Dangerous Games and Health IT Feudalism

Dr. Koppel,

This is an open letter that I plan to publish on Linux Medical News and elsewhere. As you probably know, your JAMA ‘Hold Harmless’ article presents just the tip of the iceberg. Your article and more data from the Washington Post article
make it abundantly clear that proprietary vendors are intent on establishing private property rights for something that private property rights are clearly not appropriate for. It leads to the logical absurdities, expense, and moral hazards we are experiencing now. The obvious dangers, enormous conflict of interest, as well as highly practical considerations such as simple non-performance of proprietary Electronic Medical Record software is manifest. What the proprietary industry could not achieve with vendor lock-in, legislative help like Stark exceptions, trade secrets, and inadequate products they are attempting to achieve by pure politics. Politicians, proprietary vendors and its lobby are playing ‘heads we win, tails you lose, we are king, it is good to be king’ games with our safety, our privacy, taxpayer money, and our lives. This may well succeed in ushering in a kind of digital feudalism with the most intimate details of our lives. Such landlord type games are entirely inappropriate for the practice of medicine. They are antithetical to American history and values. A generous and virtuous society should not allow this to occur. (more after the break)

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How the HIT Lobby is Pushing Experimental and Unsafe Technology on Unconsented Patients and Clinicians

Scot Silverstein has a must-read article reacting to the recent Washington Post article on Health IT lobbying: “…A lot of voices were left out of that trade group’s lobbying. That trade group’s massive conflicts of interest also seem to have blinded it to the longstanding concerns of experts in medical informatics that current approaches to health IT are insufficient and may impair healthcare quality initiatives (let’s be frank about what that really means – it means patient harm)…”

WP: The Machinery Behind Health-Care Reform

“How an Industry Lobby Scored a Swift, Unexpected Victory by Channeling Billions to Electronic Records” The Washington Post has an eye-opening article on what really happened with the Health IT stimulus bill. It looks like Buckminister Fuller’s GRUNCH of Giants is alive and well. I now see the connection between HIMSS, Partners and AMIA. I’ve often wondered why AMIA has always been dominated by the Northeast/Massachutsetts crowd, why things like the Linux Medical News Freedom Award has been given such a cold reception year after year, and why AMIA leaders seem to hold such contradictory positions to AMIA’s mission. Things like government intervention bad (but we lobbied for it secretly), taxpayer money good, proprietary vendors good, physicians and taxpayers in perpetual financial servitude good. Now I know. That the health IT in the stimulus bill isn’t a social experiment at best (I’m being charitable) or simply a wealth transfer to proprietary vendors and government at worst is evident. Prove me wrong.

OpenEMR to be Used for Health Maintenance in Mumbai (Bombay)

Jain Suveinay and Dr. R. D. Lele of Lilavati Hospital in Mumbai (formerly Bombay), India are working on a project to use OpenEMR in a trial Health Maintenance Organization. Their plan is to deliver health care to include 100 doctors managing the health care of 50000 families (4 members per family) spread over a wide area network. The patient population lives in a slum area of Mumbai. Jain Suveinay: We will have a central server which will be accessed by the GP’s. Links to pharmacy and hospital will be also there. There is more information concerning this initiative at Health Maintenance in Mumbai

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GNUmed 0.4.4 released

GNUmed EMR for medical offices has been updated to version 0.4.4. Fixes include reenabled path sanity check that fell off when fixing Windows and a fix that makes recent notes in SOAP plugin copy-able for pasting. A new Live-CD has been released as well. More info can be gotten from