http://www.hiewatch.com/perspective/future-hie-private

    80% of the 220 State and Federal Exchanges are stalled or failing as federal funding dries up.  97% of insurance companies do not believe public exchanges are are viable.  Only 10 exchanges predicted to exist past 2017.  88% of physicians view insurers as being the group that can address the sharing of patient data.  If these numbers are true than we are looking at a collapse of the entire ACA system.  Insurers will look to the government for bailouts on costs incurred due to provisions in the ACA which raise costs.  Premiums will go up across the board.  People will once again be dropped from plans and have to find new care providers. Which will mean collected data that is utilized to improve outcomes will be lost or have to move to other private exchanges.   This is a fundamental problem with the ACA, while it's ideals are good for people, it is based upon a fundamentally flawed and failing business model.  Most of the time the "smartest people are outside of the room, not in the room."    This should be a wake up call to all healthcare consumers and healthcare providers.

George Washington had mail opened to gain intelligence secrets about British

http://www.foreignpolicy.com/articles/2014/01/29/if_george_washington_were_alive_he_d_be_reading_your_email_founding_fathers_nsa


#nsa #privacy #constitution #security Washington had a "mini NSA" Madison paid for prostitutes for British Ambassador

One of the first Clinical Trials information system to seamlessly communicate test result information from Investigators to Reference Laboratories to Pharmaceutical Companies.  This Product along with Protocol Master was utilized in Pharmaceutical Companies such as Roche, Johnson & Johnson (Janssen Division) and Otsuka America.  The Protocol Master product was used as a front end to an early Oracle database and incorporated coding for adverse events, WHO codes, ICD9, and CPT coding.  The system utilized the ASTM 1238 protocol for the clinical transactions.

The utility of the system was part of a demonstration at the DIA (Drug Information Association) meeting in 1992 by Otsuka America Pharmaceuticals.

Adaptive Clinical Trials Gaining Acceptance

Adaptive Clinical Trials

http://www.clinicalinformaticsnews.com/cln/2014/1/28/adaptive-clinical-trial-designs-gradually-gaining-acceptance.html

Healthcare IT problems persist. New technology. same issues!

Healthcare IT article Repositories were Clouds, Mobility were Modems

http://www.slideshare.net/ebukstel/corporate-computing-bukstel-halfpenny-drchart-emr-ehr-university-of-minnesota-hp-hl7-astm-1238?from_search=1

EMR designed by Ed Bukstel in 1987 and programmed by Charles Halfpenny resulted in a feature article in Corporate Computing concerning the Implementation Proposal for University of Minnesota, family medicine clinics, and information sharing across the enterprise.  Sound familiar?

The EHR and EMR applications and technologies that are being implemented "successfully" are at varying stages of "success."  As I look back and into the future, this is truly "deja vu all over again."