Last week I spent the day at eMDs talking with Dr. Winn and the excellent eMDs team.
Sadly, I cannot talk about eMDs Open Source plans yet, but I can say that they will soon be making a big splash. I had some pretty cool pictures from my visit, including one with Robby the Robot, so post also servers to announce that I have migrated FredTrotter.com to wordpress, in order to be able to post pictures with my blog posts.

Although the National Health Council recommends you to keep a personal health record and take it with you to your doctor,it�s one thing to document your medical information�

It�s another to know when and how to use it. Open MedicDrive,a collaborative open architecture based application has launched the educational Wiki for advancing and educating users about the role of Healthcare Information Technology in Personal Health Record Management.

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Slate has a cautionary tale for public/private initiatives or ‘how municipal Wi-Fi is such a flop’. This may shed some light on the failings of RHIO’s:

Today, the limited success stories come from towns that have actually treated Wi-Fi as a public calling. St. Cloud, Fla., a town of 28,000, has an entirely free wireless network. The network has its problems, such as dead spots, but also claims a 77 percent use rate among its citizens. Cities like St. Cloud understand the concept of a public service: something that’s free, or near-free, like the local swimming pool. Most cities have been too busy dreaming of free pipes to notice that their approach is hopelessly flawed.

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We reported on the Advance HIE article: Getting Beyond Economics last week. The article appeared online briefly for free but it now requires a free registration required login. It is very thought provoking: “…Health insurers and medical software companies, not subject to such regulations, have provided free software and hardware directly to providers. New York City recently awarded a $19.8 million contract to a proprietary EHR vendor, which will permit the city’s Department of Health and Mental Hygiene to provide free software to physicians and clinics to be used for care of patients (“Big Medical Step, Starting with the City’s Poor,” New York Times, April 16, 2007). While this may be a good idea from the standpoint of affordability and interoperability if the patients all go to the clinics that use this particular system, it won’t be much help when those patients seek care somewhere else. Additionally, it is not clear how much � and for how long � training, technical support and upgrades are to be provided under this grant. But it is a safe bet that additional products and services won’t be provided free indefinitely.

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Modern Health care is reporting that the Oregon RHIO planning has come to a halt: “The health plans were willing to pay, but the hospitals thought it was a more challenging venture,” Gibson said. The project did not get funded because “it lacked a sustainable business model. If you look carefully at his (Witter’s) business plan, sustainable operation was way off in the future. He just said in year five or beyond, there would be services that might be salable. You still had the first few years that might not be sustainable.”

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Public Service Announcement:

“Our Father’s life was shortened by many years because a laboratory test result that showed a reversible kidney failure was lost in the paper shuffle.”

— The Dunn Family

The not-for-profit Harris County Health Information Cooperative (HCHIC) is announcing its inaugural fund raiser at St. Arnold’s brewery September 20th, for a Houston, Texas area, county-wide or state-wide, non-proprietary Electronic Medical Record system: “Much like a lighthouse benefits all of us, your tax-deductible contribution to HCHIC will be used for desperately needed Electronic Medical Record (EMR) unification with proven and robust non-proprietary software that will be implemented, developed and promoted in Harris County and Texas. If you cannot attend the event, your tax-deductible contribution can be sent to HCHIC 4010 Blue Bonnet, Suite 202 Houston, Tx 77025. Individual memberships starting at $100 are available as well as silver ($500), gold ($1000) and platinum ($10,000) Sponsorships. Membership and Sponsorship donations received prior to October 31st will be ‘founding’ memberships. Membership allows voting rights as well as access to internal communications. Current goal: $80,000. 3 year budget goal: $2 million.” All implementation and development products will be FOSS licensed.

Many in Health IT are moving to all over-the-web ‘asp’, software-as-service Electronic Medical Records services with total centralized control of data. John C. Dvorak sounds off a note of caution for such a trend with the recent Windows Genuine Advantage server outage which should be a wakeup call for those moving to ‘online everything’ applications: ‘What is often lost in individual analyses of how to proceed with your data-processing needs is the concept of “being at the mercy of a single company.” It’s something that you need to avoid at all costs. This Windows Genuine Disadvantage pothole should make all users rethink their strategies…’ He further notes that this outage “happened to Microsoft, not to Alabama Joe’s Server Farm and Toaster Repair.” a note of caution indeed.

The Personal Health Record (PHR) Functional Model from HL7 will be released soon. Watch out ….
The working group of HL7 on electronic information sharing between doctors and patients is going to release a Personal Health Record Functional Model soon. It is done by the volunteer group.

You should soon be able to get a copy of the model from:
www.hl7.org/ehr

Check it out…

This article is out on the Houston Psychiatric Society website: “Three major healthcare groups: Harris (Houston) and Tarrant (Dallas) County Mental Health Mental Retardation Authority (MHMRA) and Gateway to Care are either near Request for Proposal (RFP) or already have proposals for Electronic Medical Record (EMR) systems. A decision will be made in the next two months. Linking the MHRMRA’s and Gateway to Care via the same EMR system would be a historic, rare, once-in-a-lifetime opportunity. For the success of these initiatives and the future of our patients, it is of critical importance that the systems chosen 1) be non-proprietary, Free and Open Source Software (FOSS) licensed products and 2) use the same software base. Advocacy for such a system by Houston Psychiatric Society and its members is crucial.”

The personal health record (PHR) is different from an EHR. The PHR is an electronic, lifelong record of health information that is maintained by individual citizens. These individuals own and manage the information in the PHR, which comes from both their healthcare providers and the individuals themselves. This article recently published in Virtual Medical Worlds describes the current state of affairs with regards to the development and implementation of PHR systems in some detail. Here are just a few of the many collaborative projects, activities, and organizations involving the development and implementation of personal health record (PHR) systems that are described in the article. Many of these are open source solutions, e.g. AHIMA and myPHR; MyHealtheVet ; Eastern Maine Healthcare; and MyOnlineHealth; and iHealth Record.