Health Care Law Blog

Thursday, September 21, 2006

Robert M. Kolodner, MD: New National Coordinator for Health Information Technology

News reports indicate that Robert M. Kolodner, MD, Chief Health Informatics Officer at the Veterans Health Administration, has been named the interim National Coordinator for Health Information Technology for for the Office of Department of Health and Human Services (HHS). Mr. Kolondner will be replacing David Brailer who left the position in May.

Click this Google News link for more current information.

Tuesday, September 19, 2006

New HISPC Project Website

The Health Information Privacy and Security Collaborative (HISPC) now has its own website through the A gency for Healthcare Research and Quality. The HISPC project is being coordinated by RTI International in conjunction with the National Governor's Association Center for Best Practices.

West Virginia is one of 33 states participating in the grant project looking at the variations that exist in each state with respect to privacy and security practices and policies and the legal bases for such practices and policies. The new website allows you to get information and links on the other states participating in the grant project.

The goals of the project are to:

identify both best practices and challenges
develop consensus-based solutions for interoperable electronic health information exchange (HIE) that protect the privacy and security of health information
to develop detailed implementation plans to implement solutions

I've previously posted about the HISPC project here and here.

HIPAA Decision: Findley v. Findley

Out of the State of Louisiana, Court of Appeals, Third Circuit, comes a decision examining the release of medical records in light of Louisiana law and HIPAA.

The decision, Larry L. Findley, Jr. v. Billie Findley , CW 06-266 (Supervisory Writs from the Fourteenth Judicial District Court, Parish of Calcasieu, No 2004-00401), issued by Judge Michale G. Sullivan affirmed the trial court's denial of a motion to quash and denied the writ.

The issues presented to the court were:

1) Does this court have jurisdiction to review Sister Depwe’s refusal to produce her records except as provided in 45 C.F.R. §§ 160 and 164?

The court found that it did have jurisdiction to address the issues presented under HIPAA.

2) Is Sister Depwe’s refusal to produce the records at issue justified by 45 C.F.R. § 164.524?

The court found that HIPAA does not preclude the disclosure of medical information in this case.

3) Does the Health Insurance Portability and Accountability Act (HIPAA ), 42 U.S.C. 1320a-1320d-8, preempt Louisiana law?

The court found Loisiana law contrary to HIPAA since a health care provider would find it inpossible to comply with Louisiana law and HIPAA, but also finds that Loisiana law is more stringent because it allows an individual patient greater rights of access to his/her medical records.

For more background on the decision read the full opinion. Thanks to Kirk Nahra via the AHLA HIT listserve for alerting me about the decision.

Friday, September 15, 2006

Viral Video Chart: Explosion of Internet Video

For some fascinating facts (blurbs) on the growth (explosion) of the online video market -- courtesy of the likes of YouTube, Google Video and MySpace -- check out Viral Video Chart. Viral Video Chart tracks the world's most talked about videos.

Over the last year I've watched with interest the growth of video social networking. I'm amazed by the stats (60,000 new videos uploaded and over 100 million viewed a day) and yet 75% of the people that I talk to have never heard of YouTube. Just amazing what the figures will show as more people explore this type of online medium.

Thanks to Denise Howell and Jeff Jarvis for the tip on Viral Video.

Some of the facts from the Viral Video Chart: Blurb:

The most viewed video on YouTube is currently The Evolution of Dance, which was watched by 10 million people during April 2006 and has now been viewed over 30 million times. The guy doing the dance medley, Judson Laipply, is now not merely a motivational speaker from Cleveland, Ohio, but an internet superstar.

According to Hitwise, the top 5 sites in the US for online video are YouTube (43% market share), MySpace (25%), Yahoo! (10%), MSN (9%) and Google (6%) (Hitwise, 24 May 2006)

Hitwise ranks YouTube the 42nd biggest website in the world (Hitwise, 24 May 2006)

Every day over 60,000 new videos are uploaded to YouTube and over 100 million videos are viewed - that's 3 billion videos a month (USA Today, 16 July 2006)

YouTube was founded by a bunch of twenty-somethings in February 2005, launched in September 2005, has taken $11.5m funding from Sequoia Capital, and is estimated to be losing about $1m a month in bandwith fees. (Wikipedia)

Speculation about YouTube's valuation is currently a favourite pastime of the blogosphere, with Techcrunch suggesting it could be worth as much as $2 billion (CNET, 24 August 2006)

For just one of the many examples of the creativity being released on YouTube check out this video, "Here It Goes Again".

Wednesday, September 13, 2006

Washington Post Article: Nonprofit Hospital Report and Hearings

Today's Washington Post article, "Hospital Charity Care Is Probed," provides a summary of some of the findings of the United States Senate Committee on Finance review of nonprofit hospitals. The report findings are part of the ongoing hearings on whether nonprofit hospitals provide sufficient community benefits to justify exemption from federal and state tax.

For more information on the Finance Committee hearings and the actual testimony at the hearings check out the hearings website. The hearings website includes the committee member statements and witness statements.

Thanks to Michele Grinberg for tip on this article.

West Virginia Hospital Association Announces New President & CEO

Today's Charleston Gazette and Charleston Daily Mail business briefs announced the new President and CEO of the West Virginia Hospital Assocation. Joseph M. Letnaunchyn, previously the president and CEO of the Delaware Healthcare Association, will start in November. Mr. Letnaunchyn replaces Steven Summer who resigned this summer to take a similar position with the Colorado Hospital Association.

Sunday, September 10, 2006

News Rivers and Bloglines Mobile

Like Dave Winer I recently broke down and purchased a Blackberry to replace my aging cell phone. I've been taking Winer's News River feeds for a spin and find them user friendly and valuable to check in on the BBC and NYT news. However, in all the buzz about the River feeds I've seen little discussion on Bloglines Mobile and how it differs in application. I use Bloglines as my RSS reader of choice and I added the mobile version to my Blackberry. I've been very happy having the mobile version available to check feeds. There are a couple of annoying features that I have come across -- but otherwise it looks and operates great. I think both are valuable tools for mobile news consumption -- and they are suited for different purposes. Doc Searls hits on some good points about getting the publishing world to focus more on the needs of mobile cell phone news junkies.

My Bloglines Mobile contains the specific information that I want pushed to me to monitor, review and read. For example, I've set up news feeds to monitor particular news topics on clients that I do work for. I can use it to quickly monitor without wading through all the other news. Plus, the news isn't just from the NYT or BBC. On the otherhand, there are times that I just want to scan the news -- like looking through the local paper every morning. I not particulary interested in any specific item.

My analogy building off a quote of Dave Winer in a post by Kevin O'Keefe. Somedays I like to stand around on the bank all day long and watch all the boats go up and down the River -- but other times I only want to be alerted to specific ones (like the Delta Queen). I want to know when she is coming along so I can run down to the bank, watch her and hear her calliope.

UPDATE: A new feature added to Bloglines Mobile to make reading your favorite feeds easier. Bloglines has integrated Skweezer technology that optimizes web pages for use on mobile devices. I haven't had much of chance to try it out but I look forward to using the feature.

Thursday, September 07, 2006

Seinfeld Meets Jeopardy: I'd like mainstream technology for $1,000

Two interesting posts crossed my RSS feed this morning that I thought I would tie together in a third post. The first from Lee Kraus blogging over at Learning & Technology mentioning a recent Jeopardy episode where Alex said, "download a file and load it on an Ipod. . ." Response by the contestant, "What is a podcast?" The second by Kevin O'Keefe at Real Lawyers Have Blogs who admits that he has been on Seinfeld rerun and was watching the episode where Jerry says, "what the hell is email?"

Both posts provide a perspective on how new technology often gets introduced into mainstream society. The posts started me thinking about the following questions. What TV show or movie first introduced the cell phone? Has RSS been mentioned in a TV show or movie? Has a blog been incorporated into a TV or movie plot?

Answers welcomed via comments.

Extra credit question: Who created Jeopardy? Answer.

Wednesday, September 06, 2006

WV Chamber Isssues 2006-2007 Health Policy Recommendations

The West Virginia Chamber of Commerce issued its Policy Recommendations for 2006-2007. The twenty-nine different policy recommendations were developed by the Chamber's committees and adopted on August 29 by the Chamber's Board of Directors.

Included in the announcement are several health care related policies including: Decreasing The Prevalence of Unisureds, Expanding Health Insurance Availability, Health Care Funding and e-Health Technology.

Tuesday, September 05, 2006

WV Executive Order: Commitment to State's Efforts on Privacy and Information Security

On August 29, 2006, Governor Joe Manchin signed Executive Order No. 6-06 authorizes the state's Chief Technology Officer and Chair of the West Virginia Health Care Authority to oversee the implementation of additional privacy and security policy for state government. The goal of the executive order was to acknowledge and build on the state's continuing efforts to maintain a high level of information security and enhance the protection of private information.

The Executive Order requires the development of privacy and information security principles that will guide government agencies in their daily efforts to protect citizens' personally identifiable information. Sonia Chambers, Chair of the West Virginia Health Care Authority will be responsible for protecting the privacy of confidential and personally identifiable information collected and maintained by Executive Branch agencies, while the West Virginia's Chief Technology Officer, Kyle Schaffer, will be responsible for information security for all Executive Branch agencies. The Order also requires the development of privacy and information security programs and teams comprised of representatives from all Executive Branch department-level organizations that will develop and implement new policies and conduct audits of agency privacy programs.

Sunday, September 03, 2006

Charleston Regatta: AnythingThat Floats

CIMG1978
Originally uploaded by Coffield.

Photos from the 2006 Charleston Regatta Anything That Floats Race. My favorite entry were the employees from Kid Country Toys. They didn't know whether the Black Pearl would sail or sink -- but sail it did down the Mighty Kanawha.

We live only a few blocks from the boat launch and our family hasn't missed this the last couple of years. The best part are the skits that recount the antics and history of the Kanawha River Navy. All the entrants seem to be known for their bribery of the judges.

Although the Black Pearl was the best floating entry -- my vote for best skit went to the Shadys Meet the Bradys. Where the WV family met the Brady Family and the curse of the VW. While preparing this post I quickly googled the Kanawha River Navy and came across the group's website, including some great photos from last year's event.

Below are some more photos that I took along with a link to my Flickr photos with a few more.

Friday, August 25, 2006

West Virgina Medicaid Initiative: Policy Meets Practicalities

David Harlow's HealthBlawg provides very interesting commentary on West Virginia's Medicaid Redesign efforts to implement change to the West Virginia Medicaid program, including pointing out a New England Journal of Medicine article, Personal Responsibility and Physician Responsibility - West Virginia's Medicaid Plan.

The article examines the practical realities of implementing a Medicaid plan that includes implementing consumer driven and patient responsibility components into a program that serves the most vulnerable sector of the West Virginia health care population -- the poor, uneducated, young/aged health consumer. West Virginacategory. The article also raises interesting questions about the role physicians play in the redesigned program and the fact that physicians will be faced with policy and ethical issues under the program changes.

Thursday, August 24, 2006

A little Nick: I'm a liberal and a conservative, that I am as complex as the universe and as simple as a newborn child's cry . . .

Don't miss reading this post by my favorite hospital blogging CEO, Nick Jacobs over at Nick's Blog. Much of what Nick has to say strikes a chord with me and this post is a great example of his creative, optomistic and insightful look at health care and life.

Nick's statement of "everything in moderation" is something that I have heard forever (prize to the first Coffield reader who can cite the originator of this quote) and believe in. It's applicable to everything from diet to politics to work to play.

Just a taste. Enjoy the post:

This week a person called me to criticize me, accuse me of misdeeds because we were supportive of Mr. Murtha, and then he said, "Let me guess, you're a liberal?" The label was placed. (There's a lot of labeling going on in this country right now.) It is my belief that everything is relative. It is my belief that I am a liberal and a conservative, that I am as complex as the universe and as simple as a newborn child's cry.

When I asked my critic why he was convinced that the truths that he espoused were accurate, he proudly boasted into the telephone. "I listen to Rush." Let me assure you that "I don't listen to Rush, EVER." Mom always said, "Everything in moderation." Not too Republican. Not too Democrat. Not to fatalistic. Not too utopian.

During an exchange at a board meeting this week, I started a string of comments directed toward my board that went something like this, "We have $750,000 coming from grants, right?" My Foundation Director said, "Yes, maybe," and my Chief Financial Officer said, "It's not here yet." To which our board chairman replied, "Perfect, the Optimist, the Realist and the ACCOUNTANT." The next day we received the first $350,00 of the $750,000. Hah.

Executive Order Impacts Health Care

President Bush signed an Executive Order on August 22 requiring federal agencies to do more to inform public health care consumers about the cost and quality of health care services.

The Executive Order: Promoting Quality and Efficient Health Care in Federal Government Administered or Sponsored Health Care Programs directly impacts the Defense Department (military health care system), DHHS (Medicare and Medicaid), Office of personnel Management (Federal Employees Health Benefits Program) and Departmetn of Beterans Affairs (VA Health System).

For more information be sure to read the Fact Sheet: Health Care Transparency Empowering Consumers to Save on Quality Care which is linked with the Executive Order. Also, check out the most current discussion via Google News.

Monday, August 14, 2006

The important lesson from sandcastle building

As I return to West Virginia after a week spent at the beach -- this post by Jim Carrol, Futurist, Trends & Innovation Expert, caught my attention. Much of my week on the sand was spent enjoying building sandcastles with my son, daughter and our friend's two children. All ranged in age from 2 to 6. I love the creative side of sandcastle building -- more so than most adults, I think. Jim's post titled, Why innovation thrives in sandcastle building," hit the mark for me.

I was also intrigued by Jim's recent comments on the 10 major health care and pharmaceutical trends. I'm not a regular reader of Jim's blog but have now added it to my RSS reader.

Thanks to Denise Howell for pointing me to this post. Don't move on until you click on the "sandcastle link" above highlighting some amazing sandcastle construction courtesy of Flickr.

Sunday, August 13, 2006

Topsail Beach and Web 2.0

I've been off the grid for most of the week while spending time with my family and good friends at Topsail Beach, NC. Our family's first time at Topsail -- what a great beach community. The web access was limited but luckily I had my new Blackberry 8700c (I finally broke down and got a blackberry to give it a try) which allowed us to get to the grid to look up vital information like "how to skimboard."

On our way back to WV we are spending a few days in Chapel Hill with family and I'm now catching up with some backlogged grid reading. Coincidently one of the posts I read was by Matt Ballard, another West Virginia blogger who specializes in economic development for the Charleston Area Alliance. His post, "Trip to North Carolina Leads to Flickr Encounter," highlights and my finding it (and commenting) while in Chapel Hill further highlight in simple terms the powers of the new web 2.0 interaction and communication.

In conversation I often talk about the new people focused technology and what it means over the coming years. This new technology has been referred to as Web 2.0.

As a good starting point, Mike Arrington at TechCrunch has put together a 24 minute documentary on "What is Web 2.0?"

Tuesday, August 01, 2006

Interesting Statistic: Online Social Networking and the Health Care Industry

"Among 21 year olds, 61% of web content created by someone they know."

Interesting stat courtesy of Denise Howell's attendance at Always On 2006. Interesting because I find myself more and more attracted to websites, blogs and other online content created by individuals I know or have met. This stat supports discussions with my nieces and nephews (all 20 somethings) who have grown up with and are more comfortable with online social networking including, text messaging, facebook, MySpace, Flickr, YouTube, etc. Interestingly, my 83 year old dad, a retired physician and resident historian of New Martinsville where I grew up, has become a regular on classmates.com sharing old high school stories and family information. This trend will only continue as they move into the workplace and beyond.

I'm interested in watching thie impact that online social networking will have on the delivery of health care in the United States. This is made all the more interesting by the aging baby boomers who are quickly moving into the largest users of health care (aka pig in python concept). For example:

More doctors and patients blogging
Online direct communication between patient and provider
Network aggregation of treatment information
Online support and communities of patients with specific diseases and the providers who treat them
Podcasting health information and medical advice
Videocasting health education or training for health care professionals

Scoble is on the same track with his recent comment that it's humans who optimize the web. He comments:

When I search on “Office Furniture” why is the first thing I see stores? I don’t wanna see freaking corporate info. I wanna know what HUMANS like to use in their offices. . . None of the big search companies have figured out that it’s the humans who “optimize” the Web. . . I’ll be looking for who lets me get to the other humans the fastest.

The younger generation and others who get it are trending in this direction and the web companies who answer will be the leaders. For another example of the shift in the younger (actually youngest) generation of web users take my 5 year old who yesterday wanted to order a costume for Halloween. Can't be too early for Halloween. He's been driving us crazy this week with an obsession for a particular costume. My wife and I finally collapsed and she asked him whether or not he wanted to call in the order or do it over the web. His response with a slight look of why are you even asking that was, "the internet . . . I want to see the costume." Then he said, "we can just Google it." His selection of web visual content vs. static telepphone audio struck me as interesting. This is the same 5 year old who who earlier this year we watch pull a Peter Pan video down and type in the words P-E-T-E-R-P-A-N from the cover into Google. He knew what he wanted even though he couldn't yet spell it out.

Tags: health care, health, blogging, AO

Healthcare Blogging Summit 2006

For those readers who are health care bloggers or interested in becoming a health care blogger or better understanding the impact of blogging on the health care industy you may want to plan to attend the Healthcare Blogging Summit 2006 scheduled for December 11th in D.C. The event is being held in conjunction with the Consumer Health World conference.

The event is the brainchild of Dmitriy Kruglyak of The Medical Blog Network. The summit looks like it will be a great event based on the speakers lined up for various panel discussions. I plan to try to attend and meet in person some of the health bloggers I've communicated with.

If you blog on health care industry related topics take time and complete a survey being conducted by The Medical Blog Network and Envision Solutions called Taking The Pulse Of The Healthcare Blogosphere. The results will be released and discussed at the Healthcare Blogging Summit and should provide the first organized look at the state of the healthcare blogging community.

HITSpere: A Network of Healtcare IT Blogs

If you are interested in the latest on health care, medical and clinical information technology be sure to check out HITSphere, a network of healthcare IT blogs including my Health Care Law Blog.

HITSphere was founded and is managed by Shahid Shah who blogs at as The Healthcare IT Guy. Shahid describes the HITSphere as a healthcare IT blogoshpere launching pad where health IT blogs are aggregated and the HITSphere community that he is putting together can help bring out in the open the myriad problems in healthcare IT in a way that transcends technology.

Grand Rounds 2.45: Inside Surgery

Grand Rounds 2.45 is up at Inside Surgery.

I especially enjoyed reading long summer night by About a Nurse which provides a glimpse into the therapeutic nature and use of blogs by health care professionals. As a health lawyer I was struck by the implications posting about health care situations and how these conversations might ultimately make their way to court. I've yet to see a professional negligence case or a breach of privacy claim involving a health care practitioner who blogs about the event and then is either sued or called to testify -- but I am sure that day is coming.