We reported recently on a memo issued by President Barack Obama last week to all federal agency and department heads requiring them to come up with at least two mobile device applications using government data.
Stories about the memo, widening the use of the Veteran's Affairs Department Blue Button patient download technology, and a new national mobile technology strategy appear here and, with some industry IT mavens' reactions, here.
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A decade ago, a not-for-profit organization called WorldVistA was launched with two missions.
One was to promote the use of the Veterans Affairs Department's public-domain VistA electronic health-record system outside the VA, both in the U.S. and abroad.
The other was to preserve the life's labors of thousands of government workers who created the excellent VistA system over the previous three decades.
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Tom Munnecke, like other veteran programmers who have worked with the VistA electronic health-record system developed by the Veterans Affairs Department, has seen this movie before.
The plot of previous versions always centered on forces within and outside the VA who were trying to kill off VistA and replace it with something giant corporations with government contracting vehicles could use to bill taxpayers billions of dollars to produce.
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Here's my take on the Defense Department's latest update on the proposed joint Pentagon/Veterans Affairs Department Electronic Health Record development project:
The goal of the project is to create a new electronic health-record system for use by the Military Health System and the Veterans Health Administration. Together, they operate about 110 hospitals and 1,100 clinics.
The 55-page report, "Department of Defense Enterprise Architecture to Guide the Transition of the DoD Electronic Health Record, and Related Matters," quickly turns into alphabet soup. By page 5, readers are already wading through paragraphs of brain-numbers: "The DoD/VA functional community leads the requirements development process through the FCPG, under the guidance of the ICIB. The FCPG identifies and defines proposed joint functional capabilities, then orients baseline architectural artifacts with the logical construct of the ECCF. A C-IPT—guided by the ECCF—re-engineers joint functional processes and supplements the descriptive content of architectural artifacts, as needed."
Two dangers loom for our boat of national affairs from this almost impenetrable fog.
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I've written before about the federally supported health information technology regional extension center program established by the American Recovery and Reinvestment Act to help providers adopt and meaningfully use electronic health records systems.
Regular readers already know I'm an unabashed REC fan.
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Journalists love a spirited debate, often for selfish reasons. No matter who loses in the verbal joust, we win with a good story. On Monday, the American Hospital Association filed its public comments with the CMS to its proposed Stage 2 meaningful-use rules.
Yesterday, Christine Bechtel struck the AHA with a blog blast. Bechtel's post on the website of the National Partnership for Women & Families, charged the AHA with having "little interest in advancing meaningful-use criteria that would result in tangible benefits for patients."
Bechtel is a vice president of the partnership and an active outside adviser in federal health information technology policymaking. She is a member of the federally chartered Health IT Policy Committee and serves on six of its work groups, including ones focused on meaningful use and privacy. In her committee work, she is neither a rabble-rouser nor a wallflower.
Bechtel offers as an example of AHA recalcitrance its call for extending the compliance period in the Stage 2 rule to 30 days for hospitals to respond to a patient's request to "view, download and transmit" electronic copies of their medical records. HHS' proposed rule calls for access in 36 hours, she says.
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I had a long conversation with Todd Cozzens Thursday about his future—and ours. Cozzens is still in Boston, but is finishing his first full week there as a venture partner—essentially the East Coast eyes and ears—for Silicon Valley-based Sequoia Capital, a premier private-equity and venture-capital firm with a long track record in technology investing.
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Previously, I blogged about the Colorado Regional Health Information Organization's blueprint on how patients' behavioral-health records might be linked to other medical records in health information exchanges.
The word "barrier" in the CORHIO report in referencing patient consent laws sounded familiar. A scan of our archives reminded my why.
In 2002, HHS rewrote the Health Insurance Portability and Accountability Act privacy rule, eliminating patient consent as a requirement for most healthcare records disclosures.
In 2005, HHS awarded a $17 million contract to RTI International and the National Governors Association with the aim, in part, to provide ammunition for then-Rep. Nancy Johnson (R-Conn.), whose health information technology bill called for federal pre-emption of state privacy laws in favor of one uniform federal law.
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Earlier this month, the Colorado Regional Health Information Organization released what its authors must hope will become a blueprint for sharing behavioral-health records via health information exchanges.
I hope not.
The 34-page report, "Supporting Integration of Behavioral Healthcare through Health Information Exchange" (PDF), is part of CORHIO's Behavioral Health Information Exchange Project.
The project erroneously supposed that patient consent laws are "barriers" to exchange. In fact, these laws are the opposite. They're vital foundations to sharing accurate patient records.
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The recent breach of patient-identifiable healthcare records in Utah is unusual, but not unique, in that it reportedly involved the work of hackers and the extent of the exposure was not immediately known.
According to the publicly available segment of the 410 major breach reports collected by HHS' Office for Civil Rights, 24 (not quite 6%) were the result of hacking, primarily of computer servers. Those 24 breaches exposed 550,083 patients' records, or just 3% of the nearly 19.2 million records involved in all 410 reported incidents involving more than 500 patient records.
So far, the Utah breach, at the latest report could involve as many as 780,000 beneficiaries of the state's Medicaid and Children's Health Insurance Program participants. That would make it the single-largest breach involving hacking since the civil rights office began collecting breach reports in September 2009 under a congressional mandate.
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The recent breach of patient-identifiable healthcare records in Utah is unusual, but not unique, in that it reportedly involved the work of hackers and the extent of the exposure was not immediately known.
According to the publicly available segment of the 410 major breach reports collected by HHS' Office for Civil Rights, 24 (not quite 6%) were the result of hacking, primarily of computer servers. Those 24 breaches exposed 550,083 patients' records, or just 3% of the nearly 19.2 million records involved in all 410 reported incidents involving more than 500 patient records.
So far, the Utah breach, at the latest report could involve as many as 780,000 beneficiaries of the state's Medicaid and Children's Health Insurance Program participants. That would make it the single-largest breach involving hacking since the civil rights office began collecting breach reports in September 2009 under a congressional mandate.
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