Archive for the ‘electronic health records’ Category

BTC — Imagine members of the hit reality TV show, Jersey Shore, unable to drive suddenly because they weren’t able to provide the right Papers.  What could be worse? If the network couldn’t hire them because of a technicality on their government issued IDs.

Here’s a follow up from Ed Hasbrouck, posting mail from a New Jersey citizen whose genius Garden State government went ahead with adopting Real ID compliant regs as law.

“I am a natural born citizen of the United States, born and raised in the State of New Jersey. I have lived here most of my life. I have never been convicted of a felony nor even a misdemeanor. I have never been arrested, nor even ever received so much as a parking ticket. I do not receive any funds from Welfare, Social Security, or any other government program. I am not a terrorist.

Yet, in the State of New Jersey, it is illegal for any employer to hire me, and has been for about the last 6 years.”


Here is second life for news that matters.

REAL ID Act making it hard for legal immigrants to renew driver licenses

TSA pat down despite medical ID card — Don’t miss priceless explanation from TSA’s Pistole-bot.

Austin PD bone up on social media, high tech crime investigations 

Ohio Appeals Court Strikes Down GPS Vehicle Spying

Internet firms co-opted for Internet [data] surveillance

No2ID reports the UK’s National Healthcare Database is still a threat to privacy

“NO2ID along with our friends in the NHS Confidentiality Campaign have
long argued that electronic records might well be beneficial to
patients, and many GPs are using them – but that is not the same as
creating a system where privacy barriers are torn down, and all
medical records are potentially available anywhere depending on
official whim.”

US Attorney General defends EU data sharing agreement

BTC –  There are quite a few really good action alerts worth working on if you’re active.  Here are link to a few I believe will make a difference.

*Stand with BORDC to challenge FBI abuses

*Join the Healthcare Privacy Debate 2.0 @The Economist…
Weigh in your views on privacy and healthcare handling of your records.


*Celebrate Bill of Rights Day –  Sunday, December 5th

*Go check out films featured at this years Artivist Film Festival
   Our pick : “Hempsters” 

BTC – RFID or radio frequency ID, a widget identity technology used in retail sales, has had it’s day in the sun due to a misanthropic association with surveillance.  The fact is RFID is an evolving technology and tool serving a multitude of purposes.   RFID, like scorpions or rattlesnakes, left to their own devices are harmless.  However, when applied to intimate spaces the prospects for damage to privacy increase exponentially.


Contracts for modern health records management, data storage and health card utility are constantly negotiating what technologies are most effective at costs to perform for patients.  Avnet , and RFID proponent will be speaking to hospital administrators at the Medical Design and Manufacturing East Conference about RFID as an option for patient health cards, Monday June 7th.


Chief concern with new licenses and identity cards have been fraud and “tamper proof” cards.  Western Hemisphere Travel Initiative (WHTI) compliant border cards and legalized immigrants receiving Green cards might have to put up with a laser optical RFID strip.  If we want to find out whether or not these RFID strips broadcast the information the same way RFIDs have in the past within it’s “optical security media” might require another MythBuster’s visit.

World of Warcraft’s social networking UI “Real ID” impacts gamer privacy

Virtual privacy is being challenged and impacted by World of Warcraft’s Real ID.  One of Warcraft’s social networking strategies was to get Facebook’s technology integrated with their systems.

“If you aren’t familiar with it, Real ID is the new feature for the latest iteration of where you can friend people you know and communicate with them no matter what Blizzard game they are playing (although, for now, this will only pertain to WoW and StarCraft II, eventually Diablo III). In SC2, the only way you can add someone as a friend is to have their email address. Furthermore, this is their email address. And if they accept, it shows their real-life name.”

BTC – Advances in healthcare records management strangely puts doctors in the liability role, this time for patient identity theft.  The AMA filed suit to stall the a “red flags rule” based on banking privacy rulings pushing medical administrators into the role of (not just data handlers) creditors.

“This unjustified federal regulation of medicine treats physician practices like banks, credit card companies and mortgage lenders,” AMA President-elect Cecil B. Wilson, MD, said in a statement. “The extensive bureaucratic burden of complying with the red flags rule outweighs any benefit to the public.”

The nature of this ruling and the exchanges leads us to a couple of queries:

1) Is patient medical identity another form of debtor currency?

2) If someone steals your identity are they also stealing your healthcare “credit”?


Documents obtained by Hampshire GP, Dr Neil Bhatia under the Freedom of Information (FOI) Act reveal plans for Release 2 information (non GP information) to be uploaded to NHS computerised Summary Care Records(SCR). When you attend a hospital, specialist clinic or out-of-hours
surgery or clinic, details of your attendance can be uploaded to your Summary Care Record.

This is termed “SCR Release 2 information”, and will be uploaded in addition to your GP Summary. The FOI documents reveal that it will be possible for non-GP care settings (such as A & E and outpatient departments) to create a record, not just to add to one created in general practice. The uploading of Release 2 information has not yet begun but the documents raise serious concerns about the levels of consent that are planned for uploading medical records into centralised databases. The best advice is to opt-out now if you don’t want any data uploaded to your SCR. Do not wait until the SCR goes live in your area – it might be too late then as you might have Release 2
information about yourself already uploaded.

Related news: SCR suspension “means nothing”

Dr Bhatia’s website is at

Links to opt-out forms:

Dogs & The Database State 
DOCUMENTARY: Erasing David, featured at SXSW ’10
Tax Records ‘sold’ to junk mail firms
National ID Card fails national-to-international relevancy tests

Anticipating these opportunities it appears some Indian IT companies had started gearing up even while the Bill was being debated. For instance Wipro Technologies, another major Indian IT company, claims that besides EHR, it has already started working on related IT applications to provide remote managed services, interoperability testing, digitization of medical records, and integration of EHR and public health records.

c/o International Beat, Indrajit Basu

The passage of Obama’s healthcare reforms Bill, which aims to ensure millions — 32 million according to Congressional Budget Office estimate — uninsured Americans get medical coverage may be US’s most sweeping health-care legislation in four decades. But while it rewrites the rules governing the world’s largest medical industry, America’s healthcare sector predicts that it will have to struggle to overhaul its IT systems in order to be ready for the ensuing healthcare reforms.

What’s more; while US’s healthcare IT is gearing up for a long-drawn mission to tackle extensive and expensive solutions, the Indian IT sector is looking forward to a multibillion-dollar opportunity from the legislation, which is “historic” according to many.

The bill that expands coverage to Americans who were so far been unable to afford medical insurance, is expected to bring in major changes in the medical insurance sector forcing them to overhaul their systems.

The sector would have to throw money, people and technology in order to prepare for the changes, say sources. “Consequently, a huge opportunity has opened up for the Indian IT outsourcing sector that already plays a significant role providing IT services to the US healthcare industry,” says a spokesperson of Infosys Technologies, the Nasdaq-listed Indian IT company, which is one of the largest IT outsourcing service provider.

India’s money-spinning IT outsourcing sector that earns close to $40 billion a year in providing IT outsourcing service to the US, reckons that Obama’s plan would need at least $20 billion to be spent of healthcare IT alone. Most of this money is expected to be spent of creating Electronic Health Records (EHRs) for all Americans by 2014.

Traditionally the American healthcare IT has been relatively slow in adopting technology, which has often come as a problem in upgrading its healthcare systems. But the new Bill would require a lot of automation in the healthcare system which means that the sector would have to integrate systems and create cutting edge technology-driven healthcare applications.

It would also require solutions to assist the US healthcare industry to prevent leakages and reduce costs and waste.

“That means trickling down of opportunities to Indian IT companies in the form of long-term partnerships with the US healthcare industry,” said another industry source.

Anticipating these opportunities it appears some Indian IT companies had started gearing up even while the Bill was being debated. For instance Wipro Technologies, another major Indian IT company, claims that besides EHR, it has already started working on related IT applications to provide remote managed services, interoperability testing, digitization of medical records, and integration of EHR and public health records.

Besides, a significant amount of business is anticipated from enrollments, claims processing and providing customer services with technology and tools.

The Bill is indeed set to change the face of healthcare delivery in the US. Besides focusing on extending healthcare to American citizens, it also aims at streamlining the entire administrative system to drastically cut the nation’s healthcare cost.

Thus, services such as finance and accounting, research and analytics will be high in demand as well since these too help in reducing cost and increase efficiency, say experts.

As White House pushes expansion, critics cite errors, drop-off in care

c/o Washington Post

By Alexi Mostrous

In a health-care debate characterized by partisan bickering, most lawmakers agree on one thing: American medicine needs to go digital.

When President Obama designated $19.5 billion to expand the use of electronic medical records, former House speaker Newt Gingrich (R-Ga.) said it was one of only “two good things” in February’s stimulus package.

But such bipartisan enthusiasm has obscured questions about the effectiveness of health information technology products, critics say. Interviews with more than two dozen doctors, academics, patients and computer programmers suggest that computer systems can increase errors, add hours to doctors’ workloads and compromise patient care.

“Health IT can be beneficial, but many current systems are clunky, counterintuitive and in some cases dangerous,” said Ross Koppel, a sociologist at the University of Pennsylvania School of Medicine who published a key study on electronic medical records in 2005.

Under the stimulus program, hospitals and physicians can claim millions of dollars for IT purchases, and will be penalized if they do not go digital by 2015. Obama has said the changes will save billions and will minimize medication errors.

But health IT’s effectiveness is unclear. Researchers at the University of Minnesota found in March that electronic records prevented only two infections a year. A 2005 report in the journal Pediatrics found that deaths at the children’s hospital at the University of Pittsburgh Medical Center more than doubled in the five months after a computerized order-entry system went online. UPMC said the study had not found that technology caused the rise in mortality and maintained that medication errors were down 60 percent since computers were introduced in 2002.

Others studies have concluded that health IT saves time and reduces errors. It has been used successfully in organizations such as the Department of Veterans Affairs and Kaiser Permanente.

Documenting the flaws

However, the Senate Finance Committee has amassed a thick file of testimony alleging serious computer flaws from doctors, patients and engineers unhappy with current systems.

On Oct. 16, the panel wrote to 10 major sellers of electronic record systems, demanding to know, for example, what steps they had taken to safeguard patients. “Every accountability measure ought to be used to track the stimulus money invested in health information technology,” said Sen. Charles E. Grassley (Iowa), the panel’s ranking Republican.

Anonymous reports sent to the Joint Commission, the body charged with certifying 17,000 health-care organizations; Grassley’s staff; and the Food and Drug Administration disclose problems, including:

— Faulty software that miscalculated intracranial pressures and mixed up kilograms and pounds.

— A computer system that systematically gave adult doses of medications to children.

— An IT program designed to warn physicians about wrong dosages that was disconnected when the vendor updated the system, leading to incorrect dosing.

— A software bug that misdiagnosed five people with herpes.

David Blumenthal, the head of health technology at the Department of Health and Human Services, acknowledged that the systems had flaws. “But the critical question is whether, on balance, care is better than before,” he said. “I think the answer is yes.”

Over the next two months, Blumenthal will finalize the definition of “meaningful use,” the standard that hospitals and physicians will have to reach before qualifying for health IT stimulus funds. He would not say whether applicants would have to submit adverse-event reports, a safety net that many doctors and academics have called for but that vendors have resisted.

“If you look at other high-risk industries, like drug regulation or aviation, there’s a requirement to report problems,” said David C. Classen, an associate professor of medicine at the University of Utah who recently completed a study on health IT installations.

Today, barely 8 percent of hospitals have even a basic electronic medical system. Only 17 percent of physicians use electronic records, and many of those are uninstalling them, including 20 percent of physician groups in Arizona, according to a June survey by HealthLeaders-InterStudy.

Outside the United States, countries further along the digital curve have experienced major problems with American-made health IT systems.

In Britain, a $20 billion program to digitalize medicine across the National Health Service is five years behind schedule and heavily over budget. A British parliamentary committee in January criticized the vendor, Cerner, as “not providing value for money.”

Sarah Bond, a Cerner spokeswoman, said patient safety had improved and errors had dropped at U.S. hospitals that used Cerner products.

Cerner’s stock price has risen 122 percent since February. Shares in Allscripts, another major health IT player whose chief executive, Glen E. Tullman, served on Obama’s campaign finance committee, rose by 126 percent over the same period.

But rising share prices have not always translated into better care.

“It’s been a complete nightmare,” said Steve Chabala, an emergency room physician at St. Mary Mercy Hospital in Livonia, Mich., which switched to electronic records three years ago. “I can’t see my patients because I’m at a screen entering data.”

Last year, his department found that physicians spent nearly five of every 10 hours on a computer, he said. “I sit down and log on to a computer 60 times every shift. Physician productivity and satisfaction have fallen off a cliff.”

Other doctors spoke of cluttered screens, unresponsive vendors and illogical displays. “It’s a huge safety issue,” said Christine Sinsky, an internist in Dubuque, Iowa, whose practice implemented electronic records six years ago. “I can’t tell from the medical display whether a patient is receiving 4mg or 8mg of a certain drug. It took us two years to get a back-button on our [Electronic Health Record] browser.”

She emphasized that electronic records have improved her practice. “We wouldn’t want to go back,” she said. “But EHRs are still in need of significant improvement.”

More than one in five hospital medication errors reported last year — 27,969 out of 133,662 — were caused at least partly by computers, according to data submitted by 379 hospitals to Quantros Inc., a health-care information company. Paper-based errors caused 10,954 errors, the data showed.

Tracking the mishaps

Legal experts say it is impossible to know how often health IT mishaps occur. Electronic medical records are not classified as medical devices, so hospitals are not required to report problems. Many health IT contracts do not allow hospitals to discuss computer flaws, say Koppel and Sharona Hoffman, a professor of law and bioethics at Case Western Reserve University in Cleveland.

“Doctors who report problems can lose their jobs,” Hoffman said. “Hospitals don’t have any incentive to do so and may be in breach of contract if they do.”

For one senior internist at a major hospital, who requested anonymity because he said he would lose his job if he went public, a 2006 installation provoked mayhem. “The system crashed soon after it went online,” he said. “I walked in to find no records on any patients. It was like being on the moon without oxygen.”

While orange-shirted vendor employees “ran around with no idea how to work their own equipment,” the internist said, doctors struggled to keep chronically ill patients alive. “I didn’t go through all my training to have my ability to take care of patients destroyed by devices that are an impediment to medical care.”