American College of Physicians gets excited about Electronic Health Records

The American College of Physicians is promoting the virtues of electronic health records. Contrast this offering with this.

Hat tip Ted Shortliffe.

Our Data Ourselves

The American Recovery and Reinvestment Act has important medical privacy mandates which in theory should allow for increased "liquidity" of our own healthcare data. That is, it should allow patients to request an electronic copy of their record where there is one to be had. Specifically (thanks to AMIA for a very useful summary):

Privacy –Title XIII Subtitle D

•Sec. 13405

Provides individuals the right to obtain from a covered entity using an EHR a copy of their information in electronic format, allowing the individual to designate a 3rdparty, such as a PHR, to receive a copy

This has been a long time coming and it is a welcome development. It should further stimulate an industry working on the personal use of such data.

Boston University sets an important example

Boston University in its entirety has adopted an open access policy that includes both the undergraduate and graduate schools. This move signals the continued tectonic shift in the awareness of faculty of the importance of providing more efficient access to their scholarly output, for themselves, for their colleagues and for their students. Details of the policy can be found here.

Your face or your health?

The recent brouhaha regarding the Facebook change of terms or service illustrates just how much many care about their personally placed public information. Do we, as patients, care any less about who gets to have our personal data in perpetuity? Should we advocate for tighter personal control of our health information?

How long do you have to wait in the Emergency Room?

If you ever have had a visit to the emergency room that was not a life-threatening emergency you might have made an unfavorable comparison of queue management there to that in a supermarket. It is therefore all the more stark how innovative this site from Australia is in this regard. What will it take to make this functionality available routinely? It certainly would allow consumers to effectively spread the load across the local emergency rooms.

Hat tip to HISTalk via Dan Nigrin.

Enabling the new peer review

From the capacious open source code vaults at Google, here is an interesting application called gpeerreview. It allows irrepudiably sourced reviews of any publication. In their own words:

How does it work?

1. First, you read someone's paper.
2. Next, write a review. (The review is just a simple text file that contains a few scores and your opinions about the paper.)
3. Use GPeerReview to sign the review. (It will add a hash of the paper to your review, then it will use GPG to digitally sign the review.)
4. Send the signed review to the author. If the author likes the review, he/she will include it with his/her list of published works.
5. Prospective employers or other persons can easily verify that the reviews are valid.

Why?

• Peer reviews give credibility to an author's work.
• Journals and conferences can use this tool to indicate acceptance of a paper.
• Researchers can also give credibility to each other by reviewing each others' works.
• This enables researchers to publish first, and review later.
• It meshes seamlessly with existing publication venues. Even the credibility of works that have already been published can be enhanced by obtaining additional peer reviews.
• A decentralized social-network of reviewers and papers is naturally formed by this process. The structure of this network reflects that of the research community.

This is a nice idea and if paired with the right social networking web infrastructure, could make for a nice peer view community. More evidence of the growing search for alternative modes of publication and peer review.

Can the healthcare system keep up with Grandpa?

A sensible senior citizen has come up with an efficient and cost-effective portable medical record. It's his key medical facts stored on a commodity USB drive and hung on his person by lanyard or bracelet. Alas, the real question is, how many clinical practices have a care provider who has the wherewithal and willingness to plug this drive into their office (or emergency room) computer to check the contents of the record? Perhaps the stimulus package can help increase this likely small number?

Peter Suber Speaks

What is the Future of Open Access?

A talk by Peter Suber

Thursday, February 26, 12:30 pm
Pound Hall 100, Harvard Law School
RSVP requested (rsvp@cyber.law.harvard.edu)
This talk is co-sponsored by the Harvard Office for Scholarly Communication and the Harvard Law School Library

Eloquent cri de coeur

This piece by Patrick Swayze speaks for itself. I would add that the investment in additional NIH funding is lessened if the results of the funded research are not delivered efficiently to our taxpayers.

The Empire Strikes Back?

House Judiciary Committee Chairman John Conyers has introduced legislation to overturn the legislatively mandated open access publication of National Institutes of Health-supported biomedical research (i.e. taxpayer supported research).

The text of the introduced legislation currently states: "No Federal agency may, in connection with a funding agreement-- (A) impose or cause the imposition of any term or condition that--`(i) requires the transfer or license to or for a Federal agency of- `(I) any right provided under paragraph (3), (4) or (5) of section 106 in an extrinsic work; or..."

Peter Suber provides a sober analysis of this effort and makes the point very clearly that the current mandate does not in anyway violate publisher's copyright. This is certainly an interesting time, made all the more vivid by the extent of the economic stakes.

Cloudy translational biomedical science

Dennis Wall and Peter Tonellato are leading a genuinely innovative seminar in the biomedical application of cloud computing. Applications ranging from population simulations in healthcare to interpreting personal genomes. The seminar is available by Webex.

Can there be an Apple for scientific publication?

It remains a matter of debate whether or not iTunes from Apple has resulted in a greater diversity of musical offerings. It is less controversial that Apple has created a market force which has enabled consumers to buy affordable single tracks from an album without digital rights restrictions that are often inconvenient, if not onerous. This has caused a shift of power from the recording industry to Apple and perhaps the consumer. So, is there an player equivalent to Apple in the sphere of biomedical publication? Will it be one of the current open access publishers or a "player" as unanticipated as Apple was for music distribution?

For example, Google could host a full peer-review and dissemination/annotation publication ecosystem if it wished. Or the AAMC could host a distributed biomedical research press. Or the NIH could spend less than 5% of its total budget and create a high quality peer-reviewed system that would hew to the highest standards and directly bring the output of NIH-funded biomedical research directly to the consumers without any additional cost.

Open access evolution: extinction and new models

In the current maelstrom of competing models for sustainable, affordable, or profitable publishing enterprises, an early pioneer of open access publication recently closed it doors. The Medscape Journal of Medicine (MJM), was a brave experiment, particularly in that the authors were not charged large fees as is done for many of the current open access journals. Most relevant for future scholarship is how the back issues of MJM will be kept readily accessible. Most encouragingly, it seems that copies of MJM will be archived with Pubmed Central which constitutes one of the wiser investments of our tax dollars.

Concurrently, we see the emergence of a new model of peer review from the Journal of Biology (hat tip David Osterbur). In this model, authors whose manuscripts were accepted for review can choose to not have their manuscripts re-reviewed but instead can appeal to the editors for publication without revision. Their appeal may not be accepted (in which case the manuscript is rejected) or it is accepted in which case it is published along with an editorial commentary. Regardless of the merits of this model, it does provide editorial added value to each publication, in contrast to many open and closed access journals.