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April 1, 2008
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The following commentaries are the most read postings from HCI's Blogosphere. To read other postings and leave your comments and questions, visit, register with a username and password, and blog away.

HIMSS UpdatenotPosted on: 2.28.2008 7:29:25 AM Posted by Vince Ciotti

Visited HIMSS in Orlando yesterday and here's the highlights:

  • McKesson's $3.8M booth dwarfed the exhibits like a high-tech cathedral

  • Epic's homey setting was replete with Prairie-home companion furniture

  • Siemen's high-tech lighting effects soared (no pun intended)

  • GE has more square footage than recently-acquired products…

  • Cerner's monster booth was rumored to be not coming back next year!?

  • Microsoft was swarmed with Microserfs trying to spell Azyxxii in Thai …

There were 26,000 attendees: about 25,900 vendor reps & consultants, chasing about 100 CIOs. At an average of $3K each for airfare and a week of out-of-pocket, plus an average of $100K per booth for the 900+ vendors, now you know why health care costs are 20% of our GNP and Medicare reimbursement is being cut. Wonder what all those dollars invested into actual R & D might accomplish?

Altruism or Exploitation?Posted on: 2.29.2008 4:06:12 PM Posted by Jim Feldbaum

At HIMSS this week there was much buzz about Google's entry into the electronic health record arena. Google plans to supply a password-protected service that would store health records on Google computers with a directory that lets users import doctors' records and their personal drug history and test results. Although Google will permit sharing of information between providers, control of all information will rest in the patient's hands. Google has initiated a pilot program at the Cleveland Clinic.

At HIMSS the Google booth was not on the main aisle. It was not giving away iPods or videogames - no free beer, pens, or trinkets. Still, it was so crowded that it took patience to make it to the front of the line. At this early stage Google claims that this service will be advertisement-free. Yeah, right. How colossal is that loophole? I hate to be cynical, but the consumer of healthcare is a ripe target for advertising. You only have to watch the commercials during the evening news to get a sense of how vulnerable we are presumed to be to direct advertising. At times it seems that not only are drugs being pushed, but diseases and conditions as well. Even now, when I make a generic Google search I trigger targeted ads for advertisers in my local area. I don't blame Google - that's their business and it is a profitable model.

Our inaction as a profession to create an electronic personal health record and the halfhearted support from our government has left a vacuum that private industry could not ignore.

A private practitioner can not help but worry what a patient will do when they notice a laboratory value that is out of the normal range. While the result might be clinically and statistically insignificant, I predict it will prompt a patient to make Google searches that will not be advertisement free. Such a search will, without a doubt, alarm a patient by raising the specter of terrible disease states which in nearly all cases will be irrelevant.

Our education system is recognized as being weak in the sciences. Most students have only superficial exposure to the biosciences and virtually no attention is paid to teaching Americans about their body in health and in illness. This naïveté is at the center of our vulnerability to manipulation.

One could argue that we will finally put personal medical information into the hands of patients who are clearly the rightful owners. But still, one must ask if we have altruistically begun the process of patient engagement in their own care or have we opened the doors to their exploitation.

What is the difference between unethical and ethical advertising? Unethical advertising uses falsehoods to deceive the public; ethical advertising uses truth to deceive the public.

Vilhjalmur Stefansson (1879 - 1962), “Discovery”, 1964

HIMSS Finale: It's not over 'til it's over…Posted on: 2.29.2008 10:00:48 AM Posted by Kate Huvane

After five event-filled days at HIMSS — one spent in preconference workshops and four spent speed-walking from booth to booth attempting to make all my meetings — I was understandably exhausted and looking very much forward to being back home in the Garden State. Everything was looking up. I checked out of the hotel, enjoyed a virtually traffic-free ride to Orlando Airport, and was even able to book an earlier flight, trading the 6:15 p.m. take-off for the 2:50 p.m. departure. Then, once we got into the air, the pilot announced that we'd be landing in N.J. early. Talk about the luck of the Irish! I could almost taste the Guinness and Sheppard's pie (yes, I actually like Irish cuisine) that I'd soon enjoy in celebration of a successful trip.

Unfortunately, my luck would soon run out.