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Subject: Re: [ihc] States Seek Emergency Medical Compacts
Rex, This coincidently is definately a focus of the EPRforum.org work we are doing. Providing the means for the domain workers to custom their interactions so that they deliver what they need in realtime for front-office eService applications. Mobile devices and voice enabled interfaces are also part of that mix. Its a challenge but you don;t get there until you start somewhere. I've heard that once already today! Cheers, DW. ================================= Rex Brooks wrote: > Thanks, David, > > I'm inside a case of tunnel vision lately. It's good to know we are > more or less on the same page wrt wider access for information and > cross connecting the most cogent and current information to necessary > recipients when it is most useful. I think what I am seeing are the > briefest snapshots of the elephant passing by the knothole in the > fence, and this seems more frequent lately. I say seems because I'm > just more busy than usual, and when things ease up a bit, I imagine my > focus and perspective will both improve. > > Ciao, > Rex > > At 11:10 AM -0400 9/14/04, David RR Webber wrote: > >> Rex, >> >> No - I was following you and your thread OKand concur with the >> notions. And certainly if you were on holiday - and you could >> video-conference in your home doctor in >> event of an emergency, you would definately want that. Not too >> mention the reverse when you return home, or your doctor being able >> to video-conference in a specialist and so on. >> We'd been looking at this over in EPRforum - from the point of view >> of records sharing - and digital bag management too. >> >> I just took a tangent completely - thinking about the whole notion of >> remote support - and having watched Robin Williams in the old movie >> my wife rented a few nights back! >> Some controls are in there for a reason it seems! But then in a >> moment of crisis and urgent need - any help maybe better than none - >> and some boundaries may not be as >> important.. >> >> Of course we take for granted now things like WebEx and Remote PC >> access tools - so who am I to cast the first stone, eh? ; -) >> >> The lesson is that technology changes and redefines what is needed >> and can be achieved - and challenges us to create the means >> to use it sensibly and reliably. >> >> Cheers, DW >> ===================== >> Rex Brooks wrote: >> >>> I'm a little slow on the uptake this morning, David, >>> >>> So, please excuse my lack of understanding. All I was responding to >>> was the informational context of there being such programs in >>> existence right now of which I was previously unaware. My motivation >>> was to extend that awareness, not recommend either the programs or >>> their approaches to the problem space of inadequate communication >>> between and amongst the various levels of government responsible for >>> healthcare information. >>> >>> When I said that this fits right into my work, I was referring to >>> that context, again not making any recommendation but nevertheless >>> needing to take into account that such programs may, in fact, >>> pre-empt the establishment of more generalized communication >>> channels being opened. While this article does not go beyond the >>> issues of statewide jurisdictions and does not specify how such >>> "telemedicine" actually works, I would probably recommend web >>> services with a more complete security context than, say a regional >>> coalition of states determined to make their own systems better and >>> perhaps demonstrate that a "national (or in the ihc context, >>> international) health highway system" is possible. >>> >>> Regardless, I am not quite sure what the purpose of your comment is? >>> If I am failing to see something, I would appreciate having my >>> attention drawn directly to that oversight, if you don't mind. >>> >>> Ciao, >>> Rex >>> >>> At 9:50 AM -0400 9/14/04, David RR Webber wrote: >>> >>>> I'm just wondering what you do - if as you are lying on the >>>> oerating table - peering into the video camera, you >>>> see Robin Williams in a mask and gown smiling down at you from the >>>> monitor....? >>>> >>>> DW >>>> >>>> Rex Brooks wrote: >>>> >>>>> Thanks, Ed, >>>>> >>>>> This fits right into the work I am doing building a portal to >>>>> demonstrate CAP and WSRP at XML 2004. I forwarded this to the >>>>> Emergency Management TC and the Medical Working Group of the Web3D >>>>> Consortium. >>>>> >>>>> Ciao, >>>>> Rex >>>>> >>>>> At 1:34 PM -0500 9/13/04, Ed Dodds wrote: >>>>> >>>>>> /States develop technology to share medical expertise/ >>>>>> By Kathleen Murphy - September 2004 >>>>> >>>>> >>>>> >>>>>> Arizona doctors can provide medical services to patients more >>>>>> than 2,600 miles away in Panama through a state-funded program >>>>>> that uses videoconferencing and digital technology. But >>>>>> consultations for patients in neighboring states are rarely allowed. >>>>>> >>>>>> "We can consult in Panama, but not Utah," said Sandy Beinar, >>>>>> associate director of the Arizona Telemedicine Program >>>>>> <http://www.telemedicine.arizona.edu/>. Most states prohibit >>>>>> out-of-state physicians from practicing unless licensed in the >>>>>> patient's state, even in an emergency. >>>>>> >>>>>> If there were a bioterrorist event such as a smallpox outbreak or >>>>>> anthrax attack, states could legally share fire trucks and >>>>>> helicopters but not medical expertise. But in a world reshaped by >>>>>> the 2001 terrorist attacks, states are beginning to change that >>>>>> and, for the first time, consider interstate compacts that lay >>>>>> the groundwork for medical professionals to cross state borders. >>>>>> >>>>>> In both the Midwest and the South, regional alliances are being >>>>>> forged to develop agreements and the technological know-how to >>>>>> share medical expertise in emergencies. >>>>>> >>>>>> Ten Midwestern states, led by Nebraska Gov. Mike Johanns (R), are >>>>>> making arrangements to share medical personnel and communications >>>>>> capabilities. The alliance would include Iowa, Kansas, Missouri, >>>>>> Montana, North Dakota, South Dakota, Wyoming, Colorado and Utah. >>>>>> >>>>>> Separately, 16 governors working through the Southern Governors' >>>>>> Association <http://www.southerngovernors.org/> (SGA) have been >>>>>> trying since shortly after the airplane and anthrax attacks in >>>>>> 2001 to develop an interstate emergency medical response system >>>>>> that project leaders hope is the beginning of a "national health >>>>>> highway system." >>>>>> >>>>>> The SGA project relies on telemedicine, which uses communications >>>>>> and information technology to deliver health-care services over >>>>>> long distances. States such as Texas have used telemedicine to >>>>>> treat inmates, and Alabama is starting to use it for tracking >>>>>> Medicaid patients' blood-pressure readings. >>>>>> >>>>>> Southern governors want to use telemedicine to connect medical >>>>>> expertise to a point of need, for example to allow medical >>>>>> experts to diagnose anthrax or smallpox from afar. >>>>>> >>>>>> Even with today's advances in digital technology, making online >>>>>> medical connections can be difficult. The SGA tested a network >>>>>> this spring to link state health departments, the Centers for >>>>>> Disease Control, and telemedicine programs in Florida, Kentucky, >>>>>> Missouri and Virginia. It took three months to secure network >>>>>> permissions for making an online connection that lasted 15 >>>>>> minutes -- not the type of response time sought by governors >>>>>> during a bioterrorism event. >>>>>> >>>>>> "The demonstration tested the capabilities of the region for an >>>>>> immediate response to such an emergency and found them cumbersome >>>>>> and lacking," an SGA progress report said >>>>>> >>>>>> Coordinating high-bandwidth connections between state computer >>>>>> systems (in a point-to-point T1 connection) proved tricky, said >>>>>> Lee Stevens, SGA's legislative director for health, human >>>>>> services and education. Computer security concerns and reluctance >>>>>> to open "ports," the numeric Internet gateways, required intense >>>>>> negotiation between participants, Stevens said. >>>>>> >>>>>> "The irony is that it would be much easier to practice >>>>>> internationally than across state borders," said Dr. Jay Sanders >>>>>> of the Global Telemedicine Group, an SGA project leader. The >>>>>> demonstration showed states could achieve a connection, but the >>>>>> system would be unusable in an emergency because the >>>>>> communications' quality was lacking, Sanders aid. >>>>>> >>>>>> Sanders has proposed that SGA seek private grant funding to >>>>>> establish the technical protocols on a multi-state basis. He >>>>>> advocated expanding the concept of the Emergency Management >>>>>> Assistance Compact (EMAC), the agreement that routinely enables >>>>>> emergency resource-sharing among states, to include virtual >>>>>> medical response. >>>>>> <http://www.stateline.org/stateline/?pa=story&sa=showStoryInfo&id=147127&columns=false> >>>>>> >>>>> >>>>> >>>>> >>>>>> >>>>>> SGA is expected to consider the issue at its annual meeting set >>>>>> for Sept. 12-14 in Richmond, Va., where Gov. Mark Warner (D) will >>>>>> preside as chairman. Warner has said the telemedicine project >>>>>> "can really make a difference." >>>>>> >>>>>> The Midwestern governors are working out agreements to share lab >>>>>> space and workers, using $200,000 in federal funds granted to >>>>>> Nebraska to fight bioterrorism. The agreement would include the >>>>>> creation of a Mid-America Demonstration Center for Public Health >>>>>> Preparedness at the University of Nebraska Medical Center. >>>>>> >>>>>> Both the Southern and Midwestern interstate medical agreements >>>>>> are expected to tackle issues of liability, licensure and >>>>>> reimbursement. The result will be that interstate medical >>>>>> consultations happening now sporadically -- after special >>>>>> licensing and approvals -- could occur more easily under the >>>>>> agreements, project leaders said. >>>>>> >>>>>> Reprinted with permission from Stateline.org. >>>>>> <http://www.stateline.org/stateline/> >>>>> >>>>> >>>>> >>>>>> *Kathleen Murphy* >>>>> >>>>> >>>>> >>>>>> Ed Dodds >>>>>> dodds@e-dodds.com <mailto:dodds@e-dodds.com> >>>>>> <e-dodds.communications/> <http://www.e-dodds.com/> >>>>>> 615. 429. 8744 cel | tel >>>>>> 508 . 632 . 0370 fax >>>>>> ed1dodds aim >>>>>> 49457096 icq >>>>>> Read <Conmergence/> <http://www.conmergence.com/> >>>>> >>>>> >>>>> >>>>> >>>>> >>>>> >>>>> >>>>> -- >>>>> >>>>> Rex Brooks >>>>> GeoAddress: 1361-A Addison, Berkeley, CA, 94702 USA, Earth >>>>> W3Address: http://www.starbourne.com >>>>> Email: rexb@starbourne.com >>>>> Tel: 510-849-2309 >>>>> Fax: By Request >>>> > >
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