In the late 1990's, the US Government entered into a race to map human genes. It wasn't even close, a private company (meaning for profit) blew them out of the water by almost a year.
Now in another case of trying to justify itself, the government has once again been skunked. Want to bet that they don't re-allocate the funds? That only happens to weapon programs.
Prescription Near For E-Health System?
BY DONNA HOWELL
INVESTOR'S BUSINESS DAILY
Posted 2/14/2006
A doctor in California can get lab results from a hospital in Indiana much easier than some government officials and tech and health care executives have feared.
That's a key conclusion of a yearlong test of a health network.
The project suggests that no nationally standardized electronic health records need be in place in order for health care workers nationwide to share patient data and improve care.
There's a government push to develop e-health records for most Americans by 2014, and meantime to develop a network for exchanging medical data. That's a time-consuming and costly proposition — hundreds of millions of federal dollars are going to study and spur e-health.
These new findings are important because they show just how readily a useful network can be put together — with no need for a central database or standard record.
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"The first question we asked ourselves was, 'Is a national health record required for broad interoperability?' " said the project's technical director, Clay Shirky, a telecom professor at New York University.
No, they decided.
But networks and procedures are key, said participants at hospitals and health groups in three states on Feb. 8, in describing the results of their yearlong test.
Many Systems Used
The test looked at how well medical workers in the Boston area, Indiana and Mendocino County, Calif., could trade patient data with each other. For each of them, tech systems and patient record formats differ greatly.
In Boston, they use Microsoft's (MSFT) .Net technology on Hewlett-Packard (HPQ) and Dell (DELL) servers.
In Indiana, they use Sun Microsystems' (SUNW) Java, and Apache applications on a Linux operating system.
In Mendocino, they use open-source software and Dell servers.
The three medical groups involved are part of the nonprofit Connecting for Health.
The Markle Foundation and Robert Wood Johnson Foundation fund the nonprofit.
Participants planned and built a secure network that could be reached through the Internet. For anonymity, they scrambled the data they used — 20 million records for some 500,000 patients. Then they started running tests.
The groups looked at things like how hospital A could find and get a certain patient record from hospital B using only basics such as a name, birth date and ZIP code.
They ran hundreds of thousands of queries via medical facilities that are part of MA-SHARE (the Massachusetts Health Data Consortium), the Indiana Health Information Exchange and Mendocino HRE (Health Records Exchange).
"We went to a number of institutions with multimillion-record collections, often across different databases. And we were able to get very high rates of matching with no false matching," Shirky said.
He says the network handles records much the way FedEx handles boxes. "FedEx doesn't have to know what's in any given truck or box," he said. "We would like to move the clinical record from point A to B without having to have each message's particulars."
That way, Shirky says, the network can run even as medical data standards change. When national health data records do come about, they can travel over the network just like others.
"When you request medical records, you get the medical records in whatever format they are," Shirky said.
Redundant, Unnecessary Work
The group focused on trading two common types of health data that often aren't handled well: medication lists and lab results. Shirky says that in Massachusetts roughly 15% of overall health spending is redundant or unnecessary. At times, tests are repeated because a worker can't get access to the original results.
"Not many people are aware of how fragmented health information is in the United States and how accustomed doctors are to working with almost no information," Shirky said.
The teams in the Connecting for Health project now plan to test data exchange in live clinical settings.
"We're taking what was demonstrated across three states and applying it to a lot of local-use cases," said Dr. John Halamka, chief information officer at Harvard Medical School and CareGroup Healthcare System.
CareGroup has a collection of Harvard-linked hospitals that took part in the test.
Halamka heads one such local-use case. It aims to electronically connect emergency departments and affiliated outpatient centers in the Boston area so doctors at each can get patient records right away.
Imagine a person comes into an emergency room unconscious, Halamka says. "Then you pull up the outpatient medical record," he said. "You find out they're a diabetic and probably took too much insulin. That lets you give them some glucose. And they wake up."
Halamka says better access to medical records changes therapy.
"With complete data, you're no longer flying blind," he said.
In November, the Health and Human Services Department awarded $18.6 million in contracts to four groups for development of national health information network prototypes.
The Connecting for Health project was part of one group, which also included Computer Sciences Corp., (CSC) Microsoft and Sun.
"The power of the Connecting for Health model is it accommodates a variety of technologic solutions," said Dr. Marc Overhage, president of the Indiana Health Information Exchange, on a Feb. 8 conference call.
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