What is the most sensible—i.e., the least costly and most effective—process by which to:

Patient health data are stored in disparate silos—separate islands of information residing in often incompatible EMR/EHR and PHR databases controlled by different hospitals, clinics and public health agencies, as well different group and solo practices. The question is: What is the best way for this personal health information to be shared securely between the people who need it to provide quality care to individual patients, protect populations, and perform research leading to valid evidence-based guidelines?

I recently received an anti-Obama e-mail with a link to a video that blamed the President for our country's current and future problems. This faulty/irrational way of thinking is a gross distortion of reality because no individual is responsible for our problems, not Obama, not Bush…no one!

Instead, our problems are systemic. They stem from a malfunctioning political-economic system and a misdirected culture. At its very core, our society is built on a foundation of beliefs and values that promotes much of the negative side of human nature.

I just started a Linkein group--Crafting the Future of Health IT with Novel Solutions--located at http://www.linkedin.com/groups?home=&gid=2697006&trk=anet_ug_hm&goback=%2Eanh_2697006. You are welcomed to join!

Here are four interlocking issues that must be addressed if we Americans are ever to fix healthcare:

1. Meaningful use of health IT vs. Minimally acceptable usefulness. I contend that health IT is used "meaningfully" only if it helps increase the effectiveness and efficiency of care (i.e., increases care value to the consumer).

At this link, an article titled "New technology a 'push' toward EHR future" discusses how "…push messaging, a likely first step in rolling out a proposed national health information network in time for healthcare organizations to use electronic health-record systems in a 'meaningful manner' and qualify for federal EHR subsidy payments under the American Recovery and Reinvestment Act of 2009." The article discusses how:

David Blumenthal, head of

I continue to focus on health IT issues since they are crucial in bringing high value care to the consumer. I've added the following new posts to my blog, one is about improving care through use of software that promotes best practices and the other is about different the benefits and risks of three data exchange architectures.

It's becoming increasingly clear that while a monolithic centralized network is useful for sharing patient data within a large healthcare organization, it not a suitable architecture for interconnecting everyone in the nation (and world), including all patients/consumers, healthcare practitioners/clinicians, researchers, clinics and hospitals, labs, pharmacies, regional and state health information exchanges, and others. Why?

At this link, I present a novel, economical software system that I've been developing for two decades. It uses Microsoft Office and e-mail to exchange comprehensive patient data between authorized parties, and does it conveniently, securely and at very low cost. This peer-to-peer (node-to-node) desktop-based system is much less complicated and costly than today's centralized systems and works with any other software programs.

I'm debating a cloud-computing expert about the use of the cloud for health IT. The debate focuses on issues of cost, security, complexity.

He started the discussion with this comment: