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Tag Archives: electronic medical records

Top Four Biotech Trends of 2009

These may not all be consensus picks (and don’t miss the IVB’s year-end deal-centric fun) but I’m sticking with these four trends as the ones that have really shaped the year that was:

  1. Follow-on Biologics. Call them what you want (we like “biosimilars”, but we’re internationalist like that), there’s no denying that biosimilars were a major force in the industry and in politics this year.  Some in the press are calling the 12-year exclusivity period a done deal, but I say don’t count your chickens ’til the fat lady sings.
  2. Comparative Effectiveness and Personalized Medicine (not a two-fer, a trend of convergence). How much of comparative effectiveness variation will turn out to be an artifact of genetic sub-populations (each with binary responses to the drugs in question)?  Nobody knows, but as money pours into both fields, the truth will set us (and drug pricing) free.
  3. Shifting IP Constituencies. What do you get when you cross generics-hungry pharma companies with innovation-hungry Asian countries?  A whole new world of collaboration that will ultimately change the face of TRIPS and pharma R&D.
  4. Electronic Medical Records. Not really biotech (if you want to be picky), but it will have a massive impact on the way physicians, patients and payors interact with each other and with drug companies over the coming years.  Plus, with billions allocated to electronic medical records in Canada and the U.S., the pace of innovation and implementation really took off.

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Trends Update — Electronic Medical Records: Importance of Telemedicine, Implementation and Data Security

Since the Canadian and U.S. stimuli directed fuding towards electronic medical records (EMR), we’ve been following developments in the area as part of our Biotech Trends series here on the blog and have noted successes and failures.  A few recent stories highlight risks and benefits:

A recent Scientific American story (H/T @mikesgene) turned an analytical eye on the University of Pittsburgh Medical Center‘s implementation, the current iteration of which started in 2004.  Case studies have been an important part of the EMR narrative, and many so far have focused on Kaiser Permanente’s implementation, which is the world’s largest civilian system, so it’s nice to see an in-depth analysis of a different experience.  The article closes with a quote from  National Institute of Standards and Technology (NIST) Director Patrick Gallagher, who says the stimulus effort

“is about using technology to bring health care information together to reduce medical error, reduce the need for testing, put information in front of patients, and put information in front of researchers.”

A FierceHealthIT story reported on an initiative by the American Telemedicine Association, which is running a demonstration program with DocTalker Family Medicine.  DocTalker, founded by Dr. Alan Dappen (partnered with @drval) is providing remote health services to Association members and employees.  It’s being pitched as an employee benefit that can promote worker health and productivity by reducing the need for office visits and providing round-the-clock responsiveness. 

Telemedicine’s role in EMR also features in this story about a pacemaker developed by St. Jude Medical that allows patients and doctors at the Montreal Heart Institute to get data and alerts from the device, which also transmits cumulative data to the doctors in advance of patients’ follow-up visits.

With all of these electronic data floating around, security is key, but it remains an elusive target.  Dan Vorhaus tweeted about a ModernHealthCare.com article that highlights numerous security breaches this Fall.  Microsoft’s purchase this week of Sentillion, which focuses on EMR security, was for an undisclosed sum but you can bet it’s key to Microsoft’s EMR strategy.

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Trends Update — Electronic Medical Records: Ontario’s New EMR Adoption Program

floppy-disk1Ontario is providing up to $29,800 per physician over 3 years for new adopters of electronic medical records.  In the few weeks since the program has been implemented, the OMA has gotten over 650 inquiries and over 150 applicants.  There’s a local option and a cloud option, which runs off the eHealth Ontario servers.  Interestingly, up to $14,400 is available for early EMR adopters who complete upgrades to the latest spec.

Some interesting features at OntarioMD try to increase the effectiveness of the implementation:

  • EMR Advisor, an Ontario-based blog that includes information, tips and case studies;
  • A transition support program;
  • A support guide; and
  • Practice management consultants (on the government’s dime).

Meanwhile, Canada Health Infoway got its own clean bill of health from the Auditor General.

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Trends Update — Electronic Medical Records: Pogue Mugs On CBS and Interviews Blumenthal While Australia Shows How It’s Done

floppy-disk1David Pogue waded into the EMR narrative this week, with a piece on CBS News that took a look at the U.S. efforts with an interesting focus on Kaiser’s EMR efforts. Pogue follows up with a blog post containing a transcript of his full interview with David Blumenthal.  Interestingly, the main negative angle in his CBS piece is cost; but as we’ve noted, many providers are offering loans or guarantees or both to cover the cost until the federal payments kick in.

Meanwhile, Australia is only three years away from a full national EHR system, complete with a lifetime ID and scary music for the privacy-related segments:

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Cumberland Ends Bio IPO Drought But Prices Under Range. Next Up, Emdeon.

Cumberland Pharmaceuticals (NASDAQ: CPIX) raised $85 million in its IPO today, pricing at $17 per share.  This was less than the $19-21 per share range, but since it’s the first bio IPO since November 2007 we won’t complain.

The company is planning to use the proceeds to buy late-stage or approved therapies for acute care and gastroenterology to go along with their existing approved products — Caldolor, an IV form of ibuprofen, and Acetadote, which treats acetaminophen overdose.

The WSJ Health Blog notes that Cumberland is the first of two planned healthcare IPOs this week.  Stay tuned for Emdeon, an electronic medical-billing systems company that is looking for over $330 million tomorrow.

Trends Update — Electronic Medical Records: President’s Council of Advisors on Science and Technology (PCAST) Meeting on Health IT

The President’s Council of Advisors on Science and Technology is meeting now.  The meeting is broadcast live online at  http://tr.im/vK3G.

They just finished introductions.  Eric Schimidt, Eric Lander and Harold Varmus are there, among other luminaries.  100% in-person attendance.

“21 members include 4 winners of MacArthur ‘genius’ awards, 3 Nobel laureates, 2 university presidents, as well as 16 members of one or more of the U.S. national academies of science, engineering, and medicine.”

Trends Update — Electronic Medical Records: Salesforce.com Clouds the EMR Field

floppy-disk1The WSJ Health Blog notes today that Salesforce.com’s investment in Practice Fusion, though not a large financial investment, follows an appealing trend in the EMR space.  Both Salesforce.com and Practice Fusion are cloud computing plays (aka hosted services / ASP) where software and data live on company servers rather than on local PCs in doctors’ offices. This will be particularly attractive for smaller practices without their own IT capabilities.

We’ve been following the world of electronic medical records, which has attracted billions of dollars in U.S. stimulus money and over $400 million in Canada, and have been keeping track of notable implementation successes and privacy challenges.

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Trends Update — Electronic Medical Records: Ottawa Telehealth Success, Privacy Fiasco in Alberta, Beta Test in Montreal

floppy-disk1New data yesterday from a home telehealth monitoring program developed by the University of Ottawa Heart Institute claims a whopping 54% cut in hospital readmission for heart failure patients.  Readmission rates dropped to under 15% for patients on the program, which includes daily vitals monitoring and immediate contact if anything seems amiss. UOHI says they realize up to $20,000 in savings for each patient safely diverted.

Of course, any time you create electronic medical records, you create privacy risks, as this week’s fiasco in Alberta shows.  Over 11,000 patients were notified of a privacy breach after a virus infected over 100 Alberta Health Service computers.  A follow-up CBC story quotes a computer security expert who is appalled (the virus is 7 years old).

If you still want to hop on the electronic medical record bandwagon, McGill University Health Centre is collaborating with Medical.MD to promote a 300-subscriber beta test (first-come, first served) for Medical.MD’s web-based personal health records management tool — MedforYou.  Medical.MD says the service will be very user-friendly and will include information on allergies, procedures, providers and medications as well as a journaling function.

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Trends Update — Electronic Medical Records: GE’s First Healthymagination Project Aims to Speed EMR Adoption, May Also Help GE Sell Stuff

floppy-disk1GE has put $100 million — the first installment of a promised $6 billion commitment to its “healthymagination” goals — into funding zero-interest loans to physicians’ offices, hospitals, clinics, etc. to support the purchase of (GE’s own) electronic medical records (EMR) systems.

The program is called “Stimulus Simplicity” and it has a couple of very smart features:

  1. 1.    The interest-free period extends through 2012, a year after the U.S. stimulus funding will give credits to EMR purchasers; and
  2. GE will include a “certification warranty” that will ensure the systems qualify for the stimulus funding.

Highly Ymaginitive, GE!

[A side note for the lawyers in the audience: GE says Stimulus Simplicity contracts feature "extremely simple language."  Truly plain language contracts ... that could be a $6 billion benefit right off the bat.]

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Health IT in Ontario: Electronic Medical Records, eHealth Procurement Need Help; Online Resources Make Progress

floppy-disk1The Ontario Health Quality Council’s (OHQC) 2009 Annual Report On Ontario’s Health System was released earlier this week, and it notes that Ontario lags when it comes to EMR adoption:

25 percent of family-practice doctors in Ontario had electronic medical records, compared to 50 percent in Alberta, 98 percent in the Netherlands and 89 percent in the United Kingdom.

Of course, eHealth Ontario is focused on other priorities: wait times, diabetes management, medication management…  and crisis management.  Ontario’s EMR target for full adoption is 2015, but the Ontario Medical Association and the Ontario Hospital Association both issued releases supporting the OHQC Report’s call for more EMR adoption.

Meanwhile, the Pew Research Centre has a new report out today about how consumers use the internet to find and interact with sources of health information that shows a pretty high level of engagement — according to the WSJ Health Blog’s interview with a co-author of the report:

Nearly 60% [of internet users] said they have consulted blog comments, hospital reviews and doctor reviews, listened to podcasts about health care and signed up to receive updates about health or medical issues. And 20% have posted comments, reviews, photos, audio or video online related to health care, such as participating in an online group forum.

On this front, Ontario is doing pretty well.   The Canadian Medical Association launched an online diabetes tool for family physicians with chronic disease patients at mydoctor.ca which:

allows patients to share important diabetes-related information – such as blood sugar, weight and exercise results – with their doctor in a secure, online environment.

Also, the Ontario Hospital Association’s myhospitalcare.ca website, which started off pretty thin, has gotten an information upgrade this week.

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Trends Update — Electronic Medical Records: Your eHealth Future from CNET News

floppy-disk1CNET News has been taking a look at electronic medical records over the last few days in a feature called “Your eHealth Future” (hat tip to the WSJ Health Blog).  They are covering health care reform from the IT side, presented in six articles, all accessible through this link:

  1. 1.   Dragging health records into the Digital Age;
  2. Microsoft, Google in healthy competition;
  3. What you need to know about e-health records faq;
  4. Politicos prep for another health care showdown; 
  5. Why are doctors such Luddites? and
  6. Taking your health record with you.

 

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Trends Update — Electronic Medical Records: Telus/Microsoft and GE’s Global Healthcare Initiative Come to Canada

floppy-disk1Two Canadian developments on the electronic medical records front:

Telus-Microsoft:

Telus and Microsoft are developing a patient-centred system that would allow individuals to access and manage their medical records and would interface directly with health care providers’ systems to gather and share the data.  Canada Health Infoway wants to make sure it’s secure.  The CBC story mentions that the IBM/Google Health team is looking at a Canadian implementation as well.

GE Healthcare:

GE held an event today at MaRS launching a global healthcare initiative — called “healthymagination” — with announcements in 4 other cities around the world including Washington

GE is devoting $6 billion over the next 6 years to meet three goals by 2015: reduce the cost of healthcare by 15% (focusing on procedures and processes); increase access by 15% (to services, technologies and health education); and improve quality by 15% (partner with physicians and stakeholders to simplify procedures and accelerate adoption of standards of care). 

The initiative was introduced in Toronto by Elyse Allan, President & CEO of GE Canada, and by Peter Robertson, General Manager of GE Healthcare Canada, who did a good job of speaking to Canadian-specific issues.  One program that was heavily discussed was the Pan Northern Ontario PACS Project (PNOP) agreement with GE Healthcare for the creation of a Diagnostic Imaging Repository (DI-r) and longitudinal patient records across northern Ontario.  The program is being funded in part by Canada Health Infoway and the Ministry of Health and Long Term Care’s eHealth Program.

 

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Trends Update — Electronic Medical Records: Health IT and EMR Have an Advocate in New OMA President Suzanne Strasberg

floppy-disk1Dr. Suzanne Strasberg took over as the incoming president of the Ontario Medical Association (OMA) Saturday night at their annual gala.  The OMA press release headlines Dr. Strasberg’s call for access to family physicians, but health IT also figures prominently. Dr. Strasberg indicated that she would focus on a number of initiatives, including “expansion of the use of IT and eHealth” and cited support for “Electronic Medical Records, which have enhanced patient safety and improved the quality and continuity of care, as examples of where further expansions should be made immediately.” 

Click here for our other posts on electronic medical records.

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FTC Proposed Rule for Medical Record Privacy for Non-HIPAA Entities

One of the concerns about the privacy of electronic medical records is that many of the major providers — notably Google and Microsoft —  are not “covered entities” under HIPAA and are therefore not subject to its privacy provisions.

The funding for Electronic Health Records in the American Recovery & Reinvestment Act of 2009 comes with a requirement that HHS study, in consultation with the FTC, “potential privacy, security, and breach notification requirements” with respect to entities not covered by HIPAA, and make recommendations within one year.

In the interim, Section 13407(g)(1) of the Recovery Act requires the FTC to promulgate regulations on breach of security notification provisions.

The FTC has proposed a breach notification rule, and is coordinating with HHS.  The proposed rule:

  • requires vendors of personal health records and related entities to provide notice to consumers following a breach, and reaches through to require the vendors’ service providers to notify the vendors;
  • sets the standard for what triggers the notice requirement, as well as the timing, method, and content of notice; and
  • requires FTC notification of any breaches.
Public comments are being accepted through June 1, 2009, and can be submitted online at https://secure.commentworks.com/ftc-healthbreachnotification.  In particular, the FTC is seeking comments on:
  1. the nature of entities to which its proposed rule would apply;
  2. the particular products and services they offer;
  3. the extent to which vendors of personal health records, PHR related entities, and third party service providers may be HIPAA-covered entities or business associates of HIPAA-covered entities;
  4. whether some vendors of personal health records may have dual roles as a business associate of a HIPAA-covered entity and a direct provider of personal health records to the public; and
  5. circumstances in which such a dual role might lead to consumers’ receiving multiple breach notices or receiving breach notices from an unexpected entity, and whether and how the rule should address such circumstances.

 

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Wednesday Brain Dump: Two of Everything! Edition

Two Camels!  Dolly the cloned sheep, meet Injaz the cloned camel.

Two R&D Heads!  The combined Pfizer-Wyeth will have Mikael Dolsten heading up the newly created BioTherapeutics Research Group and Martin Mackay heading up the small molecule PharmaTherapeutics Research Group.  (Two CapitalLetters!)  The In Vivo Blog has a podcast interviewing both.

Two VA Initiatives!  In addition to the electronic medical records initiative we mentioned earlier this week, the Department of Veterans Affairs is also setting up a large cohort genetic study that will establish a database of genetic information from patients that will be linked to the participants’ electronic health records.  This is great news for personalized medicine because it will ensure that the EHR standard that comes out of the VA project will accomodate and utilize individualized genotypic data.

Two R’s, Two L’s, Two B’s!  G. Steven Burrill (two r’s, two l’s, one b) says he’s confident he can raise $1 billion (there it is!) to develop the Pine Island biotechnology project and a private equity/venture capital fund, which will support development of new technologies out of the Mayo Clinic and the University of Minnesota, among others.

Two Guidance…s!  Health Canada issued a finalized version of a Guidance Document on data protection (only applicable to qualifying innovative drugs that received an NOC on or after June 17, 2006) AND a revised version of the draft Guidance Document on Subsequent Entry Biologics, (which includes a 6-year data protection period).  More to come on this.

Two Border Crossings!  Simponi, a biologic developed by Johnson & Johnson and Schering-Plough, crossed the border Northbound — gaining approval from Health Canada before the FDA; and Molecular Templates Inc. crossed the border Southbound — leaving Ontario for the Texas Life-Sciences Collaboration Center.

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Trends Update — Electronic Medical Records: Military and Vetrans System Should Speed Adoption, Standards

In a speech Thursday, President Obama announced that the Defense and Veterans Affairs departments will set up a system that will ultimately provide “unified lifetime electronic health record” for members of the armed services. 

Any large-scale government implementation like this is bound to help set standards and encourage adoption by other providers.  With luck it will also, over time, provide data on cost-savings and care improvements.

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Trends in 2009 Update: Hospital Hits Electronic Medical Record Milestone

As the momentum behind electronic medical records builds, New York-Presbyterian Hospital — with the help of the Microsoft Health Solutions Group — has  kicked it up a notch with MyNYP.org, an electronic personal health record.  According to a report in the New York Times on Sunday:

NewYork-Presbyterian Hospital … is the first large institution to move beyond the pilot stage this week as it begins to offer consumer-controlled health records for patients…

The NYP initiative facilitates the transfer of medical information into personal electronic records that are not tied to any institution.  According to the Times, Google has entered into similar partnerships with large healthcare providers so there’s more to come.

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Ontario Budget 2009: Initial Reactions are “Encouraging”

Generally positive reviews of Ontario’s 2009 budget are coming in from the innovation community:

TBI gives a shout-out to the Emerging Technologies Fund:

The Biotechnology Initiative (TBI) would like to credit Premier Dalton McGunity and Minister of Research and Innovation John Wilkinson for their quick response to the looming economic uncertainty by the creation of the Emerging Technologies Fund… The life sciences community in Ontario is greatly encouraged as a result of the creation of this Fund.

Rx&D is also “encouraged”:

Canada’s Research-Based Pharmaceutical Companies (Rx&D) is encouraged by initiatives in the Ontario Government’s 2009 budget designed to fuel innovation and growth in Ontario’s biopharmaceutical and life sciences industry…

“The support in the budget for research infrastructure, genomics, tax incentives for innovation and the increased funding for the Ministry of Research and Innovation demonstrate that the McGuinty Government is strengthening its commitment to make science and innovation a priority.” 

So is the Retail Venture Funds Association:

The McGuinty government has made encouraging policy initiatives that help bring innovative high-tech applications to market more efficiently…  The Ontario Budget released today contained far-reaching initiatives that will help the province’s entrepreneurs, scientists and researchers develop and market new technology here instead of other jurisdictions.

The Ontario Medical Association is…

encouraged that the government is investing $2-billion into eHealth, which is playing an increasingly important role in improving patient safety and efficiency of our health care system. Electronic Medical Records (EMRs) have had a tremendous impact on patient safety, continuity of care, and quality of care. To date, over 3,000 physicians have made the transition to EMRs and by the end of 2009, over 4 million patients will have an electronic health record.

Did I miss any?  Are you encouraged too?  Let us know in the comments

Other: 

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Electronic Medical Records Update: Walmart Solution, Google Problem

When we identified electronic medical records as a trend in 2009, it was before $19 billion of the stimulus was allocated to implementing EMR.  With that money on the table, the movement toward wide scale implementation has only accelerated:

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Allocating Spending to Support R&D: UK, U.S. and Canadian Approaches

The U.S., Canada and the UK have all acknowledged the central importance of R&D even in these recessionary times.  However, the three national governments have decided to focus their spending on different steps of the R&D equation:

  1. Education: UK Takes the Long View
    British PM Gordon Brown, in a speech this week, identified three priorities: research, education and training, and public discourse.  However, only one of the three, education, was the subject of specific increased targets and spending:  retraining to increase the number of science teachers, a goal to double the number of pupils in state schools taking ‘triple science’, and a new Diploma program.  The U.S. and Canada have increased funding for graduate studies, but the UK effort is focused at an earlier stage, to rebuild the interest and capabilities of domestic graduates. 
  2. Publicly-Funded Research: U.S. Takes the Lead
    The focus of the U.S. R&D spending increases has absolutely been on research.  The increases for the NIH and NSF in the stimulus and the budget will go largely to increasing the volume of publicly-funded research.  PM Brown’s speech also vowed to protect funding for science from competing demands for Government support during the downturn, but did not propose increases over the existing 10-year plan.  Canada’s budget actually cut research funding across the three main granting agencies.
  3. Commercialization: Canada Takes Off 
    Canada’s focus was on commercialization.  The 2009 budget included $200 million allocated to the National Research Council’s IRAP program — $170 million to double the program’s contributions to companies, and $30 million to help companies hire over 1,000 new post-secondary graduates.  It also provided significant additional funding to BDC.  The only comparable spending in the U.S. was the $400 million for ARPA-E, which is allocated to energy programs, and supports research as well as commercialization.  PM Brown’s speech recognized the importance of maintaining the country’s struggling start-ups, and he has reached out to big pharma, but promised no specific action.

What’s still missing:  Stimulating Output

  • Despite calls in the UK, the U.S. and Canada, there have been no major tax policy changes enacted in this round of budgets and bailouts that ease the burden on, or return money to, early-stage technology companies.  Ontario has actually taken some steps in this direction with the Ontario Venture Capital Fund and the Ontario Tax Exemption for Commercialization.
  • Nor have there been many changes that increase the value of outputs: in the bio/pharma area, the UK has probably moved farthest in this direction, with upcoming reforms of the National Institute on Comparative Effectiveness (NICE), while the U.S. has seen decreasing FDA approvals and is allocating new comparative effectiveness funds.  On the other hand, approvals of GE animals, support for personalized medicine and big spending on electronic medical records will provide support to specific industry initiatives.

Stay tuned to our Bailout Page for updates.

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TBI Breakfast: BIO and Biotech in the State of Georgia

I just came back from a very enjoyable TBI Breakfast with talks by Carol Henderson, the Director of the Georgia Department of Economic Development and Graeme McRae, the Chairman & CEO of Bioniche Life Sciences, Inc. which has an Animal Health division facility in Athens, Georgia.

Graeme’s talk, as usual, was very interesting and not very print-able.

Carol’s talk was also great.  Of course, Atlanta, Georgia is hosting BIO 2009, which is moving ahead full-steam.  Georgia also has some interesting capabilities and initiatives

Most interestingly, the State has a life sciences facilities fund that provides low interest loans secured by fixed assets to assist start-ups with finding appropriate space.   Carol mentioned that the program just funded a 15-year loan with deferred interest at 60% of Prime.

Here in Ontario, we have also identified access to facilities as a key area for government support, and the Georgia program is a model that I haven’t heard discussed here.

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Personalized Medicine: The “SNP Doctor”

BIO SmartBrief picked up a story today about a device being tested called the mohel Snip Doctor, a hand-held diagnostic device that:

looks for known single nucleotide polymorphisms (SNPs) – single letter changes in the genetic code – that can affect an individual’s response to medical treatment.

While most current approaches to personalized medicine are mechanistic (e.g., HercepTest), this device raises the possibility of a correlative approach.  Of course, it’s only a temporary measure to hold us over until our full genomes are a normal part of our electronic medical records.

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More Info on Canadian Electronic Medical Records Implementation

In our Trends in 2009 series, we noted that Electronic Medical Records are poised to make significant inroads this year in Canada and the U.S. Yesterday, Leona Aglukkaq, Canada’s Minister of Health, confirmed that:

Funding of $500 million announced today is in addition to $400 million in support provided to Canada Health Infoway in Budget 2007. This brings the Government of Canada’s total commitment to this initiative to $2.1 billion.

Canada Health Infoway in turn announced today the availability of a new certification service that will enable

Health information technology vendors entering
the Canadian consumer health solution market [to] apply for
pre-implementation certification for their consumer health platforms.

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U.S. Stimulus Compromise (Updated)

Initial reporting (NYT, WSJ) on the bill coming out of the House-Senate conference committee this evening indicates that the $789 billion package will include most of the Bio-related provisions:

Update 10am: More details from ScienceInsider based on Pelosi’s fact sheet:

  • The Department of Energy’s Office of Science, which supports US physical science, will receive $1.6 billion.
  • $400 million will be provided to fund a new mini agency within DOE called the Advanced Research Project Agency-Energy. Obama’s energy secretary, Steve Chu, is a fan. Now congress has bestowed their blessing — and big money –on his dream energy program.
  • NASA will get $1 billion including $400 million for climate change research.
  • The National Institute of Standards and Technology will receive $580 million.
  • The National Science Foundation would receive the full $3 billion increase that the House had passed last month. That’s a 50% boost to its $6 billion budget. The breakdown of that number is not clear, but the House version contained $2 billion more for research grants; $900 million for three infrastructure programs, including a revived $200 million extramural facilities competition; and $100 million for two education programs.

Update 5pm:

  • The $3 billion in NSF funding breaks down as follows: $2.5 billion for research (peer-reviewed proposals); $100 million for the university research instrumentation program; and $400 million for national labs.
  • The NIST money is for infrastructure: $220 million for lab equipment and $360 million for facilities.
  • USDA gets $850 million for infrastructure.
  • NOAA gets $600 million for facilities and equipment.

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Electronic Medical Records and Public Health

Here’s one electronic records initiative that looks good as cost-savings and doesn’t seem too controversial from a privacy perspective:

…as the province moves toward electronic health records, Dr. Barbara Yaffe,  Toronto’s associate medical officer of health, said she wants children’s immunization charts to be included.

…By law children in Ontario must be vaccinated against measles, mumps, rubella, diphtheria, tetanus and polio.

But in 2008 the city witnessed the largest outbreak of measles since the mid-1990s, as well as cases of mumps…

“[W]e would always be up-to-date on what every child has. We wouldn’t have to go through all this inefficient process of sending letters and bugging parents and even suspending some children, if we had that information.”

As a parent who is a recipient of those (many, many!) letters, I’m 100% in favour.

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Trends in 2009: Electronic Medical Records

EMR got a boost in Canada’s budget, and is getting traction in the U.S. as well.  In Canada, EMR initiatives are likely to be implemented by the Provincial health plans directly, with back-end services from a variety of vendors.  In the U.S., the ultimate structure is less clear.  Google has tried to get ahead of the trend (as has Microsoft), and the WSJ Health Blog had an interesting post last week:

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