e-HealthExpert.org - Primum non nocere

A heterogeneous group of people from the MIT, Tufts NEMC, Childrens Hospital (Boston) has been working in a very interesting project named the Guardian Angel Personal Lifelong Active Medical Assistant.
The BMJ has an 2001 article from that group named Public standards and patients control how to keep electronic medical records accessible but private, which is freely available for download, in .pdf format, from: Public standards and patients control.
The "Guardian Angel" project has threee main areas of development: PING (Personal Internetworked Notary and Guardian), HealthConnect and W3-EMRS (World Wide Web based Electronic Medical Record System).

The British Medical Journal published an article [BMJ 2005;330:581 (12 March)] by Garrido et al. reporting the results of a retrospective, serial, cross sectional study on the effect of electronic health records (EHR) in ambulatory care.
They concluded that readily available, comprehensive, integrated clinical information reduced use of ambulatory care while maintaining quality and allowed doctors to replace some office visits with telephone contacts. Shifting patterns of use suggest reduced numbers of ambulatory care visits that are inappropriate or marginally productive
See the full article at: Effect of EHR in ambulatory care.

The Journal of American Medical Association (JAMA) just published an article by Koppel et al. about the impact of a widely used computerized physician order entry (CPOE) system in facilitating medication errors at a hospital:
This study identified 22 situations in which CPOE increased the probability of prescribing errors.

See the full article at: Role of CPOES in Facilitating Medication Errors.

Harvard Business School professor Clayton Christensen has gained a reputation for his work on "Disruptive Innovations":

• Christensen's research explains why established companies - even those competently managed by smart people - have such trouble countering or embracing disruptive innovations that are on the horizon.
• His theory says that organizations customarily develop mind-sets and processes that revolve around doing what they already know.
• Once that pattern becomes established, managers have great difficulty justifying to others or even themselves the need to turn their processes upside down to respond to a barely emergent market change.
• By the time the threat is apparent, however, it's usually too late; upstart companies have seized a substantial lead.

See the full article at: Disruption is good

The Healthcare Informatics Online magazine has an article by Peter Groen (director of the Veterans Health Administration's Health IT Sharing program), were he talks about the Health IT Sharing Program, a four phase program to improve collaboration among healthcare organizations.
In that author's perspective that plan could be an effective means to pool resources to work on Health Information Systems (HIS) and develop mutually beneficial initiatives that, most likely, neither organization could accomplish on its own.

The full article is at: The Health IT Sharing Project

David A. Wheeler presents in his site Why Open Source Software a thorough analysis on why you should seriously consider to use Open Source Software in your organization.

If you're looking to hire a System Administrator to your healthcare organization, you might need to rethink your hiring guidelines and practices and hire a Linux System Administrator (SysAdmin). Few information technology professionals can appreciate the skill, knowledge and experience required to administer Linux servers and workstations.

Converting NT and UNIX SysAdmins to Linux, fails more often than not. In general, a Linux SysAdmin has an easier time working on Microsoft and UNIX operating systems than the other way around. The Linux SysAdmin could also help your organization to complete projects in time and within budget.

A well-known and highly documented process called "skunk works" gives us a hint at why Linux people can accomplish so much in such little time.

See the full story at: Linux in Government: Linux System Administrators

IT professionals are well known for using annoying clichès. An article at the IT Managers Journal lists some of the most annoying:

1. At the end of the day
2. Solution
3. Thinking outside the box
4. Synergy
5. Paradigm
6. Metrics
7. Take it offline
8. Redeployed people
9. Core Competency
10. Win-win
11. Value-added
12. Get on the same page
13. Customer-centric
14. Generation X
15. Alignment

See the full story at: IT Managers Journal

BBC News, in its article "Doctor IT upgrade support 'falls'" published Tuesday, 8 February, 2005, says that the £6.2bn overhaul of the NHS IT system could be undermined by declining support among doctors.
According to a recent report just one in five GPs are enthusiastic about the upgrade - down from more than half last year. At hospitals doctors support also fell from 75% to 51% during the same period.

Is this the the raise of the Semantic Web?
This was seen on the European Comission IDABC site:
"Semantic interoperability is central to the implementation of pan-European interoperability. The European Interoperability Framework (EIF) defines it as on of the three main dimensions of interoperability - besides organizational and technical interoperability."

You may read the full text at: Content Interoperability Strategy .