John Moore has a good summary of the ongoing debate about CCHIT, its relationship with the HIMSS trade group, and the challenge for “meaningful use.”
In summary (and I completely agree with John) – one outside, independent organization should NOT be the controlling gate for all HIT investment over the next ten years. CCHIT would like to be that organization, and who can blame them? But I’d be worried even if there wasn’t any relationship to a trade group at all.
Just saw a bit of a rant by M.G. Siegler on TechCrunch about Apple’s review process for iPhone applications. Apple has banned a variety of applications from the iPhone Apps Store, sometimes while allowing very similar applications through. Even for applications that don’t trigger arguments over appropriateness of content, the review process itself is lengthy and unpredictable. I can think of few other industries where the final step of the production process – putting the product into the hands of users – is held up for an indefinite period of time by an organization who has final say on the matter, doesn’t post the rules, and provides no guidance during the development process.
Here’s Siegler’s piece:
Let’s Stop Picking On Those iPhone App Reviewers. Actually, Let’s Not..
I mention it on this blog because I had an idea for an iPhone healthcare application that we’ve decided not to pursue because we’d have to go through the App Store approval process. The content wouldn’t have been objectionable, but we would have had to develop quite a few variations on the application for different projects, and the 1-4 week (or more) delay on approvals before we could push the app to real users made the whole thing seem a little less than viable. And I don’t think I’m the only one – a tremendous amount of the value in mobile health tools would come from very customized apps, designed for a particular clinical trial, a particular hospital, a particular quality improvement program, etc. As of today, Apple doesn’t make that possible.
That’s worth re-iterating: the Mobile Health applications that will have a real impact are going to be the little ones customized to particular projects across the whole healthcare value chain. Small contributions individually, but huge in aggregate.
Windows Mobile supports this model a bit more cleanly, but the hardware and software platform just isn’t as good (and I carry a top-of-the-line HTC Windows Mobile Touch Pro from Sprint, which is about as good as it gets if you need a keyboard). I have things I want to deploy to patients and clinical investigators on iPhones and iPod Touches, and as of right now the logistics are making that impossible.
Maybe version 3.0 of the iPhone software will help out here. Come on, Apple.
Trusera was one of the first “Health 2.0″ sites, and now it’s shutting down. I never used the site, so I have no idea about the quality of the offering. What I do know is that it was generally well regarded for what it was, and had a founding/managing team that was responsible for taking Amazon.com and Starbucks from small startups to the behemoths they are today. Both could presumably have put in the funding to keep things going indefinitely – even if it was just paying the hosting bills.
The fact that they were unable to raise outside money and unwilling to fund it themselves implies that the fundamentals must have been pretty bad. And I suspect that extends to quite a few other attempts to reinvent healthcare.
Trusera | Billy’s Journal | FAQ on Trusera’s Closure on May 27, 2009.
In the wake of Oracle’s acquisition of Sun, a group including one of the original MySQL founders is congealing around a fork of the MySQL open source codebase. The goal is to provide a safe home for the database in the event Oracle takes it in a negative direction:
I really should be writing a lengthy post about a number of important subjects that have come up recently – meaningful use, closed standards, and so forth. Unfortunately I’ve just recovered from a week of fairly aggressive, although not pig related, respiratory illness and so instead I’m going to post a music video about Health IT interoperability. The payoff is at the end.
It’s somewhat amusing to note that I first met Ross on New Year’s Eve, 1999, which happened to be the day he proposed to his wife. We then completely avoided crossing each other’s paths until 2006, when I was at CMS and he was at Pfizer and representing the industry on the AHIC Consumer Empowerment workgroup. We’ve had the opportunity to do some (non-musical) together since, which has been quite a lot of fun.
But if you read this far, one more thing to think about – HITECH has a few billion dollars in stimulus for HIT adoption. It has vastly more in penalties. The math is not uninteresting, and I’m going to do some of it this weekend.
John Halamka has posted a few thoughts from a meeting on dispute resolution in healthcare:
Life as a Healthcare CIO: Followup on Dispute Resolution
The key insight, which followed from the “ePatient Dave” data kerfuffle, is that we need to find a way to web-enable dispute resolution in healthcare. There’s not too much to add to that, except to reinforce that he’s absolutely right, and perhaps to suggest that it’s a broader issue than just PHR data disputes. In general, civilization benefits when we have more APIs to mediate our interactions with large, impersonal agencies. Two principles:
If we can’t rely on the consumer to spot all the errors (and we can’t), automated tools may be able to fill a small part of the gap by looking for logical inconsistencies. This needs to be approached with care – too many unnecessary queries to hospitals will impose too much of a burden, and “Are you sure you have this? Because if you did you’d probably be dead.” is probably not a question that the average patient wants to be asked.
I use a set of sketchy Visio stencils to create mockups for the web applications we build here, and there have been two practical pitfalls to the sketchy stencil strategy. First, the sketchy stencils created larger than expected print jobs — I’ve had a few close calls, nervously hovering over the color printer before a client meeting, waiting for my mockups to emerge. Second, when exporting the mockups to PDF (through Adobe’s PDFMaker add-on), the PDF files tend to be large, and printing from the PDFs takes even longer.
I learned recently that Microsoft provides its own Save as PDF add-on for Office 2007, so I tried it out, and was very pleasantly surprised. Microsoft’s PDF generator:
That last printing point is a big one, since it allows me to circumvent Visio’s embarassing inability to perform simple print functions, like collating multiple copies. (Rather than print in Visio, I can make a PDF and print from Acrobat Reader with ease.)
I’m actually not that big on visualizing data. Some people are textual thinkers, and that’s the category I tend to fall into. But good visualizations are powerful things, and that’s one reason I like tag clouds – words made into a picture. Everybody’s happy.
Which is why I spent a little too much time last night playing with Wordle, a service that lets you take a bunch of text and make a cloud out of it. Here’s one I made using the RSS feed for the blog:
It looks like we’re pretty interested in open source development, health, and Twitter.
On Thursday Evan and I spent the afternoon at the first session of the Harvard Medical School Dean’s Symposium. The topic was “Challenges to Successful Innovation and Translation” of medical research, and the highlight was a talk by Professor George Whitesides. Dr. Whitesides is one of those very interesting products of Cambridge, MA – he’s written over 950 papers, and co-founded twelve companies, including Geltex (which was sold a few years ago for $1.3 billion) and a little biotech named Genzyme. So when he talks, it’s worth listening.
After his talk I asked him if it would be all right if I shared “Whitesides’ Rules” on this blog. He agreed, provided that I referred to them as “Uncle George’s Homey Rules for Entrepreneurs.” So here’s Uncle George’s homespun advice for entrepreneurs. I’ve refrained from adding my own commentary, other than to type up my notes from the talk (and thus take no credit for various homey aphorisms):
And that is what Dr. Whitesides thinks bioentrepreneurs should know. Not all of these apply to Health IT, regular IT, and entrepreneurial activities that don’t have a science component. But most of them do.
