The Nation's First Statewide eHealth Network

The state of Tennessee has picked AT&T for a major initiative -- the creation of the United States' first statewide health information exchange. The project is called The Tennessee Information Infrastructure eHealth Exchange Zone and will integrate the HIPAA compliant OnDemand Platform developed by Covisint, a company who bills themselves as "the world's largest and most secure on-demand collaboration platform."

The Dallas Business Journal brings us this statement from the Governor of Tennessee:

"Tennessee is proud to be the first to expand its current state network and offer a private, affordable, statewide secure network for exchanging critical health care information among providers," Tennessee Gov. Phil Bredesen says. "Our goal is to accurately and effectively deliver information to health care providers at the point of care, which will improve the quality of health care provided to the citizens of Tennessee. If a patient's medical history and record of care are available to the hospital, laboratory, pharmacy or physician, then they will ultimately receive better and more cost-effective medical care."

AT&T will construct a Virtual Private Network (VPN) that can support a wide variety of online health oriented tasks including sharing images (X-rays, MRIs, etc), telemedicine, remote diagnostics, e-prescriptions, and broad based access to electronic medical records. The combination of AT&T's VPN and Covisint's OnDemand Platform will allow the state's six regional health data organizations, as well as medical providers who are not part of those organizations, to access electronic medical data rapidly and securely.

According to the press release, as found on Fox Business, the secure broadband infrastructure provided by AT&T's VPN is available in all 95 counties of the state. It is the latest investment by the telco, which has put more than $3 billion into wireless and wired networks throughout Tennessee over the past decade.

Covisint's platform is used by more than 30,000 companies in the auto industry for secure data sharing. While the company's roots are in the car business, they are no strangers to health care. According to Information Week health care contributed 30% of the Covisint's $40 million of annual revenue and projections point to an increase to 50% over this year.

Are there any readers in Tennessee who would like to share their thoughts and opinions on this subject? We would love to hear from you!

SOURCE: "Covisint And AT&T Enter Health Care Exchange Market " 02/25/08
SOURCE: "AT&T to Deliver Country's First Statewide eHealth Exchange Zone" 02/25/08
SOURCE: "Tennessee, AT&T team up on development of statewide health-record network" 02/26/08
photo courtesy of euthman, used under this Creative Commons license

Google Your Health Records!

Looks like Google is moving forward on its health records project. Thomas Claburn and Marianne Kolbasuk McGee of Information Week take a look at their new pilot program and some of the privacy concerns being voiced about it:

"We believe patients should be able to easily access and manage their own health information," said Marissa Mayer, VP of search products and user experience at Google, in a statement. "We chose Cleveland Clinic as one of the first partners to pilot our new health offering because as a provider, they already empower their patients by giving them online tools that help them manage their medical records online and coordinate care with their doctors."

The pilot program represents a tentative first step for Google into the thorny area of health care data issues. It also gives Google a greater opportunity to cash in on the lucrative business of health care advertising. The company on Wednesday announced the availability of its Healthcare Industry Knowledge Center to AdWords advertisers offering health care-related products and services.

Google's timing could be better. The World Privacy Forum on Wednesday issued a report warning that personal health records (PHR) are not protected by federal HIPAA privacy and security rules and that entrusting such records to a PHR service -- the very thing Google is offering -- raises a number of possible risks.

The issue with any sort of electronic medical records always boils down to the question of how secure and private are they? The article cites the recent controversy surrounding Blue Cross of California's letter to doctors asking them to identify patients with pre-existing health issues. Critics speculate that Blue Cross was collecting this information preparatory to limiting or denying coverage to those people. The fact that Blue Cross Wellpoint was fined $1 million last year for canceling and withdrawing coverage in violation of California state law does not help the company's credibility. Many worry the same could happen if insurance providers got access to Google's records.

Another major sticking point raised is the data harvesting that comes hand in hand with an advertising supported service, which all of Google's applications are:

[...] the World Privacy Forum report is skeptical that any ad-supported PHR [Public Health Records] service will really protect health information. "Advertising-supported PHRs are not necessarily likely to support or allow strict control over consumer information or to fully and readily tell consumers how personal information may be shared," the report states. "Many PHRs will only succeed if they can sell advertising, and advertisers will seek as much detailed information about PHR clients as they can obtain. Wheedling consent from consumers for the profitable sharing of records is something that some PHRs are likely to try."

Todd Chambers, chief marketing officer at Courion, an identity and access management company that works with health care industry clients, believes security and privacy worries are justified. "Obviously, it's concerning, to say the least," he said. "When you look at all the issues that hospitals and health care providers have to deal with to be compliant [with health industry regulations]... to think that there would be a business process put into place that would allow that all to be circumvented, and all that data could be put out there in the public domain, is certainly a huge concern."

Regardless of the risks, Google (NSDQ: GOOG)'s vision, or something like it, may be unavoidable. Over 100,000 of the Cleveland Clinic patients already participate in a PHR system called eCleveland Clinic MyChart. Between 1,500 and 10,000 of these will be invited to enroll in the organization's pilot program with Google, which will last between six and eight weeks. Cleveland Clinic received no funding from Google to participate in this pilot, said Dr. C. Martin Harris, Cleveland Clinic's CIO. "Google was a natural" fit to help Cleveland Clinic in this health data exchange for patients, said Harris.

It is quite probable that this sort of debate will be increasingly frequent more online and application based solutions are brought to the fore and tested. As with all things computer oriented, Google, Microsoft, and possibly Apple should be observed carefully over the next year or so. This pilot program is only the tip of the iceberg.

If you want to get an idea of what the tech community thinks on the subject, check out the short piece about this on Slashdot. The discussion in the comments is quite diverse and contains much food for thought.

SOURCE: "Google, Cleveland Clinic Partner On Personal Health Record Service" 02/21/08
SOURCE: " Google to Begin Storing Patients' Health Records" 02/21/08
photo courtesy of Yodel Anecdotal, used under this Creative Commons license

FCC's New Telehealth Program Launches in North Carolina

With health care a subject on everyone's lips these days there are many organizations chiming in with their approaches to the subject. The Federal Communications Commission (FCC) joins those ranks as they launch their new "Telehealth" initiative, debuting today in western North Carolina.

Aliya Sternstein reports for the National Journal's Technology Daily supplement (accessed for this story via Government Executive):

The FCC's plan will fund dedicated broadband networks for telehealth activities, like videoconference consultations or second opinions from out-of-state specialists. Telemedicine is intended to cuts costs, travel time and medical errors, especially for people in remote or poverty-stricken regions of the country.

"With this pilot program, the commission will be taking a major step toward the goal of connecting healthcare facilities across the nation with one another through broadband telehealth networks for the benefit of patients," [FCC Chairman Kevin] Martin said.

The plan rests on leveraging existing telehealth networks to build new, more comprehensive systems. Rural providers, nonprofit facilities and county-run institutions that want to participate can obtain funding for up to 85 percent of design, construction and operational expenses.

For-profit entities also can join the new networks but will have to pay their fair share of the costs. The set-up allows larger urban trauma centers and teaching hospitals to serve as telemedicine hubs for smaller, rural hospitals and economically strained facilities.

According to Roy Mark over on E-Week the project is certainly not lacking in scope:

The Federal Communications Commission has allocated $417 million to help build 69 statewide or regional broadband telehealth networks across 42 states and three U.S. territories...

The funding will support the connection of more than 6,000 public and non-profit health care providers nationwide to broadband telehealth networks, which can be used to transmit health records and process transactions securely.

Telemedicine already has a proven track record with one of the groups administering the FCC funds for the West Virginia pilot program: the Eastern Band of Cherokee Indians. Jon Ostendorff of the Ashville Citizen Times reports:

Telemedicine is used in treating diabetes patients in Cherokee, said Dr. Ann Bullock, a physician with the tribal health care system. Doctors on the Cherokee Indian Reservation use the Internet to send images of retinal scans to a specialist in Asheville who then recommends treatment.

“So instead to of sending all those patients over to Asheville or taking his time to always have to come out here and do those screenings, we can do them in our diabetes clinic when our patients come, and he can take a look at those,” she said. “It saves a lot of resources and time.”

This is a major step toward more widespread use of EMRs (electronic medical records). According to E-Week's Roy Mark, those involved in this pilot program will need to "implement information technology standards as set forth by the U.S. Department of Health and Human Services wherever feasible." Are the days of data portability and transparency getting closer? It's too early to tell how far this will go, but access does seem to be improving!

SOURCE: "FCC announces creation of telehealth initiative"11/19/07
SOURCE: "FCC Launches Health Networks Initiative" 10/20/07
SOURCE: "Program brings top doctors to rural areas" 11/20/07
photo courtesy of J. Reed, used under this Creative Commons license