Archive for the ‘Personalized Health’ Category

{UK} NHS ‘could save BP$15bn’ treating more patients at home.

February 3rd, 2010 No comments

[Jose's Note]

The idea of providing care at home has a lot of merit.

“The current system, focused on reactive and emergency treatment, mainly in hospitals, has changed little since the NHS was established in 1948, he said…” The same could be said for the US system.


NHS ‘could save BP$15bn’ treating more patients at home.

CBI report fuels debate about what role hospitals would have if community services were significantly expanded

* Denis Campbell, health correspondent
*, Wednesday 3 February 2010 13.10 GMT

Is it time for the NHS to offer more treatment at home? Photograph: Ian Waldie/Getty Images

The NHS could save BP$15bn by treating far more patients at home and in new high street walk-in centres, according to a new report {$FILE/CBI-Doing%20More%20With%20Less.pdf} from the CBI [Confederation of British Industry (CBI)].

Too much medical care is delivered in hospitals because there are not enough alternatives in the community, says the business group, which is urging a rapid expansion of “smarter care”.

Controversially, the report recommends that private companies should be allowed to provide the new services and that the NHS should not necessarily have a monopoly on delivering care in such ways.

It will also add to the growing pressure for the NHS to deliver much more care in patients’ homes – a demand backed by two other reports today – and will fuel the debate about what role hospitals would have if community services were significantly expanded.

“At present resources are skewed in favour of hospital care, but there is considerable scope for treating more people at home, near their workplace or the high street,” said John Cridland, the CBI’s deputy director-general.

“By re-engineering health services to give people more choice about how and where they are treated, we could diagnose problems earlier and reduce the number of costly hospital admissions.”

The NHS will have to rethink how it operates in order to cope with major problems – such as the ageing population, increasing medical problems associated with obesity and alcohol abuse, and the growing number of people with long-term conditions such as diabetes – at a time when its budget is being squeezed, added Cridland.

The current system, focused on reactive and emergency treatment, mainly in hospitals, has changed little since the NHS was established in 1948, he said. But its future will see it building on existing partnerships between the NHS and independent sectors in areas such as hip operations and the running of walk-in centres.

“If the examples of good practice contained in this report were applied more widely, we estimate that around BP$15bn could be saved by 2015,” said Cridland.

“But for that to happen the government must allow the best provider to deliver health services, irrespective of whether they are from the NHS, private or voluntary sectors.”

A separate report out today, by healthcare information analysts Dr Foster Intelligence and Healthcare at Home {}, estimates that the NHS could save up to BP$1.2bn a year by delivering in patients’ homes more chemotherapy, end-of-life care and treatment for long-term conditions.

In addition, a third paper, from the Expert Patient Programme Community Interest Company {}, says that greater use of self-management techniques by the 15.4 million people with long-term conditions could save BP$1,800 on each patient each year in care costs.

The Department of Health said that NHS services were already being delivered in these ways. A spokeswoman said: “[There is] an impressive track record in the NHS for putting more services into communities, tailoring care to people’s individual needs and giving patients more choice.

“We have more early-intervention mental health teams operating in communities, there is increasing use of telecare for older people and we have invested in new GP services to improve access to primary care.”

Contact us
Contact the Society editor

* Report errors or inaccuracies:
* Letters for publication should be sent to:

Categories: Health IT, Personalized Health Tags:

FTC reminds us that storing data in the cloud has drawbacks

January 6th, 2010 No comments

FTC reminds us that storing data in the cloud has drawbacks

[Editor's Note]

This point raised by the article below re: risks to consumer’s private data being “in the cloud” is very applicable to the entire Health IT / EMR / Personal Health Record discussion.

It’s not clear to me if in the rush to “digitize healthcare” enough attention (and priority) has been paid to protecting consumers’ privacy.

If somebody hacks into your bank account and steals US$1,000 from you that is clearly a bad outcome. But you can recover from that. Money is replaceable via a bank refund or a credit card protection plan.
But if your electronic medical record (“EMR”) is hacked whereby all future employers (and significant others) can find out about your {mental health issues} / {abortion while in college} / {paternity test results} that is not a recoverable incident.

Using paper-based records it would take a bit of work to illegally copy the records of 100 patients. Using an EMR, you can copy the records of thousands of patients in minutes onto a USB drive.

“Private information about accident victims treated at University Medical Center has apparently been leaking for months, the Sun has learned, allegedly so ambulance-chasing attorneys could mine for clients.
Sources say someone at UMC is selling a compilation of the hospital’s daily registration forms for accident patients. This is confidential information – including names, birth dates, Social Security numbers and injuries – that could also be used for identity theft.
Hospital officials knew of rumors of the leaks since the summer, but doubted them until provided evidence Thursday by the Sun. Now they’re scrambling to catch up to a crisis that may affect hundreds, if not thousands, of patients….”


The Federal Trade Commission worries that consumers don’t really understand the privacy implications to storing some of their most crucial data in the cloud, and it wants the FCC to think about such issues when finalizing its national broadband plan.

By Nate Anderson | Last updated January 6, 2010 11:47 AM

Take Google’s new Nexus One phone as a case study of the pros and cons of storing life details on remote servers. Nexus One phones can back up their complete settings to Google’s servers, including data such as “Wi-Fi passwords, bookmarks, a list of the applications you’ve installed, the words you’ve added to the dictionary used by the onscreen keyboard, and most of the settings that you configure with the Settings application.” Get a new phone and the data transfers easily.

But that data is now sitting on servers outside of your control, where it can be accessed far more easily by Google itself, hackers, and law enforcement than it ever could if kept within the device. Once data passes over the network, it gets much easier to access in realtime; once it is stored on a remote server, it gets much easier to access at any time.

And those are just the phone settings. Google also has access to search history data, anything stored in Google Docs or Spreadsheets, complete schedules stored in Google Calendar, and recent Maps searches. Combine them all, and companies like Google become one-stop shops for authorities looking for personal information.

Such issues have raised concerns at the Federal Trade Commission (FTC), especially since many consumers aren’t really aware of the data security issues raised by storing information on remote servers. “For example, the ability of cloud computing services to collect and centrally store increasing amounts of consumer data, combined with the ease with which such centrally stored data may be shared with others, create a risk that larger amounts of data may be used by entities in ways not originally intended or understood by consumers,” said the FTC in a letter (PDF) this week. {}

That letter was directed at the Federal Communications Commission (FCC), which is currently drawing up a national broadband plan that will be submitted to Congress next month. In advance of the plan’s release, the FTC wants to make sure that the FCC “considers technologies such as cloud computing and identity management in implementing a national broadband plan.”

That means publicly recognizing the FTC’s growing expertise on issues on online privacy and data security. “Accordingly, we recommend that the Broadband Plan recognize the FTC’s law enforcement, consumer education, and ongoing policy development efforts in light of its years of experience in online, and offline, consumer protection,” concludes the letter.

The FTC is in the middle of a set of hearings on these issues; the next one takes place on January 28.

Categories: Health IT, Personalized Health Tags:

Unhealthy habits are what’s killing us.

December 28th, 2009 No comments

Unhealthy habits are what’s killing us

By David Frum, CNN Contributor

* Americans’ poor health, relative to other countries, is cited as a reason for health reform
* David Frum says there’s little evidence health bill will improve U.S. life expectancy
* He says research shows unhealthy habits explain why Americans get sick more often
* Individual choices to adopt healthy lifestyles would have more impact, he says

Editor’s note: David Frum writes a weekly column for A resident fellow at the American Enterprise Institute, he was special assistant to President George W. Bush in 2001-2. He is the author of six books, including “Comeback: Conservatism That Can Win Again” and the editor of FrumForum.

(CNN) — Health care reform is proceeding toward the president’s desk, likely to become law in the new year.

Supporters promise the bill will cut costs and extend coverage.

But here’s the real test: What will the trillion-dollar expense of this bill actually buy? Will it improve America’s health? My guess: No.

For all the money Americans spend on health care (60 percent more per person than any other advanced country), Americans are not an especially healthy people.

Life expectancy at 50 in the U.S. ranks 29th in the world, three years behind world leader Japan, one and a half years behind Canada. Other indicators — infant mortality, life expectancy at birth — look even worse.

This poor performance is often blamed on the fact that millions of Americans lack health insurance. But as a recent paper for the National Bureau of Economic Research found, the U.S. — despite its kludgy health insurance system — does a remarkably good job of extending disease-fighting treatment to all.

Authors Samuel Preston and Jessica Ho observe:

* The U.S. screens a higher percentage of women for cervical cancer than any other country in a sample of 15 advanced countries.

* Americans have the highest survival rates for breast, lung, colon or rectal cancer in a sample of 20 advanced countries.

* Compared with Australia, Canada, Denmark, Finland, Sweden and Great Britain, the U.S. had the third-lowest fatality rate for male heart attack victims ages 40-64, the second-lowest for men ages 85-89 and the best for women aged 85-89.

* Americans 50 and older with heart disease are more likely to receive medication than similarly aged Europeans. Ditto stroke. Ditto high cholesterol.

Cancer and heart disease are not any old ailments. These are the leading causes of death for people 50 and older.

So if the U.S. health system does such a good job saving its middle-aged and elderly sick, why do Americans die comparatively young?

Answer: because Americans are much more likely to get sick in the first place.

And that likelihood owes very little to the health care system and a great deal to the bad choices American individuals make.

If you eat too much, exercise too little, drink too much, smoke, take drugs, fail to wear a seat belt or ignore gun safety, there is only so much a doctor or hospital can do for you.

And Americans do all those things, more than other people.

One-third of Americans are overweight. That one single fact accounts for almost 10 percent of all health care spending. At any given moment, one out of six motorists is unbelted. American children are nine times more likely to be injured in a gun accident than children in other developed countries.

If all Americans quit smoking, if everybody wore a seat belt, if gun owners consistently secured their weapons, if we all drank in moderation and abjured illegal drugs and if the one-third of the country that is overweight would drop the extra pounds, those individual actions would do more to improve health and extend lives than any contemplated by Congress or the president.

Acting on this information won’t be easy: It violates too many taboos. Americans understandably treasure their right to make their own choices, including the choice to super-size it. And many are uncomfortably aware that self-destructive behavior is most often found among the poor and among minorities: Black women are more than three times as likely as white women to be severely obese.

In the near term, public policy can achieve only a limited impact against these problems. There is evidence that youth obesity can be reduced by zoning rules that forbid fast-food restaurants to be sited within 200 yards of a school. More and better gym classes, better cafeteria menus and a ban on soda in schools would all help too.

Over the longer term, we will have to rethink the deeper structure of American food policy: subsidies to corn and soybean growers, the paving over of exurban land that might provide nearby cities with less expensive fruits and vegetables.

Ultimately, though, these are decisions that individuals must make for themselves. In this respect, the present concept of medicalized health care sends some unwelcome messages. By “outsourcing” the concept of health as something that doctors, hospitals and now government do for you — rather than something that depends considerably on your own choices and efforts — we ask the medical system to do more than any medical system can do.

As you consider your new year’s resolutions, remember: better habits will benefit not only your family and yourself — but all your neighbors and countrymen as well.

The opinions expressed in this commentary are solely those of David Frum.

Easy installers for *free* VistA EMR package.

December 7th, 2009 No comments

If you’re considering purchasing an EMR system make sure you take a look at the VistA package.

“VistA” is the EMR package developed by the Veterans Administration over dozens of years.

Here is an overview of VistA:

And for the common questions:

* “Isn’t VistA written in MUMPS?” The answer is Yes, and so are many other large EMR systems.
“..Large companies currently using MUMPS include AmeriPath (now part of Quest Diagnostics), Care Centric, Team Health, Epic Systems Corporation, EMIS, Partners HealthCare, Meditech, and GE Healthcare (formerly IDX Systems and Centricity). Many reference laboratories, such as Quest Diagnostics and Dynacare, use MUMPS software written or based on by Antrim Corporation code. Antrim, and its parent Sunquest, was acquired by Misys in 2001.”

* “But MUMPS is like 30 years old technology!” Yes, does it make the language less effective than the latest fad programming language? As a point of comparison, FORTRAN is an “old” programming language that happens to run in many mainframes _today_ processing billions of transactions.

How to Give VistA a try.

The folks at Astronaut LLC have done a fantastic job bundling all the necessary elements for you to test a full-blown VistA install at no cost and with minimum time and headaches. See:

a.) an easy-to-install server package (
Astronaut is an automatic installer for the WorldVistA edition of the Veterans Affairs VistA Electronic Medical Record system. Server rpm and deb as well as Windows client pack. Server is installed so that the Windows client pack clients should work.

b.) a client installer (
Easy Windows client installer and session manager that works with Astronaut VistA server installers.

Disclaimer: I have no financial ties to Astronaut. I’m just a passionate advocate of Open Source in healthcare.

Categories: Personalized Health Tags:

The possibilities of aligned interests on health care.

October 2nd, 2009 No comments

- – - Upcoming Event – - -

Mobile Phones For the Seniors Market
October 26, 2009
London, UK

Please download full program at:

- – - – -

..From what I can tell, it may be easier to achieve true consensus around health care reform at the local level.  That’s why much of my hope for a real health care overhaul rests on the power of local organizations, like the one I headed for three years, the Puget Sound Health Alliance.  In a few years, we were able to forge partnerships across stakeholder lines to improve the quality and efficiency of health care across the Greater Seattle region

- – - – -

The possibilities of aligned interests on health care

Posted by Minna Jung on September 22, 2009 in
health care costs health care reform health care value implementing reform quality

Margaret Stanley Margaret Stanley, former executive director of the Puget Sound Health Alliance, writes about the value of bringing diverse stakeholders into local alliances to reform health care.

As national leaders have learned again and again, assembling a fractious group of doctors, hospitals, insurers, businesses, patients and public officials around something as complex and divisive as overhauling health care isn’t easy.

But nowadays, as reasonable, well-intentioned people try to reach agreement on health reform in the midst of the ranting and clouds of misinformation, reaching consensus is especially important, because everyone’s got a role to play in making our health care better.
Read more…

Proposal to build SoFLHealth, a South Florida Regional Health Improvement Platform.

September 30th, 2009 No comments

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

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

- – - – -

“..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…

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

September 23rd, 2009 No comments

[Editor's Note]

This is a significant announcement in the promotion of Open Access. See for more information on Open Access. HealthLibrarian ( 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:

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.


- – - – -

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…

Categories: Open Access, Personalized Health Tags:

Games For Health: The Latest Tool In The Medical Care Arsenal.

August 4th, 2009 No comments

04 August 2009

Games For Health: The Latest Tool In The Medical Care Arsenal

Computer-based simulations and interactive programs are introducing a powerful new force into health care: fun.

by Carleen Hawn

ABSTRACT: At the heart of any promising plan to transform the health care system lie two priorities: broader access to care for patients, and deeper engagement in health care by patients. Although the problem of expanding access to affordable care remains unresolved, new tools for deepening consumers’ engagement in health care are proliferating like viral spores in a virtual pond. Digital games, including virtual realities, computer simulations, and online play, are valuable tools for fostering patient participation in health-related activities. This is why gaming is the latest tool in the arsenal to improve health outcomes: gaming makes health care fun. [Health Aff (Millwood). 2009;28(5):w842-8 (published online 4 August 2009; 10.1377/hlthaff.28.5.w842)]
Read more…

Categories: Health IT, Personalized Health Tags:

Aetna’s Clinical Policy Bulletins (“CPBs”) Available on HealthLibrarian, a Semantic Search Engine for Health Knowledge.

July 30th, 2009 No comments

Aetna’s Clinical Policy Bulletins (“CPBs”) Available on HealthLibrarian, a Semantic Search Engine for Health Knowledge.

Florida Startup Integrates Aetna’s Clinical Guidelines with Multi-lingual Scientific, Open Access Health Content and Community Resources

MIAMI, July 30, 2009 – Aetna is the first commercial insurance company to make its clinical guidelines available through the HealthLibrarian semantic search engine for health data.

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 to see HealthLibrarian in action now.

“Since 1999, Aetna has posted all of its clinical policy bulletins (CPBs), along with supporting citations to the clinical evidence on which they are based, on our public website,” explained James D. Cross, MD, Head, National Medical Policy and Operations at Aetna. “A great deal of scientific and clinical research goes into the development of these CPBs. Aetna’s clinical team pulls together peer-reviewed medical literature, evidence-based consensus statements, technology assessments and guidelines from professional organizations and public health agencies to use in formulating our coverage policies. Each CPB is reviewed at least annually and more often if new developments warrant. As the science evolves, so do Aetna’s clinical policies. Because we have such confidence in their integrity, we want consumers as well as physicians to have access to them. Making them searchable through HealthLibrarian will help the science reach an audience beyond Aetna’s membership providing another credible resource to help consumers and their physicians reach well informed treatment decisions.”

HealthLibrarian includes a growing number of datasources, including: Medline; FDA adverse events databases; NIH grants; Evidence-Based Medicine (“EBM”) guidelines from the UK, US: Clinical Trials; Drug Information; product label for drugs sold in the US and Spain; mental health and substance abuse providers; as well as thousands of Open Access articles.

“OpenPHI is pleased to work with Aetna to distribute its clinical guidelines to a broader, global audience. This fits with HealthLibrarian’s vision of delivering Hyper-local and Hyper-personal health information to both consumers and clinicians,” said Jose C. Lacal, Chief Vision Officer of OpenPHI. “We processed the entire contents of each CPB using our indexing and Natural Language Processing (“NLP”) technologies to allow users of HealthLibrarian to create personalized summaries of relevant information, customized for each user’s sex, age, disease of interest, and location,” Mr. Lacal concluded.

This is an example of how Aetna’s clinical guidelines will be integrated with HealthLibrarian:
a.) A user is navigating HealthLibrarian’s site looking for information on a particular topic (say “back pain”).
b.) HealthLibrarian’s semantic search engine will identify all terms and concepts related to the user’s query, using the 7 million terms in our Controlled Medical Vocabulary (“CMV”).
c.) Among other things, HealthLibrarian will indicate to the user that Aetna has a relevant CPB the user may be interested in looking at. HealthLibrarian will display the CPB’s title (say “Dorsal Column Stimulation” in this case).
d.) The CPB’s title will have embedded the URL to the actual CPB hosted at Aetna’s website
e.) If the user clicks on the title of the CPB, the user’s web browser will be directed to Aetna’s website for the user to read the latest version of the chosen CPB.

One note of caution: Aetna’s clinical policy bulletins provide a scientific and clinical basis on which Aetna medical directors can evaluate the status and medical necessity of emerging medical technologies and services. Individual health benefit plans will vary on what they cover based on the specific benefit design of the plan. Aetna members with questions on coverage should check with Aetna Member Services or consult with their employer’s health plan administrator to determine what is covered under their plan.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 36.8 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see

About HealthLibrarian

HealthLibrarian is an On-demand Data Warehouse of Global Health-related Insight. Our system integrates search, data mining, web crawling and indexing of health data from validated global sources. HealthLibrarian can be licensed for use with Health IT systems (such as Electronic Health Records), by libraries, or by government agencies.

HealthLibrarian is a service of Open Personalized Health Informatics, Corp. (“OpenPHI”), a self-funded, privately held bio-informatics startup in Miami, Florida. While some try to “improve the healthcare system,” we focus on “building a care system that improves our health.” We call that “Personalized Health.” OpenPHI simplifies the use of the vast amount of health databases, publications, and medical know-how freely available from academic and government sources across the world.

Media Contacts

Jose C. Lacal
Open Personalized Health Informatics
+1 (954) 553-1984

Wendy Morphew
+1 (212) 987 3846

Categories: Personalized Health Tags:

Whistleblower tells of America’s hidden nightmare for its sick poor

July 25th, 2009 No comments

Whistleblower tells of America’s hidden nightmare for its sick poor

When an insurance firm boss saw a field hospital for the poor in Virginia, he knew he had to speak out. Here, he tells Paul Harris of his fears for Obama’s bid to bring about radical change

The Observer, Sunday 26 July 2009

Dental care at a clinic in Wise Virginia

Patients without health insurance get dental care at a free clinic in Wise, Virginia, held every July for the past three years. More than 25,000 were treated in a weekend Photograph: John Moore/Getty Images

Wendell Potter can remember exactly when he took the first steps on his journey to becoming a whistleblower and turning against one of the most powerful industries in America.

Read more…

Categories: Personalized Health Tags: