Open Personalized Health Informatics

I’ve put together a proposal for a regional health-enhancing system. You may find this of interest:

http://www.openphi.com/files/OpenPHI_SoFLHealth.pdf

Your comments and suggestions for improvement will be greatly appreciated. Feel free to share. Regards.

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“..students of medical economics have long realized that what consumers demand when they purchase medical services are not these services per se but rather better health.”

This document outlines a vision for a care system that improves the health of all South Florida residents. The proposed platform will be based on consumer-owned IT tools (computers, mobile phones, etc.), a decentralized support infrastructure, and a close alignment of community resources with local families’ needs.

There are lots of conversations around “improving the healthcare system.” Unfortunately this industry is rife with mis-aligned incentives, starting with the root problem of a “fee-for-service” reimbursement model. Ill consumers are very profitable to healthcare providers, but not to consumers’ employers, their families, their communities, much less themselves.

The traditional framing of the issue (“let’s improve the healthcare system for all”) misses a crucial point: what SoFL residents really want is a care system that improves the health of all. Ample research evidence demonstrates that more healthcare does not automatically lead to better health.

At the end of the day, where would you rather live? In a city with the best children’s oncology hospital, or in a region where your children have the lowest possible odds of ever developing cancer?
Read more…

…Obesity is overtaking smoking as the leading cause of preventable death. It took almost 50 years from the time that smoking was definitively linked to lung cancer for the full suite of today’s wide range of smoking restrictions and taxes to be applied. They worked.

The Australian Government, when considering taxes or advertising bans on junk food or meaningful food labelling laws or limits on the amount of fat, salt and sugar in our food, is up against a $100 billion industry concentrated in a few big corporate hands.

- – [Editor's Note: related article from the New England Journal of Medicine] – -

The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages
Kelly D. Brownell, Ph.D., Thomas Farley, M.D., M.P.H., Walter C. Willett, M.D., Dr.P.H., Barry M. Popkin, Ph.D., Frank J. Chaloupka, Ph.D., Joseph W. Thompson, M.D., M.P.H., and David S. Ludwig, M.D., Ph.D.

http://content.nejm.org/cgi/reprint/NEJMhpr0905723v1.pdf

The consumption of sugar-sweetened beverages has been linked to risks for obesity, diabetes, and heart disease1-3; therefore, a compelling case can be made for the need for reduced consumption of these beverages. Sugar-sweetened beverages are beverages that contain added, naturally derived caloric sweeteners such as sucrose (table sugar), high-fructose corn syrup, or fruit-juice concentrates, all of which have similar metabolic effects.
Taxation has been proposed as a means of reducing the intake of these beverages and thereby lowering health care costs, as well as a means of generating revenue that governments can use for health programs.4-7 Currently, 33 states have sales taxes on soft drinks (mean tax rate, 5.2%), but the taxes are too small to affect consumption and the revenues are not earmarked for programs related to health. This article examines trends in the consumption of sugar-sweetened beverages, evidence linking these beverages to adverse health outcomes, and approaches to designing a tax system that could promote good nutrition and help the nation recover health care costs associated with the consumption of sugar-
sweetened beverages.

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http://www.theage.com.au/opinion/society-and-culture/obesity-is-not-a-right-20090926-g75j.html

Obesity is not a right

Michael Smith
September 27, 2009 – 12:01AM

Is it time that governments stopped people making bad decisions about their own health?

The obesity epidemic provides one of the greatest challenges of political philosophy for governments since the birth of democracy. The economic, health and mortality consequences of obesity and its partner diseases are as grave as any crisis faced by any government in history. But most governments are paralysed by the clash of fundamental democratic principles involved.
Read more…

[Editor's Note]

This is a significant announcement in the promotion of Open Access. See http://www.openphi.com/about_open_access.html for more information on Open Access. HealthLibrarian (http://www.healthlibrarian.net/search/) already includes Open Access materials from all BioMed Central publications.

My team and I are currently developing the next generation of our software platform. Based exclusively on Free / Open Source Software, this platform is designed to crawl, parse, analyze and index massive amounts of information. Particularly Open Access materials.

By using domain-specific dictionaries we are then able to provide semantic search capabilities tailored to specific industries: health, legal, business, etc. Here is an overview of what we call Platv02: http://www.openphi.com/files/OpenPHI_PlatformV02.pdf

Give me a call at +1 (954) 553-1984 to discuss how our platform could extract knowledge from your organization’s content both quickly and cost-effectively.

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http://blogs.openaccesscentral.com/blogs/bmcblog/entry/five_us_universities_to_provide

Monday Sep 21, 2009

Five US universities to provide central funding for open access publication fees

In a major step forward for the open access movement, on September 15th 2009, Berkeley, Cornell, Dartmouth, Harvard and the Massachusetts Institute of Technology  announced a joint commitment to provide their researchers with central financial assistance to cover open access publication fees, and encouraged other academic institutions to join them.
Read more…

http://www.newsweek.com/id/215291

The Case for Killing Granny
Rethinking end-of-life care.

By Evan Thomas | NEWSWEEK

Published Sep 12, 2009

From the magazine issue dated Sep 21, 2009

My mother wanted to die, but the doctors wouldn’t let her. At least that’s the way it seemed to me as I stood by her bed in an intensive-care unit at a hospital in Hilton Head, S.C., five years ago. My mother was 79, a longtime smoker who was dying of emphysema. She knew that her quality of life was increasingly tethered to an oxygen tank, that she was losing her ability to get about, and that she was slowly drowning. The doctors at her bedside were recommending various tests and procedures to keep her alive, but my mother, with a certain firmness I recognized, said no. She seemed puzzled and a bit frustrated that she had to be so insistent on her own demise.

The hospital at my mother’s assisted-living facility was sustained by Medicare, which pays by the procedure. I don’t think the doctors were trying to be greedy by pushing more treatments on my mother. That’s just the way the system works. The doctors were responding to the expectations of almost all patients. As a doctor friend of mine puts it, “Americans want the best, they want the latest, and they want it now.” We expect doctors to make heroic efforts -especially to save our lives and the lives of our loved ones.
Read more…

[Editor's Note]

The article below advances the argument that chronic care management has the potential to deliver significant health and financial benefits to both users and the community at large.

In that context, the use of consumer-owned IT tools can be leveraged to facilitate the care management process. Such tools include mobile phones.

I developed a Proposal for a mobile Chronic Care Model platform and are looking for a funding source to implement this concept. The proposal is here: http://www.openphi.com/files/OpenPHI_Mobile_Chronic_Care_Model_15.pdf

Many tele-health systems have been designed from a technical perspective. I want to develop a system based on the Chronic Care Model (see http://www.improvingchroniccare.org/index.php?p=The_Chronic_Care_Model&s=2)

Give me a call at +1 (954) 553-1984 if you are interested in funding the development of an Open Source mobile Chronic Care Model platform. Thanks.

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http://content.healthaffairs.org/cgi/content/full/hlthaff.28.6.w1025/DC1

Containing Costs And Improving Care For Children In Medicaid And CHIP

An estimated 10 percent of enrolled children –most of whom are chronically ill– account for 72 percent of these programs’ spending on children’s health.

by Genevieve M. Kenney, Joel Ruhter, and Thomas M. Selden

ABSTRACT: The current health reform debate is greatly concerned with “bending the curve” of cost growth and containing costs, particularly in public programs. Our research demonstrates that spending in Medicaid and the Children’s Health Insurance Program (CHIP) is highly concentrated, particularly among children with chronic health problems. Ten percent of enrollees (two-thirds of whom have a chronic condition) account for 72 percent of the spending; 30 percent of enrolled children receive little or no care. These results highlight the importance of cost containment strategies that reduce avoidable hospitalizations among children with chronic problems and policies that increase preventive care, particularly among African American children. [Health Aff (Millwood). 2009;28(6):w1025-36 (published online 17 September 2009; 10.1377/hlthaff.28.6.w1025)]
Read more…

http://www.computerworld.com/s/article/9137376/Open_source_software_may_unify_the_medical_records_realm?taxonomyId=88&pageNumber=1

VistA and its derivatives, in particular, could prove helpful
Steven J. Vaughan-Nichols

September 15, 2009 (Computerworld) Open-source medical software has been around for over 30 years. Unless you are in healthcare IT, however, chances are you’ve never even heard of it. But that’s poised to change.

With the passage of ARRA (the American Recovery And Reinvestment Act of 2009, also called the federal stimulus package), some $19 billion dollars have been earmarked for Medicare and Medicaid technology incentives over the next five years. This program is known as HITECH (PDF), short for Health Information Technology for Economic and Clinical Health.

The program will use carrots, in the form of several million dollars per hospital and up to $44,000 for individual doctors, and sticks, in the form of Medicare reimbursement cuts, to get hospitals and doctors to move to EHRs (electronic health records), also called EMRs (electronic medical records).
Read more…

…In our current debate on health care, many have warned that universal coverage will inevitably lead to “rationing” of health care. The argument overlooks a basic fact: the United States already rations health care. Indeed, every country rations health care, because no system can afford to pay for everything. The key distinction is the way rationing happens.

In the other developed democracies, there’s a basic floor of coverage that everybody is entitled to; that’s why nobody dies in those nations for lack of care. But there are limits on which procedures and which medications the system will pay for. That’s where the rationing kicks in. “We cover everybody, but we don’t cover everything,” the former British health minister John Reid explained.

In the U.S., in contrast, some people have access to just about everything doctors and hospitals can provide. But others can’t even get in the door (until they are sick enough to need emergency care). That amounts to rationing care by wealth. This seems natural to Americans; to the rest of the developed world, it looks immoral.

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http://www.newsweek.com/id/215290

No Country for Sick Men
To judge the content of a nation’s character, look no further than its health-care system.

By T. R. Reid | NEWSWEEK

Published Sep 12, 2009

From the magazine issue dated Sep 21, 2009

“Us Canadians, we’re kind of understated by nature,” Marcus Davies told me in his soft-spoken way. “We don’t go around chanting ‘We’re No. 1!’ But you know, there are two areas where we feel superior to the U.S.: hockey and health care.”
Read more…

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OpenPHI’s services for Contact Centers

HealthLibrarian can be easily integrated with a contact center’s software to provide valuable, personalized information to callers. HealthLibrarian’s capabilities can be integrated into all types of customer contact handled at the Contact Center: telephone calls, video calls, Web calls, e-mail, and chats.

Visit http://openphi.com/market_contact_center.html and download the white paper “HealthLibrarian and Contact Centers” {http://www.openphi.com/files/HealthLibrarian_Contact_Center.pdf} for more details, including a clearly defined set of requirements.

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eHealth for a Healthier Europe!
opportunities for a better use of healthcare resources

Available online as PDF file [84p.] at: http://www.sweden.gov.se/content/1/c6/12/98/15/5b63bacb.pdf

Executive Summary

Results
There is a significant healthcare improvement potential using eHealth as a catalyst. For the five political goals used in the study, the technology adoption is lower than 30%. The potential improvements are of such magnitude that they demand both attention and action from all member states.

Examples of quantified potentials include:
* 5 million yearly outpatient prescription errors could be avoided through the use of Electronic Transfer of Prescriptions.
* 100,000 yearly inpatient adverse drug events could be avoided through Computerised Physician Order Entry and Clinical Decision Support. This would in turn free up 700,000 bed-days yearly, an opportunity for increasing throughput and decreasing waiting times, corresponding to a value of almost Euro 300 million.
* 9 million bed-days yearly could be freed up through the use of Computer-Based Patient Records, an opportunity for either increasing throughput or decreasing waiting times, corresponding to a value of nearly Euro 3,7 billion.
Read more…

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OpenPHI’s Services to Local Governments

Cities and counties are looking for new revenue sources. Individuals and organizations that provide healthcare services (i.e. doctors, nurses, therapists) may not always have the required Business License from their city / county. OpenPHI offers local governments a risk-free mechanism to identify and contact those healthcare providers conducting business in their local jurisdiction that lack a Business License.

See http://openphi.com/market_local_governments.html for more details.

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{Australia} Government targets obesity, booze.

http://www.theage.com.au/national/government-targets-obesity-booze-20090905-fc53.html

JOSH GORDON
September 6, 2009

AUSTRALIANS will be told to drink and smoke less and consume less junk food by a new preventive health watchdog that will begin monitoring the health system within months. But it is also likely that some tougher policy interventions recommended by the high-profile preventive health taskforce, such as junk-food taxes and food labelling on the front of restaurant menus, will not be adopted.

Health Minister Nicola Roxon said legislation for a national preventive health agency would be introduced to Parliament within the next fortnight, forming a key part of the Government’s plan to slash rates of preventable illnesses such as diabetes, heart disease and some cancers.
Read more…

FOR IMMEDIATE RELEASE

Palm Beach Community College Pilots Semantic Search Engine for Health Knowledge.

Florida Startup Offers Multi-lingual Scientific, Open Access Health Content to 18,000 Students

August 25, 2009. (MIAMI, FLORIDA) – Palm Beach Community College (“PBCC”) is the first community college to join a pilot program to deploy the HealthLibrarian semantic search engine for health data across its campuses and accessible to all PBCC students and staff.

HealthLibrarian is different from traditional search engines: it does not blindly crawl the web, or present matches based on a site’s popularity. HealthLibrarian intelligently sorts and categorizes health-related information available from validated, academic, governmental and scientific sources in the so-called “Deep Web.” Users can then interactively fine-tune their query to maximize the relevance of the result set. The results presented are highly relevant and specific to the conditions or diseases of interest, and grouped by the geographical areas selected by the user. Visit http://www.HealthLibrarian.net/search to see HealthLibrarian in action now.
Read more…