Another local hospital closed its doors. This points out a major flaw in interoperability schemes. They are not resistant to business failure. The very flawed assumption is that medical entities last forever. The premise is that others get these little carefully regulated squirts of information from these entities. What if that entity no longer exists? All continuity lost, all data lost. All of these laws and regulations and standards and years spent on all these schemes are built on that flawed assumption. Now what?

Launched with great fanfare in May of 2008, according to this announcement, Google Health will stop taking new data January 2012, continue to allow data access and then cease operations January 2013: “…Now, with a few years of experience, we’ve observed that Google Health is not having the broad impact that we hoped it would. There has been adoption among certain groups of users like tech-savvy patients and their caregivers, and more recently fitness and wellness enthusiasts. But we haven’t found a way to translate that limited usage into widespread adoption in the daily health routines of millions of people. That’s why we’ve made the difficult decision to discontinue the Google Health service. We’ll continue to operate the Google Health site as usual through January 1, 2012, and we’ll provide an ongoing way for people to download their health data for an additional year beyond that, through January 1, 2013. Any data that remains in Google Health after that point will be permanently deleted…”

Huffington Post has this article about: “…Hundreds of companies–big and small, new and old–sell health information technology but industry analysts expect a wave of consolidation in the market, creating uncertainty that certain products will stay in the marketplace or even if some vendors will survive. Amatayakul said she found that up to 70 percent of vendors moved in and out of the market in some years, through mergers, acquisitions or on occasion, bankruptcy.

Congress did not address the possibility that federal incentives could be spent on products from companies with shaky finances when it wrote the stimulus law setting aside billions of dollars for electronic health records…”

Editor’s note to government: Thus the need for tax dollars only being spent on Free/Open Source licensed HIT software.

Per Richard Shilling on the Hardhats list the Federal Government is about to blow the small health IT vendor out of the water in favor of large Health IT corporation cartels: ‘…Well, it’s more like HHS contracted with CCHIT to provide certification services. And, by extension, HHS is supporting a certification scheme that *can cost in excess of $70,000*.

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The first hospital in England to install a smartcard-based Cerner system under the British Health Service IT modernisation scheme faces indefinite, multiple problems, according to an internal NHS document. This article at computer weekly reports of the problems with the proprietary system in development in the UK.

Software source code escrow with Electronic Medical Records (EMR) is an idea so flawed that it is remarkable anyone accepts this as a serious argument when making EMR purchasing decisions. Yet it repeatedly appears as a check off item on Request for Proposals (RFP) and in ‘vendor neutral’ EMR Implementation Guides. Often (always?) availability of Free/Open Source Software (FOSS) licensing does not appear as a check off item on RFPs. Bias towards proprietary EMR software seems evident. Proprietary marketers must love source code escrows. Purchasers should flee from it and get the real thing: verifiable, testable FOSS licensed EMR software in which the end users has complete access to usable EMR source code from the very beginning.

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Dr. Annie Ant�n of
ThePrivacyPlace.org an organization devoted to online privacy has posted an article that raises serious privacy questions about Microsoft’s HealthVault Personal Health Record software: “…Unfortunately, what people don�t realize is that HealthVault and similar PHR systems are not subject to or governed by law. When the Health Insurance Portability and Accountability Act (HIPAA) was enacted, we did not envision that private software firms would eventually want to create databases for our health records. As a result, HealthVault and other PHR systems are not subject to the same privacy and security laws to which traditional medical records are subject to in the United States because they are not �covered entities� as specified in the HIPAA…Microsoft appears to have sought the counsel of physicians who believe that patient consent is the best indicator of privacy protections. Unfortunately, most physicians do not understand the subtleties buried within healthcare privacy statements within the context of the software that implements those statements. For this reason, I now list three primary questions that one should ask before entrusting their health records to HealthVault or any other PHR system:” Paraphrased, the questions are:

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Microsoft has announced (NY Times Article) Health Vault. What should have followed here is a review of the service by my actually trying it. I was in the process of registering when I began reading the Terms of Service and Privacy Policy and I had to stop right there with my review when I read it. In addition to the contract being lengthy, it specifically states: “In using the Service, you may not:

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The conventional wisdom seems to be that the United States as a nation needs to ‘financially incentivize the adoption of Electronic Health Record technology’. While the intentions are good, what this seems to translate into is a rush in the next few years to get any EHR software installed at all costs. If this is done in an uncontrolled fashion with proprietary EHR software the long term consequences will be disastrous and expensive.

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According to GPLMedicine.org and a company letter, AcerMed is officially dead. Fred Trotter opines: “The important thing to note here is what did NOT matter. The AcerMed people seemed decent enough: did not matter. AcerMed was CCHIT certified: did not matter. AcerMed was recommended in the industry press and by industry experts: did not matter. Companies get sued, people get sick. When will the medical community wake up to the fact that proprietary medical software is incompatible with medicine, incompatible with free thought and dangerous to patient data?”