We're Having a Twitter Party!

Okay, I'll admit, I'm not sure exactly what that means yet, but I'm learning. This party is being hosted by Jennifer of Food Allergy Buzz and Ruth of Best Allergy Sites.

To join in the fun, on Friday May 15 at noon and again at 10:30 pm (Eastern Time), visit tweetgrid.com and type in #foodallergy. You can use another Twitter real-time dashboard of your choosing, but "tweetgrid" works and that's good enough for me.

This will take you to the party where you will see streaming conversation. During the two party times, you can ask questions or make comments on anything food allergy related. I'm participating in the noon party and I plan to be sleeping during the 10:30 pm one- yeah, I know, quite the party animal.

Anyway, I hope you'll join us.

The participating panelists are:

@chupieandjsmama
@foodallergyassistant
@foodallergymama
@allergicgirl
@nut_freemom
@foodallergybuzz
@bestallergysite

Send a note to Jennifer B. if you have food allergy products available for prizes- yes there are even prizes at this party!

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Next Steps on the HIT Policy and Standards Committees

Last week, ONC formally established the HIT Policy and Standards Committees via publication in the Federal Register. Here are the announcements:

ACTION: Notification of the Establishment of the HIT Policy Committee.

SUMMARY: This notice announces the establishment of the HIT Policy Committee. The American Recovery and Reinvestment Act of 2009 (Pub. L. 111-5), section 13101, directs the establishment of the HIT Policy Committee. The HIT Policy Committee (also referred to as the
"Committee'') is charged with recommending to the National Coordinator a policy framework for the development and adoption of a nationwide health information technology infrastructure that permits the electronic exchange and use of health information as is consistent with the Federal Health IT Strategic Plan and that includes recommendations on the areas in which standards, implementation specifications, and certification criteria are needed. The HIT Policy Committee is also charged with recommending to the National Coordinator an order of priority for the development, harmonization, and recognition of such standards, specifications, and certification criteria.

FOR FURTHER INFORMATION CONTACT: Judith Sparrow, Office of the National Coordinator for Health Information Technology, e-mail judy.sparrow@hhs.gov

SUPPLEMENTARY INFORMATION:
I. Background
The Committee and its staff are governed by the provisions of the Federal Advisory Committee Act (FACA) (Pub. L. 92-463), as amended (5 U.S.C. App.), which sets forth standards for the formation and use of federal advisory committees.

The Committee shall determine a schedule of meetings following an election of a Chairperson and a Vice Chairperson from among its members.

II. Criteria for Members
The Committee shall be comprised of the following, including a Chair and Vice Chair, and represent a balance among various sectors of the health care system so that no single sector unduly influences the recommendations of the Committee. Committee members shall be appointed in the following manner:
3 members shall be appointed by the Secretary of Health and Human Services, 1 of whom shall be appointed to represent the Department of Health and Human Services and 1 of whom shall be a public health official;
1 member shall be appointed by the majority leader of the Senate;
1 member shall be appointed by the minority leader of the Senate;
1 member shall be appointed by the Speaker of the House of Representatives;
1 member shall be appointed by the minority leader of the House of Representatives;
Such other members as shall be appointed by the President as representatives of other relevant Federal agencies;
13 members shall be appointed by the Comptroller General of the United States of whom-
3 members shall be advocates for patients or consumers;
2 members shall represent health care providers, one of which shall be a physician;
1 member shall be from a labor organization representing health care workers;
1 member shall have expertise in health information privacy and security;
1 member shall have expertise in improving the health of vulnerable populations;
1 member shall be from the research community;
1 member shall represent health plans or other third-party payers;
1 member shall represent information technology vendors;
1 member shall represent purchasers or employers; and
1 member shall have expertise in health care quality measurement and reporting.
Non-federal members of the Committee shall be Special Government
Employees, unless classified as representatives.

III. Copies of the Charter
To obtain a copy of the Committee's charter, submit a written request to the above contact.
Dated: April 23, 2009.
David Blumenthal,
National Coordinator for Health Information Technology, Office of the
National Coordinator for Health Information Technology.
[FR Doc. E9-9839 Filed 4-24-09; 4:15 pm]
------------

ACTION: Notification of the Establishment of the HIT Standards Committee.

SUMMARY: This notice announces the establishment of the HIT Standards Committee. The American Recovery and Reinvestment Act of 2009 (ARRA) (Pub. L. 111-5), section 13101, directs the establishment of the HIT Standards Committee. The HIT Standards Committee (also referred to as the "Committee'') is charged with making recommendations to the National Coordinator on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information for purposes of adoption, consistent with the implementation of the Federal Health IT Strategic Plan, and in accordance with policies developed by the HIT Policy Committee.

FOR FURTHER INFORMATION CONTACT: Judith Sparrow, Office of the National Coordinator for Health Information Technology, e-mail judy.sparrow@hhs.gov

SUPPLEMENTARY INFORMATION:
I. Background
The Committee and its staff are governed by the provisions of the Federal Advisory Committee Act (FACA) (Pub. L. 92-463), as amended, (5 U.S.C. App.), which sets forth standards for the formation and use of federal advisory committees. The Committee shall determine a schedule of meetings following an election of a Chairperson and a Vice Chairperson from among its members. An initial meeting of the Committee shall take place not later than 90 days from passage of the ARRA.

II. Criteria for Members
The HIT Standards Committee shall not exceed thirty (30) voting members, including a Chair and Vice Chair, and members are appointed by the Secretary with input from the National Coordinator. Membership of the Committee shall at least reflect providers, ancillary healthcare workers, consumers, purchasers, health plans, technology vendors, researchers, relevant Federal agencies, and individuals with technical expertise on health care quality, privacy and security, and on the electronic exchange and use of health information and shall represent a balance among various sectors of the health care system so that no single sector unduly influences the recommendations of the Committee. Non-Federal members of the Committee shall be Special Government Employees, unless classified as representatives.

III. Copies of the Charter
To obtain a copy of the Committee's charter, submit a written request to the above contact.
Dated: April 23, 2009.
David Blumenthal,
National Coordinator for Health Information Technology, Office of the
National Coordinator for Health Information Technology.
[FR Doc. E9-9838 Filed 4-24-09; 4:15 pm]
------------

We'll hear more about these committees soon, since their meetings are mandated by ARRA to occur in the month of May. Watch the ONC Website for announcements of the meetings and the members to be named.

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More Meaningful Use

My colleague Micky Tripathi testified to NCVHS about meaningful use on April 29. His major points included:

1) We need substantial implementation support and significant resources for health information exchange if we are going to achieve meaningful use. The Regional Health Information Technology Extension Centers (RHITECs) are ideal organizations to assist with these issues.

2) ARRA currently delivers incentive payments directly to clinicians. These payments should be shared with RHITECs, which will assist clinicians with implementation of EHRs. Otherwise, RHITECs will bear the burden/expense of implementation but the physicians alone will be paid for meaningful use.

3) We should use Health Information Exchange activity measurement as a �sufficient statistic� for meaningful use. We should require basic clinical summary exchange through authorized health information exchanges, and require quality measures/public health reporting to be sent to authorized data aggregation entities. If a physician is accomplishing these, then we do not need to measure at the EHR-level because they could not accomplish these things without meaningfully using the EHR.


Also, for completeness, here is the meaningful use statement from the College of Healthcare Information Management Executives (CHIME), also submitted to NCVHS. Sharon Canner from CHIME added a clarification to this testimony:

There is an error in our statement, discovered late in the process. The statement should have read �HL7 Continuity of Care Document (CCD).� CHIME Prefers the CCD; however, it may be a stretch for some hospitals initially.

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Monday Review: "Flourishing With Food Allergies", by A. Anderson

This Monday Review is brought to you by Papoose Publishing, publisher of A. Anderson's book, "Flourishing With Food Allergies".

When my son was diagnosed with food allergies in 2001, I was fortunate enough to pick up a copy of Marianne Barber's book, "The Parent's Guide to Food Allergies". My copy has yellow sticky notes protruding from three sides and white papers covered in notes written by me and my husband. It was our guidebook as we struggled to understand and deal with this stunning diagnosis. The book was copyrighted in 2001, making it timely for us. I haven't come across a book like it, so this has been the one I've continued to recommend to parents shocked by a food allergy diagnosis...until now...

The new guidebook has arrived.

A. Anderson managed to capture the sensitivity and need for practical information that parents must have. By incorporating her own story, and giving a glimpse into the lives of 14 other families from around the world who deal with food allergy, readers quickly realize, "I am not alone". Ms. Anderson devotes the second half of the book to "Solutions". She includes perspectives from top allergy docs, school teachers and a psychologist. The book progresses to practical solutions for dealing with social situations, school and travel. The conclusion of the book is devoted to a plea that we come together and ask government officials to devote more funds for studies to test, treat and eventually cure food allergies. This is a topic near and dear to my heart.

I did find the resource section of "Flourishing With Food Allergies" to be rather light. In the aforementioned "The Parent's Guide to Food Allergies", I found it helpful to have names and contact information for food manufacturers and restaurants. That said, it is a sign of the times that much of this information can now be found on the internet through blogs and websites and inclusion in a book such as this one, may make the book outdated more quickly.

"Flourishing With Food Allergies" has the most up to date information for parents and would also be a great gift for your child's teacher or school nurse.

To order, go to Flourishing With Food Allergies.com

For other food allergy information, visit the Food Allergy Assistant.

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Information Technology and the H1N1 Virus

At BIDMC, our Infection Control staff have sent out daily updates about the H1N1 Virus, our process changes to protect patients/staff, and our planning for future activities if the infection escalates.

There are many things that IT can do to support the hospital and the country during this outbreak. Here are five projects we've implemented.

1. Support CDC's Biosense

Every day, BIDMC electronically sends 4000 data elements to the Centers for Disease Control using the HITSP Biosurveillance standards. Patients are not identified - no names, MRN�s or addresses are sent. Birthdays are month and year only. Here are the data elements we send:

Inpatients
ADT information � a message that there was an admission, discharge or transfer with date and time
Diagnosis
Procedures
Pharmacy orders
Daily census

Emergency Department Visits
Visit information
Acuity
Diagnosis
Procedures
Pharmacy orders
Patient instructions

Outpatient Visits
Visit information
Diagnosis

All patients
Microbiology orders and results (including viral studies)
Radiology orders and results

The CDC uses this to track outbreaks and prioritize resource allocation.

2. Build an intranet site to educate faculty and staff

We've supported our Infection Control staff with template-based content management tools and launched "H1N1 Central". In this single intranet site we link together our institutional polices, CDC reports, local news, and best practices.

Also, all our login screens display the message

"H1N1 Influenza Employee Screen:
In order to prevent spread of infection to patients and staff,
the following guideline should be followed by all staff:
If you have two or more of the following:
- fever over 100 in past 7 days
- flu symptoms (chills, cough, sore throat, stuffy nose, body aches, headache)
in past 7 days
- contact within 6 ft of someone who has a flu-like illness
Please put on a mask if you are in the hospital, contact your manager/supervisor
immediately to arrange coverage for your absence and to advise regarding
need for swab testing. Contact your PCP if appropriate, and recover at home."


3. Employees have been told to stay home if they have flu symptoms. In the case of H1N1 or any infectious outbreak, it's important to support remote access to applications, data, and communications. BIDMC applications are all web-based and accessible anywhere in the world. All our files are web accessible as well as mountable via VPN. We have an SSLVPN from Juniper Networks available at https://secure.bidmc.harvard.edu. We have a web-based large file transfer systems available at https://transfer.bidmc.harvard.edu. We are testing the ability to route incoming phone calls to cell phones and home numbers. The combination of all these features makes working from home simple and seamless.

4. Provider Order Entry order sets for isolation of infected patients

We're enhancing our internally developed provider order entry system with order sets specific to H1N1 so that clinicians can easily order standardized protocols for H1N1 isolation and treatment.

5. Public Health data reporting

We've built an automated interface to the Boston Public Health Commission.

Every day we send the following data to them from the Emergency Department

Daily volume
Chief complaint
ICD9 codes
Date of service
Zip
Age
Gender
Race

The Public Health folks create control charts and identify unexpected variations in symptoms and diagnoses.

We also participate in the Aegis project, a regional real time mapping of symptoms from 20 hospitals. Aegis includes alerting and cluster detection tools for use by public health officials.

The Aegis team at Children's hospital has also created Healthmap which parses news stories and displays outbreak information.

We remain nimble and will support our local, regional and national stakeholders as needed during this outbreak.

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Friday Feature: Harriet Picker- Asthma and Food Allergy Activist and Educator

Harriet is a mom of two food allergic children in New York City. Learn about how she educates and advocates for those with allergies and/or asthma through our Q&A below:

FAA: What is your food allergy background?
I grew up with food allergies and asthma. Before having children, I was a teacher and then a health educator, focusing on teaching kids and parents about asthma. My older son was diagnosed with an egg and a dairy allergy at 15 months. My younger son who is now 2, is allergic to dairy, wheat, beef, nuts, soy, eggs, and legumes.

FAA: What are you passionate about in the food allergy field?
I am passionate about educating people about food allergies; I am also passionate about schools creating plans to deal with food allergies.

Many people only think nut allergies are the dangerous ones, I have to convince people that dairy, egg, soy and other allergies can be just as dangerous.

FAA: What else are you working on in the food allergy area?
My main goal is to get the NYC public school system to acknowledge the need for food allergy protocols.

I am not a fan of banning foods. However, precautions need to be put in place and a protocol established. I believe allergy tables, frequent hand-washing, and table wiping are a start. Concerning snacks, which is an issue in my school, I would end the “Shared Snack“ policy. For many reasons parents should send in their own snack for their own child. I would also suggest a birthday party notification policy. That way the parent of an allergic child can bring in something if needed.

Most importantly, staff development is necessary to teach all school staff about what food allergies are, what to look for, and the use of epi-pens. Each year teachers should ask incoming parents about food allergies and a class should establish its own policy.

Currently, I am discussing these ideas with a few allergists in NYC and with my school’s nurse. If anyone wants to contact me about this issue, find me on Twitter @Harriet75 or e-mail me at "Alisaha2@aol.com".

FAA: What are your favorite food allergy friendly food staples?
I have so many! I love rice flour, Vans wheat-free waffles, Southern homestyle corn flake crumbs, Enjoy Life boom-choco-boom dairy free rice milk crispy rice bars, all of the gluten-free Cherrybrook Kitchen cake and cookie mixes, potatoes, and rice pasta, My new favorite item, but it's hard to find, is Ricera rice yogurt.


FAA: What are some of your other interests/hobbies?
I love theatre, performing and directing! I studied theatre in college and I have a Masters in Educational Theatre. I developed an asthma program that went into NYC schools in which I combined my love for theatre and knowledge of asthma to teach kids about asthma. I love being able to combine my passions.

Thank you, Harriet, for working with schools, children and parents to create awareness around food allergies and asthma!

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Cool Technology of the Week

As folks who read my blog know, I'm a great fan of cloud computing, software as a service, and working remotely.

There's a perfect client to complement these technologies - netbooks.

Netbooks are simple computers with an operating system, a processor that's good enough, and just enough memory and storage to ensure a positive web browsing experience. Most cost under $500.

I recently evaluated the Dell Mini 10 and it's my Cool Technology of the Week.

The Mini 10 is a netbook with a 1024x567 ten inch display, web cam, an Intel Atom Processor Z520 (1.33GHz/533MHz FSB/512K Cache), 1 Gig of memory, and a 160 Gig hard drive in a 2.5 pound package for under $400.

I found the keyboard, multi-touch track pad, and 10" screen to be the right proportions for rapid typing and easy viewing with my 47 year old presbyopic eyes. I accessed all my storage and applications in the BIDMC and HMS clouds via 802.11g on my home FIOS network and found the Atom processor fast enough to meet my needs.

Here are the full specs.

The device I tested ran Windows XP, but I plan to test Ubuntu, which is offered on other Mini models, as soon as it is available.

A full featured netbook with a screen like a 720p television that's lightweight and low cost. Cool!

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