Hatfields & McCoys, Book Banning and The World Is Flat

Larry Messina beat me to the post. I agree - quote of the day from award winning author, Pat Conroy in a letter to the editor appearing in today's Charleston Gazette.

"Because you banned my books, every kid in that county will read them, every single one of them. Because book banners are invariably idiots, they don’t know how the world works — but writers and English teachers do."

More on the the story involving the suspension of two of his books, Beach Music and The Prince of Tides, from high school English class at Nitro High School.

The emailed letter to the editor was in response to an effort lead by Makenzie Hatfield, a George Washington High School senior who the article indicates is working to for form a coalition against censorship. Hatfield emailed the author about the situation and received the response.

Just another example of how the ease of modern communication (email, internet, blogging, etc.) can put anyone (student) in contact with anyone else (author). The world is flat.

Conroy also weaves in the Hatfields & McCoys and ends with my other favorite quote from the letter.

"I salute the English teachers of Charleston, West Virginia, and send my affection to their students. West Virginians, you’ve just done what history warned you against — you’ve riled a Hatfield."

New Health Care CIO Blog

A welcome to John Halamka, MD and CIO of CareGroup Health System and the Chief Information Officer and Dean for Technology at Harvard Medical School who has launched a new blog, Life as a Healthcare CIO. Dr. Halamka is also the Chairman of the New England Health Electronic Data Interchange Network (NEHEN), CEO of MA-SHARE (the Regional Health Information Organization), Chair of the US Healthcare Information Technology Standards Panel (HITSP), and a practicing Emergency Physician.

His tag line says:

Every day I experience life in the world of healthcare IT, supporting 3000 doctors, 18000 faculty, and 3 million patients. In this blog I record my experiences with infrastructure, applications, policies, management, and governance as well as muse on such topics such as reducing our carbon footprint, standardizing data in healthcare, and living life to its fullest.

Check out the great content in these recent posts, Top 10 Things a CIO Can Do to Enhance Security and the pro/cons of Flexible Work Arrangements. Looking forward to reading more of his posts. Tip to David Williams at Health Business Blog for pointing out this new health care CIO blog.

Data Missing on 200,000 West Virginia PEIA Members

WSAZ News, the State Journal and Charleston Gazette are reporting that data on approximately 200,000 past and current members of West Virginia Public Employees Insurance Agency (PEIA) is missing. According to the articles, the data was contained on a computer tape being mailed to a data analyst in Pennsylvania and was reported missing on October 18.

The data tape included names and maiden names, addresses, social security numbers, telephone numbers, and marital status of program participants and their covered dependents. The article indicates that the data tape did not contain medical or prescription claims information.

According to the article, letters will be mailed to impacted members and a hotline will be set up to answer questions about the lost data.

UPDATE: For more information check out the PEIA Data Loss Press Release and the Letter to Affected Policyholders about PEIA's Recent Data Loss.

Putting WV Mountaintop Removal In Perspective

How big are West Virginia's mountaintop removal sites? Check out the post "How Big is MTR Mining?" over at the Charlestonian Blog to better understand the scale.

AHIMA Report on State Level Health Information Exchange

The Foundation of Research and Education arm of the American Health Information Management Association (AHIMA) released a report titled "State Level Health Information Exchange: Roles in Ensuring Governance and Advancing Interoperability." The report was funded by ONCHIT.

I've just scanned the report but it appears to give a nice overview of the current status of state level initiatives to create an interoperable health information system.

Tip from iHealthBeat.

George Clooney and HIPAA Minimum Necessary Rule

An attorney I work with sent me a link to the following Fox News article, Doctors, Hospital Workers Suspended for Viewing George Clooney's Medical Records. For more news check out Google News search.

The article indicates that 40 employees at Palisades Medical Center in North Bergen, NJ were suspended for violating the hospital's HIPAA policies and procedures.

Based on the information in the article I suspect that the employees were found to have violated the minimum necessary provisions under the HIPAA Privacy Rule. This section of the rule provides:

For uses of protected health information, the covered entity’s policies and procedures must identify the persons or classes of persons within the covered entity who need access to the information to carry out their job duties, the categories or types of protected health information needed, and conditions appropriate to such access.

As more news comes out about this I suspect this might serve as a good example of application of the minimum necessary requirements under HIPAA. If the employees further disclosed the information to third parties outside the hospital (including the media) other provisions of HIPAA might also come into play.

Now Playing . . . The Digital Health Revolution

Friend and fellow health care blogger, Fard Johnmar, today officially announced the launch of The Digital Health Revolution. A project he has been working on with the folks at Scribe Media since meeting them at the fHealthcare Blogging Summit in Las Vegas.

Fard has great insight into the health care industry and I look forward to great content coming out of DHR. Check out the show here, including a very interesting interview with Susannah Fox, Associate Director with the Pew Internet and American Life Project on the topic of empowerment/revolution of the e-patient.

Enoch Choi, MD and I were lucky enough to be Fard's guinea pigs in his first (impromtu) interview for Scribe Media.

HealthVault: Adding Structure (Interoperability) to the Health Information Ecosystem

Last week (October 4) Microsoft rolled out a brand new vehicle that should help accelerate the growing consumer driven health care movement and creation of a national interoperable health information system. HealthVault is a new personal health record (PHR) platform that allows the user to gather, store and share health information online.

There has been a lot written about the roll out of HealthVault over the last week. I've read numerous articles and blog posts to try to get a better grasp of what it is (and what it is not). Over the weekend I ran across Vince Kuraitis' post at his e-CareManagement Blog which I found to have provided some good insight. Not until reading Kuraitis' post did I actually understand that HealthVault is not a PHR but a PHR platform.

In particular I like this quote by Kuraitis and his comparison of the pre-fax world:

" . . . this really isn’t about Microsoft vs. Google . . . It’s about creating a new business ecosystem based on the appropriate (honoring privacy and security) free flow of interoperable and transportable personal health information (PHI) — something that doesn’t exist today."

I'll throw out another comparison that I thought about as I read his post -- the natural gas transportation and storage industry. West Virginia is home to some large underground gas storage facilities. Basically, natural gas is pumped during off season to West Virginia from the Gulf Coast via large transmission lines or is gathered from small wells through gathering facilities and lines. The gas is then pumped and stored in previously depleted underground wells. In doing so, the natural gas can be stored safely and moved quickly to market in the northeast during the cold months.

HealthVault is setting out the same architecture, transportation and storage device for health information. The natural gas (health information) is very valuable and the system of moving it around is incredibly complex with multiple players and competitors. You have individuals and companies constantly adding natural gas (health information) to the system and end users who need natual gas (health information) at the opposite end. To date the health care industry does not have such a structured, standardized system of pipelines to protect and transport health information. We are largely still living in a paper world with systems that don't have the capability to talk to each other.

As I step back and take a look -- I see an industry in the midst of a tidal shift regarding the control of personal health information and maybe the bigger question of who wants (and can safely) control health information. Microsoft's HealthVault appears to be laying down more planks to create the platform for an interoperable system that will allow for health information to become more transportable, transparent and standardized. Ultimately, the question in my mind remains whether this will help to improve care and help each of us become better stewards of our own health?

Stay tune . . .

HealthBlawg Explores This Weeks Best Law Posts At Blawg Review #129

David Harlow of HealthBlawg takes to the keyboard like Columbus took to the seas and explores the world of law in Blawg Review #129. Don't miss this edition by one of my fellow health law bloggers.

Check out the upcoming editions at Blawg Review. If you are a new law blogger -- sign up to host or submit your favorite law related post.