April 29, 2009
Managing a Family Member's Health Care through Electronic Health Records
Kaiser Permanent's press release explains, "A key differentiating feature of My Health Manager is that it is directly connected to Kaiser Permanente HealthConnect™, one of the most robust and sophisticated electronic health records anywhere. By providing consumers with access to the same clinical record their doctors see, and with unique tools to interact with their providers and health plan, My Health Manager allows patients to become more engaged in their own health care, and it goes well beyond the standard PHRs populated solely by claims data."
Although My Health Manager provides several health management tools including health and wellness information, health plans and services, and locating services within Kaiser Permanente's expansive network, the immediate value I found is learning the details of my father's health condition by instantly accessing his physicians' notes. Moreover, I am able to track his numerous prescriptions through My Health Manager's Pharmacy Center. My father does not always understand when the physician’s diagnosis, which makes it difficult for him to explain his health issues to my siblings and me. Having direct access to my father's health records helps my family understand the diagnosis and treatment strategy.
In my blog entry, "Electronic Health Records: The Next Step in Health Care Management," I said that electronic health records (EHRs) will quickly become an essential component in health care management, which I hope will lead to a reduction in health care costs. Furthermore, not only will EHRs allow the patient to become better educated when making medical decisions, EHRs will allow families to remain informed about managing health care for their loved ones. I worry about my father's well-being; however, I am more confident assisting him to make informed decisions as a result of having direct access to his personal health records. This is particularly important since I do not reside in the same city as my father.
April 23, 2009
Ultrasound Imaging Now Possible with a Smartphone
Through a $100,000 grant Microsoft awarded in 2008, this technology is compatible with Microsoft Windows mobile-based smartphones. "As a result, it is now possible to build smartphone-compatible USB ultrasound probes for imaging the kidney, liver, bladder and eyes, endocavity probes for prostate and uterine screenings and biopsies, and vascular probes for imaging veins and arteries for starting IVs and central lines." Dr. Richard notes that this medical innovation "could become the essential computer of the Developing World, where trained medical personnel are scarce, but most of the population, as much as 90 percent, have access to a cell phone tower."
"'With 70 percent of the world's population has no access to medical imaging,'" Mr. Zar said, this technology could quickly modernize the medical industry by providing early diagnosis and cost-effective monitoring of treatable diseases. Mr. Zar further explains, "the vision of the new system is to train people in remote areas of the developing world on the basics of gathering data with the phones and sending it to a centralized unit many miles, or half a world away where specialists can analyze the image and make a diagnosis." (Photo courtesy of David Kilper/WUSTL)
This type of technology is often cost-prohibitive to become utilized in the developing world. "A typical, portable ultrasound device may cost as much as $30,000. Some of these USB-based probes sell for less than $2,000 with the goal of a price tag as low as $500." Should the price-point drop to a level that gives accessibility to hospitals and medical clinics in the developing world, can you imagine the impact of empowering a caregiver to perform a one-minute scan, transfer the data captured to a clinic anywhere in the world, and quickly receive the results?
April 21, 2009
Earth Day 2009
Many people are aware of how to take corrective action to diminish their impact on the environment, but all of us can benefit from the following suggestions provided by Earthday.gov:
- As a result of the mortgage crisis and tight credit markets, many people are opting to remodel their homes rather than purchase a new one. When purchasing appliances, use the ENERGY STAR program to find energy efficient products for your home. The right choices can save families about 30 percent ($700 a year) while reducing our emissions of greenhouse gases. In addition, purchase high-efficient plumbing fixtures and appliances;
- Turn off appliances and lights when you leave the room. This may seem obvious, but too many of us (myself included) leave on the lights after leaving a room;
- Replace incandescent light bulbs with ENERGY STAR qualified Compact Fluorescent Light bulbs (CFL), which will save about $30 over its lifetime and pay for itself in about six months. CFLs use 75 percent less energy and lasts about 10 times longer than an incandescent bulb. As a result of popularity of CFLs, many cheaper, but inefficient bulbs have found their way onto the shelves of our local stores. These "knock-offs" have a short lifespan and may carry higher amounts of mercury. Therefore, it is very important to replace your light bulbs with an ENERGY STAR qualified CFL and please remember to properly recycle your old CFLs;
- Practice the three R's (reduce/reuse/recycle): first reduce how much you use, then reuse what you can, and then recycle the rest. Then, dispose of what's left in the most environmentally friendly way;
- Recycle Electronics (eCycling): According to the Consumer Electronics Association's (CEA) April 2008 Market Research Report: Trends in CE Reuse, Recycle and Removal, Americans own approximately 24 electronic products per household;
- Look for the WaterSense label to identify water-efficient products and programs. The WaterSense label indicates that these products and programs meet water-efficiency and performance criteria. WaterSense labeled products will perform well, help save money, and encourage innovation in manufacturing;
- Sweep outside instead of using a hose. I am amazed by the number of street-level retail and restaurant businesses I see washing rather than sweeping their sidewalks;
- Start a carpool, walk, bike, or use mass transportation instead of driving. Better still, telecommute. According to CommuterChoice.com, 23.6 million employees work part-time from home during the workweek; and
- In an office, purchase recycled content, remanufactured, and recyclable office products instead of disposable supplies, and recycle them when appropriate. At a minimum, buy recycled paper and recycle it again. Setup an area to store and exchange reusable office supplies such as binders and folders. Visit the EPA for Businesses and Non-Profits website for additional information.
Earth Day Network (EDN), a Washington, D.C.-based nonprofit organization whose "mission is to broaden and diversify the environmental movement worldwide, and to mobilize it as the most effective vehicle for promoting a healthy, sustainable environment," provides a wide selection of interesting and relevant content on its website at http://www.earthday.net. Be sure to visit EDN's Earth Day In A Box and Earth Day TV.
Earth Day is an annual event for people around the world to understand and appreciate our natural resources, and to renew our commitment to building a safer, healthier and cleaner world for all of us. There are many ways you can get involved including changing a habit, volunteering, attending a festival, or lobbying your elected officials on environmental legislation. Please feel free to share how you will make a difference.
April 18, 2009
(Another) New Day for Haïti?
One of Haïti's greatest challenges is the lack of a comprehensive development plan that encompasses essential components such as education, health care, private sector, capacity building in the public sector, public infrastructure development and maintenance, and protection and restoration of natural resources. Haïti is an example of how a economic recession can send an already impoverished nation into a deep long-term depression and perhaps this new aid package will provide the necessary support to prevent Haïti from becoming a completely failed nation. The challenges are large since 80 percent of the people residing in the Maryland-sized nation live on less the $2.
Perhaps Haïti is embarking on an opportunity to change its downward spiral into a positive trajectory. The IDB said, "The recovery program, donors agreed, could generate as many as 150,000 jobs over the next two years. Delegates welcomed the Haïtian government's plans to capitalize the opportunities opened by the HOPE II Act, a U.S. trade legislation that grants Haïtian exports preferential access to U.S. markets. They also encouraged authorities to work closely with the private sector to improve Haïti's business climate."
Although the IDB's press statement notes that "besides Haïti's traditional partners from the international community, the conference attracted representatives from civil society organizations that either run programs in Haïti or have been strong advocates for the Haïtian people." I am unsure if the private sector was represented at the donor conference, but these conferences shall serve as a reminder that the private sector must take an collaborative role alongside governments, nonprofit organizations, and local citizens to acheive sustainable long-term results in socio-economic development. Donor conferences should also address foreign direct investment facilitation.
However, I am pleased to learn that during United Nations Secretary-General Ban Ki-moon's recent visit to Haïti, "He asked all 'friends of Haiti' to work with the government and the private sector to create jobs and spur economic growth by taking full advantage of openings to international markets" (see "Haiti: Ban challenges donors, investors to create 100,000 jobs").
In addition, according to The Washington Post article, "Impoverished Haiti Slips Further as Remittances Dry Up," United States Secretary of State Hilary Clinton's visit to Haïti on April 16, 2009 included a visit to a garment factory. Secretary Clinton "strolled through a huge factory in Port-au-Prince where rows of young men and women ran jeans and khaki slacks through sewing machines. Clinton noted that the nearly 500 workers earned two to three times the $2-a-day minimum wage."
Lastly, debt relief will provide Haïti with another tool to change course. The IDB notes, "The heads of the International Monetary Fund and the World Bank appraised the conference on Haïti's progress towards reaching the completion point of the Enhanced Initiative for Heavily Indebted Poor Countries, which will enable Haïti to benefit from debt relief. The process may be finished by the end of June, after which the IDB, the IMF and the World Bank stand to provide Haïti with $1 billion in immediate debt relief. IMF Managing Director Dominique Strauss-Kahn said debt cancellation could free up to $40 million a year for poverty-reducing and pro-growth spending in Haïti."
April 13, 2009
Biotechnology-Based Solutions from the Ground Up
PointCare's goal "is to provide this same quality of diagnostic technology to people in developing countries. We do this by implementing new and innovative biotechnology" such as the PointCare NOW (pictured above), a near-patient HIV monitoring solution "designed to optimize precious patient-physician interaction" that "delivers diagnostic results in minutes at the point-of-care, enabling immediate counseling and care by the physician." With this innovation, "physicians are given the appropriate information required for monitoring and/or providing antiretroviral therapy against HIV." PointCare NOW's features include:
- A DualZone platform that measures all essential haematology parameters, and both absolute and lymphocyte percentage CD4 T-cell results;
- Compact, portable ready-to-use unit, designed to serve patients where they are;
- Test results in less than 8 minutes;
- Fully automated from start-up to shutdown;
- Closed-cap sample handling – containment system complies with the highest industrial bio-safety standards;
- Stores up to 8,000 patient records, expandable to 50,000 patient records and 50 control runs with supplied USB memory stick;
- Dramatic reduction in the cost of reagent supply management--unlike traditional CD4 reagents, PointCare's are heat stable to 30°C therefore not in need of cold chain shipping or refrigerated storage; and
- No calibration or complex setup required.
PointCare lists the following benefits of using their innovation:
- Universal access – for the very first time, no matter where they live and from infancy to adulthood, everyone has access to essential hematology and HIV-immune monitoring;
- Fewer visits – instead of visiting the clinic to be tested, and then returning another day for their results, patients only need to visit once for rapid one-stop testing and diagnostic results, and immediate counseling and treatment;
- Portable – to reach more HIV patients you can set up the PointCare NOW at a different locations on a daily or weekly basis so it is always where it’s needed;
- Easy to use – almost anyone can operate this innovative, fully automated solution with minimal training;
- Improved operator safety – this fully closed, automated system with closed-cap sampling offers significant bio-safety features over other available hematology systems; and
- Cuts hidden costs – heat-stable, long shelf-life reagents eliminate the considerable hidden costs of refrigerated shipping and cold storage, and enable bulk ordering.
The BBC News posted an article on April 12, 2009 about the value of PointCare's innovation by delivering HIV monitoring to the patient (see "Mobile technology battles HIV"). PointCare donated its equipment to a medical clinic in Bwindi, Uganda, which "has been able to monitor the health of patients with HIV from a clinic that fits into the back of their four-wheel-drive 'community ambulance.'" Enhancing the clinic's mobility is essential considering the transportation infrastructure is very limited and many patients live a day's walk from the hospital. Bwindi Community Hospital now provides health care for about 40,000 people including 1,000 HIV positive patients. (Photo of Bwindi Community Hospital staff with the traditional birth attendants and healers courtesy of BBC News)
The BBC News article quotes a physician with the Bwindi Community Hospital, "'Now our death rates from HIV are very low. We're able to diagnose it early, manage it early and keep people living with HIV fit and well. Over a reasonably short period of time, we've been able to change HIV from being a death sentence into something that people can live with and lead productive lives.'"
April 12, 2009
Economic Recession Brings Back Oldest Business Method
Why Dibits rather than Dollars? According to Dibspace, which does not charge a registration or transaction, "Because we're all about helping you fill up your workday even when cash is in short supply. Though Dibits aren't cash, the pricing is the same. So if you normally charge $100, you'd charge 100 Dibits on the site." Dibspace allows you to fill in available time with three options: Appointment, Date Range and Available Now. As Ms. James explains, "Small businesses suffer from wasted time -- time when a client is not booked, or a customer cancels at the last minute."
A business submits invoices through Dibspace just like a financial transaction. And what happens if a customer does not pay? After confirming that an invoice was sent and at least three days has elapsed, the provider can file a dispute claim where Dibspace will pay the bill for them and close the transaction.
Who can benefit the most from Dibspace? "Though any business could benefit from Dibspace, it's ideal for businesses whose product is time-dependent. This includes businesses like massage therapists, attorneys, live theaters, yoga studios, spas, local inns, CSAs, consultants, graphic designers, tool rentals..."
Unfortunately, free does not always mean free thanks to the Internal Revenue Service. Ms. James' article explains that even the Internal Revenue Service gets its piece of the pay for cashless transactions. "The IRS considers Dibspace a barter exchange, and mandates that it issue tax forms to clients and to the IRS."
I have yet to try Dibspace, but for those of you who have or using a similar service, I invite you to share your experiences.
April 9, 2009
Supporting Innovative Solutions on Climate Adaptation
The grant competition on climate adaptation focuses on three sub-themes:
- Resilience of Indigenous Peoples Communities to Climate Risks--promote Indigenous Peoples communities' and organizations' development of innovative ways to conserve agriculture, land, water and soil management practices; apply innovative adaptation plans and communication strategies based on Indigenous systems to accelerate learning and knowledge sharing on climate change adaptation;
- Climate Risk Management with Multiple Benefits--empower poor communities to test innovative, low-cost strategies to spread climate risk and forge innovative partnerships that increase vulnerable communities' access to climate risk management knowledge, information, and services that produces multiple social and environmental benefits; use innovative means to help educate communities on climate risks that leads to empowerment for action.; and
- Climate Adaptation and Disaster Risk Management--develop innovative arrangements that diffuse climate-related disaster risks faced by the poor and vulnerable; create innovative low-cost approaches for spatial planning for climate resilience and for construction of housing and local infrastructure resistant to climate-related disasters; improve the capacity of local communities to access and use multi-hazard risk information to enhance their early warning systems and other community-based responses to climatic extremes and climate change.
April 7, 2009
The True Price of Bottled Water
"From 1976 to 2007, the average amount of bottled water drunk per person per year in the United States jumped from about 6 liters (1.6 gallons) to 116 liters (30.6 gallons). In 2007, the last year for which numbers are available, Americans purchased more than 33 billion liters of bottled water. Globally, the number was 200 billion liters. Even just since 2001, bottled water sales have increased by 70 percent in the U.S. [Americans] now buy more bottled water than either milk or beer."
To better understand the environmental impact of bottled water, Peter Gleick, president of Oakland, California-based Pacific Institute and Heather Cooley, a Senior Research Associate with the Pacific Institute's Water Program, conducted three case studies: water that was bottled and used in Los Angeles; water bottled in the South Pacific and sent by cargo ship to L.A.; and water bottled in France and shipped in various ways to L.A. Each scenario looked at the energy requirements in collecting, treating, bottling, labeling, packaging, cooling, and transporting the liquid.
Ms. Sohn explains, "For water that is consumed near its source, producing PET [polyethylene terephthalate] plastic bottles is the most energy-intensive step, according to their results, which appeared in the journal Environmental Research Letters (see "Energy implications of bottled water"). For bottles that make longer trips, transportation has the biggest impact. In other words, buying water that was bottled near your home rather than in places like Fiji can help reduce your carbon footprint. Better yet, Gleick said, put away your wallet and turn on the faucet instead. 'We have very good tap water in this country,' he said. 'It's cheap. It's readily available. And it's much lower in energy use.'"
The findings of Mr. Gleick and Ms. Cooley's report have merit. In fact, the negative impact of bottled water caused Seattle's Mayor Greg Nickels to sign an Executive Order effective January 1, 2009 to eliminate city's purchasing of bottled water (see "Mayor to End Purchase of Bottled Water at City Hall"). Mayor Nickel's Executive Order not only highlights the environmental impact that "in 2006 it is estimated that producing the bottles for American consumption required the equivalent of more than 17 million barrels of oil, not including the energy for transportation, requiring 3 liters of water to produce each single liter of bottled water, and producing more than 2.5 million tons of carbon dioxide," but the financial impact as well, "the average price for bottled water is approximately $1 per pint (16 oz.) bottle or $8 per gallon and the average price for Seattle water is only 1/3 of 1 cent a gallon."
In the United States and other industrialized nations, we have the option (or luxury) to consume clean tap water. However, a report was released in 2008 that highlighted the amount of pharmaceutical toxins found in U.S. tap water and there remains a great amount of misinformation regarding the health implications of America's tap water. While industrialized nations have access to clean tap water, the same cannot be said about people living in developing nations.
There is a need for drastic improvement of public sanitation including accessibility to clean water. In addition to the costs and environmental impact caused by bottled watter, plastic containers are a significant source of litter in many developing nations. Moreover, as a result of the lack of recycling facilities, most plastic water bottles end up in garbage dumps, which are then burned causing the release of toxins into the air. I have visited numerous cities and villages in the developing world where the air is polluted as a result of garbage burning.
With Congress' stimulus package, there should be a concentrated effort to modernize or maintain America's access to clean water. From the billions of dollars recently committed to supporting developing nations, I hope to see a concentrated effort to build capacity in public infrastructure that includes recycling centers and increased access to clean water.
April 2, 2009
Will Increased Financial Support Lead to Better Accountability?
I am not questioning the actions the world's industrialized nations to increase financial support to developing nations, but will an increase of financial support lead to better accountability of spending? Does sending more money help alleviate the problem of corruption that plagues many developing nations? What measurable and definable results should G-20 nations expect? As the world economies have become globalized, the need to help the world's poorest population takes on a different precedence. I realize there is a global economic crisis that requires quick and decisive action, but each spending package should require built-in accountability measures.
Part of this money, as explained in The New York Times, will support the International Monetary Fund, "which has emerged as a 'first responder' in this global crisis, making emergency loans to dozens of countries." The G-20's pledge triples "the resources of the Fund to $750 billion — through a mix of $500 billion in loans from countries, and a one-time issuance of $250 billion in Special Drawing Rights, the synthetic currency of the Fund, which will be parceled out to all its 185 members."
A recent World Bank article said "that economic growth in developing countries would slow sharply to 2.1 percent in 2009, a more than three percentage point decline from last year. Growth would actually decline in Central and Eastern Europe, Central Asia, and Latin America and the Caribbean. An estimated 53 million more people would be trapped in poverty this year, subsisting on less than $1.25 a day, because of the crisis. The world economy would contract by 1.7 percent this year compared to growth of 1.9 percent in 2008 – the first global decline since World War II. Global trade in goods and services would fall six percent this year, the largest decline in 80 years."
The New York Times article mentioned above addresses how some countries are seeking tightened regulations of hedge funds and other global financial institutions including those located in tax havens such as Liechtenstein and Switzerland. Tighter regulations, however, is only part of the solution and the world’s industrialized nations should expect increased transparency and accountability in how the funds are appropriated.