Feature Articles

The Politics of the EHR: Why we’re not where we want to be and what we need to do to get there

By now, it seems abundantly clear that the vast potential offered by universal adoption of electronic health records (EHR) has not been achieved.  Indeed, the fulfillment of that potential seems a long way off.  Unsolved problems with interoperability, usability, safety, and security, to name a few, remain, and continue to pose barriers to universal adoption. There is ample evidence in the medical literature, of the unsolved problems of the EHR.  Indeed, two recent reports that offer (probably inadequate) solutions highlight the difficulties that exist with the EHR.  The proliferation of these problems has only increased with the increase in adoption of the EHR by physicians and institutions.   The Texas Medical Association has asked the (at the time) ONC, Farhad Mostashari, MD, to establish a health IT patient safety czar.1 Read More »

Open Source & IT Procurement

Paul Matthews, Chief Executive of the Institute of IT Professionals (IITP) congratulated Commerce Minister Foss for listening to the IT industry and supporting the nearly unanimous passage of New Zealand's recent law banning software patents. Read More »

Cancer And Clinical Trials: The Role Of Big Data In Personalizing The Health Experience

Despite considerable progress in prevention and treatment, cancer remains the second leading cause of death in the United States. Even with the $50 billion pharmaceutical companies spend on research and development every year, any given cancer drug is ineffective in 75% of the patients receiving it. [...] Read More »

Genomics And The Role Of Big Data In Personalizing The Healthcare Experience

Genomics is making headlines in both academia and the celebrity world. With intense media coverage of Angelina Jolie’s recent double mastectomy after genetic tests revealed that she was predisposed to breast cancer, genetic testing and genomics have been propelled to the front of many more minds. Read More »

Health IT Innovation? Not Without Open Platforms

The issue here is closed platforms, which enable most EHR vendors to position themselves as the single source of innovation. They also create dependent customers and glacial progress in two parallel areas of innovation—evidence-based medicine and information technology.  No one company can keep up with the natural pace of advancement in either realm, let alone both. Read More »

Overview of Open Source and VistA in the UK's NHS

There is much widely publicised interest from NHS England in encouraging the development and implementation of open-source software in the National Health System (NHS) with the debate raging in a number of forums, notably on EHI where this article and the comments it has generated are vital reading for anyone interested in this issue. This debate has been fueled by the availability of NHS England’s £260 million Technology Fund which is actively soliciting open source projects include bids to implement an NHS VistA... Read More »

Guest Article: Shakespeare in Namespace, or why Blue Button took off as fast as it did

While Veterans Affairs was struggling with the nuances of the implementation of the Blue Button personal health record, and while the VA and the Pentagon are wrestling the Health Data Dictionary to the ground, we lived – and lived through – the hell of multiple rigid conventions described in [David] Weinberger’s book [Too Big to Know]. Read More »

VHA Providing EHR Training for Health Professional across the U.S.

The Veterans Health Administration (VHA) currently operates more than 1,500 sites of care, including 152 hospitals, 965 outpatient clinics, and over 130 VA nursing homes. Last year, over 116,000 health professional trainees received some or all of their clinical training in these VA healthcare facilities. The VA has academic  affiliation agreements with more than 1,800 colleges, universities, and medical schools across the U.S.   All of the physicians and healthcare professionals that pass through the VA receive training in the use of the VistA electronic health record (EHR) system. Read More »

EHR Systems & Cost Transparency in the Healthcare Industry

Cost transparency is obviously a big issue in the healthcare industry. Whether it’s the amazing variation in costs hospitals charge patients for similar medical procedures, or the costs associated with acquiring and implementing an Electronic Health Record (EHR) system for a hospital - Why are all these costs often carefully hidden?  Is there something special about the healthcare industry that says – "Let's not talk about how much things really cost." Apparently, many industry leaders must feel that hospitals boards and patients have no need to know this information. Read More »

'Opening Up' the FDA

The President's Executive Order on Open Government Data states, "Government information shall be managed as an asset throughout its life cycle to promote interoperability and openness, and, wherever possible and legally permissible, to ensure that data are released to the public in ways that make the data easy to find, accessible, and usable." Interestingly, the Department of Health and Human Services (HHS), which includes the Food & Drug Administration (FDA), has a tradition of expansive disclosure of information and/or data it generates or collects – contrary to current practices at the FDA. Hopefully, changes being made to 'open up' the FDA will start to accelerate. Read More »

Defense Probably Goes Commercial, Not Necessarily Proprietary

Secretary of Defense Chuck Hagel’s long-awaited (in health IT circles, anyway) decision on the Department of Defense’s core health IT system has been made. The VA’s VistA system is out as the preferred DoD solution - unless it’s not. I’ll explain. Read More »

VistA, AHLTA, CHCS: An Evolving Alternative Roadmap to the Future

Thinking outside the box - A proposed alternative approach to help move the U.S. Department of Defense (DoD) and Department of Veterans Affairs (VA) in a common direction with regard to the future of their clinical IT systems, i.e. VistA, AHLTA, CHCS. Read More »

Case Study: MD Anderson Successfully Implements Tools to Migrate Clinical Research Data from MUMPS to Oracle

The University of Texas MD Anderson Cancer Center has successfully completed the initial stages of a major migration of their MUMPS-based Clinical Trials Databases to Oracle as one of the critical stages in MD Anderson’s multiyear eResearch project to modernize management of Clinical Trials. The MD Anderson Cancer Center chose CAV Systems' Evolve Suite to carry out the migration. The institutions have produced a case study outlining the background and results of this extraordinary project. Read More »

Mobile Health IT Solutions for Healthier Aging

A report entitled "Using Mobile Technologies for Healthier Aging" was released in March 2013. The report, written by Ada Kwan, was co-sponsored by the mHealth Alliance , United Nations Foundation, and Pfizer. The stated objective of this report was to provide momentum and spur further conversation on ways mobile technologies can help people age better and remain in reasonably good health. Read More »

VistA as an EHR System Core for DoD

Here is a copy of the full text of the proposal submitted by the US Department of Veterans Affairs (VA) to the Department of Defense in response to the Request for Information for an electronic health record (EHR) solution that can replace the existing DoD EHR system. This is the approach that makes the most sense as the current core EHR that the Department of Defense (DoD) uses is based on a 30-year-old version of VistA. The current EHR crisis facing DoD stems from the inability to upgrade this older version of VistA. What the VA is proposing is basically an upgrade to DoD's existing core EHR. Read More »