The Onus is on Scientists – Shame on the AAAS

The American Association for the Advancement of Science (AAAS) has just come out against California’s Proposition 37, which would mandate the labeling of genetically-modified foods. In my opinion, the AAAS has failed its duty as promoters of Good Science. The question is not whether genetically-modified foods are safe. I see the benefits, and I see the downsides (especially as a security guy, since food safety testing is, in my opinion, very poorly done), and the debate will rage on for a long time. But whether genetically-modified foods are safe is not the issue. The issue is whether consumers have a … Continue reading The Onus is on Scientists – Shame on the AAAS

Jumpstarting Health IT innovation

Until last month, I was lead architect on the SMART Project at Harvard Medical School and Children’s Hospital Boston (now I’m an advisor). One key issue that all Health IT folks grapple with is how to make the Health IT ecosystem more dynamic and innovative, because technology in that space moves so slowly. The SMART Project is one attempt to jumpstart Health IT innovation. If you’re interested in this stuff, you might want to read the blog post I wrote on the SMART site about how SMART addresses the Presidential Report on Health IT. Key ideas: PCAST very eloquently identifies … Continue reading Jumpstarting Health IT innovation

The Health IT report is very good; some opinionated suggestions

“Oy,” I thought, when I received a copy of “REPORT TO THE PRESIDENT REALIZING THE FULL POTENTIAL OF HEALTH INFORMATION TECHNOLOGY TO IMPROVE HEALTHCARE FOR AMERICANS: THE PATH FORWARD” [PDF]. I worried this would be a lot of vague, easy-to-agree-with advice with little actionable material. I was wrong. Hats off to the team that wrote this! Problem Analysis is right on Some nuggets of the problem analysis, all from the executive summary (a quick and useful read): First, most current health IT systems are proprietary applications that are not easily adopted into the workflow of a clinician’s day, and whose … Continue reading The Health IT report is very good; some opinionated suggestions

Taxing Human Transactions – Part 1

The worst part of my job is dealing with the mess of document formats and coding systems in healthcare. The acronym soup is insane: HL7, CCD, CCR, CDA, Green CDA (which I just heard about from John Halamka’s blog but… no link!), and that’s just the document formats. Then there are coding systems like LOINC, SNOMED, SNOMED-CT, UMLS, ICD9, ICD10, RxNorm, … Interestingly enough, the issue is not how many there are. The issue is how they’re licensed. Here’s a screenshot from the HL7 website that should tickle your funny bone: So, HL7 is unlocking the power of health information, … Continue reading Taxing Human Transactions – Part 1

The first good mainstream article on vaccines in a while

I meant to mention this a while ago, but I keep forgetting. Amy Wallace at Wired wrote a fantastic piece on how irrational fears of vaccination are putting us all at risk. The feedback to Ms. Wallace has been enormous, and although tilted towards the positive, the negative feedback from the anti-vaccination crowd is insulting, misogynistic, ad-hominem crap. I’m a scientist and engineer, but I’m not a medical doctor. Back in 2004, when Robert Kennedy Jr. published his anti-vaccine piece in Salon/Rolling Stone, I worried that there was something to his claims. I asked around. I’m lucky enough to work … Continue reading The first good mainstream article on vaccines in a while

ITdotHealth – a new forum for Health IT discussion and a workshop next week

Next week, I’ll be in Boston for 2 days for a workshop we’re putting together at Harvard Medical School on Health IT Platforms. We’ll be using this workshop to launch a new hub for discussion and debate around the design of a modular health IT infrastructure. Check out the new site ITdotHealth, the welcome message, and of course the Twitter feed. Continue reading ITdotHealth – a new forum for Health IT discussion and a workshop next week

What about the less obvious errors?

The New Scientist points out a case of genotyping error by one of the consumer genomics companies, where a software bug caused a genotype to appear non-human. The article attempts to be reassuring: Before other deCODEme customers get too irate about errors in data for which they have paid almost $1000, the bug affects only a tiny portion of the results presented. Most importantly, the disease-risk summaries provided by deCODEme seem to be based on the correct genetic information. “seem to be” is the operative terminology, indeed. As is typical in security / quality-control settings, the question here is, if … Continue reading What about the less obvious errors?

Open Licensing in Health IT

John Halamka, renowned CIO of the Beth Israel Deaconess Medical Center (BIDMC), is a blogger, and he just added a Creative Commons license after making the following remarks: I want my blog to be used for education, training, and research. I hope that its contents appear in derivative works such as other blogs, websites, and wikis. I’d prefer that these derivative works be openly shared. I would also ask that any material that is repurposed has attribution to me as the author. Content from my blog should not be sold. Charging for access to that which I make freely available … Continue reading Open Licensing in Health IT

Loosely Coupled Health IT

My research group, Children’s Hospital Informatics Program, just released a statement of principles in designing the next generation of Health IT, and folks are picking it up. The key concept is substitutability, or what software/Internet architects have called loose coupling. The idea is to build modular rather than monolithic systems, and ensure that the modules are connected in loose enough ways that innovation is possible within each component independently of the others. Sounds kinda obvious, right? Not so in Health IT, which is only just now starting to get the point of the Web. So, for example, if you think … Continue reading Loosely Coupled Health IT

Empowering the Patient vs. Enabling an Artificial Monopoly

Health Information Technology is moving along fairly quickly, with the stimulus money and the rise of Personally Controlled Health Records (Indivo/Dossia, Google Health, Microsoft HealthVault). I’m quite optimistic about the future of health data: there is a growing effort to free the data in order to empower patients. And then there are some really boneheaded efforts that appear to be for patient safety, but end up creating all the wrong incentives and further blocking patients from taking an active role in their care. This week provided fantastic examples of both. Harvard’s own Donald Berwick explains to the New York Times … Continue reading Empowering the Patient vs. Enabling an Artificial Monopoly