The December 2005 issue of the journal Pediatrics has a report that found a coincident increase in mortality after implementing a ‘Commercially Sold’ Computerized Physician Order Entry (CPOE) system. The increased mortality may have been due to delays in medication and IV administration in the ICU caused by the new system: ‘…Although CPOE technology holds great promise as a tool to reduce human error during health care delivery our unanticipated finding suggests that when implementing CPOE systems, institutions should continue to evaluate mortality effects, in addition to medication error rates, for children who are dependent on time-sensitive therapies.’ The study notes that mortality rate studies on CPOE as opposed to adverse drug events(ADEs) studies has not been done before. The CPOE in the study DID reduce ADE’s as expected.

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I wrote this wrapup of the HIMMS “Enabling e-Health for RHIOs” Webinar held yesterday. ‘…If you start a [Regional Health Information Organization] RHIO, try not to call it that since RHIOs are seen as pie in sky dreams that may have unattainable goals. In the San Diego example he said they called theirs an HIE (health information exchange). I�m not sure what changing the name does, but apparently he thought that calling it an HIE and not a RHIO at least got it off the ground…’

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The Humano2 is the world’s first open source platform for creating and sharing enterprise application. The ground-breaking platform allows to customize applications or built entirely new ones in minutes without programming. Editor’s note: comments on this? I am unfamiliar with it.

Exceptions to anti Physician-self-referral laws are being proposed by CMS. The laws ban physicians from referring patients to entities in which they have a financial stake like laboratories. Originally designed to prevent abuses, “They were never intended to stand in the way of bringing effective electronic health care to patients…These new proposals would allow hospitals and certain health care organizations to furnish hardware, software, and related training services to physicians for e-prescribing and electronic health records, particularly when the support involves systems that are �interoperable� and thus can exchange information effectively and securely among health care providers…” Could this be good or bad for Free and Open Source Electronic Medical Records? Is there potential for abuse by creating monocultures of proprietary hardware and software through hospitals dictating proprietary solutions? Could this make the problem of fragmentation even worse?

Slashdot had a link to this ArsTechnica article about experiences with live bootable CD distribution’s (both Linux and Windows) custom built for use in disaster response situations like shelters. Highlights are that there are a number of advantages to this approach such as not molesting what is already on donated PC’s that must be returned. The most used applications were: e-mail, web browsing, and accessing FEMA databases which unfortunately still can only be done through Microsoft Internet Explorer and not FireFox. One of the most-needed applications was VOIP. Interesting read.

I’ve been monitoring news about Hurricane Katrina’s aftermath since I have a family of refugees staying with me. So far, the best source has been this blog and the Hurricane Central photo gallery on the Times Picayune website. News has been rapidly forthcoming on that website throughout this disaster. Remarkable seeing much of this happen in real time.

Interesting story first seen on slashdot about a new technique for the early detection of diabetes via MRI. Per slashdot it uses Linux as part of the processing, however, none of the linked articles mention this. It has also only been shown in rats but is very likely to be translated for human use.

Noted medical informatician and past contributor to Linux Medical News Scot Silverstein writes on the AMIA clinical information system working group forum: ‘…Don Lindberg in 1969: “computer engineering experts per se have virtually no idea of the real problems of medical or even hospital practice, and furthermore have consistently underestimated the complexity of the problems�in no cases can [building appropriate clinical information systems] be done, simply because they have not been defined with the physician as the continuing major contributor and user of the information” (Lindberg DAB: Computer Failures and Successes, Southern Medical Bulletin 1969;57:18-21). In Collen’s book of the history of medical informatics, other pioneers in clinical IT gave similar advice (e.g., Octo Barnett’s “Ten Commandments” in 1970).

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From this Government Computer News article: ‘State and local governments are giving more consideration to use of open-source code to help relieve budget pressures, according to market research firm Input Inc.

The Reston, Va.-based firm reported this month that state and local government agencies are leading the public sector market in adopting open-source software because of IT budget restraints, increasing hardware and software licensing costs, and the need to manage operations more aggressively than the federal government…’

Here is a link to a web page that maintains a table of Windows and Linux application equivalents or analogs. Thanks to J. Antas for this link.