Re: [openhealth] Re: I have been invited to testify on 'Meaningful Use'
Scot, your links did not come through. -FT On Sun, Apr 19, 2009 at 1:09 PM, Scot Silverstein wrote: >> > The data model is more a symptom than an underlying cause of the problem. > > I would agree and say in more detail that the lack of understanding of the > critical importance of a robust conceptual and logical data model for the > myriad facets of medicine is a symptom of an underlying set of problems - > that fall under the very broad categories of false assumptions and > underestimations. > > The set of problems has been studied with regard to IT for many years; for > example see this work: > > Social Informatics. An introductory essay entitled “Learning from > Social Informatics” by R. Kling at the University of Indiana can be > found at this > link. The book “Understanding And Communicating Social > Informatics” by Kling, Rosenbaum & Sawyer, Information Today, 2005 > (Amazon.com link here) > was based on this essay. > > Scot > > [email protected] wrote: - > > To: [email protected] > From: Rod Roark > Sent by: [email protected] > Date: 04/19/2009 11:08AM > cc: [email protected], "[email protected]" > > Subject: Re: [openhealth] Re: I have been invited to testify on 'Meaningful > Use' > > > > > > > > > > > > > > > > > > > > Interesting article, but I'm not sure its conclusions are on-target. > > The data model is more a symptom than an underlying cause of the problem. > > > In my view the key point is that we cannot trust the existing > > "custodians" of medical IT to get it right. They haven't come close > > yet. The only way we'll get there is to require complete transparency > > at all levels. And fortunately the new administration does seem to > > value transparency. > > > And yes, transparency is of course what FOSS is all about. However that > > point should not be raised prematurely. > .. but perhaps when responding to > > the question of "how do we achieve transparency" > > > > Rod > > > Scot Silverstein wrote: > >> If you get a chance, please touch on "meaningful misuse" as in this story >> by a software engineer who became a patient: > >> > >> The Data Model That Nearly Killed Me > >> > http://www.syleum. > com/2009/ > 03/17/healthcare > -data-model/ > > >> > >> Scot > >> > >> > - > - > -- > >> Scot M. Silverstein, MD > >> Consultant in Medical Informatics > >> Teaching faculty in Healthcare Informatics and IT (Sept. 2007-) > >> Director, Institute for Healthcare Informatics (2005-7) > >> College of Information Science and Technology > >> Drexel University > >> 3141 Chestnut St. > >> Philadelphia, PA 19104-2875 > >> > >> Email: > scot.silverstein@ > ischool.drexel. > edu > > >> Bio: www.ischool. > drexel.edu/ > faculty/ssilvers > tein/biography. > htm > >> Common Examples of HIT difficulty: > >> www.ischool. > drexel.edu/ > faculty/ssilvers > tein/medinfo. > htm > >> ARS KU3E, member www.arrl.org > >> > >> > -openhealth@ > yahoogroups. > com > wrote: - > >> > >> To: > open-ehealth- > collaborative@ > googlegroups. > com > > >> From: fred trotter < > fred.trotter@ > gmail.com >> > >> Sent by: > openhea...@yahoogro > ups.com > > >> Date: 04/18/2009 06:05PM > >> cc: " > hardh...@googlegrou > ps.com > " < > hardh...@googlegrou > ps.com >>, " > openhea...@yahoogro > ups.com > " < > openhea...@yahoogro > ups.com >> > >> Subject: [openhealth] Re: I have been invited to testify on 'Meaningful Use' > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> Sounds good... its got to be short. I do not have much time! > >> > >> > >> -FT > >> > >> > >> On Sat, Apr 18, 2009 at 4:52 PM, Edmund Billings > >> > >> < > >> edmund.billings@ > >> medsphere. > >> com > >>> wrote: > >> > >>> We should collaborate on a position paper I will work so
Re: [openhealth] Re: I have been invited to testify on 'Meaningful Use'
> The data model is more a symptom than an underlying cause of the problem. I would agree and say in more detail that the lack of understanding of the critical importance of a robust conceptual and logical data model for the myriad facets of medicine is a symptom of an underlying set of problems - that fall under the very broad categories of false assumptions and underestimations. The set of problems has been studied with regard to IT for many years; for example see this work: Social Informatics. An introductory essay entitled “Learning from Social Informatics” by R. Kling at the University of Indiana can be found at this link. The book “Understanding And Communicating Social Informatics” by Kling, Rosenbaum & Sawyer, Information Today, 2005 (Amazon.com link here) was based on this essay. Scot [email protected] wrote: - To: [email protected] From: Rod Roark Sent by: [email protected] Date: 04/19/2009 11:08AM cc: [email protected], "[email protected]" Subject: Re: [openhealth] Re: I have been invited to testify on 'Meaningful Use' Interesting article, but I'm not sure its conclusions are on-target. The data model is more a symptom than an underlying cause of the problem. In my view the key point is that we cannot trust the existing "custodians" of medical IT to get it right. They haven't come close yet. The only way we'll get there is to require complete transparency at all levels. And fortunately the new administration does seem to value transparency. And yes, transparency is of course what FOSS is all about. However that point should not be raised prematurely. .. but perhaps when responding to the question of "how do we achieve transparency" Rod Scot Silverstein wrote: > If you get a chance, please touch on "meaningful misuse" as in this story by > a software engineer who became a patient: > > The Data Model That Nearly Killed Me > http://www.syleum. com/2009/ 03/17/healthcare -data-model/ > > Scot > > - - -- > Scot M. Silverstein, MD > Consultant in Medical Informatics > Teaching faculty in Healthcare Informatics and IT (Sept. 2007-) > Director, Institute for Healthcare Informatics (2005-7) > College of Information Science and Technology > Drexel University > 3141 Chestnut St. > Philadelphia, PA 19104-2875 > > Email: scot.silverstein@ ischool.drexel. edu > Bio: www.ischool. drexel.edu/ faculty/ssilvers tein/biography. htm > Common Examples of HIT difficulty: > www.ischool. drexel.edu/ faculty/ssilvers tein/medinfo. htm > ARS KU3E, member www.arrl.org > > -openhealth@ yahoogroups. com wrote: - > > To: open-ehealth- collaborative@ googlegroups. com > From: fred trotter < fred.trotter@ gmail.com > > Sent by: openhea...@yahoogro ups.com > Date: 04/18/2009 06:05PM > cc: " hardh...@googlegrou ps.com " < hardh...@googlegrou ps.com >, " openhea...@yahoogro ups.com " < openhea...@yahoogro ups.com > > Subject: [openhealth] Re: I have been invited to testify on 'Meaningful Use' > > > > > > > > > > > > > > > > > > > > Sounds good... its got to be short. I do not have much time! > > > -FT > > > On Sat, Apr 18, 2009 at 4:52 PM, Edmund Billings > > < > edmund.billings@ > medsphere. > com >> wrote: > >> We should collaborate on a position paper I will work some points. > > >> Edmund > > >> > __ > >> Edmund Billings MD > >> 415.505.8953 > > >> On Apr 18, 2009, at 2:46 PM, "fred trotter" < > fred.trotter@ > gmail.com > >> wrote: > > > >>> Hi, > >>>It looks like I have been invited to testify in Washington on > >>> what it means to have 'Meaningful Use' of EHR systems. > > http://www.ncvhs. > hhs.gov/090428ag > 2.pdf > > > >>>As before, I want to ensure that my testimony reflects the > >>> attitudes and values of our culture. Using Google moderator for the > >>> CCHIT meeting seemed to work. It is even more important this time, > >>> because I may be the only voice of reason (the FOSS angle) at this > >>> meeting. For this reason: > > > http://moderator. > appspot.com/ > #15/e=4a793& > t=4a795 > > > > >>> -- > >>> Fred Trotter > > http://www.fredtrot > ter.com [Non-text portions of this message have been removed]
RE: [openhealth] Re: I have been invited to testify on 'Meaningful Use'
When it comes to using computational models for cognitive support - which can be argued to be one of the biggest gaps in today's HIT (see http://www.nlm.nih.gov/pubs/reports/comptech_prepub.pdf) -- innovative use of spreadsheets as reporting tools has enormous benefits. If we really want to improve healthcare quality and efficiency, then we should expand our data models to include information on clinical processes outcomes that go way beyond transactional (i.e., administrative claims data) data; the mind-body connection; compliance to and variance from evidence-based guidelines; the efficacy and cost of complementary and alternative treatment approaches; observations of daily living (see http://rwjfblogs.typepad.com/pioneer/2009/04/2nd-round-project-healthdesign- cfp-targets-observations-of-daily-living.html); etc. And these data should be made available to researchers who crunch the numbers and collaborate with clinicians to generate and evolve clinical the guidelines. Furthermore, we need more innovative software programs that deliver cognitive support to clinicians and consumers through use of computational models. In other words, today's data and technology standards, and the conventional crop of HIT tools, are sorely inadequate. Radical innovation is needed for radical healthcare reform/transformation; and I contend that the innovative use of spreadsheets is a key component to realizing this goal. Steve --- Stephen E. Beller, PhD CEO/President National Health Data Systems, Inc. Wiki: http://wellness.wikispaces.com <http://wellness.wikispaces.com/> Blog: http://curinghealthcare.blogspot.com <http://curinghealthcare.blogspot.com/> Web: http://www.nhds.com <http://www.nhds.com/> From: [email protected] [mailto:[email protected]] On Behalf Of Mark Spohr Sent: Sunday, April 19, 2009 12:17 PM To: [email protected] Cc: [email protected]; [email protected] Subject: Re: [openhealth] Re: I have been invited to testify on 'Meaningful Use' The article seemed to be more about how the EMR/PHR was NOT used, rather thank MIS-used. He kept pointing out that there was information in the EMR which would have improved his care. However, people were not even looking at the EMR. The data model is really irrelevant to the use of data. The user interface and work flow determine how useful the record is. You could store all of your data in a spreadsheet and if it had a good user interface and good work flow access, it would be golden. (Please don't take this as an endorsement of spreadsheets... I am a founding member of a society dedicated to stamping out spreadsheets and people who think they are databases.) .Mark On Sun, Apr 19, 2009 at 5:08 PM, Rod Roark mailto:rod%40sunsetsystems.com> > wrote: > Interesting article, but I'm not sure its conclusions are on-target. > The data model is more a symptom than an underlying cause of the problem. > > In my view the key point is that we cannot trust the existing > "custodians" of medical IT to get it right. They haven't come close > yet. The only way we'll get there is to require complete transparency > at all levels. And fortunately the new administration does seem to > value transparency. > > And yes, transparency is of course what FOSS is all about. However that > point should not be raised prematurely... but perhaps when responding to > the question of "how do we achieve transparency" > > Rod > > Scot Silverstein wrote: >> If you get a chance, please touch on "meaningful misuse" as in this story by a software engineer who became a patient: >> >> The Data Model That Nearly Killed Me >> http://www.syleum.com/2009/03/17/healthcare-data-model/ >> >> Scot >> >> >> Scot M. Silverstein, MD >> Consultant in Medical Informatics >> Teaching faculty in Healthcare Informatics and IT (Sept. 2007-) >> Director, Institute for Healthcare Informatics (2005-7) >> College of Information Science and Technology >> Drexel University >> 3141 Chestnut St. >> Philadelphia, PA 19104-2875 >> >> Email: [email protected] <mailto:scot.silverstein%40ischool.drexel.edu> >> Bio: www.ischool.drexel.edu/faculty/ssilverstein/biography.htm >> Common Examples of HIT difficulty: >> www.ischool.drexel.edu/faculty/ssilverstein/medinfo.htm >> ARS KU3E, member www.arrl.org >> >> [email protected] <mailto:-openhealth%40yahoogroups.com> wrote: - >> >> To: [email protected] <mailto:open-ehealth-collaborative%40googlegroups.com> >> From: fred trotter mailto:fred.trot
Re: [openhealth] Re: I have been invited to testify on 'Meaningful Use'
The article seemed to be more about how the EMR/PHR was NOT used, rather thank MIS-used. He kept pointing out that there was information in the EMR which would have improved his care. However, people were not even looking at the EMR. The data model is really irrelevant to the use of data. The user interface and work flow determine how useful the record is. You could store all of your data in a spreadsheet and if it had a good user interface and good work flow access, it would be golden. (Please don't take this as an endorsement of spreadsheets... I am a founding member of a society dedicated to stamping out spreadsheets and people who think they are databases.) .Mark On Sun, Apr 19, 2009 at 5:08 PM, Rod Roark wrote: > Interesting article, but I'm not sure its conclusions are on-target. > The data model is more a symptom than an underlying cause of the problem. > > In my view the key point is that we cannot trust the existing > "custodians" of medical IT to get it right. They haven't come close > yet. The only way we'll get there is to require complete transparency > at all levels. And fortunately the new administration does seem to > value transparency. > > And yes, transparency is of course what FOSS is all about. However that > point should not be raised prematurely... but perhaps when responding to > the question of "how do we achieve transparency" > > Rod > > Scot Silverstein wrote: >> If you get a chance, please touch on "meaningful misuse" as in this story >> by a software engineer who became a patient: >> >> The Data Model That Nearly Killed Me >> http://www.syleum.com/2009/03/17/healthcare-data-model/ >> >> Scot >> >> >> Scot M. Silverstein, MD >> Consultant in Medical Informatics >> Teaching faculty in Healthcare Informatics and IT (Sept. 2007-) >> Director, Institute for Healthcare Informatics (2005-7) >> College of Information Science and Technology >> Drexel University >> 3141 Chestnut St. >> Philadelphia, PA 19104-2875 >> >> Email: [email protected] >> Bio: www.ischool.drexel.edu/faculty/ssilverstein/biography.htm >> Common Examples of HIT difficulty: >> www.ischool.drexel.edu/faculty/ssilverstein/medinfo.htm >> ARS KU3E, member www.arrl.org >> >> [email protected] wrote: - >> >> To: [email protected] >> From: fred trotter >> Sent by: [email protected] >> Date: 04/18/2009 06:05PM >> cc: "[email protected]" , >> "[email protected]" >> Subject: [openhealth] Re: I have been invited to testify on 'Meaningful Use' >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> Sounds good... its got to be short. I do not have much time! >> >> >> -FT >> >> >> On Sat, Apr 18, 2009 at 4:52 PM, Edmund Billings >> >> < >> edmund.billings@ >> medsphere. >> com >>> wrote: >> >>> We should collaborate on a position paper I will work some points. >> >> >>> Edmund >> >> >>> >> __ >> >>> Edmund Billings MD >> >>> 415.505.8953 >> >> >>> On Apr 18, 2009, at 2:46 PM, "fred trotter" < >> fred.trotter@ >> gmail.com >> >>> wrote: >> >> >> Hi, >> It looks like I have been invited to testify in Washington on >> what it means to have 'Meaningful Use' of EHR systems. >> >> http://www.ncvhs. >> hhs.gov/090428ag >> 2.pdf >> >> >> As before, I want to ensure that my testimony reflects the >> attitudes and values of our culture. Using Google moderator for the >> CCHIT meeting seemed to work. It is even more important this time, >> because I may be the only voice of reason (the FOSS angle) at this >> meeting. For this reason: >> >> >> http://moderator. >> appspot.com/ >> #15/e=4a793& >> t=4a795 >> >> >> >> -- >> Fred Trotter >> >> http://www.fredtrot >> ter.com > > > > > Yahoo! Groups Links > > > > -- Mark Spohr, MD
Re: [openhealth] Re: I have been invited to testify on 'Meaningful Use'
Interesting article, but I'm not sure its conclusions are on-target. The data model is more a symptom than an underlying cause of the problem. In my view the key point is that we cannot trust the existing "custodians" of medical IT to get it right. They haven't come close yet. The only way we'll get there is to require complete transparency at all levels. And fortunately the new administration does seem to value transparency. And yes, transparency is of course what FOSS is all about. However that point should not be raised prematurely... but perhaps when responding to the question of "how do we achieve transparency" Rod Scot Silverstein wrote: > If you get a chance, please touch on "meaningful misuse" as in this story by > a software engineer who became a patient: > > The Data Model That Nearly Killed Me > http://www.syleum.com/2009/03/17/healthcare-data-model/ > > Scot > > > Scot M. Silverstein, MD > Consultant in Medical Informatics > Teaching faculty in Healthcare Informatics and IT (Sept. 2007-) > Director, Institute for Healthcare Informatics (2005-7) > College of Information Science and Technology > Drexel University > 3141 Chestnut St. > Philadelphia, PA 19104-2875 > > Email: [email protected] > Bio: www.ischool.drexel.edu/faculty/ssilverstein/biography.htm > Common Examples of HIT difficulty: > www.ischool.drexel.edu/faculty/ssilverstein/medinfo.htm > ARS KU3E, member www.arrl.org > > [email protected] wrote: - > > To: [email protected] > From: fred trotter > Sent by: [email protected] > Date: 04/18/2009 06:05PM > cc: "[email protected]" , > "[email protected]" > Subject: [openhealth] Re: I have been invited to testify on 'Meaningful Use' > > > > > > > > > > > > > > > > > > > > Sounds good... its got to be short. I do not have much time! > > > -FT > > > On Sat, Apr 18, 2009 at 4:52 PM, Edmund Billings > > < > edmund.billings@ > medsphere. > com >> wrote: > >> We should collaborate on a position paper I will work some points. > > >> Edmund > > >> > __ > >> Edmund Billings MD > >> 415.505.8953 > > >> On Apr 18, 2009, at 2:46 PM, "fred trotter" < > fred.trotter@ > gmail.com > >> wrote: > > > >>> Hi, > >>>It looks like I have been invited to testify in Washington on > >>> what it means to have 'Meaningful Use' of EHR systems. > > http://www.ncvhs. > hhs.gov/090428ag > 2.pdf > > > >>>As before, I want to ensure that my testimony reflects the > >>> attitudes and values of our culture. Using Google moderator for the > >>> CCHIT meeting seemed to work. It is even more important this time, > >>> because I may be the only voice of reason (the FOSS angle) at this > >>> meeting. For this reason: > > > http://moderator. > appspot.com/ > #15/e=4a793& > t=4a795 > > > > >>> -- > >>> Fred Trotter > > http://www.fredtrot > ter.com
Re: [openhealth] Re: I have been invited to testify on 'Meaningful Use'
If you get a chance, please touch on "meaningful misuse" as in this story by a software engineer who became a patient: The Data Model That Nearly Killed Me http://www.syleum.com/2009/03/17/healthcare-data-model/ Scot Scot M. Silverstein, MD Consultant in Medical Informatics Teaching faculty in Healthcare Informatics and IT (Sept. 2007-) Director, Institute for Healthcare Informatics (2005-7) College of Information Science and Technology Drexel University 3141 Chestnut St. Philadelphia, PA 19104-2875 Email: [email protected] Bio: www.ischool.drexel.edu/faculty/ssilverstein/biography.htm Common Examples of HIT difficulty: www.ischool.drexel.edu/faculty/ssilverstein/medinfo.htm ARS KU3E, member www.arrl.org [email protected] wrote: - To: [email protected] From: fred trotter Sent by: [email protected] Date: 04/18/2009 06:05PM cc: "[email protected]" , "[email protected]" Subject: [openhealth] Re: I have been invited to testify on 'Meaningful Use' Sounds good... its got to be short. I do not have much time! -FT On Sat, Apr 18, 2009 at 4:52 PM, Edmund Billings < edmund.billings@ medsphere. com > wrote: > We should collaborate on a position paper I will work some points. > > Edmund > > __ > Edmund Billings MD > 415.505.8953 > > On Apr 18, 2009, at 2:46 PM, "fred trotter" < fred.trotter@ gmail.com > > wrote: > >> >> Hi, >> It looks like I have been invited to testify in Washington on >> what it means to have 'Meaningful Use' of EHR systems. >> http://www.ncvhs. hhs.gov/090428ag 2.pdf >> >> As before, I want to ensure that my testimony reflects the >> attitudes and values of our culture. Using Google moderator for the >> CCHIT meeting seemed to work. It is even more important this time, >> because I may be the only voice of reason (the FOSS angle) at this >> meeting. For this reason: >> >> http://moderator. appspot.com/ #15/e=4a793& t=4a795 >> >> >> -- >> Fred Trotter >> http://www.fredtrot ter.com >> >> > > > --~--~-- ---~--~-- --~-- --~-- -~--~ ~ > You received this message because you are subscribed to the Google Groups > "Open eHealth Collaborative" group. > To post to this group, send email to open-ehealth- collaborative@ googlegroups. com > To unsubscribe from this group, send email to open-ehealth- collaborative+ unsubscribe@ googlegroups. com > For more options, visit this group at http://groups. google.com/ group/open- ehealth-collabor ative?hl= en > -~-- ~~--- -~~-- ~ ~--~- -~--- > > -- Fred Trotter http://www.fredtrot ter.com [Non-text portions of this message have been removed]
Re: [openhealth] Re: I have been invited to testify on 'Meaningful Use'
Fred, CCHIT is designed to keep us little people out. As an independent I do not have or see the value in spending 30K+ to compete with big players. CCHIT has virtual monopoly which in itself is against American values. Shams --- On Sat, 4/18/09, fred trotter wrote: From: fred trotter Subject: [openhealth] Re: I have been invited to testify on 'Meaningful Use' To: [email protected] Cc: "[email protected]" , "[email protected]" Date: Saturday, April 18, 2009, 5:05 PM Sounds good... its got to be short. I do not have much time! -FT On Sat, Apr 18, 2009 at 4:52 PM, Edmund Billings wrote: > We should collaborate on a position paper I will work some points. > > Edmund > > __ > Edmund Billings MD > 415.505.8953 > > On Apr 18, 2009, at 2:46 PM, "fred trotter" > wrote: > >> >> Hi, >> It looks like I have been invited to testify in Washington on >> what it means to have 'Meaningful Use' of EHR systems. >> http://www.ncvhs. hhs.gov/090428ag 2.pdf >> >> As before, I want to ensure that my testimony reflects the >> attitudes and values of our culture. Using Google moderator for the >> CCHIT meeting seemed to work. It is even more important this time, >> because I may be the only voice of reason (the FOSS angle) at this >> meeting. For this reason: >> >> http://moderator. appspot.com/ #15/e=4a793& t=4a795 >> >> >> -- >> Fred Trotter >> http://www.fredtrot ter.com >> >> > > > --~--~-- ---~--~-- --~-- --~-- -~--~ ~ > You received this message because you are subscribed to the Google Groups > "Open eHealth Collaborative" group. > To post to this group, send email to open-ehealth- collaborative@ > googlegroups. com > To unsubscribe from this group, send email to open-ehealth- collaborative+ > unsubscribe@ googlegroups. com > For more options, visit this group at http://groups. google.com/ group/open- > ehealth-collabor ative?hl= en > -~-- ~~--- -~~-- ~ ~--~- -~--- > > -- Fred Trotter http://www.fredtrot ter.com [Non-text portions of this message have been removed]
