healthy4u

Are EMR's More Secure and Trustworthy Than Paper Records?

Contrary to utopian praise of EMR's as more secure than paper records: <blockquote> <a href="http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/08/09/MNN9191UPS.DTL" style="font-weight: bold;">Routine complication from surgery turns fatal</a> Lance Williams, Chronicle Staff Writer Monday, August 10, 2009 A hospital patient suffers excruciating pain from what turns out to be a routine complication from elective surgery. As her condition deteriorates, she and her family plead to see the doctor. But no doctor examines her until the next morning, when she goes into shock, is rushed into intensive care and dies. Then, after her death, the hospital deletes portions of the woman's medical file in what the woman's family says is an attempt to cover up its horrendous mistakes.</blockquote> Is this possible? Read on: <blockquote>The allegations, contained in a lawsuit filed in Santa Clara County Superior Court, describe events that seemingly could occur only at an institution that provides medical care at its worst. Instead, the claims concern a 2007 fatality at what is regarded as one of the best hospitals on the West Coast - Stanford University Medical Center in Palo Alto. The case of Diane Stewart, 70, who died of a bowel obstruction after knee replacement surgery, shows that bad mistakes and worst-case outcomes are possible even at world-renowned hospitals, said her family's lawyer, Christopher Dolan of San Francisco. Medical errors occur because "we have corporatized medicine and marginalized the professional's role," Dolan said. "We took the same principles used in automation, to do the job cheaper and faster, and applied it to medicine."</blockquote> Healthcare IT notwithstanding, I believe those observations are accurate. However, a more serious issue is the role of HIT in marginalizing the medical professional with respect to the IT professional, in what I've called (in this blog and elsewhere) a cross-occupational invasion of medicine by the IT profession. <blockquote> "I believe Stanford is making a concerted effort to obstruct our family from learning the truth about what happened to our mom," he wrote in a complaint to the state Medical Board. In 2008, investigators from the state Department of Public Health found that "relevant" portions of Diane Stewart's computer file had been deleted after her death and that a supervisor instructed a nurse to make postmortem "late entries" to describe her care. </blockquote> This may be a case where the CIO and other IT leaders need to be called to the stand to testify, possibly on criminal charges, since some cooperation from such personnel would be required if there is merit to allegations of post-death EMR alterations/erasures. <blockquote>In a written statement, the hospital said that only temporary notes that were never intended to become part of Diane Stewart's permanent record had been discarded. </blockquote>Never intended to become part of her medical record? This "Watergate 18 minute gap"-reminiscent explanation raises a number of questions: <ul><li>How did these "Temporary Notes" come to be discarded?</li><li>What was temporary about them? </li><li>Does Stanford's EHR have a "Discard Temporary Notes" button?</li><li>What authority and authentication is required in order for "Temporary Notes" to be discarded?</li><li>What is Stanford's definition of a "Temporary Note" in an EHR?</li><li>What might such notes contain?</li><li>Who might they have been written by, and for what purpose(s)? </li><li>If they involve decisions made in healthcare, why are they considered "temporary?"</li><li>Are there notes made in a paper record that are considered "temporary" that can legitimately be discarded after a suspicious patient death?</li><li>Are there backups that contain these notes, or were they erased too?</li><li>Was such backup erasure initiated manually (e.g., by a human) or automatically?</li></ul> Since these notes were discarded (erased), of course, we may never know what they contained. Electronic records leave no erasure marks, and with collusion of the appropriate personnel, reality can be whatever one wants it to be in the electronic world. This represents yet another sociotechnical obstacle standing in the way of achieving a computer-based utopia in healthcare. -- SS

Are EMR's More Secure and Trustworthy Than Paper Records?

Contrary to utopian praise of EMR's as more secure than paper records: Routine complication from surgery turns fatal Lance Williams, Chr...

Đọc thêm »

Final Settlement of UnitedHealth Backdating Case

Last year, we <a href="http://hcrenewal.blogspot.com/2008/07/unitedhealth-settles.html">discussed</a> a preliminary settlement of allegations against the leadership of one of the US (and the world's) biggest health care insurance companies/ managed care organization. Now the settlement appears final, as reported by the AP (and <a href="http://www.nytimes.com/aponline/2009/08/11/business/AP-UnitedHealth-Settlement.html">published in the NY Times</a>), <blockquote> UnitedHealth Group Inc. moved closer to finally putting its stock options backdating problems behind it Tuesday, when a federal judge approved a class-action settlement of more than $925 million. Minnetonka, Minn.-based UnitedHealth will pay $895 million toward a settlement for shareholders. Former Chairman and CEO William McGuire contributes $30 million and cancels 3.6 million stock options. The insurer's former general counsel, David J. Lubben, will pay $500,000. The parties first agreed to this settlement more than a year ago, and U.S. District Court Judge James M. Rosenbaum granted preliminary approval in December. He then approved it in an order filed Tuesday. The settlement is one of the largest involving options backdating cases if not the largest, said Peter Henning, a law professor at Wayne State University in Detroit. The lawsuit centered on a scandal over stock options backdating that forced McGuire to step down from both roles in 2006. The litigation claimed investors were hurt because UnitedHealth and McGuire didn't really grant stock options when they said they did in the late 1990s and early 2000s. Backdating involves manipulating the timing of options grants so they look as though they were made on days when the stock's value was lower. Doing this can boost a recipients' windfall when they sell the stock. The practice is not illegal if it is properly disclosed. But concealing it can hide the true costs a company incurred, inflating its profits and possibly its stock price. UnitedHealth wiped out more than $1.5 billion in past profits when it acknowledged that it backdated stock options. This was the second approval granted this summer for a large settlement involving UnitedHealth stock options. Last month, Rosenbaum also approved the resolution of a derivatives case that pitted UnitedHealth shareholders against McGuire and several other company executives. The shareholders had accused the executives of failing to fulfill their fiduciary duties by allowing the backdating. They recovered mostly options and cash for the company. Court papers put the value of that settlement, which also was approved by a Minnesota state judge, at around $718 million in January. </blockquote> Note that this year we <a href="http://hcrenewal.blogspot.com/2009/01/unitedhealth-and-ingenix-settles.html">discussed</a> a settlement made by UnitedHealth's Ingenix subsidiary. Here on <a href="http://hcrenewal.blogspot.com/">Health Care Renewal</a>, we discuss problems afflicting the leadership and governance of health care organizations. So, we have discussed a seemingly endless parade of <a href="http://hcrenewal.blogspot.com/search/label/legal%20settlements">legal settlements</a> of allegations of unethical behavior by health care leaders, and even outright <a href="http://hcrenewal.blogspot.com/search/label/crime">criminal behavior.</a> These cases suggest that the leadership culture of many health care organizations accepts unethical, and sometimes even criminal behavior, at least as long as their leaders bring in money in the short-term. Yet shouldn't health care organizations, which are supposedly about helping patients, improving health, preventing disease, etc, be held to a higher standard of ethics than, for example, garbage hauling firms? The parade of stories about misbehavior among health care leaders suggest that some of their organizations do not even rise to the ethical standards of trash haulers. Further, it is reasonable to hypothesize that unethical and at times criminal leadership is bad for health care, bad for patients, and bad for the public health. It likely is an important cause of rising health care costs, declining health care access, and poor health care quality. However, despite the ongoing storm of discussion and opinion about health care reform here in the US, few would-be health care reformers are addressing these issues. What discussion there is of "fraud and abuse" seems to be about low-level offenses, not about leadership. In fact, influential voices in the discussion come from leaders of some of the same organizations that have made huge settlements of allegations of bad behavior, accepted deferred prosecution agreements, or have seen previous leaders resign in disgrace or go to jail. I respectfully suggest that meaningful health care reform is unlikely unless we deal with the problem of conflicted, unethical, and sometimes corrupt leadership of health care organizations.

Final Settlement of UnitedHealth Backdating Case

Last year, we discussed a preliminary settlement of allegations against the leadership of one of the US (and the world's) biggest healt...

Đọc thêm »

Google Code Jam returns

Are you energized by cracking conundrums? Are you keen to crank out some code? Here at Google, we know the rush of encountering a challenge and rising to meet it, transforming a problem into a solution and a solution into code. Since 2003, we've been sharing that experience with a global community of computer scientists through our annual programming competition, Google Code Jam. Today, we're excited to announce Google Code Jam 2009, powered by Google App Engine. This year, contestants will compete in several 2½-hour online rounds, attacking three to four difficult algorithmic problems during each round. To code up solutions to the problems, they'll use the programming language and tools of their choice; when those solutions are ready, they'll try them against our fiendish test data. One wrong answer out of a hundred, and it's back to the drawing board! <a href="http://code.google.com/codejam">Registration</a> opens today. So visit the Google Code Jam site to register, read the rules and — most importantly — begin to practice by trying out the problems from last year's contest, so you'll be in shape when the qualification round starts on September 2. After four tough rounds of online competition, the top 25 competitors will be flown to our <a href="http://maps.google.com/?q=Google%20Inc.@37.423156,-122.084917&hl=en">Mountain View headquarters </a>to to match wits for the $5,000 first prize — and the title of Code Jam champion. On your mark, get set... CODE! Posted by Bartholomew Furrow, 20% Tech Lead for Google Code Jam

Google Code Jam returns

Are you energized by cracking conundrums? Are you keen to crank out some code? Here at Google, we know the rush of encountering a challenge...

Đọc thêm »

Shareholders Take Notice That Patients Used As Unconsented Guinea Pigs, Physicians as Bank by Health IT Vendors

At my Jan. 2009 post "<a href="http://hcrenewal.blogspot.com/2009/01/wsj-waste-feared-in-digitizing-patient.html">Waste Feared in Digitizing Patient Records: Wall Street Journal</a>" and others I have written about the illegitimacy of the abuse of patient rights, as well as abuse of clinician trust committed by health IT vendors using patient care settings as an unconsented software development laboratory and beta testing site. I wrote: <blockquote>The IT industry uses hospitals, doctor offices and patients as alpha and beta test sites and subjects, unregulated by the FDA or other agency. When HIT fails, there is no central agency to report the failures to, only the vendor. Fixes go into a "queue" for remediation, with priority level decided by the vendor.</blockquote> Clinicians are also used by HIT vendors as a form of bank and insurance company. HIT vendors depend on (free!) physician and nurse ingenuity in finding workarounds to the ill-conceived design and user experience (<a href="http://tinyurl.com/hostileuserexper">link</a> to my eight part series on this issue) that their products usually present so that their products can even be salable. This, of course, taxes and tires clinicians at the expense of patients and hampers and complicates EHR diffusion. Clinicians become, in effect, unpaid development consultants to HIT companies (or, perhaps more accurately, since EHR's do become essential to medical practice, indentured servants to the HIT vendors). Also, under the unethical, Joint Commission-violating and executive fiduciary responsibility-violating "Hold Harmless" and "Defects Nondisclosure" HIT contracting clauses, clinicians pay the price for bad patient outcomes, even if the causative factor was HIT errors. (See <a href="http://www.hcrenewal.blogspot.com/2009/03/health-it-hold-harmless-and-defects-gag.html">Health IT Hold Harmless and Defects Gag Clauses: Have Hospital Executives Violated Their Fiduciary Responsibilities By Signing Such Contracts?</a>, and my July 22, 2009 JAMA <a href="http://jama.ama-assn.org/cgi/content/extract/302/4/382">letter to the editor</a> on this issue.) Thus, clinicians become an insurance company, bank and risk safety net (a term that might not be inappropriate is "suckers") for the HIT vendors. This is not an optimal way to treat one's ultimate customers. HIT is <a href="http://www.tinyurl.com/hit-misadventure">a mess</a>, but that doesn't stop HIT vendors from simply lying about their financial status and future projected business to the investor community. Now, HIT company shareholders are taking note of these industry (mal)practices. These (mal)practices are hitting shareholders where it really hurts - in the pocketbook. My comments in [red italics]: <blockquote> <a href="http://www.healthcareitnews.com/news/allscripts-shareholders-file-class-action-suit">Allscripts shareholders file class action suit</a> Healthcare IT News August 05, 2009 | Bernie Monegain, Editor CHICAGO – Allscripts shareholders have filed a lawsuit alleging the company broke federal securities laws when it went live with the newest version of its EHR clinical software, Touchworks [i.e., a "version" that had not been thoroughly tested and validated outside hospital walls, a practice HIT vendors get away with due to the near spinelessness of regulators such as the Joint Commission, FDA, and others - ed.] . Allscripts officers say the suit is without merit. [As I pointed out at "<a href="http://hcrenewal.blogspot.com/2008/10/do-healthcare-organizations-truly-want.html" style="font-style: italic; font-weight: bold;">Do Healthcare Organizations Truly Want Electronic Health Records To Succeed?</a>" regarding the lawsuit my own organization filed against this company and its partner Medicomp Systems (civil complaint PDF <a href="http://www.ischool.drexel.edu/faculty/ssilverstein/DUCOM_EMR_Complaint.pdf" style="font-style: italic; font-weight: bold;">here</a>), where incomplete, untested and non-functional software was sold by this company for use by our physicians, I'd say the allegations do deserve further investigation - ed.] "We are aware of the lawsuit and have reviewed the complaint," Allscripts officials said Wednesday. "While it is our policy not to comment on the substance of pending litigation, we believe the lawsuit is without merit and will vigorously defend the allegations." The lawsuit, which seeks class action status, has been filed in the United States District Court for the Northern District of Illinois on behalf of those who purchased the common stock of Allscripts-Misys Healthcare Solutions, Inc. (formerly known as Allscripts Healthcare Solutions, Inc.) between May 8, 2007 and Feb. 13, 2008. It names Allscripts-Misys Healthcare Solutions, CEO Glen Tullman and Chief Financial Officer William J. Davis as defendants. At a user conference in Orlando, Fla., July 30-31, Allscripts CEO Glen Tullman told some of the attendees that Allscripts might have rushed version 11 of Touchworks to market too quickly. ["Might have" rushed it out too quickly? It had, in fact, been delayed several months according to the lawsuit. "Perhaps" the delays needed to be lengthier. In other words, f*** the doctors and patients, we're getting this cr** out the door so as to not further injure our profits with further delays - ed.] He said the company was caught off guard by providers who found new uses for the product. ["New uses?" (We all know that when companies sell broken HIT, it's always the doctors' fault) ... Likely translation: clinicians tried to practice medicine the way they saw best, not the way the Allscripts software designers saw best or "approved of." (Arrogance, anyone?) The clinician users tried to use the software in a real-world setting while applying the improvisations needed for proper patient care in a poorly bounded, uncertain environment (per <a href="http://www.ctlab.org/documents/Hiding%20in%20plain%20sight.pdf">Nemeth and Cook</a>) and found the software's support of the uncertainties and realities of the clinical environment, and likely the software's stability itself, poor - ed.] Tullman and Faisal Mushtaq, the company's senior vice president of product development, said Allscripts has invested roughly $14 million to improve stability and performance [after throwing the doctor and patient test subjects to the wolves after a "might have rushed it out" premature rollout - ed.], and they expect the next version, to be rolled out soon, to work more smoothly. [I really despise the "version 1.1 will be much better" in healthcare settings, as it goes back to the issue of sick patients as unconsenting subjects in a software testing lab, and physicians as a bank and insurance company for the vendors when things go wrong -ed.] The complaint alleges that defendants failed to disclose the following adverse facts: * Allscripts lacked the necessary resources [i.e., smart, a.k.a expensive, people who actually know what they're doing thanks to the appropriate informatics education and expertise. Were the ones they did have tied up in patchwork remediation and crisis management? - ed.] to install V-11 software at customer sites; Allscripts had no historical basis to estimate the completion of V-11 or the impact V-11 sales might have on the company's 2007 revenues and earnings [if they made stuff up, that would not be too uncommon in today's financial environment. Also, the "lack of necessary resources", not unique to Allscripts, portends quite poorly for the planned, manic rush to national EHR by the cavalierly short deadline of 2014 - ed.] * The complexity of V-11 had materially and adversely lengthened the sales cycle and revenue recognition cycle for the company's V-11 sales contracts [Another instantiation of my belief that business IT sales practices are inappropriate for clinical IT, where there are unconsenting "customers" with special rights - patients. One also wonders: did clinicians balk at a Rube Goldberg contraption but hospital executives purchase it anyway? - ed.]; * Allscripts was currently experiencing adverse and continuing delays in the installation of V-11 software systems [which were perhaps not revealed by clients, thanks to secrecy clauses regarding defects and problems as noted by Penn's <a href="http://jama.ama-assn.org/cgi/content/extract/301/12/1276">Koppel and Kreda</a> in JAMA? - ed]; * Based on the foregoing, defendants had no reasonable basis for their statements concerning Allscripts' current and future financial performance and projections. The law firm of Izard Nobel LLP, based in West Hartford, Conn. announced the class action lawsuit on Wednesday. Click here to read the complaint: <a href="http://www.izardnobel.com/allscriptsmisyshealthcare/">http://www.izardnobel.com/allscriptsmisyshealthcare/</a> .</blockquote> The PDF of this class action complaint is <a href="http://www.izardnobel.com/admin/uploads/2453451964a78a212b0bdc.pdf">here</a>. So, it seems entirely possible the defects nondisclosure clauses promulgated by these vendors, and accepted by meek hospital executives and CIO's, may have supported and/or led to a situation of shareholder fraud. It would be ironic indeed if these cavalier HIT practices end, and the HIT vendors began to adhere to principles of responsibility and resilience engineering, not due to regulatory pressures but due to shareholder lawsuits. Finally, Allscripts CEO Tullman was a campaign adviser to the President on healthcare. It's perhaps due to advisers like this that national plans for healthcare reform are sinking like the Titanic. As per my Feb. 18, 2009 <a href="http://hcrenewal.blogspot.com/2009/02/medinformaticsmd-in-wall-street-journal.html">Wall Street Journal letter</a>: <blockquote>... it is the government that has been deceived [rather than the public] by the HIT industry and its pundits. Stated directly, the administration is deluded about the true difficulty of making large-scale health IT work. The beneficiaries will largely be the IT industry and IT management consultants ... The government has bought the IT magic bullet exuberance hook, line and sinker.</blockquote> -- SS addendum: Perhaps I should self-turn in this post as "fishy" to the <a href="http://www.google.com/search?q=healthcare+reform+snitch+line&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a">healthcare reform snitch line</a> at "flag@whitehouse.gov"?

Shareholders Take Notice That Patients Used As Unconsented Guinea Pigs, Physicians as Bank by Health IT Vendors

At my Jan. 2009 post " Waste Feared in Digitizing Patient Records: Wall Street Journal " and others I have written about the illeg...

Đọc thêm »

Sixth International Congress on Peer Review and Biomedical Publication

I just found out that the program of this year's Sixth International Congress on Peer Review and Biomedical Publication, to be held on September 10-12, 2009, in Vancouver, BC, Canada is likely to be of great interest to Health Care Renewal readers. The conference is held every four years on topics relevant to medical journal editors and reviewers, but previous conferences emphasized topics as impact factors, blinded review, open publishing, etc. This year, however, there will sessions on: <ul><li>Authorship and Contributorship - including 3 of 4 presentations on ghost-writing</li><li>Data Sharing and Conflicts of Interest - including 4 of 5 presentations on conflicts of interest in research</li><li>Publication Bias - including 3 of 3 presentations which appear to discuss research manipulation and suppression </li><li>Rhetoric - including 3 of 3 presentations apparently about how articles reporting original research may exaggerate or distort the results</li></ul>There will also be poster presentations on relevant topics. See <a href="http://www.ama-assn.org/public/peer/preliminary_program.html">this link </a>for further information and registration information. This conference program seems to have a higher concentration of Health Care Renewal relevant topics than any conference of which I am aware to date.

Sixth International Congress on Peer Review and Biomedical Publication

I just found out that the program of this year's Sixth International Congress on Peer Review and Biomedical Publication, to be held on S...

Đọc thêm »

New tools for Google Services for Websites

<a href="http://googleblog.blogspot.com/2009/03/google-at-your-service.html">Earlier this year</a>, we launched <a href="http://www.google.com/webmasters/provider/index.html">Google Services for Websites</a>, a program that helps partners, e.g., web hoster and access providers, offer useful and powerful tools to their customers. By making services, such as Webmaster Tools, Custom Search, Site Search and AdSense, easily accessible via the hoster control panel, hosters can easily enable these services for their webmasters. The tools help website owners understand search performance, improve user retention and monetize their content — in other words, run more effective websites. Since we launched the program, <a href="http://www.google.com/webmasters/provider/success.html">several hosting platforms</a> have enhanced their offerings by integrating with the appropriate APIs. Webmasters can configure accounts, submit Sitemaps with Webmaster Tools, create Custom Search Boxes for their sites and monetize their content with AdSense, all with a few clicks at their hoster control panel. More partners are in the process of implementing these enhancements. We've just added new tools to the suite: <ul><li><a href="http://www.google.com/webelements/">Web Elements</a> allows your customers to enhance their websites with the ease of cut-and-paste. Webmasters can provide maps, real-time news, calendars, presentations, spreadsheets and YouTube videos on their sites. With the Conversation Element, websites can create more engagement with their communities. The Custom Search Element provides inline search over your own site (or others you specify) without having to write any code and various options to <a href="http://googlecustomsearch.blogspot.com/2009/08/custom-search-with-custom-style-peanut.html">customize further</a>. </li><li><a href="http://code.google.com/speed/page-speed/">Page Speed</a> allows webmasters to measure the performance of their websites. Snappier websites help users find things faster; the recommendations from these latency tools allow hosters and webmasters to optimize website speed. These techniques can help hosters reduce resource use and optimize network bandwidth.</li><li>The <a href="http://www.google.com/webmasters/provider/tips.html">Tips for Hosters page</a> offers a set of tips for hosters for creating a richer website hosting platform. Hosters can improve the convenience and accessibility of tools, while at the same time saving platform costs and earning referral fees. Tips include the use of analytics tools such as Google Analytics to help webmasters understand their traffic and linguistic tools such as <a href="http://translate.google.com/translate_tools?hl=en">Google Translate</a> to help websites reach a broader audience.</li></ul>If you're a hoster and would like to participate in the Google Services for Websites program, please <a href="http://services.google.com/feedback/webmaster_provider_signup">apply here</a>. You'll have to integrate with the service APIs before these services can be made available to your customers, so the earlier you start that process, the better. As always, we'd love to get <a href="http://www.google.com/support/forum/p/Webmasters?hl=en">feedback</a> on how the program is working for you, and what improvements you'd like to see. Posted by Rajat Mukherjee, Group Product Manager

New tools for Google Services for Websites

Earlier this year , we launched Google Services for Websites , a program that helps partners, e.g., web hoster and access providers, offer u...

Đọc thêm »

AFL/CIO Interested in Healthcare IT Failure?

In today's Wall Street Journal, in a piece entitled "<a href="http://online.wsj.com/article/SB20001424052970204908604574334623330098540.html">You Are Terrifying Us</a>" about the growing opposition to the administration's healthcare reform plan, columnist Peggy Noonan writes: <blockquote>... But every day the meetings seem just a little angrier, and people who are afraid—who have been made afraid, and left to be afraid—can get swept up. As this column is written, there comes word that John Sweeney of the AFL-CIO has announced he’ll be sending in union members to the meetings to counter health care’s [i.e., the reform plan's - ed.] critics.</blockquote> Massive expansion of healthcare IT is one of the cornerstones of the healthcare reform initiative. I have expressed <a href="http://hcrenewal.blogspot.com/2008/12/open-letter-to-president-barack-obama.html">my concerns</a> in an open letter to the President on this blog about the dangers of too rapidly pushing health IT in its present underdeveloped and experimental condition. With that in mind, I've just noted several "hits" on my Drexel website on healthcare IT failure from the following IP number (internet digital address): <blockquote>06 Aug, Thu, 16:22:42 12.4.17.250 Netscape 7 Windows XP 06 Aug, Thu, 16:45:53 12.4.17.250 Netscape 7 Windows XP 06 Aug, Thu, 17:03:07 12.4.17.250 Netscape 7 Windows XP </blockquote> These occurred as a result of someone at IP 12.4.17.250 searching Google on the phrase "drexel university health information tech." I cannot tell what they looked at besides the site's main page at 16:22, but at 16:45 and 17:03 the referring URL's were: <a href="http://www.ischool.drexel.edu/faculty/ssilverstein/failurecases/?loc=about" style="font-style: italic; font-family: arial;">http://www.ischool.drexel.edu/faculty/ssilverstein/failurecases/?loc=about</a> In other words, my biographical information was being reviewed. IP 12.4.17.250 <a href="http://ip-lookup.net/index.php">translates as follows</a>: <blockquote>AFL-CIO AFLCIO-17-0 (NET-12-4-17-0-1) 12.4.17.0 - 12.4.17.255</blockquote> Perhaps someone at AFL-CIO is interested in pursuing a graduate certificate in healthcare informatics at Drexel, or perhaps someone there is conducting background research on potential or perceived IT-related "impediments" to healthcare reform. (Such as my writings?) I don't know which, but I thought the hits interesting. -- SS Aug. 11 update: This "hit" just in on unknown referrer: <blockquote>Aug, Tue, 08:13:39 12.32.3.194 Netscape 7 Windows XP </blockquote>IP 12.32.3.194 translates to: <blockquote> UNITED STEELWORKERS OF AMERICA UNITED-S 21-3-192 (NET-12-32-3-192-1) 12.32.3.192 - 12.32.3.199 </blockquote> A lot of hits on my HIT failure site with union labels lately. -- SS

AFL/CIO Interested in Healthcare IT Failure?

In today's Wall Street Journal, in a piece entitled " You Are Terrifying Us " about the growing opposition to the administrati...

Đọc thêm »