Thursday, April 22, 2010

John Halamka on EHR

"From the doctor's brain to the patient's vein." - John Halamka, CIO of Harvard Medical School, on the impacts of EHR.

Wednesday at Bio-IT World started out with a keynote by John Halamka, M.D., M.S., CIO of Harvard Medical School, and fourth person to have his genome publicly sequenced. John walked the group through the implications of hundred of pages of $30B Healthcare IT legislation. Regarding privacy concerns he said, "there will not be a massive database in the basement of the White House run by Sarah Palin." He said the goal is to go from 20% to 100% use of EHR in five years, and characterized fully implemented Electronic Health Records as improving the accuracy and efficiency of medical records - "from the doctor's brain to the patient's vein."

John also related an interesting story about their one and only data breach. It started with an employee looking at a particular clinical trial involving 4000+ subjects. They found the data very compelling, and made a copy on their laptop (encrypted), which was then forgotten. A year later the employee left Beth Israel Deaconess and went to UCSF, and in the process copied the contents of their laptop to a new unencrypted laptop (CA has less stringent encryption requirements than MA). The laptop was stolen by someone, pawned, when the pawnshop owner couldn't get the system to boot, he called Dell Tech Support. Dell, upon discovering the contents of the laptop, contacted Beth Israel, and the laptop was returned in 24 hours. He said that he spends $1M annually on information security for BID, and that they are attacked every seven seconds over the Internet, half of which come from eastern Europe and other half of which come from eastern Cambridge.

Some other points of interest:
  • Lab tests will start using controlled vocabulary to ensure consistency across providers.
  • Patients will be able to get a full copy of their EHR.
  • The Social Security Administration spends $500M annually managing paper records, which are subsequently digitized.
He also commented on the growing collection of wifi-enabled devices capable of measuring and reporting body telemetry. He is using a home scale which automatically transmits his weight, body mass, and other data to Google Health and Microsoft Health Vault.

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