HIT Standards Committee Slides

It appears there is temporarily a problem with the links on the ONC web site for the June 30, 2010 HIT Standards Committee meeting materials. http://healthit.hhs.gov/portal/server.pt?open=512&objID=1816&parentname=CommunityPage&parentid=11&mode=2&in_hi_userid=11113&cached=true


I have posted them below:

Health IT Meets Rocket Science

In thinking about health IT, NASA might be the last federal agency that comes to mind. That’s what makes a seven-year joint venture between the space agency’s Jet Propulsion Laboratory and Childrens Hospital Los Angeles such an unlikely partnership.

Yet the two have an ongoing common need: to easily share and analyze massive amounts of data across far flung labs and clinics across the nation.

NASA’s research target was planetary science; Childrens Hospital’s was early detection of pediatric cancer. A chance encounter of researchers associated with the two fields at a 2003 conference ultimately led to a project to use grid software developed by JPL to help build a system to support the early detection of pediatric cancer.

(for more see http://www.govhealthit.com/Article.aspx?id=74068

*NOTE ~ This will be presented at O'Reilly OSCON in Portland, Oregon July 22, 2010

Enrollment Workgroup 6-28-2010

The Enrollment Workgroup of the HIT Policy and HIT Standards Committees are working to come up with a set of standards which would facilitate enrollment in Federal and state health and human services programs. At their June 28, 2010 meeting they discussed key takeaways from their first meeting and had a general discussion on a base use case of a consumer-facing web portal. This web portal would allow applicants to:

• Identify available services for which they might be eligible
• Conduct initial screening and enrollment checks
• Retrieve electronic verification information from outside sources
• Determine eligibility or forward eligibility “packet” (screening information and verification information) to programs for final determination
• Store and re-use eligibility information

They also came to consensus on areas of focus and a timeline for their standards work. It was very satisfying to hear the focus on keeping the consumer at the center of their efforts.

The slides from the meeting are below:

via healthit.hhs.gov

The Spooky Founding of Facebook

The Social Network comedy-drama film directed by David Fincher about the founding of Facebook, which will be released later in 2010. The film features Jesse Eisenberg, Brenda Song, Justin Timberlake, Andrew Garfield, Rooney Mara and Armie Hammer. The film was written by Aaron Sorkin and adapted from the book The Accidental Billionaires: The Founding of Facebook A Tale of Sex, Money, Genius and Betrayal by Ben Mezrich.

It looks like the movie might be interesting but the teaser trailer below definitely seems overly dramatic and a little spooky. It will be interesting to see how well the movie follows the book. In the 262-page book Mark Zuckerberg is portrayed as a cold hearted genius with a yen for Asian women who is willing to steal ideas and turn on his friends to create the world's dominant social network. Much of the book is sourced from Eduardo Saverin, one of the founders of Facebook, who is no longer on speaking terms with Mark Zuckerberg. I'm sure the movie will be hyped beyond belief and will open in October 2010 with long lines at theaters around the country.

Interoperability Framework Overview

There was a very interesting presentation to the HIT Policy Committee from Douglas Fridsma, MD, PhD the Acting Director of the Office of Interoperability & Standards at ONC. The slides are below:

Recommended Reading

I tweeted some links from Wiley InterScience yesterday of some great articles, but it appears there are some problems with session cookies when trying to access the articles after closing your browser, etc. So here is the launching pages for the articles and if you click the PDF link you should have free access to the articles:

The Impact of Web 2.0 on the Doctor-Patient Relationship - http://www3.interscience.wiley.com/journal/123334069/abstract

Prescription Data Mining and the Protection of Patients’ Interests - http://www3.interscience.wiley.com/journal/123334064/abstract

The Physician-Patient Relationship and a National Health Information Network - http://www3.interscience.wiley.com/journal/123334062/abstract

Leveraging the Electronic Health Record for Public Health Alerting

With the passage of the American Recovery and Reinvestment Act and its focus on EHR systems, public health has an unprecedented opportunity to leverage the information, technologies and standards enabled by this effort to support critical public health functions such as alerting and surveillance. Having public health systems interface with EHR might be able to prevent clinicians from being bombarded during health emergencies, as they were during the H1N1 pandemic with multiple sources, some of which provided contradictory information. The CDC hosted a conference call on June 22, 2010 on this subject.

Nedra Garrett, MS, acting director of the CDC's division of informatics practice, policy, and coordination, discussed strategies to increase compliance with public health recommendation and guidelines, and also how improved dissemination of public health information at point of care can lead to more timely patient specific information by utilizing EHR systems. She said some of the challenges are to connect public health alerts and guidance to relevant patient data in the EHR and to make sure systems have a meaningful impact on point-of-care practices, such as ordering lab tests and distributing educational information to patients.

The slides from her presentation are below:

Rule on meaningful use of EHR is coming soon

We are getting very close to having a final rule issued on meaningful use. I believe the final rule will have some significant changes from the proposed rule regarding how high a bar we must reach to qualify for the first year incentive payments. The proposed rule contains 25 measures that providers must use to qualify for federal incentives beginning January 2011. The rule also contains 23 measures through which hospitals must demonstrate meaningful use of healthcare IT for incentives beginning Oct. 1, 2011. I do not think the timelines will change, and I think that the measures are likely to stay basically intact. It is very difficult to substantially change a proposed rule, without requiring a whole new comment period.

So what exactly can they do make the rule more palatable and allow the greatest number of providers and hospitals to participate in incentive payments? It would be a terrible thing to offer a stimulus that few could qualify for... There were many, many comments submitted on the proposed rule, from every area of the industry, and I think most pointed in the same direction. We need to flatten the slope of adoption or we could see some massive failure points, particularly in rural and underserved areas, which actually need the stimulus the most.

A few thoughts on what may be possible:

• Only require a certain number of measures to be met in the first year and move away from "all or nothing approach" - this will almost certainly happen, and it will be interesting to see how far they are dialed back
• Reduce the number of quality measure reporting requirements by allowing identification of selected clinically relevant measures
• Clearer definition of terms such as "health information" and making "48 hours" something achievable by using business days instead
• Tweaking the definition of a "hospital-based physician" even further than accomplished through recent changes in legislation
• Reduction in administrative burden of reporting computerized physician order entry measures
• Scale back objectives and measures that don't directly apply to EHR adoption, such as checking insurance eligibility electronically

This is but a small sampling of what might be in store. There will certainly be some scaling back of the requirements. Hopefully, it will be enough to encourage adoption without making it too difficult in the out years to achieve the later stages. If stage one meaningful use is too far watered down, then it will be a long jump to stages two and three. I think we will see the final rule before the Fourth of July - possibly even this week. You can bet there will be tweets and blog postings galore when this baby drops
;-)

Clay Shirky: Creativity and Generosity in a Connected Age

At the second WIRED Business Conference Clay Shirky explains how widespread education coupled with 21st-century technology has enabled what he terms "cognitive surplus," or the potential for large and cumulative creative endeavors. He argues that while it is responsible for inanity like Lolcats, "doing something is different from doing nothing." The full conference is available for purchase at Fora.tv and be sure to get his new book Cognitive Surplus: Creativity and Generosity in a Connected Age.



For a fascinating insight into a visionary mind, look how he starts his days:

Clay Shirky: What I Read

In the morning, I basically check two things. The obvious one is Twitter. I use Tweet Deck for friends, commentators and media outlets. The people I followed after seeing their tweets were @mike_FTW, Paul Kedrosky, Joe Solomon, Newt Gingrich

After I scan Twitter I check Netvibes, a module-based RSS reader. It's a lovely piece of software. My main source for world news is Al Jazeera. The rest of the RSS stuff is all feeds from opinionated aggregators. I look for relevant research, interesting themes and funny stories on sites like 3quarksdaily, Crooked Timber, Boing Boing and Slashdot. On Twitter and Netvibes, if I see something I want to read, I just open up a string of tabs. Usually between one and two dozen depending on what I see.

The only blog I read where I read it for a specific blogger's voice is Sady Doyleat Tiger Beatdown. I've read every word that Sady's written. She would be number one. If I had to pick two other bloggers it'd beNew York Times (though I generally only read the Times on the weekend),The New Yorker and The Atlantic. Neither of those really cover breaking news so I pile them up and save them for plane rides.

(via Atlantic Wire)

How to Survive a Medical Malpractice Lawsuit

Below is an excerpt from the new book by Dr. Ilene Brenner, MD, an Emergency Room physician and Adjunct Professor, Emory University, Atlanta, Georgia. She also writes a blog at drbrenner.blogspot.com and tweets @irb123. This is a medical malpractice survival book written by a doctor for doctors in non-legalese language that is easy to understand. It is designed to help navigate through what can be a mysterious and terrifying process.

"That dreaded day arrives. And no it is not just a bad dream. That police officer at your front door is not ringing the doorbell to warn you of a prowler in the neighborhood. He has come to serve you with papers notifying you of a complaint filed by a patient: a patient you may or may not remember seeing. Although anybody who serves you with papers is called a process server, in some jurisdictions, like mine, it is done by a sheriff ’s deputy. The feeling is akin to being hit on the head with a bat, stabbed in the back, and disemboweled, all at the same time. Thoughts run through your mind like, 'Will I lose my job?'; 'Is my money protected?'; 'Am I a bad doctor?'; and 'Is my career over?'

You are justifiably depressed, confused, frustrated, and angry. When you have had a few minutes, hours, or days to assimilate this experience that unfortunately has begun a new chapter in your life, you undoubtedly ask, 'Now what?'

When it happened to me, I called my father. Then again, not everyone has a medical malpractice defense trial attorney for a father. Most physicians do ot have an attorney who is readily available to give appropriate and timely advice to initiate damage control. Through this book I am going to suggest what to do and, equally important, what not to do...

Getting sued can damage your self-confidence. However, do not let fear consume you. Make every effort to continue practicing the good medicine you have been doing for years. It is possible that the lawsuit is a result of your unintentional negligence. If that is the case, realize you are human. We all make mistakes."

Using her personal experience and expertise, she offers a glimpse into the medical malpractice process and acts as a guide to help a physician effectively deal with the situation. She leads through the process from the moment they receive a summons, through the trial, and into the appeal process. There is some excellent advice on how to best choose an attorney. She also points out that while good documentation won't necessarily keep you from being sued, it is the cornerstone of a good defense. And there is some very good advice about when to keep your mouth shut:

"There is a common misconception amongst physicians that if they explain things well, their intelligent responses will prove to the plaintiff’s attorney that the whole thing is a mistake. They may also think that they need to explain their defense clearly and completely to the plaintiff’s attorney. However, as will be detailed later on in the chapter, a general rule is, “the less you say the better.” Since there is the potential to do significant damage to your case, it is critically important that you perform well; otherwise you may be forced to settle an otherwise winnable case."

There is an excellent review in Emergency Physicians Monthly by Louise B. Andrew, MD, JD. She points out the need to be careful about differing statutes between states, but overall gives a very positive review. Dr. Andrew basically breaks the book into tow sections. The first is a walk through the process of litigation, the second is a practical discussion n preventative measures and reducing risk.

Kevin Klauer, Editor-in-Chief for Emergency Physicians Monthly, interviewed Ilene Brenner and discussed what to do and what not to do when you find yourself in a malpractice suit.

Ilene has done an excellent job of writing a readable and understandable treatise, which includes great advice on how to respond to a lawsuit, and also how to avoid one in the first place. We live in a very litigious culture and this resource is a must have for any clinicians book shelf.

Temporary Certification of Electronic Health Record Systems

Certification of Health IT will provide assurance to purchasers and other users that an EHR system, or other relevant technology, offers the necessary technological capability, functionality, and security to help them meet the meaningful use criteria established for a given phase. Providers and patients must also be confident that the electronic health IT products and systems they use are secure, can maintain data confidentially, and can work with other systems to share information. Confidence in health IT systems is an important part of advancing health IT system adoption and allowing for the realization of the benefits of improved patient care.

Eligible professionals and eligible hospitals who seek to qualify for incentive payments under the Medicare and Medicaid EHR Incentive Programs are required by statute to use Certified EHR Technology. Once certified, Complete EHRs and EHR Modules would be able to be used by eligible professionals and eligible hospitals, or be combined, to meet the statutory requirement for Certified EHR Technology.

The Final Rule on temporary certification program to assure the availability of Certified EHR Technology prior to the date on which health care providers seeking the incentive payments would begin to report demonstrable meaningful use of Certified EHR Technology will be published June 24, 2010. You can learn more about the certification programs here:
http://healthit.hhs.gov/portal/server.pt?open=512&mode=2&objID=1746

The Final Rule is below:

It's Elementary Doctor Watson

IBM is working on a computing system that can understand and answer complex questions with enough precision and speed to compete against Jeopardy! contestants. The New York Times gives a good overview of the project. Code-named "Watson" after IBM founder Thomas J. Watson, the IBM computing system is designed to rival the human mind's ability to understand the actual meaning behind words, distinguish between relevant and irrelevant content, and ultimately, demonstrate confidence to deliver precise final answers.

“The essence of making decisions is recognizing patterns in vast amounts of data, sorting through choices and options, and responding quickly and accurately,” said Samuel J. Palmisano, IBM Chairman, President and Chief Executive Officer. “Watson is a compelling example of how the planet – companies, industries, cities – is becoming smarter. With advanced computing power and deep analytics, we can infuse business and societal systems with intelligence. This project is the latest example of IBM’s longstanding commitment to fundamental research and to overcoming ‘grand challenges’ in science and technology.”



This challenge is much more than just a game. Jeopardy! demands knowledge of a broad range of topics including history, literature, politics, film, pop culture and science. What's more, Jeopardy! clues involve irony, riddles, analyzing subtle meaning and other complexities at which humans excel and computers traditionally do not. This, along with the speed at which contestants have to answer, makes Jeopardy! an enormous challenge for computing systems. You can play the New York Time's interactive game to get a sense of what Watson is like.

Senate Fiddles as Medicare Burns

The Senate voted on June 17, 2010 against postponing a scheduled 21% reduction in Medicare reimbursement to physicians and other health providers, the so-called "doc fix." The 56-40 vote late in the day fell four votes short of the 60 required. Because the "doc fix" was defeated, CMS is ready to authorize its contractors to begin paying physicians at the lower rate.

Senate Fiddles as Medicare Burns

“Congress has broken its promise to America’s seniors and military families. Today is the last day that Medicare can hold claims, and it is now 17 days past the Senate’s deadline to stop the cut. Tomorrow, physicians will start seeing a 21 percent cut in Medicare payments that will hurt seniors’ health care as physicians are forced to make difficult practice changes to keep their practice doors open.

“The Senate has been debating this issue for weeks and the latest proposal is a six-month delay of the cut. Delaying the problem is not a solution. Continued short-term actions are creating severe instability that harms seniors as physicians make decisions to protect their practices from Medicare’s volatility. Continuing down this path just slaps a Band-Aid on a problem that needs urgent surgery.

“This week congressional offices are rec eiving hundreds of signed white lab coats from AMA member physicians as a symbolic reminder of the need for quick resolution to the immediate Medicare crisis and the importance of solving the problem through repeal of the broken Medicare physician payment formula.”

Statement attributable to:
Cecil B. Wilson, MD
President, American Medical Association

Privacy & Security Standards Workgroup

The Privacy and Security Standards Workgroup of the HIT Standards Committee met on June 17, 2010.

The following are members of this Workgroup:

• Dixie Baker, Chair, SAIC
• Steve Findlay, Co-Chair, Consumers Union
• Anne Castro, BCBS/South Carolina
• David McCallie, Cerner
• Gina Perez, Delaware HIE
• Wes Rishel, Gartner
• Sharon Terry, Genetic Alliance
• Aneesh Chopra, OSTP/Chief Technology Officer
• John Halamka, Harvard Medical School
• John Moehrke, HITSP
• Ed Larsen, HITSP
• Walter Suarez, Kaiser Permanente
• Andrew McLaughlin, OSTP

The workgroup is tasked with making recommendations to the HIT Standards Committee on specific privacy and security safeguards that should be included in the definition of Meaningful Use, with a specific focus on the eight (8) areas listed in Section 3002(b)(2)(B):

(1) Technologies that protect the privacy of health information and promote security in a qualified electronic health record, including for the segmentation and protection from disclosure of specific and sensitive individually identifiable health information with the goal of minimizing the reluctance of patients to seek care (or disclose information about a condition) because of privacy concerns, in accordance with applicable law, and for the use and disclosure of limited data sets of such information;

(2) A nationwide health information technology infrastructure that allows for the electronic use and accurate exchange of health information;

(3) The utilization of a certified electronic health record for each person in the United States by 2014;

(4) Technologies that as a part of a qualified electronic health record allow for an accounting of disclosures made by a covered entity (as defined for purposes of regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996) for purposes of treatment, payment, and health care operations (as such terms are defined for purposes of such regulations);

(5) The use of certified electronic health records to improve the quality of health care, such as by promoting the coordination of health care and improving continuity of health care among health care providers, by reducing medical errors, by improving population health, by reducing health disparities, by reducing chronic disease, and by advancing research and education;

(6) Technologies that allow individually identifiable health information to be rendered unusable, unreadable, or indecipherable to unauthorized individuals when such information is transmitted in the nationwide health information network or physically transported outside of the secured, physical perimeter of a health care provider, health plan, or health care clearinghouse;

(7) The use of electronic systems to ensure the comprehensive collection of patient demographic data, including, at a minimum, race, ethnicity, primary language, and gender information; and

(8) Technologies that address the needs of children and other vulnerable populations.

Below are the slides from a presentation by Mike Davis and David Staggs of the Department of Veterans Affairs:

This is the video referenced in the presentation above:

 

Previous Privacy and Security Standards Workgroup meetings:

5.21.2010

5.14.2010

4.1.2010

2.18.2010

1.26.2010

11.19.2009

The ONC's David R. Hunt, MD, FACS Updates SACGHS

The charge of the Secretary's Advisory Committee on Genetics, Health, and Society (SACGHS) includes:

• Assessing how genetic technologies are being integrated into health care and public health,
• Studying the clinical, public health, ethical, economic, legal, and societal implications of genetic and genomic technologies and applications,
• Identifying opportunities and gaps in research and data collection analysis efforts,
• Examining the impact of current patent policy and licensing practices on access to genetic technologies,
• Analyzing uses of genetic information in education, employment, insurance, and law,
• Serving as a public forum for discussion of issues raised by genetic and genomic technologies.

The SACGHS held their twenty second meeting June 15-16, 2010.

The main agenda item was an exploratory session on the implications of affordable whole-genome sequencing. The meeting also included updates and discussions on other issues SACGHS has been addressing, including the work of the Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children related to the retention and use of dried blood spot specimens from newborn screening. There was also an update from David R. Hunt, MD, FACS the Medical Officer at the Office of the National Coordinator for Health IT. This was a continuing discussion from his earlier presentation in February.

I will post meeting materials and rough draft transcripts as they are available.

These are the Presentation Materials currently available for the meeting: CDC Guidelines for Good Laboratory Practices in Genetic Testing Bin Chen, PhD, FACMG Office of Surveillance, Epidemiology, and Laboratory Services Centers for Disease Control and Prevention (CDC) Atlanta, GA Whole-Genome Sequencing-Implications for Clinical Care Charis Eng, MD, PhD, FACP Session Co-Chair Overview of WGS Dietrich A,. Stephan,PhD President and CEO Complete Genomics Implications of Affordable Whole Genome Sequencing: Quality and Management of WGS Data Clifford A. Reid, Ph.D. President and CEO, Complete genomics Preparing and Managing Whole Genome Sequence Data for the Clinical Setting Martin G. Reese,PhD Co-Founder, President and CEO Omicia WGS Data and Clinical Utility W. Gregory Feero, M.D., Ph.D. Faculty, Maine-Dartmouth Family Practice Residency Program, Augusta, ME Special Advisor to the Director for Genomic Medicine NHGRI, NIH Impact of Whole Genome Sequencing on the Practice of Health Care Emily Edelman, MS, CGC National Coalition for Health Professional Education in Genetics Economic Value of Whole Genome Sequencing Steven Teutsch, MD, MPH Chief Science Officer Los Angeles County Dept of Public Health

Enrollment Workgroup First Meeting

The new Enrollment Workgroup of the Health IT Policy & Standards Committees had their first meeting June 14, 2010. The slides from the meeting are below. The audio is posted below and on the ONC website.

Audio of the meeting:


Some of the highlights included:

Update on State/Local eHuman Services efforts by Steve Fletcher, Chief Information Officer, Utah; Bobbie Wilbur, Social Interest Solutions; and Ruth Kennedy, Louisiana Medicaid

Discussion of Internet/Web Services /Consumer Data Platform with Wes Rishel, Gartner; Julie A. Rushin, Deputy CIO, IRS; Paul Swanenburg, Social Security Administration; and Bryan Sivak, CIO, Government of D.C.

Quote of the day: Wes Rishel ~ "I have been work being in the area of interoperability for healthcare systems since Moses was a lad. I sincerely hope to see some of it before I die."

Ray Kurzweil ~ Humanity+ Summit @ Harvard

What does it mean to understand the brain? Where are we on the roadmap to this goal? What are the effective routes to progress - detailed modeling, theoretical effort, improvement of imaging and computational technologies? What predictions can we make? What are the consequences of materialization of such predictions - social, ethical? Kurzweil will address these questions and examine some of the most common criticisms of the exponential growth of information technology including criticisms from hardware ("Moore's Law will not go on forever"), software ("software is stuck in the mud"), the brain ("the brain is too complicated to understand or replicate"), ontology ("software is not capable of thinking or of consciousness"), and promise versus peril ("biotechnology, nanotechnology, and artificial intelligence are too dangerous").

Ray Kurzweil gave the keynote talk "The Democratization of Disruptive Change: The Power of Hierarchical Thinking" at the Humanity+ Summit at Harvard on June 13, 2010. He gave some fascinating insights into what he sees in store for the future of humanity. I suggest you follow Humanity+ on Twitter and check out the tweetstream from the #HPlus hashtag. They will be posting more material at their website at http://humanityplus.org/

You can watch the archive of the LiveStream video and the presentation is below:

The original presentation can be downloaded here:

http://www.kurzweilai.net/pps/kurzweilpowerpoint/

RNAi offers hope for drug discovery

As scientists continue to investigate the human genome, where we now have the complete genetic sequence, there have been remarkable developments in the understanding of disease and consequently a large increase in the number of molecular disease targets to impact a broad range of human disease. The discovery of RNAi is a major breakthrough in biology, and this technology has the potential to make a broad and significant impact. A company called Alnylam Pharmaceuticals is leading the effort in translating the science of RNAi into a robust drug discovery capability. With RNAi it is possible to target virtually any gene in the human genome involved in the causal pathway of disease. The possibility of targeting these previously "undruggable" targets with RNAi is transformative for new drug discovery.

I spoke to Alnylam's CEO John Maraganore:



Below is a rough draft transcript of our conversation.

Alnylum is a company that is focused on creating a whole new class of medicines with a new discovery based on a new discovery in biology called RNA interference or RNAi as it's abbreviated and it's a technology and an approach that we think can transform the treatment of many human diseases because we can silence disease causing genes and basically by turning those genes off temporarily, we can make a difference in people's lives by treating their disease in ways that can't be done with today's medicines.
And the other part of the company, which is quite exciting, is that with what we've been doing over the years now, our technology and innovation is now becoming increasingly a game changer in much of a biomedical discovery, both in industry and in academia. So we've got partnerships with companies like Roche and Novartis and Cicada amongst others, Medtronic as well, and we've also been able to work real closely with major academic institutions like MIT and Plank and Stanford and UT Southwestern and work together on our technology. So it's a company that's hopefully what we believe is going to make a big difference in the treatment of disease with the types of approaches that we're taking. And then at the same time we're finding that we're able to work real closely across the entire biomedical world to basically advance our technology. 

Q: Tell us about your newest scientific advisory board 

That's a group that's focused on are one of the applications of our technology focused on transforming biologics manufacturing. You know, there's a whole range of medicines that are used today that are collectively called the biologic system: includes recombinant proteins like the use of factor eight for hemophilia or monoclonal antibodies like the use of the drug Avastin for cancer. And then also vaccines, and we've recently started up an effort where we're using our technology to fundamentally transform how those types of products are made. And so the group you're referring to was a recent assembly of some world renowned scientists that are going to help advise us on, on our biotherapeutics effort. But Alnylum overall has had a very active scientific advisory board since 2002 with people like a Phil Sharp and Tom and Bob Langer amongst other people that had been advising or company. 

One of the fun things and exciting things about what we've done, is that as we've developed our advanced technology, we've also realized that the role of RNA in general in human biology is far broader than we ever expected. And that allowed us to understand more about micro RNA; these are small RNA that are present in all of ourselves and then we figure out the technologies that allow us to either turn up or turn them down. And by what we've been able to learn is that by sometimes turning them down you can treat specific diseases and sometimes by turning them up you can treat other diseases.

And so a company that we've cofounder with Isis called Regulus. This is an exciting effort that's a focused on micro RNA therapeutics and we and Isis both own 50 percent of that company. So we have a high a retention of the ownership there. We're excited about where that's going and there's a lot of interest in the pharmaceutical industry for where that's going as well.

New ONC Workgroups

The Office of the National Coordinator for Health Information Technology (ONC) has organized a workgroup (subcommittee) under the auspices of the HIT Policy Committee to move forward on a range of privacy and security issues. A new Privacy & Security Tiger Team will work over the next few months to address the requirements of HITECH and the needs of many new organizations created under that law. The Tiger Team is comprised of the following members from the HIT Policy Committee and the HIT Standards Committee as well as National Committee on Vital and Health Statistics:

• Deven McGraw, Center for Democracy & Technology, Co-Chair
• Paul Egerman, Co-Chair
• Dixie Baker, SAIC
• Christine Bechtel, National Partnership for Women & Families
• Rachel Block, NYS Department of Health
• Neil Calman, The Institute for Family Health
• Carol Diamond, Markle Foundation
• Judy Faulkner, EPIC Systems Corp.
• Gayle Harrell, Consumer Representative/Florida
• John Houston, University of Pittsburgh Medical Center; NCVHS
• David Lansky, Pacific Business Group on Health
• David McCallie, Cerner Corp.
• Wes Rishel, Gartner
• Micky Tripathi, Massachusetts eHealth Collaborative
• Latanya Sweeney, Carnegie Mellon University

It is expected the work of the Tiger Team will be completed by late fall 2010.






The ONC has also organized to respond to a section of the Affordable Care Act which asks the HIT Policy and HIT Standards Committees to come up with a set of standards which would facilitate enrollment in Federal and state health and human services programs, including offerings by new health insurance exchanges. This might include standards for:

• Electronic matching across state and Federal data;
• Retrieval and submission of electronic documentation for verification;
• Reuse of eligibility information;
• Capability for individuals to maintain eligibility information online; and
• Notification of eligibility

This workgroup is chaired by Aneesh Chopra, Chief Technology Officer, and Sam Karp, co-Chair, California Healthcare Foundation. The other members of this group are:

• Cris Ross, SureScripts
• James Borland, Social Security Administration
• Kevin Concannon, U.S. Department of Agriculture
• Stacy Dean, Center on Budget & Policy Priorities
• Steve Fletcher, CIO, Utah
• Reed V. Tuckson, UnitedHealth Group
• Ronan Rooney, Curam
• Rob Restuccia, Community Catalyst
• Ruth Kennedy, Louisiana Medicaid Department
• Ray Baxter, Kaiser Permanente
• Deborah Bachrach, Consultant
• Paul Egerman, Businessman
• Gopal Khanna, CIO, Minnesota
• Bill Oates, CIO, City of Boston
• Anne Castro, Blue Cross/Blue Shield South Carolina
• Oren Michels, Mashery
• Wilfried Schobeiri, InTake1
• Bryan Sivak, CIO, Government of D.C.
• Terri Shaw, Children’s Partnership
• Sallie Milam, West Virginia, Chief Privacy Officer
• Dave Molchany, Fairfax County

For a meeting schedule of all ONC upcoming meetings go here: ONC Calendar

Posted via web from Ahier.net

HHS and Institute of Medicine Promote Community Health Data Initiative

HHS and the Institute of Medicine launch a new initiative to make health data more usable for consumers and communities. This event, at the IOM, features demonstrations of innovative applications for combining and displaying health and healthcare data to assist communities in new effort for disease prevention, health promotion and measurement of healthcare quality and performance.



IOM President Harvey Fineberg; HHS Secretary Kathleen Sebelius; HHS Deputy Secretary Bill Corr; Applications Developers

Under the initiative, HHS health data will be made freely available so that software developers can create innovative applications and make the data more useful for consumers and communities. At the June 2 event, Secretary Sebelius explains the initiative, and early developers demonstrated their new applications. See more at the HHS OpenGov website http://www.hhs.gov/open/datasets/communityhealthdata.html

Design Framework for HHS’s Community Health Data Initiative

D8: Apple CEO Steve Jobs

In his appearance at D: All Things Digital on June 1,2010, Steve Jobs speaks with Walt Mossberg and Kara Swisher about Apple's issues with Flash and many other topics.



Jobs talks about the connection between the iPad and the iPhone



Jobs talks about Apple's relationship with Google



Jobs talks about the problem with getting involved in television technology



Jobs discusses AT&T

Global Health Corps

Global Health Corps (GHC) aims to mobilize a global community of young leaders to build a movement for health equity.

GHC believes that a global movement of individuals and organizations fighting for improved health outcomes and access to healthcare for the poor is necessary in order to change the unacceptable status quo of extreme inequity. hey are working to build this movement by recruiting, training, and supporting the movement's future leaders and by diversifying the pool of young people working in global health. As reported in the San Francisco Chronicle:

When first daughter Jenna Bush attended a Bay Area AIDS summit hosted by Google.org two years ago, some skeptics doubted it would amount to more than a photo op.

But they were wrong. In a conversation with a Google staffer and a Stanford AIDS activist at one session, she helped come up with a big idea: A plan to improve health care access in the poorest parts of the United States and the world. What may have seemed like a pie-in-the-sky plan has morphed into a nongovernmental organization with an impressive roster of donors and more than $1 million in funding. Few may have heard of the Global Health Corps, but as its influence grows, that is likely to change.

"So many ideas come up in group conversations that never get realized," said corps founding director Dave Ryan, who at the time was the executive director for Face AIDS, a nonprofit group that helps Rwandans living with HIV. "But when we all got together, we saw there was something special that could happen."

Having watched friends transition from college into careers through organizations like Teach for America, they wondered whether they could create a similar organization dedicated to health care.

"We felt like there should be a similar program for public health," said Charlie Hale, who works in Google's direct ad sales division and is one of the group's co-founders.

They enlisted an eager group of socially conscious friends and secured $250,000 in seed money from Google.org. Jenna's sister, Barbara Bush, became the president of the organization, after spending time working in Africa with UNICEF and the U.N. World Food Program

Read more: http://www.sfgate.com

Barbara Bush appeared on CNN June 1, 2010 to discuss the organization:

 

One of former President George W. Bush's daughters is aiming to change the face of global public health and she intends to use members of her generation to do it.

Former first daughter Barbara Bush's new non-profit, Global Health Corps, was inspired by a 2003 trip that she took with her parents to five African countries. The Bush family was in Africa at the time promoting the Bush administration's anti-AIDS initiative.

A visit to a health clinic for people battling HIV opened Barbara Bush's eyes to how she might make a difference in the health field.

"I think that was the first time that – I was not pre-med; I hadn't studied health – that was the first time that I thought well maybe, what am I doing? Maybe I should focus on this," the Bush daughter said in an interview Tuesday on CNN's American Morning. "And I can. You really can work in the health field even if you're not a doctor or a nurse."

Bush decided to take that premise and use it as the foundation of Global Health Corps, a non-profit that recruits young professionals who are age 30 or younger to work for a year in health organizations.

"They're not doctors or nurses. They're filling any needs that the organizations have. And what we've found is all of our partners want people with technology skills. They want program management skills. They want monitoring and evaluation support. They just want general program support – which are skills that tons of people have. They just don't know they can use them in the health field."
For example, Bush said one participant in the non-profit's first crop of fellows is a former Google employee with a background in product management who is now working on health management information systems in Tanzania.

more at politicalticker.blogs.cnn.com

What Motivates Us?

After Tim O'Reilly tweeted a great eleven minute RSA Animate video, which was adapted from Daniel Pink's talk at the RSA, I started browsing a number of Dan Pink's talks and have been intrigued by many of his concepts. Daniel Pink is the author of four provocative books about the changing world of work, including two on my reading list: A Whole New Mind and Drive. Below are two videos that lay out the philosophy behind this new way of looking at what motivates us and how we can better use this knowledge to work smarter and live better.


Two questions that can change your life:



Daniel Pink's Ted Talk on the surprising science of motivation