Publications

    Selected Presentations

    Recent talks (OK, some are not so recent)

    Project Heatlh Design. August 17, 2011
    Battling the Odds: Medical Care During the American Civil War
    St. Louis, August 4, 2011

    Medical Banking Institute

    State of Missouri: Senate Healthy Missourians 2020 Committee

    AHRQ National Meeting (16-September-2009)

    California eHealth Collaborative (18-May-2009)

    A Report on Long-Term Care in the State of New York

    My colleagues and I worked for several months with a remarkable cadre of leaders in New York State to summarize the care of those with progressive, intermittent frailty. We addressed long-term care from the perspective of housing, culture, personnel, and financing.

    Cumberland Pediatrics: Kids

    BMIF 300: Foundations of biomedical informatics and evidence-based practice course: November 18, 2008

    These are some notes and links for a lecture given to biomedical informatics graduate students.

    AMIA: November 10, 2008

    This is a brief overview of the MidSouth eHealth Alliance Exchange

    California Privacy and Security Advisory Board Symposium Keynote

    On October 28, I gave a keynote for the California Privacy and Security Advisory Board's "Cornerstones for Information Exchange" symposium. The title is: Fear, Greed, and Consequences, and our Privacy.

    Institute of Federal Health Care (e-prescribing)

    On October 24, I participated in a roundtable discussion sponsored by the Institute of Federal Health Care. Participants included a number of individuals responsible for military (TriCare), Indian Health, Veterans Health Administration, ONC, SureScripts-RxHub and Aetna. The session was moderated by Dr. Rick Erdtmann of the Institute of Medicine.

    Vanderbilt noon seminar presentation: September 1, 2008

    I have recently given a broad overview of the regional informatics initiative in Memphis. It is high-level with little detail. There is some overlap with my Medicaid MMIS keynote.

    Nashville MMIS Conference

    I had the pleasure of delivering a keynote address to the Medicaid MMIS Conference held in Nashville the week of September 15.

    Other Presentations



    News

    Memphis Health Information Exchange enters third year (May, 2008)

    Secure, Personal Health Information Access for 750,000 Consenting Individuals

    On May 3, 2008, our Memphis-based health information exchange has been in clinical operation for two years. Funded by AHRQ, the State of Tennesse, and Vanderbilt and governed by the non-profit MidSouth eHealth Alliance, the Exchange has come a long way

    The Exchange currently has 356 people using the system for clinical care.

    • Physician / Provider roles - 199
    • Nurse roles - 109
    • Registrars and unit clerk functions - 48
    These numbers will change as the last major system goes "near real time" in the next few weeks and as more ambulatory care providers are introduced to the program. The number of clinicians will increase and the number of registrars and unit clerks will decrease dramatically.

    Data come from approximately 30 sites. Use is in all major emergency departments, several ambulatory clinics, and among some hospitalists. Access is only through secure ID. 100% of accesses undergo some form of audit. Use is restricted to clinical settings. No aggregate data or metrics are kept. Patients may "opt out" at the institutional level.

    The Exchange grants secure  access to almost 3 million patient encounters.

    • Total number of unique individuals - 1,050,000
    • Total number of unique individuals with clinical data (not just claims) - 809,000

    We are still working on the latest inventory of specific data elements.

    From our February estimates, the system has over 300,000 procedures codes, 2.6 million diagnostic codes. On a daily basis, the system adds approximately 33,000 encounters,  850 microbiology tests, 1,200 chest x-ray reports and some 80,000 laboratory test results. (Follow this link to a February 2008 update)

    More data and implications will be soon be found on my policy blog and at our Regional Informatics Site