Archive for March, 2009

Chivers Me Timbers

Friday, March 27th, 2009

EARLY THIS MORNING, Moscow-based New York Times correspondent C.J. Chivers was detained by the South Ossetian KGB as he tried to cross into Mogabruni, an Ossetian village on the border with Georgia, which claims its territory.

Told that he did not have the proper accreditation in South Ossetia, now technically an independent nation, Chivers was sent back to Georgia whence he came.

At least that’s what’s being reported in Russia.

“In truth, the whole thing amounted to nothing,” said Moscow bureau chief Clifford J. Levy in an email.

Chivers, it turns out, was not detained at all. He and his fixer, who had a Georgian passport, were stopped at a Russian-Ossetian checkpoint. They had been headed to nearby Akhalgori/Leningor to visit a local resident who had invited them over. The Ossetian guards called the resident, who confirmed the invitation, but Chivers and his fixer, Olesya Vartanyan, were told they had to wait: The supervisor, apparently, was in the shower.

Chivers waited for two hours, during which time he and Vartanyan were treated with utmost hospitality. “During this time, the men at the checkpoint gave us pears to eat, and offered seeds, and chatted amiably with us about a range of subjects,” Chivers wrote in a late-night email from Georgia. “Our passports/documents were returned to us midway through this time,” he added, “We never were told, and we never had the impression, that we were detained or under any sort of restriction or arrest.” His request to enter South Ossetia was denied this time around, and Chivers was told that, next time, he would have to enter South Ossetia through Vladikavkaz, a ridiculous and roundabout request since the village was visible from the checkpoint. Vladikavkaz is 30 miles away.

Contrary to alarmist reports in the Russian press, courtesy abounded. The Russians and Ossetians gave the two Times journalists a lift back to the Georgian checkpoint, but not before inviting Chivers on a trip to the countryside, “or perhaps for some trout fishing in the mountains.”

Within the hour, Chivers and Vartanyan were receiving frantic phone calls checking in on their welfare. A standard bureaucratic encounter had made it into the echo chamber, where it had morphed accordingly.

“I am quite surprised that this is a story, because it was numbingly normal interaction with a border checkpoint, and nothing else,” says Chivers. “The men at the checkpoint were rule- and security-conscious, but they also exhibited the hospitality and politeness I have long experienced on many trips to many places on both sides of the Caucasus.”

Tech Rx for Health Care

Monday, March 16th, 2009

Tucked deep in the stimulus bill passed in February is a $19 billion bundle of grants and incentives designed to wake up America’s technologically sleepy health-care industry. The hope is that hospitals will swap paper records for digital files, enabling doctors and nurses to easily update records, share health information with others in the industry, and even diagnose diseases remotely—while saving the system billions.

It all sounds great: I Imagine your doctor using her smartphone to call up your records or checking on your recovery via Twitter. The economy would benefit too, as big companies like IBM and HP deploy employees to help hospitals go high tech.

It won’t be an easy upgrade, though. The system is made up of tens of thousands of doctors’ practices, hospital chains, and insurers, all of which operate on different software platforms that don’t talk to one another—if computers are used at all. Older physicians are often cool to the idea of ditching their charts and prescription pads; getting them onboard will take time and training.

Despite the challenges, some hospitals are starting to go paperless. Caritas Christi Health Care, a nonprofit Catholic medical organization overseen by the Boston Archdiocese, last year launched a $70 million, four-year tech face-lift. What started out as a cost-cutting measure—the struggling six-hospital chain has amassed more than $270 million in debt—has turned into a grand experiment in modernizing health care. Caritas CEO Ralph de la Torre aims to completely digitize the hospital, using a centralized computer system to store patient records and track and manage admissions. “It’s going to be one collective brain that encompasses all a patient’s needs,” says de la Torre, a surgeon who was hired last year to run Caritas.

De la Torre in turn hired Todd Rothenhaus, a computer scientist and practicing ER physician, and John Morey, who helped create Microsoft Outlook. Using developers and off-the-shelf medical software from specialty firms such as eClinicalWorks, Rothenhaus and Morey have helped create a system called PatientKeeper that allows hospital employees and doctors to access records from any of the hospital’s facilities via computers or smartphones. (Twenty doctors in a pilot group are already using PatientKeeper. Early feedback is positive, Morey says.) Each patient, identified by a number to protect his privacy, will be traceable across all specialists, procedures, tests, and medications.

This unified system will help the hospital manage a patient’s stay, and it should prove to be a statistical gold mine: Caritas can analyze the records for trends that can help administrators figure out what kinds of drugs and vaccines to have on hand (say, in a flu outbreak), pinpoint safety issues (why is there a spike in falls in this unit?), and even make staffing decisions, based on patient traffic.

Medical economist Jeffrey C. Bauer of ACS Healthcare Solutions says too few hospitals are embracing tech the way Caritas is. He estimates that most hospitals spend only 2% of their budgets on information technology on average, but probably need to spend “double to triple” that amount to make their operations more efficient.

If de la Torre succeeds in computerizing Caritas, he’ll probably improve profits and patient care alike: When a patient calls for an appointment, for example, the admissions staff could use the online system to find a physician with an immediate opening who accepts the patient’s insurance. Getting patients help right away makes their conditions easier—and less expensive—to treat.