HLDN: HIPAA’s Impact on Radiology

Health Leaders Daily News has a feature article on HIPAA’s impact on Radiology: ‘…If radiology images and reports were confined to the radiology department, implementing HIPAA privacy and security regulations in the industry would not be as challenging because the problems could be localized and manageable. But images and reports are distributed and accessed by personnel throughout the hospital (in the ER, ICU, etc.), and even by physicians outside the hospital. With the advent of digital archiving and transmission of images and reports, the HIPAA challenge becomes even greater. Proper access control, authorization and subsequent audit trails are critical…

Pharma IT Opens

Robert Perry wrote in saying: I have just implemented a new site on the web www.4pharmait.com
specifically for Information Technology (IT) professionals who work in the Pharmaceutical/BioTech industries. The site is based on Linux/PHP/MySQL PHPNuke implementation.

If your readers would like to connect with other PharmaIT professionals working in the pharma industry please visit www.4pharmait.com. Feel free to add http://www.4pharmait.com to your list of medical computing links.

Kind Regards,


Two Linux Supercomputers

Here’s a pair of supercomputing articles for your interest courtesy of Karsten Hilbert: ‘…Biotech company Medica Holdings Ltd today said it had formed an agreement with IBM that will allow its subsidiary Cytopia to speed up discovery of drug candidates to treat immune disease and cancer.

Medica said the Melbourne-based Cytopia would deploy IBM’s latest generation Linux supercomputing technology, allowing it to increase 100 fold its speed and selectivity in screening drug candidates… You can find this article here. The next one can be found here: ‘…It may not be much more than a pipsqueak right now, but the computer system now being set up at the Department of Energy’s Pacific Northwest National Laboratory is expected to grow into the world heavyweight of Linux supermachines…

Linux Medical Billing Anyone?

Can anyone direct me as to where I can possibly find any software preferably open source that is able to do medical billing on the Linux platform? Knowing I’m a Linux guy, I’ve had several friends approach me with this question, even to the point that I’m now pretty curious myself. Also if anyone could tell me how Linux fits in with the whole HIPAA thing? And last but not least, is there any open source or even other practice management software that happens practice management under Linux that is ready to be pushed into the end user environment? If so, is billing incorporated with this software as well? Thanks for any and all assistance and suggestions. I’m kind of a newbie to the health care potion of IT under Linux.
Also, please feel free to email me with any additional info. ajlimberry@shorelinuxsolutions.com

SJBJ: Cost, doctor usage are obstacles to IT system

The San Jose Business Journal has an article about a practice that built its own record software due to the high cost of closed software: ‘…Software companies wanted to charge Camino Medical Group nearly $10 million to install an electronic medical records system for its 175 physicians, a price the nonprofit couldn’t afford.

“We didn’t have that kind of money,” says Mahnaz Choobineh, chief information officer for Palo Alto Medical Foundation, the parent organization of Camino Medical.

Three years ago, Camino hired a few people to build its own electronic system for medical records, patient referral and real-time messaging for staff. The cost: $500,000… “Our biggest challenge is convincing the doctors to drop the paper and start using the computer,” says Ms. Choobineh. Transferring medical information from paper file to electronic format is a habit that doctors still need to get used to, she says…’ It would be great if they open sourced it, or put the development effort into an already existing free/open package.

Another Bionic Eye

Karsten Hilbert wrote in with this link to another report of a bionic eye implanted in a man who had lost his sight 20 years ago: ‘… “You actually have a fifth sense restored. And that is what I absolutely adore about this device,” the man, who wished only to be identified by his first name, Jens, said at a conference where early results from the work were revealed. “You are no longer blind. You might be blind to some objects, some situations, but you are not totally blind anymore.”…
While the device does not restore full vision, Jens was able to see clearly enough to drive a car in an empty parking lot to demonstrate the difference the device has made…’
Related story here.

HPS: The Next Level

The following essay was first printed in the June issue of the Houston Psychiatric Society Newsletter and contains perspectives on ways to unify the software architecture for mental health in Houston, Texas using free and open source software.

The Next Level of Efficient Practice 5/5/02

Ignacio Valdes, MD, MS

The Next Level of Efficient
Practice: We Can Do It

An interesting
aspect of being a Psychiatry resident is that you get the “grand tour” of
mental health delivery organizations in a given area. From this experience
one notices trends among them. One facet is the increasingly
wide range of styles, and complementary clinical
computing software available.

observation is the number of major clinical software programs used in different locations in Houston.
These number at least five. Each from a different vendor. Another observation
is that there are a number of patients who have been treated by one of these
clinical venues, sometimes more than once in the same day. The inherent duplication of work is manifest.

A laudable
goal for practitioners and patients would be to actively seek a unified computer
software architecture for all care entities in the city. Achievement of
this could result in a large-scale reduction in cost as well as improvement
in the quality of mental health care in Harris County through ease of coordination
and the resulting reductions in redundant work. It will also result in reductions in medication errors. Furthermore, a standard
software interface for clinicians would make everyone from technicians to
medical students to residents to attendings far more effective upon the arrival to any organization they happen to move to. It would also reduce errors caused by inexperience and avoid the chore of re-learning a new interface
at each site. This is not an exotic technology or concept. It has been done successfully for years at the Veterans Administration hospitals nationwide.

stating such a goal of software unity is easy, achieving such a goal is not. One of the biggest concerns is software security and confidentiality. Another is that several mental health organizations have already made substantial
investments in software infrastructure and are locked in to the vendors they have chosen. The lock-in is due to the high cost of purchasing software they already have and the high cost of converting to another system. Another is the far more mundane factor, and perhaps the most difficult is standardization, or approximation to a standard, of common forms (such as admission histories and mental status results) across organizations that have never collaborated so closely before. Formidable obstacles indeed.

when one considers the amount of redundant work that is performed each day in Harris County by practically every worker on each patient, the potential savings and improvement in care are also prodigious.

mental health is unique in that patient data can be safeguarded more easily among its practitioners through the use of a private network, which is physically separate from the Internet. Therefore, it is much easier to secure from intrusion. Moreover, “the pandora’s” box of patient data security has already been opened through the use of computer systems that are already in place. We are not benefiting as much as we could simply because of incompatibilities.

is also a way around the expense of clinical software in the form of software that does not have proprietary licenses attached to them. This kind of software is covered under a license, which guarantees the freedom for the software to be used, studied, and extended without restrictions by a parent organization. This removal of restrictions has resulted in clinical software such as the Psychiatry oriented SQLclinic (http://www.sqlclinic.org)
program, which is currently in use in New York. It is freely available for download on the Internet in a fully functional form. There are other clinical software packages which have licenses that guarantee freedoms such as OSCAR
and FreePM. OSCAR and FreePM are similar to SQLclinic, but they are more oriented toward general medicine. This usage is quite distinct from proprietary clinical softwares, which are restrictively licensed so that use, study, or extension to fit needs without consent or a fee to the vendor is prohibited. Additionally, compatibility and interface issues either can be avoided using these types of software.

all of the mental health organizations in Houston, there are more than enough information technology resources to use a system such as SQLclinic and to modify it to suit local conditions and have a unified software architecture for the city. The key ingredients are recognition of patient care and economic reasons for doing so and cooperation through the use of non-proprietary software.
Perhaps the most important factor is the political will and far-sightedness to undertake this. Houston could become a model of software collaboration for the nation if it has the desire to undertake this. Dare we begin?

you are interested in discussing the development of a common software architecture
for mental health in Houston, contact the author at ivaldes@hal-pc.org

Billable Virtual House Calls

USA Today has a short piece on aparently text-based ‘virtual house calls’ that are billable: ‘…Proponents say virtual house calls — meant to take place within a doctor-patient relationship established in person — are designed to replace unnecessary office visits, not quick phone calls or e-mails that still will be handled for free.

Patients log onto a secure Web site. If required to pay, they provide a credit card number and answer questions about their complaint. A doctor reviews the answers and replies, generally within a business day. If the doctor decides the patient needs to come in after all, there usually is no charge for the Web exchange…