Suffering and Dying for Healthcare in Las Vegas

By Donna Smith–

Happy Easter everyone. Happy season of new life and blooming flowers. It�s the season of rebirth and regeneration. So, if that�s the case, then what the hell is up with letting thousands of people wait and suffer and die because we do not have the money to treat their illnesses anymore? In Las Vegas. It�s Vegas, baby. But it could be Sioux City or Boston or even Missoula. It is the reality of our national healthcare disgrace in America.

If you watched CBS�s �60 Minutes� on Sunday, April 4, then you saw the same horrifying story I did. Budget cuts had to be made at the county hospital in the recession, the hospital CEO said. Outpatient chemotherapy clinic is closed. Letters go out to the patients. Treatment ends. People suffer with growing tumors, broken bones from metastasized cancers; people suffer to breathe. The budget is cut. It�s horrifying stuff this national disgrace. (If you didn�t see it, you can watch it here.)

Want a chocolate Easter egg? How about some jelly beans in a basket?

Meanwhile, a young mom and cancer patient in Las Vegas goes untreated� she worked and had insurance until she got too sick. Then, well, you know the drill by now. She�s dying. She�s suffering. She even had her hospital bed repossessed. She�s one of us. She is me. She is you. She is your child. And she is just one of thousands who got the letters telling them their treatments were ending. Done. No more care.

And now there is no bail-out for her or for any of us if we�re in her shoes. Where�s her bail-out? No one is even talking that way or thinking that way. Healthcare reform is on their radar, they say. We�ll get it done this year, they proudly exclaim. Meanwhile, this woman suffers. Another person dies. What is there to be proud of?

Could this Congress act now on our behalf, please? There is a war against humanity going on in these United States. My Congress and my President are to be keeping me safe and secure in my home. But so long as they know of these lethal abuses within the healthcare system, they are not honoring their commitments to me. Or to you.

This isn�t Iraq or Afghanistan. It�s Las Vegas.

We could see swift action, if we had lawmakers who saw this as an attack on our citizens. For instance, there could be a moratorium on any patient having cancer treatment discontinued due to budget cuts or insurance company bottom lines. Clean and clear. No more letters cutting off treatment. While they dance their political dances on the long-term policy, could they please act as if we�re under attack? Because we are. People are being put to death through budget cuts and profit-margins, and many are getting less care than is guaranteed a prisoner under our set of laws protecting those who are incarcerated.

Yet we sit in calm meetings in Washington, DC, — and we argue about who sits in the White House forums and who does not — and in other venues around the nation trying to decide if the political impact of health reform plans will harm re-election chances for our favorite elected friends or make the insurance or big corporate hospital interests upset with our lawmakers. Blah, blah, blah� while another dozen or score or more die. Cancer doesn�t wait for anyone to decide who is in and who is out.

Happy Easter. The season celebrating the risen prince of peace isn�t so damn peaceful for people on the wrong side of the recession. Especially people with cancer.

I just want that young woman and the thousands of others in her same inexcusable situation in these United States to know we�re fighting for what is just� healthcare is indeed a human right. Health insurance will not get us there � it can be lost, it can be changed, it can be inadequate, it can be denied and it can be dishonored.

But healthcare is a human right. It is not a political football. I pray we have the strength to do what is right and just, publicly funded and privately delivered healthcare � and do it now � because doing less would not be what we are all about as people. We are better than this.

During Easter and every season, we are better people than this. I know we are because we still have the ability to be horrified when a young mother in Las Vegas suffers needlessly. I hope she takes her place in heaven knowing we cared. Happy Easter, Yolanda Coleman. May God somehow make your pain a little less severe today. I am sorry you have hurt so badly during this time. You deserved better.

Donna Smith is a community organizer for the California Nurses Association and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.

Maine's HIE goes to Dell's cloud for image-sharing

PORTLAND, ME – A picture is worth a thousand words, the old saying goes. Today, HealthInfoNet, Maine's statewide health information exchange, is launching a pilot that will put both images and words at the fingertips of healthcare providers – the better to make the right decisions for their patients.

Working with Dell, HealthInfoNet will create what its officials say is the nation’s first statewide medical image archive.

[See also: Maine HIE to match outcomes with cost]

"This is totally a cloud-based offering, which will be a subscription model, where we will charge on a per-study basis to put the studies in the archive, and have the ability to pass forward those images to anywhere they are needed – have the ability to provide business continuity and even disaster recovery if needed," explains Jerry Edson, former CIO at Maine Medical Center and now a HealthInfoNet consultant.

HealthInfoNet already provides image reports, but with the new archiving system it will be able to offer up the images themselves. It’s "something providers have asked for and told us will better support their treatment decision-making," says Todd Rogow, director of information technology at HealthInfoNet.

The pilot will last through the summer, "to be sure you know that everybody can touch it, feel it. They can be confident that it’s working the way that it needs to work," says Edson. "In the fall, we will move from the initial participants of the pilot to the statewide rollout."

[See also: Maine receives grant to connect behavioral healthcare to HIE]

In addition to leveraging the HIE, the service prepares Maine’s providers for sharing images through the NwHIN Direct and Connect systems, Rogow notes. It also supports the development of accountable care organizations and other shared-risk models.

"As the concept of ACO starts to come into place," says Rogow, "a service like this fits very well and is very needed."
 
An estimated 1.8 million medical images (X-rays, mammograms, CT scans, MRIs etc.) are generated in Maine each year, totaling more than 45 terabytes of data. The organizations participating in the pilot generate 1.4 million of those images.

Today, the images are stored in a number of electronic archives at separate locations and mostly shared between non-affiliated providers by copying the images to CDs.

By consolidating the images into a single archive, HealthInfoNet estimates that Maine’s providers stand to save $6 million over seven years through reduced storage and transport costs.

"When a patient has an X-ray or MRI at a facility outside our system, it can take days for their doctor at Maine Medical Center, for example, to get a copy of that image," says Barry Blumenfeld, MD, CIO at MaineHealth. "This new service will save time for our providers and their patients. With instant access to a patient’s images, medical staff can treat them much faster and the patient won’t have to take the time to pick up and deliver CDs."
 
Officials note there are several additional benefits of having images stored in one place. First, easier access to past image studies should lead to fewer repeat tests, meaning less cost and less radiation exposure for patients. Also, HealthInfoNet will be able to link each image with a single patient identifier through its HIE Master Person Index, making it easier for providers to search for all of a patient's prior images when needed to track changes over time. For example, a radiologist wants to see all of a woman’s past mammograms, not just her most recent, to better detect changes in her breast tissue.
 
To build and operate the new cloud-based archive, HealthInfoNet selected Dell through a rigorous RFP process that involved vetting by both Maine clinicians and health information technology professionals. Dell manages one of the world’s largest cloud-based clinical archives through its Unified Clinical Archive solution, with more than 71 million clinical studies, nearly 5 billion diagnostic imaging objects and supporting more than 800 clinical sites.
 
HealthInfoNet, Dell and the pilot group of Maine healthcare organizations will work together over the summer to confirm the system design and integrate the service with existing PACS systems and the HIE. HealthInfoNet expects to end the pilot phase in the fall and expand the service statewide by 2013.

Besides making records readily accessible, says Jim Champagne, executive director, Dell Healthcare Services, Dell executives are proud that they were able to build a model that is self-sustainable financially.

"You don’t have to go out for a bunch of grants in order for that to be self-sustaining," he says. "We’re offering here to the providers not only the tools to exchange, but also a cost-effective archive and cost-effective disaster recovery solution around it that makes sense financially from cost of ownership.”

Dell has operates two data centers and one on the West Coast, where data is stored and managed.

Champagne says Dell has more than 10,000 interfaces to connect with the PACS in the marketplace today.  Dell has worked with small regional facilities and IDNs that share information across multiple collaborative hospitals, "but nothing at the level that we’re seeing in this partnership across the entire state," says Champagne.

[See also: Maine practice celebrates its meaningful use status]