Quest Diagnostics Settles

The latest big settlement, as <a href="http://www.bloomberg.com/apps/news?pid=newsarchive&sid=aE6x.6gl4G70">reported by Bloomberg</a>:<br /><blockquote><br />Quest Diagnostics Inc. the world’s largest provider of medical diagnostic tests, <em>agreed to pay $302 million to resolve allegations that its Nichols Institute Diagnostics unit manufactured, marketed and sold misbranded diagnostic test kits</em>, the U.S. government said.<br /><br />The accord, which the U.S. said is <em>one of the largest recoveries ever in a case involving a medical device</em>, settles federal civil and criminal probes by prosecutors in the office of Brooklyn U.S. Attorney Benton Campbell.<br /><br /><em>Nichols pleaded guilty to a felony misbranding charge</em> today before U.S. District Judge Sterling Johnson in Brooklyn and agreed to a fine of $40 million, Campbell said.<br /><br />The kits that were misbranded involved a test used by labs called the Advantage Intact PTH Assay test, which is used to measure parathyroid hormone levels in patients, Campbell’s office said.<br /><br />Quest also agreed to pay $262 million plus interest to settle federal False Claims Act allegations relating to <em>the test and four others made by Nichols that allegedly provided inaccurate and unreliable results</em>, the U.S. said.<br /><br />Madison, New Jersey-based Quest also agreed to pay various state Medicaid programs about $6.2 million to resolve similar civil claims.<br /><br />Quest closed the Nicholas unit in 2006 and hasn’t sold the parathyroid test kits since 2005, Samuels said.<br /><br />The U.S. began its probe after a whistleblower suit was filed that alleged that the Advantage Intact and another test, the Bio-Intact PTH Assay, produced elevated results, Campbell’s office said.<br /><br />The tests were used by doctors to determine if patients suffering from conditions such as end-state renal disease were also suffering from hyperparathyroidism, a condition which involves overactivity of the parathyroid glands.<br /><br />Contrary to Nichols’s claims on inserts and marketing materials, <em>the firm was aware in or about May 2000 that the test wasn’t providing consistent result</em>, Campbell’s office said.<br /></blockquote><br />A settlement here, a settlement there, soon it may add up to some real money. <br /><br />We have posted again and again about legal settlements, sometimes huge, made by prominent health care organizations (see some of them <a href="http://hcrenewal.blogspot.com/search/label/legal%20settlements">here</a>). In the current case, the US Attorney stated that a prominent corporate provider of diagnostic services failed to reveal that its "test wasn't providing consistent results," and the company itself, or rather, one of its subsidiaries that is now closed down, pleaded guilty to "misbranding." <br /><br />Despite the outrage that ought to ensue after a diagnostics company admitted it concealed the fact that it knew its tests were inconsistent, and still provided and billed for test results, I suspect that this settlement, like others before, will sink without too many ripples. <br /><br />Yet this inexorable train of settlements suggests something fundamentally wrong with our health care system. Organizations that provide vital services to patients too often do so dishonestly, putting patient safety at risk. Although physician errors provoke endless headlines and much physician agony, organizational errors of apparently equal import vanish without a trace.<br /><br />I will note also that in this case, like many others before, only the corporation paid a penalty. The effects of this penalty, paid with fungible money, may be dispersed among shareholders, employees, clients, and/or patients. Yet it is not clear whether anyone directly responsible for the inconsistent test results, and the hiding thereof will pay anything additional. <br /><br />As long as poor organizational practices, and the cover-up of same, result in no negative consequences for those who are responsible for them, and as long as even discussion of such issues is <a href="http://hcrenewal.blogspot.com/2007/08/bling-bling-poltical-correctness-and.html">anechoic</a>, why should such practices and cover-ups stop?

Quest Diagnostics Settles

The latest big settlement, as reported by Bloomberg : Quest Diagnostics Inc. the world’s largest provider of medical diagnostic tests, agree...

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Hard at play in Google Labs with Similar Images and Google News Timeline

At Google, we are constantly researching, designing, and brainstorming about the next big idea, and when we think we've found something compelling, we often use our "<span style="background-color: rgb(255, 255, 255);"><a href="http://googleblog.blogspot.com/2006/05/googles-20-percent-time-in-action.html" id="q3jc" title="20-percent time">20-percent time</a></span>" to build a working version. Back in 2002, we created <span style="background-color: rgb(255, 255, 255);"><a href="http://www.googlelabs.com/" id="eo47" style="color: rgb(85, 26, 139);" title="Google Labs">Google Labs</a></span> to give these budding experiments a home where users could try them and share their thoughts with us. Some of our most popular products began this way, including Google Maps, iGoogle, and Google News.<br /><br />In keeping with our long-standing tradition of bringing new ideas to our users early in the development process, we're proud to welcome two new innovations to Google Labs: <a href="http://similar-images.googlelabs.com/" style="color: rgb(85, 26, 139);">Similar Images</a> and <a href="http://newstimeline.googlelabs.com/" style="color: rgb(85, 26, 139);">Google News Timeline</a>.<br /><br /><span style="font-weight: bold;">Similar Images</span><br /><br />Image Search is a tool you can use to find just about any kind of image, but it can sometimes be difficult to find the right image if you can't describe it in words. The new Similar Images feature was developed with just this in mind. Using it you can now find images that look like an existing result simply by clicking on a link. Using visual similarity, you don't have to refine the text of your search, instead, you can just click on the link of an image you like. For example, if you search for [<a href="http://similar-images.googlelabs.com/images?q=jaguar">jaguar</a>], you can use the "Similar images" link to quickly narrow your search.<br /><br />Image Search results will vary for the query [<a href="http://similar-images.googlelabs.com/images?hl=en&q=jaguar&btnG=Search+images" id="iaa:" title="jaguar">jaguar</a>]:<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEildFrZTOrAD2TQsAE2UOlpkzhnTOCB_wnL0zIDcKA5Xkz3SgWY9BY8AjasEp0gkaqBf0raGQzBt0_Kb10lO4I0RxokesNohhZ6S6DkZNDJex4Mlqt46Iym4KlSRG7rMtWNB_iu35hEtrsj/s1600-h/jaguar-screen-crop01.png"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5326818615988614386" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEildFrZTOrAD2TQsAE2UOlpkzhnTOCB_wnL0zIDcKA5Xkz3SgWY9BY8AjasEp0gkaqBf0raGQzBt0_Kb10lO4I0RxokesNohhZ6S6DkZNDJex4Mlqt46Iym4KlSRG7rMtWNB_iu35hEtrsj/s400/jaguar-screen-crop01.png" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 129px;" /></a><br />With one click, we can help you find more pictures of the [<a href="http://similar-images.googlelabs.com/images?q=jaguar&qtype=similar&tbnid=_xSOihbrgAXmcM&prev=/images%3Fq%3Djaguar%26hl%3Den&tprev=/images%3Fq%3Djaguar%26hl%3Den" id="awuw" title="cat">cat</a>]:<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4VIzf7t2d5FNCyD5dSASEe8dI-aXYiAuypr5Zxs8wx7D5UEagP1o-yCsxm7Wd0PLsBaOUu3MsUpYVe05Rxdm2QrJJQb87JfDeSKP5WOnx3QBelWcR5CaFsCu8zkoN8FuxEK0fC_g3hD5r/s1600-h/jaguar-cat-crop01.png"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5326818975691165986" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4VIzf7t2d5FNCyD5dSASEe8dI-aXYiAuypr5Zxs8wx7D5UEagP1o-yCsxm7Wd0PLsBaOUu3MsUpYVe05Rxdm2QrJJQb87JfDeSKP5WOnx3QBelWcR5CaFsCu8zkoN8FuxEK0fC_g3hD5r/s400/jaguar-cat-crop01.png" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 105px;" /></a><br />Or more pictures of the brand of [<a href="http://similar-images.googlelabs.com/images?q=jaguar&qtype=similar&tbnid=1F6xFNAoV1zjPM&prev=/images%3Fq%3Djaguar%26hl%3Den&tprev=/images%3Fq%3Djaguar%26hl%3Den" id="q.nr" title="brand of car">car</a>]:<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtGqYHNLRljco2IYZtUqWmtMEmJCVBU8wJgYIzMeFTppBWRdAjr1MEMF5MSd3tZHaa01ONqt06Pk3-ItyiEtwJ_2IJtsq778E33ir9By2R6zpQhW7h5mMqyUP86x8_QMtj7GBWdj-1Vy4j/s1600-h/jaguar-car-crop01.png"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5326819249288153266" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtGqYHNLRljco2IYZtUqWmtMEmJCVBU8wJgYIzMeFTppBWRdAjr1MEMF5MSd3tZHaa01ONqt06Pk3-ItyiEtwJ_2IJtsq778E33ir9By2R6zpQhW7h5mMqyUP86x8_QMtj7GBWdj-1Vy4j/s400/jaguar-car-crop01.png" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 107px;" /></a><br />You might try exploring the pyramids of <a href="http://similar-images.googlelabs.com/images?q=Egypt" id="dt3_" title="Egypt">Egypt</a> or discovering the <a href="http://similar-images.googlelabs.com/images?q=Forbidden+City" id="sbzc" title="Forbidden City">Forbidden City</a>. Or you might go shopping for an elegant <a href="http://similar-images.googlelabs.com/images?q=evening+gown" id="ltby" title="evening gown">evening gown</a> or that perfect pair of <a href="http://similar-images.googlelabs.com/images?q=shoes" id="j9dh" title="shoes">shoes</a>. So if you see an image you like, but you're stumped on how to describe it, just click the "Similar images" link to see more like it.<br /><br />Interested in learning more? Check out this video tour.<br /><br /><object height="295" width="480"><param name="movie" value="http://www.youtube.com/v/6fD2t4d2Ln4&hl=en&fs=1&rel=0"><param name="allowFullScreen" value="true"><param name="allowscriptaccess" value="always"><embed src="http://www.youtube.com/v/6fD2t4d2Ln4&hl=en&fs=1&rel=0" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" height="295" width="480"></embed></object><br /><br /><span style="font-weight: bold;">Google News Timeline</span><br /><br />Google News Timeline organizes information chronologically by presenting results from Google News and other data sources on a zoomable, graphical timeline. You can navigate through time by dragging the timeline, setting the time scale to days, weeks, months, years, or decades, or just including a time period in your query (i.e., "1977"). To see this in action, check out the results viewed by month in the <span style="background-color: rgb(255, 255, 255);"></span><a href="http://newstimeline.googlelabs.com/?date=2006-05-01&zoom=2" id="b_-4" title="summer of 2006">summer of 2006</a>.<br /><br />Google News Timeline can present results from lots of different sources, including both recent and archival news, scanned newspapers and magazines, blog posts, and sports scores and media like music and movies. You can view multiple sources simultaneously, allowing each source to lend context to the others. Try out some of our favorite queries like [<a href="http://newstimeline.googlelabs.com/?q=Jack+Nicholson&corpus=movie">jack nicholson movies</a>], [<a href="http://newstimeline.googlelabs.com/?q=Barack+Obama&corpus=newsquote">barack obama quotes</a>], and [<a href="http://newstimeline.googlelabs.com/?q=baseball&corpus=newsphoto">baseball news photos</a>]. To read more, check out our post on the <a href="http://googlenewsblog.blogspot.com/2009/04/introducing-google-news-timeline.html">Google News Blog</a>.<br /><span style="font-weight: bold;"><br />Google Labs reloaded</span><br /><br />These are just two examples of Google's innovation at play, with plenty more to come. In order to keep up with our engineers, we decided it was time to remodel Google Labs to make room for more — you guessed it — innovation! We started with the foundation: we rebuilt the service from scratch using <a href="http://code.google.com/appengine/">Google App Engine</a>, and we moved it to a new home at <a href="http://www.googlelabs.com/">www.googlelabs.com</a>. We also redesigned the website to make it easy and fun to discover new experiments as they arrive and to follow them as they evolve. We even added an <a href="http://www.googlelabs.com/rss">RSS feed</a> and an <a href="http://www.google.com/ig/directory?type=gadgets&url=hosting.gmodules.com/ig/gadgets/file/109878180592838349936/google_labs_gadget.xml">iGoogle gadget</a> to make it easier to stay up to date.<br /><br />When you visit the site, you can also hear from the innovators themselves and share your thoughts, helping us shape your favorite experiments into future Google products. So come early and come often and bring your adventurous spirit — after all, we're building these experimental products and features for you!<br /><br /><span class="byline-author">Posted by Chuck Rosenberg, Similar Images, Andy Hertzfeld, Google News Timeline, and Michael Cohen, Google Labs</span>

Hard at play in Google Labs with Similar Images and Google News Timeline

At Google, we are constantly researching, designing, and brainstorming about the next big idea, and when we think we've found something ...

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BLOGSCAN - Whose Interests Does Health Care Advocacy Serve?

<span style="color:#006600;">Merrill Goozner, </span><a href="http://www.gooznews.com/archives/001390.html"><span style="color:#006600;">on the GoozNews Blog</span></a><span style="color:#006600;">, dissected recent pronouncements on health care reform by economist Uwe Reinhardt. Reinhardt compared our US "system" of financing health care with those of some other countries. He noted some advantages of the latter systems, but wondered whether US citizens would accept the trade-offs they implied. In particular, he wondered whether the US would accept the tight regulation of private insurance companies found in Germany. But he conveniently failed to note that the German plan's success may depend on its exclusive use of only not-for-profit health insurers. Mr Goozner wondered whether if this omission had to do with Mr Reinhardt's position on the board of a for-profit US health insurance company, a relationship not disclosed in Mr Reinhardt's New York Times blog post. (We have </span><a href="http://hcrenewal.blogspot.com/2009/01/what-ruc-prominent-health-care-policy.html"><span style="color:#006600;">posted</span></a><span style="color:#006600;"> before about how Mr Reinhardt's authoritative writings on health policy have not been accompanied by disclosure of his positions on the boards of several major health care corporations.) Once again, it is hard to tell whose interests prominent health care advocacy serves.</span>

BLOGSCAN - Whose Interests Does Health Care Advocacy Serve?

Merrill Goozner, on the GoozNews Blog , dissected recent pronouncements on health care reform by economist Uwe Reinhardt. Reinhardt compare...

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BLOGSCAN - Trial Results Via Press Release

<span style="color:#006600;">See posts by Gary Schwitzer </span><a href="http://blog.lib.umn.edu/schwitz/healthnews/176708.html"><span style="color:#006600;">on the Schwitzer Health News Blog</span></a><span style="color:#006600;">, and by Merrill Goozner </span><a href="http://www.gooznews.com/archives/001391.html"><span style="color:#006600;">on the GoozNews Blog</span></a><span style="color:#006600;"> on a new low in disclosing results of randomized controlled trials. It seems that Dendreon, the maker of the Provenge vaccine intended to treat prostate cancer, put out a press release that said the vaccine prolongs survival, but was completely lacking in data. Even preliminary results of the trial have not yet been released, much less has anything subject to peer review appeared. Nonetheless, the usually reliable New York Times called the trial "decisive." PR has trumped clinical science. </span>

BLOGSCAN - Trial Results Via Press Release

See posts by Gary Schwitzer on the Schwitzer Health News Blog , and by Merrill Goozner on the GoozNews Blog on a new low in disclosing resu...

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Everyone's An Expert in Healthcare and Health IT? (PARODY WARNING)

<div style="text-align: left;"><span style="font-style: italic;font-size:85%;" >(Note: be aware the "story" about Amazon.com below is a parody.)</span><br /></div><br />At "<a href="http://hcrenewal.blogspot.com/2009/02/informatics-or-infomagic-health-it.html">Informatics, or Infomagic? Health IT Cannot Flourish When Everybody is an Expert</a>" I lamented that those lacking biomedical and healthcare informatics experience were growing bolder in their <span style="font-style: italic;">cross-occupational invasion of medicine</span>, and were deluded about their own lack of knowledge in a very specialized domain. The IT specialties appear the most intrusive, followed by anyone who's made money with computers.<br /><br />I've written many times on a <span style="color: rgb(255, 0, 0); font-weight: bold;">critical first principle</span>: health IT applications are <span style="font-weight: bold;">medical devices for complex clinical environments that happen to involve computers</span>. However, consistent with the diminution of critical thinking skills that bought us our currently economically and culturally depressed society, the prevailing model of health IT is that they are <span style="font-weight: bold;">management information systems that happen to involve doctors and nurses</span>.<br /><br />This latter belief manifests itself frequently in the news, and will only increase thanks to the $20+ billion to be thrown at the problem via the <a href="http://www.blogger.com/www.whitehouse.gov/the_press_office/arra_public_review/">ARRA</a>. This is more than the annual budget of NASA (which, ironically, if forced to retire the Space Shuttle without a replacement project of equal scope, will idle tens of thousands of aerospace professionals whose innovations have profoundly influenced miracles of modern technology - including computers).<br /><br />An example of cross occupational boundary confusion is below, where it is seemingly wished by a hospital CIO that an online <span style="font-weight: bold;">merchant</span> selling "<span style="font-weight: bold;">electronics, apparel, computers, book, DVD's & more</span>" would become involved and offer deep insights into medical devices and the needs of clinicians.<br /><br />Written as a spoof or parody (which, I am sorry to admit I originally thought was real), is this apparently fictional tale of Amazon's <a href="http://callitanything.blogspot.com/2009/04/amazoncom-to-build-new-ehr.html">Jeff Bezos</a> joining the EHR bandwagon:<br /><br /><blockquote><span style="font-weight: bold; color: rgb(255, 0, 0);">*** NOTE: THE FOLLOWING IS A PARODY, NOT REAL ***<br /><br /></span>--------------------------------------------------------------------<br /><span style="font-style: italic;">Amazon.com announced today that it will develop a new Electronic Health Record based upon the </span><span style="font-weight: bold; font-style: italic;">same user interface experience and underlying information technology that it uses to support its global ecommerce business</span><span style="font-style: italic;">. </span><br /><br /><span style="font-style: italic;">Said Amazon braintrust, Jeff Bezos, “</span><span style="font-weight: bold; font-style: italic;">Our experience with user interfaces and high performance computing are ideally suited to help healthcare</span><span style="font-style: italic;">. </span><span style="font-weight: bold; font-style: italic; color: rgb(255, 0, 0);">[Ideally suited to healthcare? Really? - ed.]</span><span style="font-style: italic;"> We nudge people’s decision making and behavior with the gentle push of data. When you buy a book on Amazon.com, your user interface is different than my user interface when buying the exact same book. Amazon generates the user interface based on the analytics of the broader context of the customer’s profile, purchasing history, geographic location, and other similar customers’ profiles. The parallels in healthcare are numerous and obvious. </span><span style="font-weight: bold; font-style: italic; color: rgb(255, 0, 0);"><span style="font-style: italic;">[Obvious to whom? - ed.]</span><br /></span>--------------------------------------------------------------------<br /><br /><span style="font-weight: bold; color: rgb(255, 0, 0);">*** NOTE: THE PRECEDING IS </span><span style="font-weight: bold; color: rgb(255, 0, 0);">A PARODY, NOT REAL ***</span><br /></blockquote><br />The spoof was revealed by this sentence in the middle of the essay:<br /><br /><blockquote>The Amazon story is a spoof, <span style="font-weight: bold;">though I wish it weren't</span>. :-)</blockquote><br /><span>I understand the intentions, but</span><span style="font-weight: bold;"> </span><span>that fact might have been made a <span style="font-weight: bold;">bit more obvious</span>.</span><span style="font-weight: bold;"> </span>I was fooled on first read. (In fact, I first believed the author was pointing out weaknesses with this scheme.) Such web based stories, especially with names of prominent people and companies, can propagate internationally via seach engines, automated aggregators, finance boards and other services and mislead. Further, those who are not native English speakers or who read it in computerized translation might also be misled. Et cetera. We have enough rumors on the internet, thank you very much. And yes, perhaps I'm being oversensitive after being taken in.<br /><br />That said, and while I am laughing at myself for being fooled, at the content I am not laughing. To the original author of the spoof, a CIO at a prominent hospital system and data warehousing expert (but not a clinician), I would ask the following:<br /><br />The <a href="http://www.achievement.org/autodoc/page/bez0bio-1">biomedical training and experience</a> of Mr. Bezos is what, exactly? Might such training and experience be important?<br /><br />Do physicians need more variation in the presentation of information and the user interfaces they deal with, or less?<br /><br />You opine that you wish Mr. Bezos joins <a href="http://hcrenewal.blogspot.com/2009/04/should-google-seek-resignations-of.html">Google's PHR experts</a>, Intel's <a href="http://hcrenewal.blogspot.com/2007/07/intels-former-ceo-ehrs-for-his-horses.html">Craig Barrett</a> and others in espousing what's best for a field in which they are amateurs. Why?<br /><br />Don't we hear enough stories <a href="http://hcrenewal.blogspot.com/2009/04/96m-medical-it-system-down-under-is.html">like this</a> that could benefit from more <span style="font-weight: bold;">highly domain specific expertise</span>, not less?<br /><br /><span style="font-weight: bold;">Here's my humor for the evening:</span><br /><br />When first principles are ignored, anybody is a medical expert and can inform the design of medical devices. Next, will you wish <a href="http://www.centurynovelty.com/catImages/209-067_large.jpg">Crazy Drinking Straw</a> company will offer wisdom on <a href="http://www.cookmedical.com/ai/content/lg_thumbnail/ai_beacon.jpg">catheters</a> used in angiography, and M&M Mars will offer profound insights into the manufacture of medicinal pills? (After all, <span style="font-weight: bold;">M&M's</span> and <span style="font-weight: bold;">pills</span> are very similar, so why not?)<br /><br /><br /><div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhKh67N-u7yL2A6xSgVKKgkks_lYxLmMqnOj7ii2osQ2mV86EXDD6c8EWRZ0Qtr7EmWGpMHKsJk1AhslzVBl-dhGdwugZKj_ymp_Q7ijoUiYNbVbl3occZUTT281-tOUeAfa5AiVikp5xhg/s1600-h/mmpill.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5326538953698990242" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhKh67N-u7yL2A6xSgVKKgkks_lYxLmMqnOj7ii2osQ2mV86EXDD6c8EWRZ0Qtr7EmWGpMHKsJk1AhslzVBl-dhGdwugZKj_ymp_Q7ijoUiYNbVbl3occZUTT281-tOUeAfa5AiVikp5xhg/s320/mmpill.jpg" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 320px; height: 168px;" /></a><span style="font-size:85%;"><span style="font-family:arial;">M&M's and pills are very similar in many ways.<br />Perhaps Mars Candy Co. should go into the generics business?</span></span><br /></div><br /><br />However, my stating in detail why I see an "Amazon EHR" to be as strange as the examples above and why I believe the parody author's logic is flawed would likely be ill received, so I'll leave it at that.<br /><br />My most fervent wish is that business folks would stick to selling books and <em>chotchkas</em>, designing microprocessors, and other goods and services where their expertise is valid.<br /><br />And others stop "wishing" for cybernetic miracles by the unqualified.<br /><br />Finally, my apologies to Mr. Bezos for an initial version of this post attributing the parody's ideas to him.<br /><br />-- SS

Everyone's An Expert in Healthcare and Health IT? (PARODY WARNING)

(Note: be aware the "story" about Amazon.com below is a parody.) At " Informatics, or Infomagic? Health IT Cannot Flourish W...

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$96m Medical IT System Down Under is Useless: Whistleblowers

The U.S. is about to embark on spending more money the the annual budget of NASA on health IT. If the experiences in other countries are an indication, I am afraid we will see more "<a href="http://en.wikipedia.org/wiki/Apollo_1">Apollo 1's</a>" than "<a href="http://en.wikipedia.org/wiki/Apollo_11">Apollo 11's</a>."<br /><br />Here's a situation being experienced Down Under (I'd posted an insiders's view on the HIT situation there in late 2007 <a href="http://www.ischool.drexel.edu/faculty/ssilverstein/failurecases/?loc=cases&sloc=australia">at this link</a>):<br /><br /><blockquote style="font-family: arial;">The Age.com.AU<br />Nick Miller<br />April 17, 2009<br /><br /><a href="http://www.theage.com.au/articles/2009/04/16/1239474999842.html">$96m medical IT system useless: whistleblowers</a><br /><p class="details"> </p> <p> </p><p>A NEW $96 million computer system for Victorian hospitals that promised to cut down on dangerous medication errors will be almost useless when it goes "live" this year, insiders say.</p> <p>Other new computer systems that handle finance and manage patient records are plagued with serious problems that take days, even weeks, to fix.</p> <p>And in a further embarrassment for the years-overdue $360 million HealthSMART program, a hospital chosen by the Government to be a flagship "lead agency" — Ballarat Health System — has quit the project because it could not justify the expense.</p> <p>An anonymous letter from "health-sector employees" sent to <i>The Age</i> says the Cerner clinical systems, intended to cut down on mistakes in doses or combinations of medicines, is being rushed into hospitals — with none of the medication functions working — so the Government will not be embarrassed before next year's election.</p> <p>"The whole reason for this system was to introduce electronic medication," the letter says. "But next year is an election year and we must hit the agreed dates. <span style="font-weight: bold;">This means the system will be almost useless when first live."</span></p> <p>Documents released to <i>The Age</i> by the Department of Human Services under freedom of information, and the department's own website, confirm that when clinical systems go live at the first two hospitals late this year, they will not include its most significant functions.</p> <p>These include ordering pathology tests or medical scans, medication management for emergency patients or inpatients, and "decision support" functions that cross-check drugs and doses.</p> <p>Leaked reports show other new HealthSmart systems <span style="font-weight: bold;">are highly unreliable</span>.</p> <p>In the last quarter of 2008, the reports showed serious problems with the "PCMS" system, which tracks patient records, books operating theatres and warns doctors of a patient's particular allergies or chronic health problems.</p> <p>As of December, the system was used at five health services, including Northern, Frankston and Royal Women's hospitals.</p> <p>Hospitals also reported major problems with the FMIS financial software that runs budgets, purchases, accounts and assets at seven hospitals, including Box Hill, Northern, Frankston, Monash and Peter Mac.</p> <p>Ten hospitals were targeted for the Cerner clinical system, with Eastern Health, the Royal Victorian Eye and Ear Hospital and Ballarat Health Service as "lead agencies". <i>The Age</i>'s FoI documents say Ballarat is "unlikely to proceed given costs included in business-case".</p> <p>One hospital CEO told <i>The Age</i> he "will be very surprised if it stacks up", as the system cost hundreds of thousands of dollars to run each year.</p> <p>Another senior Victorian health IT expert said most hospitals would never take up the software. "<span style="font-weight: bold;">No one likes using it because it's s---,</span>" he said. "It's totally inflexible." <span style="font-style: italic; color: rgb(255, 0, 0); font-weight: bold;">[I guess I don't need to spell out the expletive - ed.]</span></p> <p>A Health Department spokesman denied all the allegations, without giving any detail.</p> <p>A spokesman for acting Health Minister Lisa Neville denied that hospitals were being pressured over HealthSMART to avoid embarrassment before the election.</p> <p>Opposition health spokeswoman Helen Shardey said it was vital that Victoria's hospitals got a modern IT system, but the Government was failing to deliver one. "It's a massive cost to health services, and it seems the timing is being driven by the next election rather than the best clinical care," she said.</p><p><br /></p></blockquote>I can add little by way of commentary to this article. It speaks for itself and bodes poorly for our new Apollo project-in-postmodern-times challenge of "<a href="http://www.scribd.com/doc/12392282/To-The-Moon-In-A-Hot-Air-Balloon-Why-Is-Clinical-IT-Difficult">Reaching the Moon by Hot Air Balloon</a>."<br /><br />-- SS

$96m Medical IT System Down Under is Useless: Whistleblowers

The U.S. is about to embark on spending more money the the annual budget of NASA on health IT. If the experiences in other countries are a...

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A Software Engineer's Eloquence on Health IT

<span style="font-size:100%;"><span style="font-family:arial;">Here is an eloquent piece from the same software engineer/patient whose travails were covered at "<a href="http://hcrenewal.blogspot.com/2009/04/most-interesting-patient-account-of.html">A Most Interesting Patient Account of Misery by EHR</a>."</span><br /><br /></span><span style=";font-family:Default Sans Serif,Verdana,Arial,Helvetica,sans-serif;font-size:100%;" >If we had more people of this mindset <span style="text-decoration: underline;"></span>in healthcare IT, we'd be much further along the diffusion curve and have far better, safer HIT:<br /><span style="font-weight: bold;"><br /></span>From <a target="blank" href="http://dmsblog.burtongroup.com/data_management_strategie/2009/04/unfortunate-issues-for-a-national-health-it-network.html">Unfortunate Issues for a National Health IT Network</a>:<br /><br /><br /><div style="margin-left: 40px;">It would be wonderful if HIT could deliver President Obama's, or former PM Tony Blair's, vision. It would also be wonderful if HIT was about "saving lives". Tragically, the opposite is too often true. Poorly implemented HIT can do great harm ...<br /><br />As IT professionals, we must resist the allure of wealth, prestige, and "solving big problems" when the cost of our exuberance is measurable in human lives. We must in the case of HIT proceed as trusted engineers, as builders of the great bridges over which our loved ones drive. We must rationally and soberly asses the HIT challenges we face before we start coding. If we are not up to this challenge, then we have a professional obligation to walk away from the fun and the money. While a national HIT network may someday deliver "life-saving" technology, achieving that vision will be a long, arduous, and expensive journey that requires of IT professionals a renewed emphasis on user interface design and data engineering fundamentals. </div></span><br /><br />Addendum- A reader at the AMIA clinical information systems workgroup points out that these words are truly worthy of the spirit of ACM.org's <span style="text-decoration: underline;"></span><a href="http://www.acm.org/about/se-code">Engineer’s Code</a>:<br /><span style=";font-family:Arial;font-size:85%;color:navy;" ><span style=";font-family:Arial;font-size:10;color:navy;" ></span></span><br /><blockquote style="font-family: arial;"><span style="font-size:130%;">“Ethical tensions can best be addressed by thoughtful consideration of fundamental principles, rather than blind reliance on detailed regulations. These Principles should influence software engineers to consider broadly who is affected by their work; to examine if they and their colleagues are treating other human beings with due respect; to consider how the public, if reasonably well informed, would view their decisions; to analyze how the least empowered will be affected by their decisions; and to consider whether their acts would be judged worthy of the ideal professional working as a software engineer. In all these judgments concern for the health, safety and welfare of the public is primary; that is, the "Public Interest" is central to this Code.”</span></blockquote><br />Now, if only such words could form the standard of practice, not the exception.<br /><br />-- SS

A Software Engineer's Eloquence on Health IT

Here is an eloquent piece from the same software engineer/patient whose travails were covered at " A Most Interesting Patient Account o...

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