower expenses.

“We’re really trying to build a new way of archival and retrieval of data,” says Coffin. “Hospitals have traditionally taken a one-size-fits-all approach to this: storing the data on the front end in high-end storage subsystems, and on the back end on tape.

“That’s been a pretty cost-effective method,” he continues, “but frankly what’s ended up happening is they move everything to front end storage because they want instant access to it. We’re looking at ways of building a new dynamic data model that allows you to store the data on high-end storage but deliver the cost model they need in order to drive growth.”

Because, Coffin points out, “IT budgets are not increasing at the rate of storage needs for the industry.”

This new paradigm, says Coffin, will “allow us to build unlimited file systems that will allow us to store data … into the hundreds of petabytes.”

Moreover, he says, with “these vendor-neutral archives, it doesn’t matter who the PACs vendor is. Data can be stored in a vendor-neutral way and can be accessed by any of the vendors moving forward. That’s a big advantage for the hospital, as they don’t have any of this lock-in from the big software vendors.”

“Growth in the use of imaging in diagnosis and treatment, and the sophistication of digitized images, coupled with the storage requirements of the burgeoning EMR space, are putting a major strain on hospitals’ storage infrastructures,” says Judy Hanover, research manager, IDC Health Insights. “There is need for solutions like medical archiving that help hospitals deal with storing and accessing patient data and images in a way that is cost-effective and manageable for the long term.”

Non-medical staff ‘have access to health records’

I got this article from BBC News

At least 100,000 non-medical staff in NHS trusts have access to confidential patient records, claim campaigners.

Big Brother Watch, who based the figure on 151 responses from trusts, said it demonstrated “slack security”.

The group says hospital domestics, porters, and IT staff are among those with access to records in some trusts.

The Department of Health says the report muddles paper files and the newer electronic systems for which access will be strictly controlled.
Big Brother Watch asked every NHS Trust in the UK for the number of their non-medical staff who had access to confidential patient records.

Access was defined as being able to see at least a patient’s full name, date of birth and most recent medical history. No distinction was made between paper and electronic files.

The responses showed that 101,272 non-medical staff had access to records. This was an average of 732 in each trust.

Of the 194 trusts in the UK, 43 did not disclose any information or provide enough detail to be included in these figures.

Big Brother Watch says this demonstrates “slack security and monitoring around those with access to patient medical histories”.

Data concerns

Its director, Alex Deane, said: “The number of non-medical personnel with access to confidential medical records leaves the system wide open for abuse.

“Whilst Big Brother Watch has considered emergency, necessity and practicality concerns, we believe it is necessary to drastically reduce the number of people with access to medical records to prevent the high rate of data loss experienced by the NHS.”

The government is currently rolling out a medical records database for patients in England. It hopes to have 50 million records on the system by 2014.

Smartcards

A Department of Health spokesman said the report was “confused” and had muddled paper files, which potentially allow any member of staff to see confidential information, and new electronic systems which strictly control access to those directly involved in a patient’s healthcare.

“We have set clear standards for NHS organisations to adhere to on data handling, and have issued guidance that sets out the steps they must take to ensure records are kept secure and confidential,” the spokesman said.

“With the modernisation of NHS IT, access to electronic records is controlled by smartcards which allows all access to be tracked and audited so that, unlike paper files, any abuse can be traced and dealt with.

“When managed properly, it is not possible for an unauthorised member of staff to see clinical information.”

The Information Commissioner’s Office said it was vital that medical records remained private and that information was kept secure, accurate and up-to-date.

David Smith, Deputy Information Commissioner, said: “The NHS must ensure that robust criteria are applied to ensure the numbers of people who have access to medical records are kept to a minimum.”

“We will study the report carefully and will not hesitate to make our own inquiries with the NHS if further action is required,” he added.

Need to know

The trust with the highest number of non-medical staff with access was Sandwell and West Birmingham, with 2,487.
It spokesman, Nick Howells, said its figure was high because it had included health care support workers, who are not qualified nurses but work in frontline patient care.

He said the report failed to recognise that many people who work behind the scenes, like medical secretaries, pharmacy workers and clerical workers in areas of bed management need access to patient records in order to run the hospital.

“The Trust does take its responsibility to protect the confidentiality of patient notes seriously and, for all of those who have access to patient notes, that access is controlled so there are different levels of access on a need-to-know basis,” he added.

Big Brother Watch is a group which campaigns on privacy issues and was set up by the founders of the TaxPayers’ Alliance.

LUMEDX’s CardioPACS Integrates Philips Ultrasound Software

LUMEDX, Oakland, Calif, announced that its CardioPACS imaging solution has a new interface to QLAB, proprietary ultrasound software from Philips Healthcare, Andover, Mass.

Philips’ QLAB advanced 2D and 3D ultrasound quantification tools is now able to be easily integrated with CardioPACS. Radiologists can now launch the QLAB application directly from the image while within the CardioPACS application.

“We are committed to supporting interoperability with other vendors, and LUMEDX CardioPACS interface to our QLAB ultrasound application is a manifestation of our connected workflow strategy,” said Neal Grotenhuis, cardiac ultrasound product manager for Philips Healthcare in the joint announcement.

“We recognize that not all customers will have a single vendor lab and are more likely to choose equipment from vendors who work with each other to improve connected workflow. Having a customer-focused approach and a cooperative strategy with other vendors enables clinicians to choose equipment that best meets their needs based on clinical features, value and workflow,” he added.

The new interface also eliminates the need to send the images to a stand-alone laptop or workstation for quantification and thus improve workflow.

Still a Radiology Shortage? Perhaps Not.

Feeling overworked? An updated study using 2007 data was just published in the March issue of the American Journal of Roentgenology (AJR) and indicates that the radiology shortage may have abated.

The study, titled, “Who’s Underworked and Who’s Overworked Now? An Update on Radiologist Shortage and Surplus” by Soni, Bhargavan, Forman, et al, indicates the radiology shortage that was widely reported earlier in the decade may have abated.

According to the abstract, the researchers specifically were trying to determine “the extent to which radiologists desire less or more work if their income were to change by the same percentage as their workload.”

Soni, et al looked at data from the ACR’s 2007 Survey of Diagnostic Radiologists and took into consideration variables, regions, subspecialty, size of practice, and other factors. Comparisons were subsequently made to the ACR’s 2003 Survey.

What the researchers found was that the overall balance between the demand and the supply of radiologists shifted toward a surplus between 2003 and 2007. In fact, they calculated a 3% overall surplus of radiologists in 2007.

“The employment market seems generally, but not universally, to self-correct relative shortages and surpluses in individual geographic areas and subspecialties within a few years,” concluded the researchers.

Ramblings: I visited my family doctor today

I visited my family doctor today – as a patient, which I must say has been interesting because I took the opportunity to observe the workflow of the Clinic on a Monday (I waited 1 hour before I got to see the doctor and I utilized the time by reading the materials for the Certified Six Sigma Green Belt certification) and that opportunity gave me deep insight on how to better develop the product as well as marketing and branding aspects.

What was more interesting was when I took the opportunity to engage my family doctor on the topic of how a Practice Management System (PMS) and an effective Electronic Medical Record (EMR) can help a clinic achieve operation, workflow, clinical effectiveness as well as the business aspects of running a clinic. The conversation brought me further insights as well as horror stories – the doctor had to close down his clinic for an entire day the last time his existing PMS ‘broke down’.

I also took the opportunity to gain insights from the Clinic Assistant while waiting for my receipt (and medical certificate) and I must say, the primary care market is an interesting segment with lots of untapped potential, there are so many avenues to be improved with effective implementation of IT and I’m glad I’m in a position to help bridge the gap.

Thats it for now (time for me to catch on some sleep, after all, I am on medical leave 🙂

Eclipsys, Microsoft ink health IT deal

Eclipsys and Microsoft have signed an alliance agreement to offer the market integrated health IT solutions designed for physicians, nurses and hospital administrators to gain insights from data aggregated from multiple clinical and financial systems across the hospital.

Under the agreement, the companies plan to integrate components of Eclipsys’ Sunrise Enterprise suite of software applications with Microsoft’s Amalga Unified Intelligence System, a data aggregation platform that integrates clinical, administrative and financial data from disparate information systems. The integration will serve to increase the analytic capabilities that the Atlanta-based Eclipsys can provide to its clients, while making it easier for a healthcare organization to connect disparate data repositories, the firms reported.

According to the Redmond, Wash.-based Microsft and Eclipsys, the agreement will leverage open technology platforms and build upon Eclipsys’ use of the Microsoft .NET platform technology to deliver its software applications. The alliance with Microsoft coincides with Eclipsys’ plan to open up its solutions platform technology beyond its client base. Eclipsys’ clients have long had the ability to build applications on the Eclipsys solutions platform, and since 2003, Eclipsys’ clients have created approximately 2,000 medical logic modules and ObjectsPlus/XA applications that work with Eclipsys software, the companies said. The Microsoft agreement is part of Eclipsys’ open platform initiative, by which the company is seeking to work with other industry participants and enabling third parties to develop new applications that work natively with Eclipsys solutions.

Researchers use light from LEDs to send data wirelessly

I picked this article up from Computerworld.com and I think its exciting news – fast data transfer (230Mbit/sec) using visible light from commercial light-emitting diodes.

Computerworld – Light coming from lamps in your home could eventually be used to encode a wireless broadband signal, according to German researchers.

Researchers at the Fraunhofer Institute for Telecommunications at the Heinrich-Hertz Institute in Berlin experimented with using visible light from commercial light-emitting diodes to carry data wirelessly at speeds of up to 230Mbit/sec.

Research into wireless data communications using LEDs has been going on for years, but the 230Mbit/sec. speed is considered a record when using a commercial LED, according to the Optical Society of America, an organization for optics professionals.

It could also be a potential answer to the shortage of radio spectrum bemoaned by the U.S. Federal Communications Commission and others, optical communications researchers say.

One of the German researchers on the project, Jelena Vucic, said there would be an advantage in using light to carry data over Wi-Fi or another system because the lights are already in a room. Her group’s findings will be presented at the Optical Fiber Communication Conference and Exposition/National Fiber Optic Engineers Conference on March 25 in San Diego.

A signal from an LED is generated by slightly flickering all the lights in unison at a rate millions of times faster than the human eye can detect, the OSA statement said. Commercial LEDs have a limited bandwidth of a few megahertz, but Vucic’s team was able to increase the amount tenfold by filtering out all but the blue part of the LED spectrum. The team built a visible wireless system in their lab to download data at 100Mbit/sec. and then upgraded the system to get 230Mbit/sec. Vucic said the team should be able to double the data rate again with some modulation adjustments.

In 2008, a separate team of U.K. researchers also explored using visible-light LEDs for wireless communications.

Sending data over fiber-optic cable at enormous speeds has been going on for decades. However, taking data transmission to an open environment such as a living room over light from a lamp would be an enormous step, and a challenging one, said Jack Gold, an analyst at J.Gold Associates.

Gold said the German research seems to show data transmission via light only in one direction and only in one room. In comparison, Wi-Fi and other radio transmissions are bidirectional and can pass through walls.

One practical concern in using visible wireless would be getting the data signal to the light itself, Gold said.

Five features missing from most EHRs

This is an interesting article from HealthCareITnews and I agree with  most of the points .

While EHRs are increasingly essential for healthcare providers, their efficacy can be constricted by the nature of their design, their use and the interpretation of data.

Jerry Buchanan, Program Manager and Scrum Master at eMids Technologies, Inc., an IT and BPO consulting company, weighs in on some features that are missing from EHRs:

1. Information, not data

While EHRs hold data, that’s not the same as holding information, Buchanan notes. Data needs to be converted into relevant information to be of practical use. However, there’s also the possibility that EHRs can get overloaded with information. The goal, Buchanan says, is technology that organizes data in a way that assists healthcare providers most efficiently and effectively in making clinical decisions. This includes EHRs capable of providing alerts and alarms about patient conditions, given to caregivers in real time.

2. Comprehensive health history

Buchanan says that clinical data is usually entered into an EHR after a health episode. He notes that a history of recorded episodes is not the same as an overview of someone’s health history. Some health systems are beginning to change this feature, propelled by the needs of chronic disease management, Buchanan says. Ultimately, it may be the standard for all patients.

3. Information tailored for various users

Who is the audience for the EHR’s information? Buchanan says information is most useful when it matches the needs of various recipients. For example, a cardiologist, a primary care physician and a nurse might have different needs when it comes to the type of information and the level of detail they seek about a patient. Ideally, an EHR would be configured to the needs of the individual end-user.

4. Tracking the transition of care

Appropriate patient care is not static — it must flow from one caregiver to another, from one facility to another. An EHR works better for a patient if it includes features that track tasks — such as giving medications, monitoring conditions and administering medical tests — to completion, and then reassigns them, if necessary.

5. Patient-side management of information

Buchanan says the ultimate EHR would give the patient — the consumer — the ability to manage just what health-related information (HRI) is available to which practitioners.