Slashdot has a book review on Complications which: ‘…is a look at the medical profession from the inside — written by surgical resident Atul Gawande, it is a frank, thought-provoking commentary on what happens when fallible human beings do a job that requires infallibility. In its chapters, he reveals that doctors make mistakes more often than most of us think — and that while there are bad doctors, the more usual case is the good doctor having a bad day, or the problem for which all the training in the world would not have been enough…’ and are many of the reasons this web site was begun coming up on 3 years ago.
In-Flight Medical ‘Briefcase’
As reported on Slashdot and originally on the BBC: ‘…On average one plane a day has to make an unscheduled landing somewhere around the world because a passenger has fallen ill and requires medical treatment. In two minutes you have a complete examination of the patient. Not only is this highly inconvenient for other passengers, it costs an industry already struggling to cope with turbulent times a great deal of money – $50,000 to $100,000 per diversion Airbus, in collaboration with the French Space Agency, has come up with a solution – an on-board, satellite-connected medical briefcase…’
Editorial: Beth Israel Deaconess Medical Center, IT dept. Unprepared for Disaster
Updated 3/4/03 Editor: apparently this was posted in someone else’s name by a disgruntled worker so take it for what it is worth: In early November, Beth Israel Deaconess Medical Center in Boston, Ma. http://home.caregroup.org/ suffered the loss of it�s computer network for several days. The problem was allegedly caused by the failure of the IT department to practice and to enforce established rules governing the use and unauthorized additions of new software onto the network.
It should be known that the medical center was not forthcoming and open about this network failure. This only became public knowledge when the Boston Globe received an anonymous notice. The BIDMC has had so much negative publicity regarding its finances that it did not want this additional fiasco known.
The BIDMC appears to be attempting to use a one-lane road as a superhighway. Adding system after system and boasting of the terabytes that are pushed across the network. This network was apparently unmonitored and overwhelmed with traffic. Obviously this computer network is not the premier hospital computer network of which the BIDMC often boasts. The BIDMC is now aware that misleading boasts may look good in the computer magazines but do not keep your network up and running!
The IT department needs to be restructured with managers who can concentrate on the computer network and the requirements of the medical center and less on securing their own advantages and political standing within the organization.
Counterparts in the healthcare industry should use this as an example of what can happen when you force out knowledgeable and dedicated long-term employees and fail to replace them with experienced professionals. Perhaps the practice of rewarding inexperienced brown-nosers and friends with supervisory and professional positions is now harming the BIDMC. This IT department is staffed with many employees who are on the outside looking in and waiting to be led to the guillotine. The IT department is obviously unprepared for disasters such as this.
DRUGREF.ORG online
drugref.org, the online repository for free, peer reviewed collaborative pharmaceutical reference databases is going online. The goal is to create an independent free database of pharmaceutical information suitable for decision support systems and expert system engines. It is still in draft mode, discussion is invited on related mailing lists.
Key features will be peer review, independence (of anything: languages, health systems, countries, industry, sponsors), and the collaborative effort.
Information entered into the database can be tagged to be valid only for any of a specific country, a specific health system, a specific language, a specific reference model. The user can then select what type of information he wants to access (like all info in English, only if valid in Australia, only if accepted by peer review process already)
All information entered (via web interface or client software) is audited and versioned. A peer review process will then “elevate” information stepwise from “raw” to “reviewed” to “accepted”. End users can decide what level they want to access at any time.
We hope that this way, information will be purified through the peer review process to a degree where it becomes trustworthy for professional daily use.
The data structure has been developed in a way that will make it easy to use the collected data for expert system engines (decision support systems)
Everybody with an interest in such work should please join one of our mailing lists:
devel@drugref.org for those participating in related software development incl. database modelling and
discussion@drugref.org for those interested in participating in a general related discussion.
To subscribe, please point your browser at
http://drugref.org/mailinglist.html
Please note that the web site is just a draft so far, some links still broken, and the online database just a first draft with a few mock data. We hope to get the discussion on our mailing lists productive in order to improve web site and database quickly to a degree where t becomes ready for production.
My special thanks to Ian Haywood who spent a lot of time working on this already, and for implementing the first draft online database.
Merry Christmas to all of you!
Evidence-Based Medical Software?
Can Free/Open Source Medical software also be called evidence-based medical software? Horst Herb at OSHCA 2002 spoke about the ethics, or lack thereof, of using black box (proprietary) software for making medical decisions. There would appear to be a number of parallels between evidence-based medicine and free/open source medical software. One would be the ability to examine decision making to its origins in open source clinical computing software. This currently isn’t possible with proprietary clinical computing software. Another, perhaps negative, parallel is the possibility of this effective reform being ignored by many practicing physicians.
Call for exhibitors, eHealth 2003 Conference, May 22-23, 2003 Brussels
Yves Paindaveine on the openhealth-list writes: ‘Please note that the European Commission, DG Information Society, in collaboration with Directorate General Health and Consumer Protection and in collaboration with the Greek Presidency, is organising eHealth 2003 – High Level Ministerial conference and exhibition, 22-23
May, 2003, Brussels..’ The full announcement is within.
Dear Colleagues,
Please note that the European Commission, DG Information Society, in collaboration with Directorate General Health and Consumer Protection and in collaboration with the Greek Presidency, is organising eHealth 2003 – High Level Ministerial conference and exhibition, 22-23
May, 2003, Brussels
Those organisations that have implemented and use eHealth solutions in they daily work (for example Decision Support, Hospital Information Systems, Regional Health Information Networks, ePrescriptions, eBooking, telemedicine applications, education and training services, personal health systems, etc) are invited to apply for place at the exhibition and for the first eEurope Award at www.e-europeawards.com.
A panel of experts will select the best application for the exhibition based on the demonstrated contribution to quality, access and efficiency of healthcare including cost benefits. DEADLINE for applications 15 February, 2003
For further information please contact the Multilingual Helpdesk at the above website or by phone +31-43- 329-6-329 (English, French, German, Spanish and/or Dutch)
PS Link to the conference is also available at:
IMIA Open Source Working Group Formed
IMIA has formed an open source working group, particulars of which can be found here. ‘The IMIA Open Source Health Informatics Working Group (OSWG) will bring together experts and interested individuals from a wide range of health professions and with a range of interests in the potential application of open source solutions within their domains of expertise. The OSWG will explore the implications of the open source approach for all aspects of IMIA’s areas of interest. It will work with other Working and Special Interest Groups to explore the appropriate use of open source solutions and applications…’ We are reporting this a little late since it occurred October 4th, but this announcement is significant enough to put out anyway.
NEJM: Practicing Physicians and the Public on Medical Errors
The New England Journal of Medicine recently published a research paper on Physician and Public attitudes towards medical errors: ‘… Though substantial proportions of the public and practicing physicians report that they have had personal experience with medical errors, neither group has the sense of urgency expressed by many national organizations…’ The study further found that only a minority of physicans were convinced that medical reforms such as computerized order entry, that have been demonstrated to be effective, would work. So much for evidence-based medicine.
VistA Adopters
Here’s a list of adopters of the Veterans Administration VistA software from the hardhats site which includes the Indian Health Service, The National Cancer Institute, Cairo, Helsinki University Hospital, University Hospital of Kuopio, Finland, German Heart Institute, Berlin, Obafemi Awolowo University Teaching Hospitals, Nigeria. Quite a list.
MED: Linux & The Promise of Open Systems
This essay was originally published in the September/October 1999 issue of Medical Equipment Designer, but could have been written today: ‘One of the hottest topics for designers and developers these days is the promise of open systems. For a generation, product advancements in control software, motion control cards and modules, VCRs, and mobile phones have all been hobbled by the promise of profit in proprietary systems. Those of you who travel overseas know all too well that even phone jacks, electrical outlets and voltages, and telephone protocols vary from country to country. While business and engineering goals are sometimes at odds, the promise of having a universe of integrated products which can communicate with each other is strong fuel for stoking the standards engines…’