Diet and Nutrition. Natural Health, and Healthy Living

During the decade I've been CIO, IT operating budgets have been 2 percent of my organization's total budget, which is typical for the health care industry.

During the same period, IT budgets for the financial services industry have averaged 10 percent or higher.

Since 1998, I've often been told that Healthcare IT needs to take a lesson from the financial folks about doing IT right.

The Boston Globenicely summarized the financial issues at the core of the crisis

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It appears that at least the first phase of personal health record (PHR) certification from CCHIT (Certification Commission on Health Information Technology) will focus on a narrow set of attributes. CCHIT Chairman Mark Leavitt told a group earlier this month that the first set of PHR standards will focus primarily on privacy, security and interoperability.

Leavitt indicated that functionality standards would initially only address what functions are needed to support privacy, security and interoperability. I asked him the following question: Given that what many consumers need to know is how useful would different PHRs be to helping them and their families manage their health, wouldn’t it make sense to include a broader assessment of functionality in CCHIT’s PHR certification?

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Last week, Congress got a step closer to passing a Mental Health Parity bill after years of debating the issue. The bill would require insurance companies to provide the same coverage for physical and mental ailments.

For more than a decade, both houses have passed different versions of the legislation only to see it fall apart at the end. The biggest hiccup now seems to be that the bill doesn't specify which mental disorders it will include.

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A huge bailout is being planned in Washington to avert a calamity that was brought about, in large measure, by the financial system operating the way financial operators told us it was supposed to function. The money is needed, we are told, to bail out the financiers who assured us -- up until just a couple of weeks ago -- that the system they operated was sound and would need no rescue.

What is the likely spill over to health care from the misbehavior of the financial system's owners, operators, and managers? I'm going to suggest there are likely to be both direct and indirect effects. One of the indirect effects is that we may lose faith in doctors, nurses, and hospitals, or at least come to suspect that the practice of their craft and trade is not aligned with their espoused principles of "doing no harm" and acting in our best interests.

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Last week, came the announcement that Suzanne Delbanco, founding director of the Leapfrog Group, has assumed the presidency of a company that tracks compliance with safety and quality practices via remote video. Big Brother, meet the Joint Commission.

The report, in Modern Healthcare, describes the process this way:

Video auditing refers to a system in which cameras are mounted in targeted locations to continuously capture specific clinical processes, such as observing handwashing and hand-sanitizing stations. [Using video] fed through a Web-based link, independent, third-party observers audit the recordings and provider reports on safety incidents.

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A couple of weeks ago I did a post, The Pretend Presidential Debate on Health Care--The Health Care Press Needs to Force the Presidential Candidates to Get Real on Health Care "Change".

In it I made the point that facing a $500 billion budget deficit next year, the sunset of the Bush tax cuts in 2010, fixing the alternative minimum tax problem once again, and the cost of the Freddie and Fannie bailout, the presidential candidates needed to get real abouthealth care reform. Instead of giving us their rote health care talking points, I said they needed to start telling us how they were really going to deal with health care reform in the face of all of these challenges.
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There's few areas I am more interested in these days than the social history of medicine, so this call looks particularly interesting to me:

The SHAD is a peer-reviewed academic journal dedicated to publishing high-quality original academic research, reflection essays and reviews in the field of alcohol and drug history, broadly construed.

We invite authors from a range of disciplines to submit papers on the wide range of topics within the journal's purview.
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Several new or recently formed blogs have come to my attention here, and I just wanted to mention them briefly.

The BMJ journal Medical Humanities has maintained an excellent blog for some time, though I have been remiss in not linking to them until now.

The BMJ journal Journal of Medical Ethics has similarly added a blog (h/t Global Bioethics Blog).

Last, Adam Kolber over at the Neuroethics & Law Blog brings word of the Law & Biosciences Blog (out of Stanford), which touches on many issues relevant to neuroethics & the medical humanities.

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Color-coded hospital bracelets intending to identify categories of patients and prevent errors by ensuring they receive proper care have received a mixed reception, the New York Times reports.

Red bracelets indicate allergies, amber says the patient has a falling risk and purple tells hospital staff that the patient has a not resuscitate order. The DNR bracelets seem to be attracting the most criticism.

Apparently, the Joint Commission warns that the purple bracelets may "brand" patients by their end-of-life choice, and may upset family members unfamiliar with the patient's wishes.

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The growth of the e-Patients movement may be experiencing surprising strength from a completely unexpected source, with many people growing the ranks of the movement because of the greatest motivator of all: saving money.

Clay Shirky's cognitive surplus observation, made in April 2008, keeps on resonating as I see more and more evidence that, contrarily to what some naysayers would want us to think, the internet and social media are fundamentally important to a significant percentage of Americans looking for answers about wellness or sickness, health or disease.

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