$20 billion boost to online medical records systems sorely needed

Glad to see President Obama has earmarked $20 billion for bringing more medical records online. Believe me, it is terrifying to take someone suffering cardiac symptoms to the ER of the hospital that performed their open heart surgery and you are told the ER physicians can't find their records.

I guess some nay sayers are claiming it will take a long time to bring technology people up to speed to handle the new infrastructure. I agree with Greg Beese, head of the technology support firm Logic Group, who says he estimates that it would take only about two months for technology support professionals to become familiar with the medical-specific aspects of health care records. Database professionals understand the basic structure of related record storage and health care records are not that much different than storing legal records or anything else for that matter. Medical records require more multimedia container fields to store images and graphic data like ECGs but the real trick is not in the basic structure, it is in the proper tagging and cross tagging of data so interrelated causalities can be identified. That information will need to be provided by medical specialists - not technology specialists. Besides if existing systems can be leveraged as templates for systems not yet created, the conversion could be expedited.

Of course there are also the ultra paranoid in the crowd that are wide-eyed in terror over privacy issues. As long as sufficent encryption systems are placed to protect data from hackers, I don't see any reason to be any more alarmed about online medical records than online banking records. The biggest danger in shared medical records, whether paper or online, is the financial gain that could be made by insurance companies or medical groups "leaking" information to those willing to pay for it to reduce risk exposure. The current flap over Steven Jobs health and the impact it has on Apple's shares is a prime example of how certain health records could be coveted by those interested in reaping profits from the stock market. Still, a leak can occur whether the information is in hard copy or online. Placing information online may actually make such a leak easier to track. Record access logs are far more tangible than relying on a clerk's memory or trying to force a hostile witness to admit they have broken confidentiality agreements.

"The computerized records, when used properly, are an indispensable tool for measuring, tracking and improving patient care — yet only about 17 percent of the nation’s doctors are using them. They are commonplace at large medical groups, but 75 percent of doctors practice in small offices of 10 physicians or fewer.

Doctors often benefit from inefficiency, because the dominant fee-for-service payment system means they are paid for doing more — more doctor visits, tests, surgical procedures, pills.

“Paying to put computer hardware and software in physicians’ offices isn’t going to do anything unless you change the incentives in the system,” said Dr. David J. Brailer, former national health information technology coordinator in the Bush administration.

There are some experiments with a pay-for-performance approach, in which Medicare gives medical groups bonus payments for meeting certain benchmarks of quality care. Monitoring that performance requires electronic health records. Yet to date, these have been isolated tests.

“You want to pay for achievement — better health quality and efficiency,” said Dr. David Blumenthal, director of the Institute for Health Policy at the Harvard Medical School, who advised the Obama campaign. “But in the transition period, before financial incentives are reformed, you need to provide incentives or grants to use electronic health records because this technology is sort of the opening wedge to reform.”

Those eligible for grants to buy technology, a member of the Obama transition team said, will include inner-city and rural hospitals and small doctor practices. But most money, he said, will go to incentive payments to improve quality and safety of care."

But, I feel the rewards that could be realized in the advancement of treatment and quality of care will far outweigh these "chicken little (the sky is falling)" concerns.

Blogs serve as fodder for free printed dailies

Despite the headline-grabbing bankruptcies of an increasing number of sizeable newspaper empires, this start-up guru thinks he can use bloggers for the content in a new string of free printed dailies. I guess he's offering bloggers a percent of ad revenue if their article appears in a particular edition. He appears to be primarily interested in local news and images though, so unless you're visiting San Francisco or Chicago, you'd better not start counting your coins yet.

The Printed Blog, a Chicago start-up, plans to reprint blog posts on regular paper, surrounded by local ads, and distribute the publications free in big cities.

The first issues of this Internet-era penny-saver will appear in Chicago and San Francisco on Tuesday. They will start as weeklies, but Joshua Karp, the founder and publisher, hopes eventually to publish free neighborhood editions of The Printed Blog twice a day in many cities around the country.

“We are trying to be the first daily newspaper comprised entirely of blogs and other user-generated content,” he said. “There were so many techniques that I’ve seen working online that maybe I could apply to the print industry.”

As pay newspapers lose readers to the Internet, where they can read the same articles without charge, many free papers have held their own.

“The free newspaper business model is still very workable,” said David Cohen, a founder of Silicon Valley Community Newspapers, a group of free weeklies south of San Francisco that was sold to Knight Ridder in 2005 and is now owned by MediaNews. “There’s a huge readership that wants the local news, and local businesses tend to increase their advertising in bad times because they have to capture people’s attention.”

History Channel special to bring Lincoln virtually to life

This year is the 200th anniversary of the birth of Abraham Lincoln. In commemoration, The History Channel will be broadcasting a special, "Stealing Lincoln's Body" beginning February 16 at 9 p.m. EST. Many of us are aware of the thwarted attempts to steal and ransom Lincoln's corpse after it was delivered to Springfield, Illinois for burial, but, what caught my attention about this program is it's use of new visual graphics technology to present reenactments using photographs of Lincoln himself, not costumed actors.

[image - Abraham Lincoln at Madame Tussaud's in London, England]

"...the program features moving images of Abraham Lincoln, digitally created from actual historical photographs. For the first time, Lincoln walks and moves according to the historical record. The moving images and some of the stills showcase the first “virtual photography” of Lincoln and the only “virtual motion” pictures of him ever created. Using computer-generated imagery, it illustrates key sections of the story and brings them to life, often with startling effect.

These new photographs and moving images of Lincoln highlight a level of historical detail and information never seen before. Ray Downing of Studio Macbeth, who created these digital effects for STEALING LINCOLN’S BODY, explains the technique began as a kind of experiment using contemporary film technology. It gives the modern audience an opportunity to “gaze upon the noble face of our most beloved president, to see him walk down the street, to see him alive again…. Today’s technology allows us to achieve a level of photographic realism previously unattainable, with the added bonus of motion graphics."

Author and Lincoln scholar Harold Holzer , who is interviewed in STEALING LINCOLN’S BODY, says: “ The result—an uncanny, believable, realistic, living Lincoln—moving before our eyes as he must have in life, wholly imagined yet based on actual photos—took my breath away. Here is the man who lived, laughed, spoke, walked, for precious seconds practically born again.”

Here's a YouTube preview. Pay particular attention to the first few seconds - the animation is seamless!!

I have worked with a product called CrazyTalk by Reallusion to animate the faces of still images of sculptures of people from long ago and this Christmas I even used it to create an animation of my late father calling one last square dance for my other family members as a OOAK Christmas gift. I'm presently working on a project to combine such animation with artificial intelligence to enable website visitors to virtually "talk" to historical personalities using the historical sculptures of George Stuart.

So I am anxious to see how similar software can be used to create full length animation and virtual photographic reenactment.

The program's focus:

"After lying in state at the White House and at the Capitol (the nation’s first presidential state funeral), Lincoln’s body was carried by train in a grand funeral procession through several states and nearly two thousand miles, arriving in his hometown of Springfield, Illinois on May 4. However, his final burial would not take place until 1901, thirty six years later.

Before Lincoln finally came to rest in a steel-and-concrete-reinforced underground vault in Springfield , the President’s body was repeatedly exhumed and moved, his coffin frequently opened.

In 1876, 11 years after Lincoln 's assassination, a band of Chicago counterfeiters devised a fantastic plot to steal Lincoln ’s body and hold it for ransom. They wanted $200,000 and the release of the gang's master engraver who was in prison in Illinois . The Secret Service – recently formed to deal with the country's ballooning counterfeiting problem – infiltrated the gang with an informer. Yet it also set in motion a cringe-inducing chain of events in which a group of well-intentioned, self-appointed guardians took it upon themselves to protect Lincoln ’s remains by any means necessary.

Some efforts to protect the remains of the 16th President of the United States would prove to be equally misguided and macabre. Finally, in 1901, thirty six years after Lincoln ’s assassination, Robert Todd Lincoln had the body of his father interred in a massive concrete vault. The contrast between the nation’s reverence for Abraham Lincoln and the shocking manner in which his body had been treated is striking. This strange story of Lincoln at un-rest reveals how important this man was to so many, and perhaps our reluctance to let such a beloved and visionary leader go."

Teacher and student contests, original short form video about Lincoln ’s life and Presidency, related lesson plans, as well as instructions for how to donate to this campaign will be available online at www.history.com/lincoln .

STEALING LINCOLN’S BODY was produced for The HISTORY Channel by Left/Right. Productions.

Boxee may break the grip of tier-based broadcast services

Boxee may be just what we've all been waiting for to eliminate the gatekeeping of broadcast content by traditional cable and satellite providers. For years I have been frustrated by the "tier" system of purchasing broadcast content from first cable then later satellite television providers. Right now I have to pay for the maximum tier from Dish Network just to get History Channel International and the National Geographic Channel. They tout the tier as 250 America's best channels but we only watch about 15. I have no interest in using my television to play music. I have no interest in sports channels (and my husband doesn't either). I have no interest in religious channels or shopping channels or channels that blare the latest stock market reports (I can check the trading on particular stocks faster on the web). I don't have kids at home anymore so I don't need the cartoon channels, Nickelodian or the Disney channels. I'm not into racy programming so I don't need the adult channels. Netflix is far more cost effective than any of the Pay-per-view channels.

At least I have the ability to set up "Mary's favorites" so I don't have to scroll past all of the noise to select the few channels I want to watch. Even then, if I could watch programs on demand, I don't really need to constantly subscribe to even my preferred channels. The History Channel and the Military Channel rely far too heavily on old WWII newsreel footage to fill hours of programming time. Although the History Channel has been doing a little better lately, at one point in time people were calling it the "Hitler Channel". The Military Channel has also aired a few ancient warfare programs that were interesting too like "Warriors" and "The Battle for Rome" but spend most of their time acting as a running advertisement for US arms dealers and the Defense Department. Anyway, services like Boxee, in combination with websites offering on demand video, could finally put an end to this ridiculous business model that makes consumers spend so much money on product they don't even want. Of course I would have to wait for a PC version of the program and finally get around to giving up my Mitsubishi big screen TV and invest in some HD model.

"Boxee bills its software as a simple way to access multiple Internet video and music sites, and to bring them to a large monitor or television that one might be watching from a sofa across the room.

Some of Boxee’s fans also think it is much more: a way to euthanize that costly $100-a-month cable or satellite connection.

“Boxee has allowed me to replace cable with no remorse,” said Jef Holbrook, a 27-year-old actor in Columbus, Ga., who recently downloaded the Boxee software to the $600 Mac Mini he has connected to his television. “Most people my age would like to just pay for the channels they want, but cable refuses to give us that option. Services like Boxee, that allow users choice, are the future of television.”

The software, which is free and available for download at www.boxee.tv, works on Mac and Linux computers, and on Apple’s set-top box, Apple TV. A version of Boxee for Windows PCs is being tested among a limited group of users.

Boxee gives users a single interface to access all the photos, video and music on their hard drives, along with a wide range of television shows, movies and songs from sites like Hulu, Netflix, YouTube, CNN.com and CBS.com.

Unlike the increasingly long and convoluted channel directories on most cable and satellite systems, Boxee offers a well-organized directory, which can be navigated using the remote controls that now ship with most computers."

House calls via webcam a step in the right direction

At last someone is taking virtual medical services seriously on a statewide scale. The article says insured patients pay $10 - they must mean $10 per virtual session.

I have read that some doctors now offer email contact to some patients too. I've been trying to get my doctor to do that for years but she doesn't want to communicate that much. Perhaps if doctors would subscribe to a secure Twitter-like service that would enable patients to post health updates like a running dialogue it would give doctors more insight into how their patients are actually doing on a regular basis instead of just seeing patients when they have a health crisis. Doctors or their assistants could scan the dialogues periodically and if they see a troubling pattern starting to emerge they could then proactively contact the patient before a crisis arises.

American Well, a Web service that puts patients face-to-face with doctors online, will be introduced in Hawaii on Jan 15.

Its first customer, Hawaii Medical Service Association, the state’s Blue Cross-Blue Shield licensee, will make the Internet version of the house call available to everyone in the state, the company said.

The service is for people who seek easier access to physicians because they are uninsured or do not want to wait for an appointment or spend time driving to a clinic, said Roy Schoenberg, co-founder and chief executive of American Well Systems, which is based in Boston.

Dr. Schoenberg, a physician, said that American Well had piqued the interest of policy makers in Washington who want to expand access to health care. Insurers in other states will soon offer the service, he said.

Patients use the service by logging on to participating health plans’ Web sites. Doctors hold 10-minute appointments, which can be extended for a fee, and can file prescriptions and view patients’ medical histories through the system. American Well is working with HealthVault, Microsoft’s electronic medical records service, and ActiveHealth Management, a subsidiary of Aetna, which scans patients’ medical history for gaps in their previous care and alerts doctors during their American Well appointment.

The Hawaiian health plan’s 700,000 members pay $10 to use the service. The insurer also offers the service to uninsured patients for $45. Health plans pay American Well a license fee per member and a transaction fee of about $2 each time a patient sees a doctor.

Available Apps Driving Consumer Phone Choice

A couple of weeks ago I posted an article about the popularity of music games that are now available for cell phones. Today, I read a new article that pointed out how the availability of thousands of new apps is becoming the determining factor on which phones consumers ultimately purchase:

"...With the advent of touch-screen technology and faster wireless networks, the new competition and cool factor [for cell phones] revolves around thousands of fun, quirky (and even useful) programs that run on the phones.

The popularity of such applications for Apple’s iPhone, the leader of the transformation, is driving a fierce competition among the makers of the BlackBerry and Palm devices, and even Google and Microsoft.

It heralds a new era in the allure of a mobile device — the phone is no longer a fashion statement but a digital bag of tricks...

...Since July, Apple has posted more than 10,000 programs to its App Store; 9 out of every 10 iPhone users have downloaded applications — more than 300 million over all, though those include software updates and repeat downloads. Some applications are free (like Stanza, which lets you download and read books) while others typically cost $1 to $10.

Other applications help users navigate roads, find friends and local restaurants, and play odd games, including one called Sapus Tongue, in which the user swings the phone to see how far he can fling an animated monkey on the screen.

Recognizing the business opportunities, the other major cellphone and software companies are getting into the app act.

Google recently introduced the Android Market, selling applications based on Android, its operating system for cellphones. In the spring, Research in Motion plans to introduce an application store for its BlackBerry devices. Palm is thinking of retooling its software strategy, while Microsoft is in the early stages of creating its own store for phones running Windows Mobile." - More: New York Times

I liked the application called Shazam that "lets users hold the phone up to a radio to identify within seconds what song is playing and by whom — and then give users a way to buy it on Apple’s iTunes Store, of course." Google also offers one that sounds really helpful called ShopSavvy, "in which users scan the bar code of any product using the camera built into the G1 smartphone from T-Mobile. The application, which is free, then searches for the best price online and delivers the information to the phone."

As usual, though, especially with a predominately young audience, the most popular application is a wacky simulation of the sound of flatulence available for 99 cents. Hey, at least they keep us from taking ourselves too seriously!!

I see that cell phone application development is also starting to attract some serious venture capital money. Apparently, Kleiner Perkins operates a $100 million fund for iPhone application developers.