Viewpoint

When it comes to gaining some perspective, a sense of direction and even a bit of inspiration to forge ahead in the land of American healthcare information technology (IT), it turns out we can look to our friends in the Southern Hemisphere, inhabiting the land down under The Land Down Under.

New Zealanders have long enjoyed a superior high-tech healthcare experience. In fact, according to a report recently released by New Zealand Trade and Enterprise, the use of health IT in the New Zealand primary care sector is “1.6-5.1 times greater than that of the United States in all areas, ranging from electronic access to patients’ test results to computerization of routine healthcare practices.”

“The United States can learn much from New Zealand’s decades of experience in developing and implementing electronic medical records and health IT systems and technology, which has helped make New Zealand a leader in overall quality-of-care delivery among OECD (Organization for Economic Co-operation and Development) nations,” says John D. Halamka, M.D., M.S., chief information officer of Beth Israel Deaconess Medical Center, chief information officer at Harvard Medical School, chairman of the New England Healthcare Exchange Network (NEHEN) and one of Health Management Technology’s esteemed editorial board members.

According to the report, New Zealand and the United States share similarities in population health dynamics, population distribution between urban and rural areas, and high usage of information and communication technology. But there are differences as well; and this is where it starts looking not so good for us Americans. The per-capita cost of healthcare in New Zealand is significantly less than in the United States, with New Zealand per-capita health expenditures reported for 2008 equaling U.S. $2,683 versus U.S. $7,538 in the United States (OECD data). And sadly, that’s not a typo.

The New Zealand Trade and Enterprise report suggests that “New Zealand’s leadership in the development, implementation and uptake of health IT may play an important factor in the country’s strong healthcare performance and ranking.”

No doubt.

And check this out: According to the New Zealand Ministry of Health, by 2014, all New Zealanders will have electronic access to their own health information; and all health professionals caring for a person, no matter where they are in the country, will have secure electronic access to that person’s full health information. This means New Zealanders can be fully involved in their own healthcare, and clinicians will know a patient’s complete health history so they can provide them with the best care.

Until next time, here’s wishing you good healthcare IT. Apparently, the New Zealanders already have it.

Enjoy the issue.

Since I was way too young to listen to his albums and watch his films, Richard Pryor has been my favorite comedian. Despite the fact that he spoke in the patois of the street and cursed a great deal, his humor was not scatological; in fact, his comedy insights were often anecdotal in nature, and imbued with a great deal of knowledge about the human condition. It broke my heart when he was diagnosed with multiple sclerosis (MS), and we watched helplessly as he devolved from a once-vibrant, verbose slickster to a wheelchair-bound infirm who had difficulty speaking.

Thanks to healthcare IT, new findings could help shed some light on what actually causes MS – and how it may one day be cured.

Last month in a newly published paper, medical researchers at FONAR Corporation reported a diagnostic breakthrough in MS, based on observations made possible by the company’s FONAR UPRIGHT Multi-Position MRI. The findings reveal that the cause of MS may be related to earlier trauma to the neck, which can result in obstruction of the flow of cerebrospinal fluid (CSF), produced and stored in the central anatomic structures of the brain known as the ventricles. Since the ventricles produce a large volume of CSF each day (500 cc), the obstruction can result in a build-up of pressure within the ventricles, resulting in leakage of the CSF into the surrounding brain tissue. This leakage could be responsible for generating the brain lesions of multiple sclerosis.

The paper, “The Possible Role of Cranio-Cervical Trauma and Abnormal CSF Hydrodynamics in the Genesis of Multiple Sclerosis,” appears in the journal Physiological Chemistry and Physics and Medical NMR (Sept. 20, 2011, 41: 1-17). It is co-authored by MRI researchers Raymond V. Damadian, who invented the MRI, and David Chu.

The disease results in the destruction of the coverings, or myelin sheaths, that insulate the nerve fibers of the brain. The destruction prevents the nerves from functioning normally and produces the symptoms of MS. The destruction is the origin of the lesions seen on the MRI images.

But, unlike nerve tissue, the myelin sheaths can regenerate – once the cause of their destruction is eliminated. The paper suggests that surgical or biomechanical remediation of the obstruction of the flow of CSF in the cervical spine could relieve the increased CSF pressure within the ventricles and eliminate the resultant leakage of fluid into the surrounding brain tissue and the inflammation of the myelin sheaths that it generates. Once the leakage has been stopped, the myelin sheaths could be repaired by the body’s myelogenesis process with the prospect of a return to normal nerve function.

As someone who suffers from a neck injury, these findings make me nervous; yet it’s because of incredible discoveries such as this that I remain cautiously optimistic about the future of healthcare IT.

Enjoy the issue.

The 83^rd American Health Information Management Association (AHIMA) Convention and Exhibit is scheduled for Oct. 1-6 at the Salt Palace Convention Center in Salt Lake City, Utah. With a focus on “Reaching New Heights in Health Information,” the event will attract professionals from across the full and varied spectrum of health informatics and information management for a six-day-long focus on HIM’s global transformation.

The show will offer plenty of opportunity for networking, and more than 200 exhibitors are expected to show off their wares. Experts will discuss the latest developments in HITECH, EHRs, ICD-10 – and everything in between, providing a comprehensive overview of current and emerging HIM issues and challenges.

Additionally, the convention will mark the debut of new AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, FACHE, who took over as chief executive of the 61,000-member organization on Sept. 29. She joins AHIMA after serving as associate vice president for hospital operations and director of the Children’s Hospital at Rush University Medical Center in Chicago, IL. She also is a member of the Rush University faculty in the graduate program in health systems management.

Convention speakers include Apolo Anton Ohno, eight-time Olympic speed-skating medalist; Dr. Peter Tippett, VP of technology and innovation, CMO, Verizon Business; Gail Collins, first woman appointed editor of the New York Times’ editorial page, New York Times syndicated opinion columnist and blogger; Dr. T.B. Üstün, team coordinator of classification, terminologies and standards, Department of Health Statistics and Informatics, World Health Organization; Carolyn Clancy, M.D., director of the Agency for Healthcare Research and Quality; and Stephen M. R. Covey, bestselling author of “The Speed of Trust.”

AHIMA was founded in 1928 when the American College of Surgeons established the Association of Record Librarians of North America (ARLNA) to “elevate the standards of clinical records in hospitals and other medical institutions.”

As the industry changed, so did the organization’s name. In 1938 it became the American Association of Medical Record Librarians (AAMRL) and in 1970 the American Medical Record Association. Its current name, adopted in 1991, captures the expanded scope of clinical data beyond the single-hospital medical record to health information comprising the entire continuum of care.

AHIMA is committed to promoting and advocating for high-quality research, best practices and effective standards in health information and to actively contributing to the development and advancement of health information professionals worldwide. AHIMA’s enduring goal is “quality healthcare through quality information.”

For more information, check out www.ahima.org.

Until next time, here’s wishing you good healthcare IT.

I recently had the pleasure of being invited to moderate a panel at the World Congress Third Annual Leadership Summit on mHealth, held July 28-29 in Cambridge, Mass. I found the conference informative, the panelists well versed in their respective topics of expertise and the exhibitors entertaining (highlights included AT&T’s diabetes app, Humana’s wireless teddy bears and Rubbermaid Healthcare’s telemedicine solution). But what I will remember most about the event was meeting a powerfully proactive patient.

Wife and mother Natasha Gajewski was hard at work – living her busy life and staying in shape by practicing Zumba, a Latin-inspired, dance-fitness program – when she was diagnosed with a chronic, incurable disease.

Understandably, the diagnosis left her scared and feeling more than a little helpless. Her doctor suggested she keep a diary of her symptoms to help clarify her diagnosis and redefine her treatment plan. Gajewski needed an easy way to capture and log data and thought, “There must be an app for that!”

But there wasn’t.

So Gajewski decided to take matters into her own hands and build one herself.

Based upon the axiom that “participatory healthcare + evidence-based medicine = happier, healthier patients,” Symple App was born.

The intuitive interface allows users to define their own symptoms, while some elegant programming makes it possible to log symptoms with as few as a half-dozen screen touches.

The app tracks symptoms and triggers, and can even remind the user to log observations at the same time every day in order to standardize data. The tool bridges the gaps between doctor visits, allowing the patient to share only important data with their healthcare provider on a schedule that makes sense for both parties involved.

“Getting diagnosed with an incurable disease is a life-changing experience, but it’s not scary anymore,” Gajewski says. “Now, I’m a scientist of my health, not a victim of my disease.”

Symple App is currently going through its beta-testing phase.

On her Web site, www.SympleApp.com, Gajewski quotes Shannon Brownlee (from an article titled “21^st Century Leeches” in the New Health Dialogue blog), which sums up her perspective perfectly: “As a patient, I want to be the driver; my physician is the GPS.”

Enjoy the magazine. If you’re in Salt Lake City for AHIMA the beginning of October, we hope to see you. And, until next time, here’s wishing you good healthcare IT.