Mercy Ships formulary available at drugref.org

The Mercy Ships drug formulary has been made available for download at drugref.org. It is based on the WHO model formulary. Many thanks to the hard working volunteers who made this most useful 100+ page work of drug information possible. We now call for volunteers to convert this information into a machine interpretable format in order to integrate dosing and indication information etc. into decision support modules and the drugref database.

AHRQ: $41 Million In Grants

AHRQ has announced a program seeking 100 grants “…As part of a larger initiative to support investments in information technology in the nation’s health care delivery system, the Agency for Healthcare Research and Quality today announced that it is seeking applications for approximately 100 grants to plan, implement, and demonstrate the value of health information technology to improve patient safety and quality of care. These grants will be part of a $50 million portfolio of grants, contracts, and other activities to demonstrate the role of health information technology to improve patient safety and the quality of care…” Could this benefit Free and Open Source Software in Medicine? Read on for full text of the announcement.

Agency for Healthcare Research and Quality

FOR IMMEDIATE RELEASE Contact: AHRQ Public Affairs
Friday, November 21, 2003 Howard Holland, (301) 427-1857
hholland@ahrq.gov
Ron Rabbu, (301) 427-1862
rrabbu@ahrq.gov

AHRQ TO SUPPORT HEALTH INFORMATION TECHNOLOGY PROJECTS TO IMPROVE

PATIENT SAFETY AND QUALITY OF CARE

As part of a larger initiative to support investments in information technology in the nation’s health care delivery system, the Agency for Healthcare Research and Quality today announced that it is seeking applications for approximately 100 grants to plan, implement, and demonstrate the value of health information technology to improve patient safety and quality of care. These grants will be part of a $50 million portfolio of grants, contracts, and other activities to demonstrate the role of health information technology to improve patient safety and the quality of care.

“These grants will give health care providers the resources they need to implement real-world health care information technology solutions to improve the quality and safety of health care,” said AHRQ Director Carolyn M. Clancy, M.D. “This is an important addition to AHRQ’s existing $165 million investment in patient safety. I am particularly pleased that a large proportion of these grants will be used to fund projects in rural and small communities throughout America, where the opportunity is so great.”

The $41 million grant program, “Transforming Healthcare Through Information Technology,” includes grants for planning and implementation of health information technology in communities as well as grants to examine its value. The awards, supporting over 100 new research and demonstration projects, will comprise the core of AHRQ’s Health Information Technology portfolio. Applications will be accepted from public and private non-profit organizations, including universities, clinics, and hospitals; for-profit organizations (for implementation grants only); faith-based organizations; and state and local government agencies throughout the United States.

The Agency expects to award up to $24 million to fund as many as 48 new implementation grants under the first Request for Applications, with up to $14 million going to small and rural hospitals and communities. The RFA emphasizes the importance of community partnerships. AHRQ will provide up to 50 percent of the total costs in matching funds, not to exceed $500,000 per year, for each project. Letters of intent are due February 22, 2004, and applications are due April 22, 2004. For further information, go to the NIH Guide at http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-04-011.html.

As much as $7 million is expected to be awarded under the second RFA to fund up to 35 new planning grants to provide communities and organizations with the resources needed to develop their health information technology infrastructure and compete for future implementation grants. At least $5 million is expected to be used to support applicants from rural and small communities. Projects can last up to 1 year, and applicants may request budgets of up to $200,000 in total costs. Letters of intent are due March 22, 2004, and applications are due April 22, 2004. For further information, go to the NIH Guide at http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-04-010.html.

Demonstrating the value derived from the adoption, diffusion, and use of health information technology will be the focus of the third RFA, awarding approximately $10 million to up to 20 new grantees. The objective of these projects will be to provide health care facilities and providers with the information they need to make informed clinical and purchasing decisions about using health information technology. Applicants may request budgets of up to $500,000 per year in total costs. Letters of intent are due March 22, 2004, and applications are due April 22, 2004. For further information, go to the NIH Guide at http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-04-012.html.

The remainder of the $50 million portfolio will be spent on other activities, including the creation of a Health Information Technology Resource Center to aid grantees by providing technical assistance, provide a focus for collaboration, serve as a repository for best practices, and disseminate needed tools to help providers explore the adoption and use of health information technology to improve patient safety and quality of care.

AHRQ also will award the Indian Health Service $2 million in fiscal year 2004 toward the enhancement of the IHS electronic health record. This will permit individual facilities flexibility in how they configure their electronic health record system. The creation of an IHS electronic health record is consistent with tribal leaders’ identification of the need for a user-friendly data system that can provide community specific health care data and track the health status of the patient population. This need has been identified as one of seven top tribal priorities during HHS tribal consultation.

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Newsforge: Baton Rouge Hospital Installs Linux

href=”http://servers.linux.com/article.pl?sid=03/11/26/039241&mode=nested&tid=29&tid=30″>article about installing Linux from a ‘senior Unix systems administrator for Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana, where he is team lead for open source initiatives, Lawson Systems Administration, and DNS…’ Hooray, this sounds interesting. Thanks to Adrian Midgley for this link.

27,000 Thank You’s On Thanksgiving

On this occasion of Thanksgiving I would like to say 27,000 thank you’s to Linux Medical News readers, contributors and supporters. 27,000 is exactly how many unique visitors this site received last week. I’m astonished, honored and grateful that the world appears to be taking notice of the possibilities of Free and Open Source Software in medicine.

Happy Thanksgiving!

Ignacio Valdes, MD, MS

Editor: Linux Medical News

p.s. for once I am putting my degrees in because I’m tired of being mistaken for the ‘other’ doctor with the same name on Google that is not a Psychiatrist 🙂

OpenEvidence: the open source for notarisation

Financed by the European community, OpenEvidence -part of European Project Group FP5- is an open source framework for data certification, time stamping and data archival that brings technology for evidence creation, validation and long term protection of documents.

Developers of France, Belgium, Estonia and Italy share in this project their technological know-how to build an architecture that can be applied to different business models like notarisation.

Based on standards ISO 17799, British Standard 7799, IETF PKI RFC 3161 and IETF PKI RFC 3029, standardisations efforts has been made collaborating with the LTANS IETF Working group, ISO (concerning time stamping standard), PKIX certificate validation protocols, DVCS update (RFC 3029) and ISO 18509.
A demonstration service of Time Stamping using RFC 3161 by C&A (Italian partners of OpenEvidence) can be used on its web site.

For more info about OpenEvidence:
http://www.com-and.com/openevidence.html

Healthcare Hackers Survey

Calling all OS healthcare enthusiasts/hackers/whatever! I’ve decided to put my class time to good use a conduct a survey of the open source healthcare community. The idea is based on the Boston Consulting Group/OSDN Hackers Survey. For more information and to complete a survey click here. Why not help improve our knowledge about the OS healthcare community and help me get a great grade at the same time! Editor’s note: The term ‘hacker’ is usually mis-used by the popular press when the term ‘cracker’ is what is really meant. A cracker is one who illegally enters others computers or defaces website. The term hacker means someone who is capable of extraordinary engineering feats that are not illegal. Example: cracker can hotwire a car, hacker is an automotive engineer.

Open Source Working Group � UK think-tank meeting, February 2004

The Open Steps meeting, to be held near Winchester, UK, on 10-11 February 2004 is the first of a series of three meetings planned for 2004 as part of the activities of the IMIA Open Source and Open Source Nursing Informatics Working Groups. The purpose of the meeting is to identify key issues, opportunities, obstacles, areas of work and research that may be needed, and other relevant aspects, around the potential for using open source software, solutions and approaches within health care, and in particular within health informatics, in the UK and Europe. Further meetings will be held, including one at medinfo2004, to explore international validation of the issues identified.

The Open Steps meeting, to be held near Winchester, UK, on 10-11 February 2004 is the first of a series of three meetings planned for 2004 as part of the activities of the IMIA Open Source and Open Source Nursing Informatics Working Groups. This will be an invitation-only meeting, aimed mainly at the UK, but with some participation from open source colleagues and Working Group members from elsewhere in Europe and the USA.

The purpose of the meeting is to identify key issues, opportunities, obstacles, areas of work and research that may be needed, and other relevant aspects, around the potential for using open source software, solutions and approaches within health care, and in particular within health informatics, in the UK and Europe.

The meeting is funded by the British Computer Society Health Informatics Committee (BCS HIC), and is supported by the IMIA Open Source Working Group, the IMIA-NI Open Source Nursing Informatics Working Group and OSHCA (the Open Source Health Care Alliance).

The Marwell meeting will be followed by a larger meeting to be held at HC2004 in Harrogate in March, which will allow for a wider audience of clinicians, managers, informaticians and other interested parties to attend and explore and expand on the issues raised from the Marwell meeting. A further meeting, to seek international exploration of the issues raised in the first two meetings, will be held at medinfo2004 in San Francisco in September, as part of the IMIA Open Source and Open Source Nursing Informatics Working Groups� meeting. In addition, reports from all of these meetings will be made available through the chirad.info website, and we will encourage further contributions from those unable to attend the Open Steps meetings.

For further information as it becomes available see www.chirad.info/opensteps/marwell01.htm
or email opensteps@chirad.info

Dr Peter Murray
Co-chair, IMIA Open Source Working Group
Chair, IMIA-NI Open Source Nursing Informatics Working Group

Institute of Medicine- Patient Safety: Achieving a New Standard for Care

The Institute of Medicine released:
Patient Safety: Achieving a New Standard for Care
Patient Safety: Achieving a New Standard for Care, a report that describes a detailed plan to facilitate the development of data standards applicable to the collection, coding, and classification of patient safety information (…includes the reporting of “near misses” as well as errors.) The report is available on line.

“Open Source” is not mentioned in the report. However, there is a note about possibly putting VISTA into Public Domain (page 66.)

The press briefing was webcast live and is archived. No mention of Open Source at the briefing either.

IOM Report Misses the Point

This US Institute of Medicine (IOM) “report”:http://books.nap.edu/books/0309090776/html/index.html calls for increased Federal investment in a secure national healthcare information infrastructure in order to improve patient safety. If I recall correctly this is a major portion of the mandate for the “Internet 2 consortium”:http://www.internet2.edu/about/aboutinternet2.html. (“See the Health Sciences Security SIG”:http://health.internet2.edu/WorkingGroups/Security.html)

From the report:

“First, federal financial investment should support the development of critical building blocks of the national health information infrastructure that are unlikely to receive adequate support through investment by private-sector stakeholders, including the establishment of a secure platform for the exchange of data across all providers, and, as discussed below, maintenance of a process for the ongoing promulgation of national data standards. Second, the federal government should provide financial incentives to stimulate pnvate-sector investments in EHR systems; this might be done through revolving loans, differential payments to providers with certain information technology capabilities, or other means. Third, federal government funding of safety net providers will be necessary to support their transition to a safer health care delivery system.”

We should examine closely the long term effects of these financing arrangements. They are simply a quick fix to a problem that will out live the incentives. If these systems are held as proprietary applications they will serve to drive up the cost of healthcare when the funding runs out and the requiremetn to maintain them remains.

“Chapter 3”:http://books.nap.edu/books/0309090776/html/71.html#pagetop is especially important as it discusses the requirements for standards. What must be recognized here is that development of data interchange standards are in direct conflict with market share of proprietary shrink-wrapped applications.

This is a good and necessary report but it missed the basic requirement that the software must live beyond the funding cycle.