Building Unity Farm - Reflections on our First Winter

The third week of January is always the coldest time in New England.    Mt Washington was -70F and Unity Farm was 1.4F When we began this season I had no idea how to keep the animals happy and healthy in near zero temperatures.    We've learned a great deal and thus far, everything has worked.Chickens and Guinea Fowl - I've written about keeping warm in New England,  highlighting that convective, conductive, and radiated...[Readmore]

The Retirement of a Healthcare IT Legend

On Monday, I had the privilege of attending the retirement luncheon for G. Octo Barnett, the founder of the MGH Laboratory of Computer Science (LCS) and the inventor of the MUMPS (Massachusetts General Hospital Utility Multi-programming system).Henry Chueh, Division Chief of LCS, served as master of ceremonies.The attendees were the luminaries in the field of medical informatics - Donald Lindberg, Randy Miller, Clem MacDonald, Charlie Safran, Paul...[Readmore]

The Health Information Exchange Hearing

Today in Washington, the Standards and Policy Committees met in joint session to take testimony from expert stakeholders about health information exchange.Farzad Mostashari, National Coordinator, introduced the day, noting that we've made great strides since the founding of HL7 in 1987 and the creation of ONC in 2004, but there is more work to do.  The includes early successes, a discussion of barriers/challenges, the elements needed to ensure...[Readmore]

Building Unity Farm - Creating an Animal Community

On our journey to become small scale farmers, we've visited many New England farms, orchards, and CSAs.   We've had 3 major lessons learned:*Create the infrastructure you need before adding animals to the property*Do not acquire more animals than you can manage*Ensure the animals are compatible with each other and that you'll have a healthy community with symbiotic relationshipsInfrastructure - many farms we visited had inadequate or temporary...[Readmore]

Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules

On January 17, HHS released the Final Rule entitled: Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules under the Health Information Technology for Economic and Clinical Health Act and the Genetic Information Nondiscrimination Act; Other Modifications to the HIPAA RulesIt's 563 pages long and contains 7 themes:Covered entities must ensure that they obtain satisfactory assurances required by the rules from their...[Readmore]

One Degree of Separation

I have long believed that there is one degree of separation in the world of healthcare IT.   Everyone knows everyone and we're all connected in often amazing ways.   Here's one such story.When I was in college, I looked at the daunting cost of Stanford tuition, room, board, and living expenses (almost $15,000 per year!) and thought that I should leverage the impending microcomputer revolution by writing tax computation software for early...[Readmore]

Building Unity Farm - Managing Willful Dogs

Great Pyrenees are a strong willed dog breed.   Historically Basque shepherds left their dogs alone to guard flocks.   The dogs had to make decisions for themselves, sound the alarm to scare away predators, and defend their own food.   This tradition makes them very independent thinkers, frequent barkers, and are rather protective about their food. The Great Pyrenees that guard our Alpaca sleep much of the day, patrol the paddocks...[Readmore]

The January HIT Standards Committee meeting

The January HIT Standards Committee began with passionate remarks from Farzad Mostashari, emphasizing the need to maintain momentum as the country evolves from Stage 1 to Stage 2, from data capture and sharing to advanced clinical processes.   In some ways, the press and policymakers have attention deficit disorder, asking for the improved outcomes of Stage 3 before the foundation of Stage 1 and 2 is widely implemented.    All members...[Readmore]

Consumer Electronics for Home Care

As part of the "sandwich generation"  I serve as healthcare navigator to my parents and life coach to my daughter.  My parents live in Southern California, 4000 miles away from Boston.I call them each day to ensure they are doing well, exercising, and eating right.   It would be great if an "automated dashboard" or "alerts/reminders" assisted my efforts to support them.Recently, Hiawatha Bray at the Boston Globe summarized the Consumer...[Readmore]

The Rand Study and the impact of EHRs on Healthcare Costs

Last week, Rand published a study in Health Affairs (ANALYSIS & COMMENTARY: What It Will Take To Achieve The As-Yet-Unfulfilled Promises Of Health Information Technology),  revising its original 2005 healthcare IT cost savings research.The New York Times wrote about it. Several publications asked me to comment and here's what I said:"We're still at an early stage of EHR implementation, healthcare information exchange connectivity, and decision...[Readmore]

Building Unity Farm - Managing Wood

Farm properties commonly include meadows, pastures, woodland, wetland, and rocky rolling hills.   Unity Farm has all of these ecosystems.  We've recently re-surveyed all our wetlands to ensure we comply with appropriate environmental regulations that guide where we can plant, farm, and raise animals.   Our plans over the next year include adding year round growing capacity via a high tunnel/hoop house, adding an acre of high bush blue...[Readmore]

Ringworm Disease

There are many types of skin diseases, some are harmful and some are less harmful, no disease in the world gives advantage, as the Ringworm is also a skin disorder which is also know as Tinea it happens with skin fungi, it also has some types. This disease is not caused by Ringworm ( insects ) but the name is derived from the shape of the affected area, as the spots are round and red in color. (Like you can see in the image)Ringworm can mostly occur...[Readmore]

Value Cases for Clinical Documentation Improvement

As BIDMC prepares for ICD10, we're examining the entire clinical documentation process and asking how best to leverage the work we must do to support ICD10 with the innovations we believe will transform our workflow.As mentioned in a previous post, we're working with several innovators to re-examine assumptions we made for decades about clinical documentation.Here's an analysis of the types of projects we could do, the challenges, and the proposals,...[Readmore]