Dispatch from DC
by Brian Johnston, Jena Lee and Paul Weber
HIMSS Members from around the country gathered in Washington DC to participate in the National Health IT Week (September 12-16, 2011).
The conference began on September 14th with some pre-meetings and various committee meetings. For the newcomers, HIMSS had organized a “HIMSS 101” class which introduced the new members to what HIMSS is, and does, including its prime directive, priorities for 2011, organizational structure, etc. This introduction, presented by Richard M. Hodge (Senior Director of HIMSS, Congressional Affairs) was highly educational and eye-opening. The number of regulatory obligations burdening the healthcare industry was almost overwhelming. However, one of the most memorable moments in this session was when a speaker shared a lighthearted moment with the audience by naming the top 5 regulations in a sing-song rhyming fashion: HIPAA, MIPPA, ACA, AHA, CHIRA and ARRA.
On Thursday, the 10th Annual Policy Summit culminated with an opportunity for the HIMSS members to meet with their Congressional Representatives to inform, educate and present some specific recommendations that the legislative branch should pursue to improve our nations’ healthcare delivery system by supporting Health Information Technology (HIT).
This was the first time that our organization, Apria Healthcare, the leading national provider of home healthcare products and services, participated in the HIMSS Policy Summit so we had some uncertainty regarding the expectations and activities for the day on Capitol Hill. The HIMSS Advocacy and Public Policy team, led by Richard M. Hodge, developed an excellent program for the participants of the “Advocacy on the Hill”.
In the morning, we received a rousing message from surprise guest Dr. Farzad Mostashari, National Coordinator for Health IT who exhorted us to recognize that “now is the time”. His intent was primarily to indicate that lowered technological thresholds can make data availability and system functionality more accessible to more HIT users more readily but we also recognized that now is not the time to limit HIT funding or create roadblocks to effective data exchange.
We also heard a keynote speech from US Representative Michael C. Burgess, MD (R-Texas) who amused us with his experiences with HIT; first as practicing physician (read: suffering user), then as a practice leader (read: vendor/peer punching bag), and finally as a legislator (read: HIT MD in a roomful of lawyers). He is currently working to convene a Congressional Health Care Caucus and invited us to encourage our representatives to get involved.
The HIMSS Advocacy and Public Policy team invited Brad Fitch, President & CEO of the Congressional Management Foundation to present “Perceptions of Citizen Advocacy on Capitol Hill: How to be an Effective Citizen Advocate”. Based on his years of experience consulting with lobbying organizations and working on the Hill, he dispelled a number of widely-held misconceptions about working with members of Congress. They have a strong desire to do the “right thing” even in the face of political head winds and prefer hearing directly from constituents either at home or at the Capitol.
The HIMSS members participating in the Policy Summit were seated at tables aligned with their home states. There were two tables dedicated to California and we had a team of eight convened to meet with the Legislative Assistants for the two US Senators representing our state. Each of these HIMSS members would also be meeting with their local US Representative’s staff. After a lunch where we convened to discuss our presentation strategy, the California team headed to the Hart Senate Office Building to find Senator Barbara Boxer’s office and Senator Diane Feinstein’s office.
All of the HIMSS members were prepared to present the three 2011 Policy Summit “Asks” to their legislators. These were;
1) In order to improve the quality of your constituents’ healthcare while also reducing its costs, such as through elimination of duplicative care, Congress should continue its strong bipartisan support for Health Information Technology.
2) Congress should preserve the investment being made in the Medicare and Medicaid Electronic Health Records Meaningful Use Incentive Program as an essential tool that is critical to the healthcare transformation process.
3) In order to ensure that your constituent is the right person getting the right healthcare at the right time, Congress should support the development of a nationwide patient identity solution by lifting current statutory prohibition, to allow HHS to address this issue along with other health IT policy enhancements.
The California delegation met with a Legislative Assistant from Senator Boxer’s office and a Legislative Correspondent from Senator Feinstein’s office. We were prepared to be met by a bright, youthful aide and were not disappointed. In both cases, the staff member listened intently to our presentation of the problem situation and our formal “asks”. They posed good questions and were very interested in our impressions of the current situation with their constituency.
Our team agreed that both of the Senators would likely support both of the first two recommendations to maintain HIT support and to preserve funding for the Meaningful Use Incentive Program but that additional evaluation into the issues related to the third request would be necessary.
Following the meetings with the Senators’ staff, some delegates had an opportunity to visit the office of their own local United States Representative to Congress. Paul Weber met with the Legislative Counsel of the office of Rep. Dan Lungren (3rd Congressional District, CA). At this meeting the staff member was not only interested in the HIMSS “asks” but also engaged Paul in a deeper discussion about healthcare I.T. issues. In particular the staff member emphasized that this was an area of particular interest to Representative Lungren She demonstrating knowledge about the topics at hand, probing for specific examples of how healthcare I.T. helps our organization as well as how lack of standardization negatively impacts patients, providers and payers.
Taking a message directly to your Federal legislators can be extremely empowering. If the message is as clearly articulated, as compelling and as well formed as those developed by our HIMSS Advocacy and Public Policy team then the experience can be very rewarding.
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Cal eConnect Grant to Bring on New Participants
by Paul Budilo
The Orange County Partnership Regional Health Information Organization (OCPRHIO) was formed in 2006 and is a community collaboration of health care providers whose mission is to facilitate health information exchange (HIE) in Orange County, CA. Recognizing that large providers in the County have already invested in their own HIE technology the goal of OCPRHIO is to leverage the investment already made in the community and to collaborate with our partners instead of competing against them. To facilitate those health care providers that have not yet invested in an HIE infrastructure, OCPRHIO provides a gateway to obtain health information through community collaboration.
To facilitate the advancement of the organization’s efforts the OC Unites Project was initiated and in 2011 OCPRHIO was the recipient of an HIE Expansion grant. This Grant was awarded by Cal eConnect, the State of California’s governance entity for Health Information Exchange. This 18-month grant is being used to leverage existing HIE services provided by new technology partners to meet the community goals of improving patient care through better care coordination. Phase 1 participants on the OC Unites Project include: St. Joseph’s Health System, the 10th largest hospital not-for-profit hospital system in the US; the University of California, Irvine Medical Center, a 422-bed university hospital with 16,389 inpatient admissions and 406,842 outpatient visits annually; Integrated Healthcare Holdings, with 4 Orange County hospitals totaling 157,000 inpatient days and 151,000 outpatient visits annually; and Monarch HealthCare, Orange County’s largest medical group with 2,300 primary care and specialty providers, 180,000 HMO patients and 32,000 ACO patients. Rollout of the HIE to other participants within the Orange County health care community will continue throughout 2012 and 2013, adding additional functionality and expanding upon both the amount of patient information and the number of patients served.
Orange County’s health care providers serve a population of 3 million people. With 6,100 physicians in the county, an estimated 882,000 patient encounters were recorded in 2010. There are many requirements that must be achieved for an HIE to be successful. Among others it must show value to the stakeholders for participating in an HIE, the data must be accurate and timely, the HIE – itself - must be a trusted neutral and reliable entity, and the HIE must have a sustainable business model. OCPRHIO includes participation on its Board, Executive Committee, and Governance Committee from a myriad of Orange County’s health care providers. Doing so allows OCPRHIO to receive direct input from these various entities within the community to create an HIE that provides an outstanding value proposition to the end user. Additionally, this inclusive process increases the amount of data flowing into the HIE creating an even greater value proposition by enabling health care providers to make decisions about patient care based on timely and accurate information.
Whether the HIE be community or private, the success of one HIE, is the success of all.
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HIE: How to Get Data in the Hands of Those Who Use It To Improve Patient Care
by Anette Asher
A transformation of healthcare is taking place in California through Health Information Exchanges (HIEs). While attending the 2011 California HIE Stakeholder Summit hosted by Cal eConnect on Nov. 9, 2011, I learned about the state-‐funded initiative supporting HIEs in policy, IT infrastructure and how to ensure successful data exchange. The motivations for HIEs are immeasurable. Getting data to the physician faster, and turning it into useful information for our providers to respond and treat patients wisely and effectively, can assure us all of a higher level of care that will drive true Accountable Care Organizations.
The Summit offered a time to discuss the hurdles, questions and potential solutions to encourage early adoption of HIEs in as many regions as possible. What is the big issue? More than 60 percent of the state of California is rural. This is not uncommon for just about every state in the country. That means that the ambulatory providers and smaller hospital systems need to get connected both within their region and interstate.
We heard from stakeholders and government leaders, such as the California Department of Public Health, California Health & Human Services (CHHS) and the EKCITA, who was the first organization west of the Mississippi to exchange live patient data in 2008. These stakeholders are focused on public health and better patient care by seeking and leveraging the most data possible to make informed, and wise, point-‐of-‐care medical treatments and therapies. UCSD Beacon ($15 million grant) member Dr. James Killeen, Associate Clinical Professor of Emergency Medicine, has leaped over some hurdles in less than 10 months in the effort to exchange data on cardiovascular patients by having EMTs send data while patients are in transit. This allows the emergency department to prep the catheter lab before patients arrive. Rapid emergency response saves lives.
Dr. Linette T. Scott, Interim Deputy Secretary for HIT CHHS, shared what providers want, what the barriers and issues are and what is needed to take the next steps. The message? Drive forward in planning for Meaningful Use stage 3, and learn how each organization helps connect the providers to ultimately connect to the patients with better, safer and quality care. Learn more about what Cal eConnect has developed, discovered and gained in consensus to see if there is information thatyou can use on infrastructure, governance models, policy and how to create a sustainability plan.
You can tap into the Cal eConnect Monthly Technology Advisory Group, which provides a neutral forum for adoption and/or establishment of standards-‐based approaches to technical operations. The public is invited to participate in meetings. Callers will be placed in a listen-‐only mode until specified times on the agenda for questions and comments.
2011 Meeting Schedule:
Begins Jan. 19, 2012 (Third Wednesday of every month 1 p.m.-‐3 p.m.) Dial 1-‐866-‐244-‐8528
Passcode 3287176#
Webinar http://caleconnect.na4.acrobat.com/technology/
During this Summit, I learned more about HIE governance and how to develop a framework. Technical assistance and emerging standards that address compliance for privacy and security as well as using HL7 and other standards were shared. This Summit was a great forum for giving input, getting feedback and offering ideas that will accelerate the adoption of HIEs in more regions effectively.
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Ambulatory Comittee Update
by Angela Rivera
Southern California HIMSS (So. Cal HIMSS) is embarking on a new endeavor this year. In pursuit of one of the organization’s strategic goals to “Bridge the gap across all healthcare IT constituents”, we are developing a Committee to target the Ambulatory environment, most specifically Independent Ambulatory Providers and Practices. Healthcare reform continues to stress the importance of information technology adoption across the entire healthcare continuum, and while historically HIMSS focused more on the needs of hospital organizations, we understand the importance of expanding our reach to medical practices, community health organizations and ambulatory clinics to identify and demonstrate how information technology can promote clinical and business integration solutions to benefit all involved in the delivery of quality healthcare.
Earlier this year, So. Cal HIMSS’ Ambulatory Committee was launched and charged with the responsibility for ensuring that outreach to a broadened group of healthcare providers is achieved. Members of the Committee currently include:
- Angela Rivera, Chair – So. Cal HIMSS Immediate Past President and Client Partner at CTG Health Solutions
- Kay Barancik – Director Ambulatory Informatics, St. Joseph Health System
- Andre Vovan - Chairman, Chief Medical Information Officer at Mitochon Systems and Intensivist, MD, President at Newport Critical Care
- Wayne Sass – Vice President and CIO at Nautilus Healthcare Management Group
- Neeraj Bhavani - Founder & CEO, TAGNOS
To date the Ambulatory Committee has developed a Charter and identified preliminary initiatives to pursue over the coming year. The Committee’s Mission and Objectives is as follows:
The Ambulatory Committee is dedicated to expanding the awareness of the value of Ambulatory Information Systems by growing the membership of ambulatory care experts within HIMSS and by promoting the use of information technology to allow for practice transformation. The Ambulatory Committee is focused on identifying, educating and participating with local members in the areas of:
• Communicating industry and government updates and trends related to IT adoption
• Identifying and communicating issues, best practices and lessons learned related to healthcare IT adoption and meaningful use
• Translating the impact of healthcare reform to the ambulatory setting
The Committee has set high goals for themselves and can definitely use more help. If you have an interest in volunteering, please reach out to Angela Rivera at angela.rivera@ctghs.com.
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Security Discussion: Future Considerations and FutureProofing
Roger Fraumann, CISSP
The intersection of regulated life sciences, healthcare, and security (in particular cyber security) is rapidly evolving through regulation, standards and technology adoption. The regulatory life science industry will likely experience significant changes and added complexity over the next several decades as numerous developments – including theNIST Pervasive Information Technology Program[1]andNIST Body Area Networks (BAN) & Pervasive Health Monitoring[2], intelligent medical sensors and devices, Genomics and others– rapidly expand the scope and nature of the regulatory life sciences industry, with a commensurate broader establishment of standards and regulations. Meanwhile, a similar level of change in security maturity, compounded by the growing threat of cyber crime and terrorism, threaten to radically change security and network technology, standards and credentialing.
Healthcare will be impacted in several ways. How will healthcare providers establish their security policies and compliance to be coordinated with medical products? This could include infrastructure, user training, workflows and even new processes in patient management. This discussion is to get those in IT thinking and prepared for what lies ahead.
1.1. Body Area Networks and Medical Appliances/Robotics Security
Medical sensors, prosthetics, appliances and robotics of the future will likely participate in a communications network of some form, includingIEEE 802.15 Task Group6 Body Area Network[3](BAN),IEEE WG802.15.4 Wireless Personal Area Network (WPAN)[4]andIEEE P802.15.7 Short Range Wireless Optical Communications using Visible Light[5]around, within and upon the human body. By anticipating and building in accommodations for the sets of challenges this will present for regulatory life sciences, companies will be better positioned to effectively and economically address the inherent security risks to the greatest extent possible.
All software for use within humans must be under rigorous development, source code control, version control, distribution control, quality control, testing, etc. Adoption of systems similar to the "human-rated spacecraft" system approach used byNASA-STD-3001 "NASA SPACE FLIGHT HUMAN-SYSTEM STANDARD[6]"may be an appropriate pattern. It will also be important to make the software resistant to inadvertent and intentional tampering. Access to the body area network must be secured using rigorous firewalls, intrusion detection/prevention, strong cryptography and key controls.
· Internal medical devices, appliances and robots will likely include sensors and personalization settings. A variety of command/control and monitoring capabilities will be also be needed – for example, strain and wear sensors in joint replacement prosthetics, heart pacemakers, anti-seizure sensor/device, or an internal artificial pancreas of the future. In the future, it is likely that a human body may gain more than one software-enhanced device over a lifetime and each of these will need some form of standardized way to communicate with each other and outside the body in a secure fashion. For example, coupling a continuous glucose sensor with an artificial pancreas. The key will be that as medical devices interoperate, it will be imperative that each and every one has a trusted identity, with one or more to assume the additional role of acting as a secure gateway to communicate outside of the body. Because of power consumption and the desire to minimize radio energy in some areas of the body, the "gateway" appliance will likely become modularized in such a way to be initially external and perhaps eventually "attached/included" to one of the internal devices, providing trusted communications with other nearby devices in a star or mesh network within and outside the body.
· External personal medical devices, appliances and robots are also likely to include secure identification and software communications requirements. Although the devices may be external to the human body, it is increasingly likely that they will |
involve some level of secure wireless communications. For example, there is a need for building a consistent set of secure and tested command and control and communications tools for control of a medically inter-connected exoskeleton, dependent on internalnerve/muscle sensors/triggers and or brainwaves.
· External deployable medical devices, appliances and robots that can be temporarily applied for use by one or more people will be particularly vulnerable. In addition to the other attendant communications security issues will be the need to make them re-assignable as the assets are redeployed.
· Ingestible medical devices and pharmaceuticals have a complex set of life-cycle security requirements, including manufacture code controls and deployment controls. A pill that contains a secure programmable dosing engine and "navigating" digestive or circulatory system cameras provides a good example. This scenario, as well as many others, dictates the need for a standardized medical "rules of engagement" engine, much like what the military is using today in intelligent munitions.
· Human Life-grade related control and monitoring systems, both inside as well as outside the body, need to be extended and managed in such a way that the entire interaction of security systems will be protected from any form of development, supply chain or configuration penetration or error.
· Source code control, patching, version control, distribution control, quality control, and testing will all need to be "Human Life"-rated to include interactions with imaging system dosing, pharmaceuticals and the myriad of other software controlled/enhanced and communicating materials. Monitoring and managing potential interactions will add to the complexity
· Robust Body Area Network firewalls, intrusion detection/prevention, encryption and key management will all need to be created, including the need for multi-factor access and management controls and encryption key management. Similar to the existing NASA[7]systems for managing everything that is "Human Rated" for spaceflight, or FAA[8]systems for aircraft parts and avionics.
1.2. Data Security
All protected or sensitive data stored in a database, which may well need to be extended to include local, network and remote Caches (think cache poisoning, tampering, sniffing, etc.) will need to be physically and/or virtually protected by encryption, access controls and intrusion detection/prevention technologies. The more intelligence and data sharing continues to spread with intelligent medical devices, the more of a challenge this will become.
· It will be important to ensure that data input and output from all application systems to be validated for correctness, appropriateness and access controls. Validation checks will be important at each step in its journey to meet confidentiality, integrity and availability expectations.
· Applications (whether embedded, distributed, cloud or enterprise) will need to be able to detect, log and permit remedy of any corruption of information through communications and processing errors and to overcome accidental and deliberate acts.
1.3. Data Archival and Retrieval
Data management policies, including governing data and system access, collection, storage, archival and destruction will need to be implemented and documented consistently. All forms of intangible assets including data, intellectual property and processes should be identified, classified, have their ownership determined, controlled, tracked and documented in a consistent manner
· Lifetime/100+ year life-cycle data management including data capturing, filtering, categorizing, classifying, transporting, associating with other appropriate data and locations, all the relevant data captured during the life-cycle of not only the data associated with the research, production and manufacturing of the medical item, but the potential for the life-long use of that item by a Human (for example a sensory organ transplant or artificial organs).
· Lifetime/100+ year life-cycle data storage management includes |
the management of data over the various technology lifetimes of storage devices, in such a way that it remains available and viable. For example, adopting XML as the current standard and then migrating the data from various storage media, tools, formats and applications over the next 100+ years.
· Lifetime/100+ year life-cycle data encryption management includes maintaining the right level of protection, confidentiality and privacy through generations of encryption and key management. For example, monitoring and maintaining the integrity of data while migrating from one form of encryption to another form of encryption when it has become less secure and migrating and updating keys including "activation/ deactivation/ revocation" keys for medical devices, as well as management of identification and Certificate Authority.
1.4. De-Identified Data
Separation of identified and de-identified data in a secure fashion at the point of capture, transmission, sharing and storage will require new data management models, particularly in support of mobile Body Area Networks.
· Logging of identified and de-identified data to include creating an indelible trail capturing all relevant meta-data, while protecting the de-identified data sources and still providing useful collaborating meta-data. For example, the meta-data indicating the laboratory equipment calibrations and operator training certification need to accompany the test results through the de-identification process.
· Encryption and protection of data in transit needs to include laboratory stations maintaining a trusted ID and encrypting all command/control in and results out, preserving full confidentiality, integrity and assurance of data. For example, a trusted laboratory device refusing to operate after securely interrogating the appropriate operator credentials database for and finding invalid operator credentials.
· Audit Trails of identified and de-identified data must be maintained and protected separately to prevent disclosure through clock comparisons, but at the same time be useful to detect and investigate fraud or compromise in the future. For example, not only does the laboratory workstation need to separate and deliver identified and de-identified data without compromise, but it also needs to be done in such a way that the audit trails and tools necessary for the detection and remediation from fraud and compromise can be accomplished without compromise of de-identified data.
1.5. Genomic Findings
· The impact of future Genomic findings on current data may create the need to have the ability to retrofit future genomic findings in correlation with existing data that has already been captured. For example, a particular rare gene combination is discovered which has a significant impact on the analysis of patients treated with an experimental drug, shedding a whole new light on potential life-threatening contraindications. It could then become an FDA mandate or imperative to immediately reevaluate the data accumulated through the lifecycle of a drug, potentially including de-identified data as well. This may result in the need to adopt some form of secure "escrow" containing the de-identification methods, algorithms and keys, in case it is required in the future.
· Potential future government rule changes regarding genetic identification can impact de-identified data in particular, while continuing to protect the availability, integrity and confidentiality of the data and individual. The ability to anticipate and legally refer to historic data in light of the new genomic findings as a result of regulation changes may result in a competitive advantage.
· Any data which includes genomic data might be able to be used to bridge identified and de-identified data security requirements and will need to automatically assume the higher-level security requirements and must be factored into the data classification scheme.
· Any current and future security requirements in privacy, research and other regulations which include genomic data will need to be added to the issues to be address in risk analysis and security best practice. |
1.6. Wi-Fi, RFID[9]and other "Near Field" communications
"Near-Field" security (including Wi-Fi, RFID, Blue-Tooth, potentially Tetrahertz, etc.) will likely be used to support of mobile, portable and BAN devices and sensors.
· Near-field communications security, particularly with RFID (as in Passports, credit cards, tire pressure sensors, etc.) and with Bluetooth (as in keyboard, mouse, headsets, or virtually any other Bluetooth enabled devices) provide ample examples for the need for improvements in security. Previous RFID standards were not designed to be secure or support encryption, as most devices do not have enough computing power to do data encryption to protect the data. It is essential that any near-field life sciences based communications enabled devices to have "Human Life" level security-by-design protections built in.
· Adopting proprietary near-field communications security that is not "Standards Compliant" is fraught with risks and likely won't outlast the potentially100+ year life-cycle necessary for implanted Life Science products.
· For the most part, implementers have moved up the short-ranged data communications technology curve to use Wi-Fi to be able to gain some level of security, confidentiality and assurance. And even the best security technologies implemented with Wi-Fi today are barely adequate and may not be able to protect a high-value target like Human Life.
· The inherent risks of unsecured near-field communications cannot be understated. It is only a matter of time before murder and other mayhem through unsecured near-field links will be possible if, not already conducted. Risk assessments and product liability studies should factor in near-field communications security, reliability and health issues.
[1]www.nist.gov/itl/pit/index.cfm
[2]www.nist.gov/healthcare/emerging/ban.cfm
[3]www.ieee802.org/15/pub/TG6.html
[4]standards.ieee.org/develop/project/802.15.4.html
[5]standards.ieee.org/develop/project/802.15.7.html
[6]https://standards.nasa.gov/documents/viewdoc/3315785/3315785
[7]NASA = National Aeronautics and Space Administration
[8]FAA = Federal Aviation Administration
[9]RFID = Radio Frequency IDentification
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Exploring the Ethics of HIT, CER Interface
By Dennis A. Robbins Ph.D. M.P.H.
Despite four decades of attempts to improve our health care system, the U.S. ranks 37th internationally in terms of quality. We now have an immense opportunity to change the trajectory of this downward spiral with the promise of Health Information Technology (HIT) and Comparative Effectiveness Research (CER); powerful tools to help make decisions in the light rather than the dark. However, within the dark shadows still lurks influential spoilers, individuals acting on the basis of political self-interest rather than the public good. Tremendously rich data sets and evidence-based medicine (EBM) will be undermined and diminished until we get our ethics in line.
The central issues we need to address on the HIT/CER interface involve the following:
1. Data sharing and acquisition for the public health and welfare
2. Balancing proprietary and public health interests
3. Allowing facts and science rather than ideology drive clinical decisions
4. Introduction of a politically agnostic ethics
To refine the issue in light of broader context, we need to rethink ethics. Far too often, ethics is seen in the negative: something that is wrong, a violation or bad choice. Historically, the major ethical sources in medicine include luminaries as Hippocrates, Aristotle, Mill, and Kant, all of whom offer positive proscriptions rather than negative admonitions. They talk about dos rather than don’ts and provide guidance that is surprisingly consistent
We are now on the cusp of unprecedented opportunities to regain stature, quality, value, and efficiency by shifting the trajectory of cost down and quality up through the infusion of HIT and large scale practice-based CER. What is missing from the equation is a robust discussion of ethics about how to best use information from robust data sets drawn from electronic health records (EHRs), claims data, patient reported outcomes for the greater good. These data have the potential to help us not only make more informed decisions, but also begin to bend the cost curve, reduce waste, and recapture quality. The ethics component involve mandating the responsibility we utilize these data to make life better for so many and either not abuse or misuse what otherwise would be protected. The caveat involves ways that we must protect and insulate privileged or confidential information from misuse, abuse and anything that would have out any individual at undue risk or disadvantage. So issues of depersonalizing and objectifying data to protect individuals are critical elements in this process. Similarly allowing data and good information to rise to the top rather than being fouled by political and ideological adolescence must stop immediately
The purpose of CER is to make information based on medical science and evidence available to increase the likelihood of choosing the optimal treatment option as well as to forecast new treatments/ products/ technologies/costs. CER uses large data sets to compare different drugs, devices, surgical interventions, behavior changes, and delivery strategies head to head in real world settings. CER methods are agnostic to specialties, historical preferences, or perceived value. This clear-headed approach can help us move from eminence-based practice to evidence-based practice.
Despite the promise of CER, widespread and politically fueled concern continues about the misuse of data and knowledge. Perhaps this is the ideal intersection to return to the roots of ethics and personal and professional integrity. Similar to the need to elevatethe level of discourse with the infusion of evidence-based medical criteria, we must we elevate the level of ethical discourse.
Indeed we must be willing to surrender ourselves to the promise of something larger and more conclusive. Rather than being clogged with our “perspective,” we need to welcome an opportunity to alter and expand horizons “Faithful expression to the data need fear nothing from the finest arguments.”
Dennis Robbins Ph.D., M.P.H., {DennisRobbins@cox.net, (Dennisrobbins.com)} is an active force in Practice Based Research Networks, a Board Member DARTNet, a National Research Network, PEARL Research Network and CINA advisor. Robbins has authored 8 books and > 350 articles/chapters/reviews as well as served as a columnist/board member for several healthcare journals. |
Seasons Greetings from the President
Season's Greetings from President
It is this time of the year when we celebrate holidays with families. Well we have a lot to celebrate as a chapter. We just received the national HIMSS 2011 Chapter of the Year Award in the Large Chapter category last week. Congratulations to all the chapter members, especially all the chapter volunteer leaders and supporters for your hard work and dedication! This is a great honor and tremendous achievement for the chapter. The award is based on several criteria, including Engagement with professional societies and healthcare IT entities, Academic Outreach, State Advocacy Activities, Communications, and Additional Chapter Initiatives.
We have completed another successful, record-setting CIO Forum on December 1. More than 200 attendees came to the Center for Healthy Communites to share several prominent CEO/CIOs insights concerning healthcare and Health IT. The networking opportunity was also one of the highlights of the day-long event.
Membership continues to grow reaching over 2,000. One of the most exciting developments is that our provider membership has reached 75% of the total membership, indicating the strength of our membership foundation.
One distinction that makes our chapter strong and stand out is our comprehensive and highly-valued educational and networking events. In the coming months, we have several important programs planned for you and registrations are open now. (See "Upcoming Events" below for more details)
This is an exciting year for healthcare and health IT. I would like to take this opportunity to thank our tireless and dedicated chapter volunteer leaders for taking the chapter to the next level and providing exceptional value to our members. We'd like to invite you to be a part of the volunteer leaders by contacting us at www.himss-socal.org.
We look forward to seeing you in 2012.
Happy Holidays and a Healthy New Year!
Sam King, FHIMSS, CPHIMS, FHFMA
President, HIMSS Southern California Chapter
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