Sindya N. Bhanoo

David Blumenthal: Uncle Sam's EHR man

Last month, President Obama picked Harvard Medical School professor David Blumenthal as his national coordinator of health information technology.

Blumenthal will facilitate transitioning the nation to electronic health records over the next couple years. He has long been a supporter of electronic health records, but wrote in a paper that he recently published in the New England Journal of Medicine that EHR will face "huge challenges."

Why? It's laborious to make the change, many doctors and hospitals have been less than welcoming, and there are many privacy concerns.

A recent New England Journal of Medicine study found that fewer than 1.5% of hospitals have EHR implemented in all their clinical units. In addition, the Healthcare Information and Management Systems Society rates hospitals based on how advanced their health IT is, on a scale of 0 to 7. Only 15 hospitals - all in the Kaiser Permanente system and NorthShore University Health System - received a 7 for their sophisticated electronic medical record systems.

Blumenthal has a lot to tackle, but he has been interested in EHR for a while. In 2006, he published a study that found only about 5% of hospitals nationwide had implemented EHR.

"We are pitifully behind where we should be. We must find ways to get more physicians to embrace this technology if we are to make major strides in improving health care quality," Blumenthal said in an interview several years ago. 

He assumed his new role this week.

Inaccuracies of the BMI - bad news for Indians

My latest piece for The Post is about BMI - Body Mass Index - the metric that is commonly used to estimate whether our percent body fat is in the appropriate range.

A new study in the British Journal of Nutrition claims that since the BMI formula is based on data from Caucasians, it may not be an accurate representation for other national origin groups.

From the article:

"This scale was created years ago and is based on Caucasian men and women," said Molly Bray, one of the study's researchers and an associate professor of pediatrics at Baylor College of Medicine in Houston. "It doesn't take into account differences in body composition between genders, race/ethnicity groups and across the life span."

Bray and her colleagues are using another method, a low-dose X-ray called DXA, to estimate bone density, lean mass and fat mass.

Based on the DXA reading, the researchers found that an African American woman, for example, may not be overweight or obese even though the BMI formula, which considers a person's height and weight, indicates that she is.

"Right now non-Hispanic white women are not considered obese until they have a BMI of 30 or above," said Bray. "For African American women the number to cross is around 32." Women in some other racial and ethnic groups were considered obese even if their BMI number was below 30.

What was left out is that the numbers were most skewed for Asian Indians. Our body fat might be 6% higher than what a current BMI measurement estimates.

We definitely need to see more research on this, but meanwhile I'm wondering if I should be going on a diet.

Comcast Twitters

We'd been having trouble with our Internet lately, so I've been on the phone with Comcast. I also noticed that there's a lot of Twitter activity about Comcast.

That led to short piece for The Industry Standard about Comcast's twittering customer service representatives. The reps use Twitter to reach out help customers with problems who are tweeting their woes, which is great. The problem is that the there's a bit of a communication gap between the twittering reps and the regular reps.

For The Standard, I've also been writing quite a bit about information technology in health, an area that will see a lot of development in the next few years. President Obama has allocated about $19 billion to help digitize electronic health records, and doctors will be getting some attractive incentives to help them make the switch to EHR.

At the moment, I have two upcoming pieces. One is about how BMI (body mass index) may not really be all that accurate for Non-Caucasians. That's good news for some ethnic groups, but very bad news for Asian Indians. I'll post my story tomorrow.

My other upcoming piece is about the struggles new grads are facing as they finish school this year -- it's a tough job market!

I'm also putting together a pilot podcast about emerging technologies for the developing world...an experiment, so we'll see how it goes.