The Flea Flicker: Risks of (anonymous) Medical Blogging

Kevin M.D. has the full roundup from the blogosphere of the unmasking of Flea (cached version) at his malpractice trial. Today's Boston Globe reports more of the details. More details courtesy of New York Personal Injury Law Blog.

I periodically ran across Flea's posts over the last year and was surprised a few months ago when I started to notice his posts discussed his ongoing malpractice case, including discussions with his defense counsel. My initial reaction -- does his defense counsel know about his blogging. The answer was no. At the time, like Eric Turkewitz I concluded that there was a high risk (if uncovered by the plaintiffs attorney) that his blogging publicly would potentially waive attorney client privilege. Eric also provides some great links of previous posts about Flea.

This situation highlights the potential risk faced by medical bloggers and a reason why lawyers need to better understand the blogosphere and the impact of online social networking on themselves and their clients. The fall out from this case will be interesting to watch.

UPDATE (6/4/07): More today from Eric Turkewitz and how plaintiff's counsel uncovered that Flea was Dr. Lindeman in his post, "Deconstructing the Trial - Part 1." A comment to the post raises the most important lessons for physicians or other bloggers who find themselves facing litigation. The comment reads:

This is a great example of why it's important to tell your lawyer about things like this. If Flea's lawyers had gone through all the posts on his blog, they would undoubtedly have prepared him for this question. These kinds of prior statements are neither unusual nor damning - you just have to know how to handle them.

In fact I'll say it again - TELL YOUR LAWYER ABOUT THINGS - whether you are the plaintiff or defendant. Usually its embarrassing or uncomfortable things that clients don't want to tell you and these things can significantly impact the outcome of litigation. It's these hidden facts or facts that weren't explored far enough (or understood) by defense counsel that can come back and bite. I suspect that defense counsel has a new appreciation for blog content.

Deconstructing the Trial of Flea - Part 2 is now also available where Mr. Turkewitz provides some insight into whether or not the existence of Flea's blog was a factor in settlement of the case.

Tip to Kevin M.D. for highlighting today's post by Mr. Turkewitz.

EWeek.com Article: Google and Health Care

Today I noticed a little more traffic to my blog with much of it coming from www.eweek.com. As a result of a little searching I found an article (Google Aims to Extend Data Mantra into Health Care) quoting from one of my previous post (What Google Health Might Look Like).

My previous post on Google Health was a a reaction and response to a post at the Google Blog by Adam Bosworth, Google's VP, asking to hear from others about how you and I as patients know whether we are getting the best care. The post was not just about "concerns over what could be lost in the digitizing of medical information" (as quoted in the article) but rather an overall examination of what Google Health and some of the other Health 2.0 type companies may bring to bear on our traditional health information system and how this may ultimately impact the quality of health care we receive.

HealthDot Interview: Health Care Blogging and Social Media

Earlier this month I attended and spoke on a panel addressing some of the legal implications for health care bloggers at the 2007 Health Care Blogging Summit.

During one of the breaks I had the opportunity with a couple of my health blogging colleagues, Enoch Choi, M.D. who blogs at MedHelp.org and medmusings and and Fard Johnmar of Envision Solutions blogging at Envision 2.0 and Healthcare Vox, to do an impromptu interview with Scribe Media who was capturing video content at the event.

We had some great discussion on the issues resulting from the growing use of blogging and social media by health care professionals and its potential impact on the health care industry.

Fishy FestivALL 2007

As a follow up to my recent post about Charleston being featured in Kiplinger's Best Cities At Every Stage of Your Life it reminds me to mention that FestivALL is on its way (June 21-24).

FestiVALL is just one example of why I think Charleston received a postive ranking in Kiplinger's bohemian factor. Here are posts (here and here) about last year's Charleston's premier arts event. For more background check out What is FestiVALL.

I got excited earlier this week after seeing the production photos of the 2007 FestiVALL Catfish over at friend and fellow blogger, Dale Morton's Costume Blog. (official FestiVALL catfish photo above).

Here is the quick overview of FestiVALL 2007 (For more info on 2007 FestiVALL check out the full schedule of events). Also, to stay up on FestiVALL check out the FestiVALL Blog by Adam Harris hosted via the Gazz Blogs.

This year our kick-off concert features the soulful sounds of The O’Jays at the beautiful Maier Foundation Performance Hall of The Clay Center on Thursday.

Friday night is party time on the river! Fund for the Arts’ Blues, Brews & BBQ will take place outdoors along the banks of the Kanawha at the University of Charleston with The Robert Cray Band and more. Phenomenal Australian guitarist Tommy Emmanuel will be in concert at The West Virginia State University Capitol Center Theater and A Gershwin Gala music and story tribute to the great George Gershwin will be at The Clay Center in a cabaret setting.

Saturday brings one of Charleston’s most popular events, Fund for the Arts’ Wine & All That Jazz, again outdoors on the U. of C. lawn. Smooth jazz sax man Eric Marienthal heads a bill that also includes the finest local and regional jazz artists and the fruits of local vineyards. Also on Saturday, The Capitol Street Art Fair fills two blocks with quality artists and crafts artists. They will be selling and, in some cases, demonstrating their work. On Saturday evening enjoy part one of The WV One Act Play Festival at The Clay Center. This year it will be topped off by a Late Night Cabaret performance. Also on Saturday night, at The WVSU Capitol Center Theater, you can hear the WV brother/sister duo of Tim and Mollie O’Brien in concert. Tim won a Grammy in 2005 for best traditional music recording and you may know Mollie as a long time regular on A Prairie Home Companion.

On Sunday, The Capitol Street Arts Fair returns and The One Act Theater Festival continues. On Sunday night, FestivALL 2007 ends with a very special edition of Charleston’s own internationally popular live music radio program, Mountain Stage.

On Wednesday, June 20, there will be a FestivALL West Virginia Day Celebration on the lawn of the Clay Center. It will feature popular local bands including the reunion of two of Charleston’s most popular 60’s and 70’s rock bands, The Mojos and Quiet. Later that evening, it’s the Gazz FestivALL Preview at Blues BBQ restaurant with more music and a discussion of FestivALL’s theme, “A City Becomes a Work of Art”, by city artists.

Check the Dance listings for performances by The Charleston Ballet, The River City Youth Ballet, West Virginia Dance Theatre, JADCO, Allegro and other companies. There will be 36 hours of free music on stages at Davis Park (blues, jazz), Haddad Riverfront Park (Charleston dance bands), Capitol Market (country and bluegrass), Charleston Town Center (eclectic mix) and at The Capitol Center FOOTMAD Stage (traditional Appalachian and folk). FOOTMAD will also be having a big Contra Dance Weekend.

Chalk artist Julian Beever will be coming in from Belgium to do one of his incredible “three dimensional” sidewalk drawings and the popular GO FISH catfish sculptures will be back in Brawley Walkway (Fife Street) and elsewhere. Street performers of all types will perform up and down Capitol Street. There will be family activities on The West Side and East End and, especially for the kids, The Kanawha Public Library’s Street Fair will take place on Saturday.

The City of Sistersville River Taxi will be ferrying folks across the Kanawha and last year’s extremely popular Location!Location!Location! “Ten Minute Play” contest winners, staged in the lobby of the Security Building, will be encored. Plus, a new contest, “A Streetcar Named…” will result in a twenty minute play that will be acted on a KRT Trolley as it makes its rounds.

In short, there will be plenty to keep the whole family entertained.

New WV Law Blog: West Virginia Business Litigation

Just a quick note to welcome another West Virginia lawyer, Jeff Mehalic, now blogging at West Virginia Business Litigation. It appears he started blogging in April. Looking at his past few posts looks like he will be generating some great content. Interesting reading, especially for West Virginia lawyers.

Welcome Jeff. I've added you to my blog roll list under the West Virginia Blog section. Be sure to check out some of the other West Virginia blogs. Your blog also now entitles you to attend the next meeting of CAB (reminds me that we need to schedule a get together).

Shhhh! . . . Charleston, West Virginia Is A Good Place To Live

Congratulation to Charleston, West Virginia for its ranking in Kiplinger's Best Citites for Every Stage of Your Life cover story. The ranking includes the top 25 places to launch a career, raise a family, retire in style, and more.

Charleston was ranked under the Best Cities for Empty-Nesters. Although my nest is still full its still a great place to live. Here is what Kiplinger had to say about Charleston in its online content (you can view this via the slide show feature linked in the article):

CHARLESTON, W.V.
BEST CITY FOR EMPTY-NESTERS

Population: 301,716
Cost-of-Living Index: 93 (100 being national average)
Percentage of Workforce in Creative Class: 27.9%
Bohemian Indicator: 69
Creative-Class Salary Growth (2000-2005): 9.8%

Charleston has an interesting combination of a low cost of living with a relatively strong creative class. The city is surprisingly cosmopolitan, with fine restaurants, art galleries, specialty shops and cafés along its tree-lined downtown streets.

For those looking into Charleston don't miss local photo bloggers, ImageSmith (Tom Hindman) and Rick Lee, for some super shots of Charleston and West Virginia. Check out just one of the fantastic photos of downtown Charleston and the Kanawha River. The photos from the two local photo bloggers sure beat the photo Kiplinger used in its online content from the Charleston Visitors Bureau.

UPDATE: Skip Lineberg does a follow up post, Living In Charleston Rates High With Kiplinger, at his Marketing Genius from Maple Creative blog.

Justia's RSS Federal Register

Do you have a need to monitor the federal rules, proposed rules and orders on a particular topic or particular agency? If so, Justia's Regulation Tracker to the rescue. A very useful tool for those of us in the highly regulated world of health care.

Thanks to Tom Mighell at inter alia I just learned about this new feature. I've added a couple of test RSS feeds on topics that I regularly try to monitor. You can also browse by government agency. I've been using Justia's federal court filings RSS feeds for a while to monitor cases filed in the Southern and Northern Districts of West Virginia but wasn't aware of this new federal rule tracker.

Pew Internet and American Life Survey On Technology Use

The AP reports on the findings of a new Pew Internet and American Life Project survey, "A Typology of Information and Communication Technology Users." The report doesn't really surprise me (like it does the AP writer) because the findings reflect what I see on a daily basis in our law firm.

As an "omnivore lawyer" (see my quiz results below) who serves as back up to our IT staff on "user problems" I think the survey is pretty accurate. I like the categories/classifications used in the survey -- especially the "lackluster veterans".

Take the Pew/Internet Quiz and see where you fit. I would be interested to give the quiz to various groups that I interact with and see where they fit. For example - lawyers in my firm? hospital CEOs? physicians? health information management professionals?

Check out the full survey results here. Here is a portion of the AP story:

A broad survey about the technology people have, how they use it, and what they think about it shatters assumptions and reveals where companies might be able to expand their audiences.

The Pew Internet and American Life Project found that adult Americans are broadly divided into three groups: 31 percent are elite technology users, 20 percent are moderate users and the remainder have little or no usage of the Internet or cell phones.

But Americans are divided within each group, according to a Pew analysis of 2006 data released Sunday.

The high-tech elites, for instance, are almost evenly split into:

• "Omnivores," who fully embrace technology and express themselves creatively through blogs and personal Web pages.

• "Connectors," who see the Internet and cell phones as communications tools.

• "Productivity enhancers," who consider technology as largely ways to better keep up with their jobs and daily lives.

• "Lackluster veterans," those who use technology frequently but aren't thrilled by it.

Here are my results from the quiz:

Based on your answers to the questionnaire, you most closely resemble survey respondents within the Omnivores typology group. This does not mean that you necessarily fit every group characteristic.

Omnivores make up 8% of the American public.

Basic Description
Members of this group use their extensive suite of technology tools to do an enormous range of things online, on the go, and with their cell phones. Omnivores are highly engaged with video online and digital content. Between blogging, maintaining their Web pages, remixing digital content, or posting their creations to their websites, they are creative participants in cyberspace.

Defining Characteristics
You might see them watching video on an iPod. They might talk about their video games or their participation in virtual worlds the way their parents talked about their favorite TV episode a generation ago. Much of this chatter will take place via instant messages, texting on a cell phone, or on personal blogs. Omnivores are particularly active in dealing with video content. Most have video or digital cameras, and most have tried watching TV on a non-television device, such as a laptop or a cell phone.

Omnivores embrace all this connectivity, feeling confident in how they manage information and their many devices. This puts information technology at the center of how they express themselves, do their jobs, and connect to their friends.

Who They Are
They are young, ethnically diverse, and mostly male (70%). The median age is 28; just more than half of them are under age 30, versus one in five in the general population. Over half are white (64%) and 11% are black (compared to 12% in the general population). English-speaking Hispanics make up 18% of this group. Perhaps unsurprisingly, many (42% versus the 13% average) of Omnivores are students.

CMS Proposed Rule Modifies PPS For Home Health Agencies

Last Friday, April 27, 2007, CMS issued a proposed rule (CMS-1541-P) modifying the prospective payment system (PPS) for home health agency reimbursement. The proposed rule will be officially published in the Federal Register on May 4, 2007. The details of how to comment on the proposed rule is included in the rule. According to the press release, the deadline for filing comments on the proposed rule June 26, 2007.

The summary from the proposed rule states:

This proposed rule would set forth an update to the 60-day national episode rates and the national per-visit amounts under the Medicare prospective payment system for home health services, effective on January 1, 2008. As part of this proposed rule, we are also proposing to rebase and revise the home health market basket to ensure it continues to adequately reflect the price changes of efficiently providing home health services. This proposed rule also would set forth the refinements to the payment system. In addition, this proposed rule would establish new quality of care data collection requirements.

CMS issued a press release, CMS Proposes Payment Changes For Medicare Home Health Services providing an overview of the proposed changes. Also, CMS issued a Fact Sheet outlining some of the proposed PPS home health changes as compared to the current home health PPS payment system. For more information go to the CMS Home Health Agency Center.

I plan to take a closer look at the proposed rule and would welcome any comments on what impact these changes may have on existing home health providers.

UPDATE (6/18/07): Today CMS issued correction of technical errors in the proposed rule issued May 4, 2007. The corrections are entitled, "Medicare Program; Home Health Prospective Payment System Refinement and Rate Update for Calendar Year 2008; Correction" (72 FR 33425).

Also, one of the comments to this post mentions materials from Beacon Health providing analysis on the proposed Home Health PPS Reform and tips for submitting comments to CMS. Those interested in the changes might want to check out this information.

Kaiser/Deal Battle Finally Hits West Virginia Press

I woke up this morning and pick up my Charleston Gazette off the front lawn to see the headline "E-mail jolts HMO giant" as the front page story. Yawn, not because I was up late but because this was old news to me. Guess it was probably "new news" to many West Virginia readers.

The front page story was a regurgitation of the WSJ article (read some interesting follow up comments from the WSJ Health Blog) that really didn't add anything new to the overall story. There was a companion article, Misleadership critic testified for gay hate crimes law as a teen, that did highlight Justen Deal's West Virginia roots.

I've followed this Deal/Kaiser ordeal over the last year since originally reading about the incident via a number of health care related blogs I follow. I've not gone in depth on the specifics on the incident and accusations regarding Kaiser's HealthConnect, thus don't have the ability to comment on whose side to take, but I do find interesting the aspect of the David vs. Goliath struggle that continues online in large part as a result of the blogospere and new media tools.

Like Dmitriy, the real story is not what happened last November that was reported as front page news today in Charleston, West Virginia. Instead the story is about the distribution and discussion surrounding Mr. Deal's original email via the blogosphere and social/industry media using blogs and web 2.0 driven tools. The ability of individuals to challenge ideas, groups, companies and industries with these new tools. The power you and I have in collaboration with others to change traditional notions of business, industry and government. Once you start to understand this story you gain a new appreciation for what might be unfolding before us all.

The other story this situation highlights in my mind is the question of how long traditional media will survive without changing. So often I find myself reading articles in the morning paper that I have already read the night, day, week or in this case year before. Like this morning - it made me question why I continue to subscribe to my local paper? I find it fascinating that even the writers and editors are moving beyond the traditional constraints of the news media industry structure.

The discussion of this and other topic will continue at next week's Health Care Blogging Summit where I will be participating as a part of a panel discussion on the impact of health care blogging with another Kaiser whistleblower.

New HIPAA Privacy Compliance and Enforcement Website

Yesterday I received an email via the OCR-Privacy listserv announcing the launch of a new HHS web site on HIPAA Privacy Compliance and Enforcement.

I haven't had time to check out the new website but plan to in the coming days. While scanning the website I found the "Enforcement Highlights" and "Case Examples" section very interesting. In the meantime, here is the press release issued in the email by HHS.

To coincide with the fourth anniversary of the enforcement of the HIPAA Privacy Rule, the Department of Health and Human Services (HHS) announced today the launch of an enhanced Web site that will make it easier for consumers, health care providers and others to get information about how the Department enforces health information privacy rights and standards. In launching the website, Winston Wilkinson, the Director of the HHS Office for Civil Rights, noted: "HHS has obtained significant change in the privacy practices of covered entities through its enforcement program. Corrective actions obtained by HHS from these entities have resulted in change that is systemic and affects all the individuals they serve."

The Health Information Privacy Web site provides comprehensive information about the Privacy Rule, which creates important federal rights and requirements to protect the privacy of personal health information. The enhanced Web site, http://www.hhs.gov/ocr/privacy/enforcement provides information for consumers, health care providers, health plans and others in the health care industry about HHS’s compliance and enforcement efforts. The new information describes HHS activities in enforcing the Privacy Rule, the results of those enforcement activities, and statistics showing which types of complaints are received most frequently and the types of entities most often required to take corrective as a result of consumer complaints. The other information on the Web site covers consumers’ rights to access their health information and significantly control how their personal health information is used and disclosed, as well as guidance about how to submit complaints about possible violations of the law and extensive guidance for entities who must comply with the rule.

HHS issued the patient privacy protections pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The first and only comprehensive federal privacy standards to protect patients' medical records and other health information provided to health plans, doctors, hospitals and other health care providers took effect on April 14, 2003. Developed by HHS, these standards provide patients with access to their medical records and more control over how their personal health information is used and disclosed. The regulation covers health plans, health care clearinghouses, and those health care providers who conduct certain financial and administrative transactions (e.g., enrollment, billing and eligibility verification) electronically. HHS has conducted extensive outreach and provided guidance and technical assistance to providers and businesses to help them to implement the new privacy protections. These materials are available at http://www.hhs.gov/ocr/hipaa.

Enought Health 2.0: What about Law 2.0? Avvo

Caught this at Between Lawyers and Real Lawyers Have Blogs while RSS'ing this morning. Lately I've done a number of posts on Health 2.0 companies and thought I would switch gears to Law 2.0.

I'll be watching with interest the roll out of Avvo, a new online legal services startup that has garnered significant (to the tune of $10M) interest from the VC community. Apparently, Avvo is short for "Avvocato," which is lawyer in Italian. If you want to sign up to beta test Avvo or share your ideas on how to make the legal industry a simpler place, you can let Avvo know.

UPDATE (6/4/07): Kevin O'Keefe at LexBlog is reporting today that Avvo is making its official entrance tomorrow. I'm interested to see what they offer to the legal community and those who need/use lawyers.

UPDATE (6/11/07): Denise Howell at Lawgarithms has the latest on the threat to sue Avvo and great analysis (with links) of some of the legal issues swirling around reputation based rating systems like Avvo for lawyers and Section 230 immunity. Also, this week's Blawg Review #112 at Justia's Legal SEO and Marketing Blog spills a lot of "l-ink" over Avvo. David Harlow of HealthBlawg makes an interesting observation of the difference between lawyers (Avvo) and physicians (Sermo).

UPDATE (6/12/07): More from Kevin O'Keefe at LexBlog on the pending class action lawsuit that appears likely to be filed against Avvo.

In Honor of VT

Tonight I saw this photo/graphic on Rick Lee's Blog and thought I would share it with those of you who regularly visit here. If you are inclined (and a blogger) take a few minutes and post the image. I'd like to see this spread around the blogger community to honor those at Virginia Tech and the community of Blacksburg, Virginia.

You can find a link to the image here.

McClinics: Convenient Care Clinics Are Taking Off

Thanks to Alan Goldberg, Moderator of the AHLA HIT listserve for linking to this article in the Economists on McClinics.

The article caught my eye with the following first paragraph:

“IN NO other industry is the relationship between the consumer and the provider as unbalanced as in health care,” says Joseph Maloney of Health Stop, a pioneering retail health-care chain. In a recent case study on his firm prepared by Regina Herzlinger of Harvard Business School, Dr Maloney observed that the typical patient frequently waits a week for an appointment, then an hour longer at the doctor's office or, worse yet, is forced to go to an emergency treatment centre. As Dr Maloney summarised, “Any dry-cleaner that operated this way would be put out of business.”

The article also covers RediClinic, another Steve Case funded health venture which is part of the "Revolution" concept of Revolution is - Resorts - Living - Health - Future. This week Revolution Health will be making its official debut.

For the practitioner's view on RediClinics check out The Solo Practitioner and more from Technorati.

UPDATE: Over the last couple of weeks there have been numerous articles and online discussion regarding Walmart, CVS (Minute Clinic) and Target's movement into the retail clinic concept and what impact it might have on the traditional model of physician office health care delivery. The WSJ Health Blog post about whether retail clinics will be the disruptive innovators of health care. The WSJ Health Blog poses the following Health Blog Question of the Day: Are retail clinics a force for good or a prescription for bad medicine?

I will be interested to watch how the West Virginia's provider communities, legislature and health regulators look at the development of these clinics.

There are a number of legal issues that quickly come to mind as a part of developing these in West Virginia and other states. For example, how will these clinics be viewed, especially if they offer some diagnostic services under West Virginia's certificate of need laws. How will the clinics be viewed within the gray area of West Virginia's corporate practice of medicine doctrine. What position will the Board of Medicine take on these clinics.

I'm also intrigued by the idea that these types of clinics might become the backbone of a national health information network. If anyone is good at standardization at low cost its Walmart. Why not Walmart EMR. In West Virginia, like many other rural states, Walmart has become the defacto center of commerce in small communities. Here in West Virginia the local hospital and Walmart are the two biggest employers in most rural counties. Interesting to see that Walmart's clinic concept includes contracting with local hospitals.

UPDATE (5/18/07): Walgreen Co. is the latest to get into the convenient health care clinic area with its announcement of the acquisition of Take Care Health Systems. According the the news article,Take Care Health Systems operates 50 health care clinics in Chicago, Kansas City, Milwaukee, St. Louis and Pittsburgh." For more on the acquisition here is the Walgreen press release.

What Google Health Might Look Like

Google Vice President, Adam Bosworth asks the following question over at the Google Blog -- How do you know you're getting the best care possible? Note: At the end of his post he asks to hear from you.

Those interested in seeking improved health care information online and becoming more engaged (and knowledgeable) in their own health care will find his post interesting. It also might shed some light on Google Health. For example, Bosworth talks about how do you know what online medical information is reliable? Are you getting the best standard of care? I would add to the list of his questions -- can I know what I am going to have to pay before I receive the care? what health care provider can provide me with the most economical health care?

The post highlights what I see as the need for "us" as patients to be become better advocates for ourselves when visiting a health care professional for treatment. More individuals are faced with the question of care vs. cost which has lead to patients being more active consumers of health care. As more and more of the costs of health care are shifted to individuals the resulting outcome is that those individuals have been forced to take a more active role in trying to manage their health care and the associated costs.

Technology is finally allowing health care consumers (and physicians) to free themselves from the historic systems of the industry. Health consumers are starting to use technology to take an interest in understanding their condition, seeking support from others, managing the care and conditions, monitoring payment and cost, finding the best physician, diagnosing themselves, seeking cheaper/faster care, monitoring the public health conditions and otherwise looking online for their health care needs and wants. It will be interesting to see what impact the political climate of 2008 will bring to this discussion. Update: I've linked to some of the smaller health 2.0 companies experimenting in the health sector. Today I noticed that Matthew Holt, one of my favorite health care policy bloggers, speculates a bit on which large lady will chant, WebMD, Google, Revolution Health or Microsoft. Today's NY Times features Revolution Health as it readies for its official launch this week.

Mr. Bosworth addresses a point that I have often discussed with others -- how do you and I as patients find out who best to treat us? What doctor is best suited to treat my needs based on numerous factors. Mr. Bosworth poses this question -- "what does 'best' really mean?" Maybe I'm a more conservative patient or a patient who desires a more aggressive approach requiring surgery. How does search account for such subtleties. Different doctors take different approaches to these types of patients. My on experience is that I start with my primary care doctor's recommendation (or another trusted source) - but often there is no way to confirm the recommendation. I'd like to back up this information with more detailed information.

Bosworth's post also discusses Google's "labeling" feature (not sure what this feature is - I ran a Google search trying to find out more info about the feature but don't see anything). Mr. Bosworth concurs that the "labeling" feature needs to be highlighted and explained better by Google.

Also, an interesting stat that I noticed while reading Mr. Bosworth's wikipedia entry. A survey of 1,000 people found that 12% first turn to Google to learn about a medical problem. For other interesting stats from the survey check out, More people consult Google over health.

Also, on a related note -- for an insiders view of how Google is learning about the how to share data without revealing private information check out Privacy Preserving Data Mining by Shahid Shah, The Healthcare IT Guy. Shahid takes the logical step of thinking how Google might apply this type of learning in the health care industry.

Collaborating On Health 2.0

A couple of weeks ago I had the opportunity to speak to a local group of business executives on the topic of The Value of Blogging in Business with Skip Lineberg and Matt Ballard. During Skip's Ten Reasons To Blog portion of the presentation he used a couple of slides highlighting the concept of "reaching the world . . . or reach across town -- do either . . . Do both!"

This week I have a wonderful example. Over the last few months I have had the opportunity to communicate with Bertalan Meskó a medical student at the University of Debrecen, Hungary who blogs at ScienceRoll (and his Hungarian blog, MedIQ). He has an interest in the concepts of health 2.0 and medicine 2.0 that I have spent a fair amount of time lately writing and thinking about on this blog. This week Bertalan posted about his upcoming Genetics and Web 2.0 Presentation.

Traditional notions of collaborating or doing business with someone down the street vs. across the globe have changed. This change impacts all industry -- from the practice of law to the practice of medicine to all industries. Just an example to think about what impact it might have on you as I sit here in Charleston, West Virginia and Bertalan sits in Debrecen, Hungary.

Bertalan also gives credit to Ves Dimov, M.D., an Assistant Professor at the Cleveland Clinic who "gets" the new health 2.0 technology and is harnessing the technology in practical ways via his blog, Clinical Cases and Images - Blog. His post and presentation on How to Use Web 2.0 In Medicine? is another good introduction to health/medicine 2.0 concepts.

UPDATE: This evening I saw this post by Tony Chen at Hospital Impact providing a Consumer's Guide to Healthcare 2.0 Websites. Great summary of Health 2.0 type companies and their popularity via alexa rankings.

The Candid CIO

Thanks to Will Weider, CIO at Affinity Health System in Wisconsin, who blogs at Candid CIO for linking to my summary of Health Care Blogging and Web 2.0.

For those of you interested in hospital health care IT issues I would suggest reading Will's blog (or better yet pick up Will's RSS feed).

Recent HIPAA Enforcement Stats

for the latest on HIPAA enforcement statistics by OCR click over to Mike Cassidy's post at the Med Law Blog: HIPAA Criminal Verdict and Enforcement Statistics. The post also contains some stats on the number of matters reported to the DOJ for investigation.

The post includes a summary of United States v. Ferrer, S.D. Fla., No. 06-CR-60261-CR-Cohn, the first criminal HIPAA verdict entered in January 2007. The case involved the wrongful disclosure of individually identifiable health information and identity theft of 1,100 patients from the Cleveland Clinic which were used to fraudulently bill Medicare claims to the tune of $7M.

WV Pro Hac Vice Admission Fees To Increase

The West Virginia Bar Blast reports that the pro hac vice admission fees for West Virginia will increase effective July 1, 2007. The fees will increase from $150 to $250. The West Virginia Supreme Court of Appeals entered the Court Order amending Rule 8.0 of the West Virginia Rules of Admission to the Practice of Law on March 19, 2007.

The complete Rules for Admission to the Practice of Law in West Virginia can be found on the Rules Section of the WVSCA website. Also, you may want to check out Advisory Opinion 93-005.

With April 15 quickly approaching out-of-state lawyers may also want to read the following summary by Susan Romaine on a 2006 tax publication issued by the West Virginia State Tax Department regarding tax obligation of nonresident lawyers. The West Virginia State Tax Department publication, Nonresident Lawyers - Tax Reporting and Filing Requirements, provides more details.

These requirements apply to any out-of-state law firm or attorney who enters for the purpose of practicing law or conducting business relating to the practice of law in The requirements are directed towards any attorney who enters the state for relatively short periods of time for the purpose of taking depositions, consulting with local legal counsel and clients, conducting discovery, attending court proceedings, and engaging in settlement negotiations and for trials or other work in The requirements apply to any attorney working under these conditions, whether they are paid on a contingency fee,hourly fee, or other basis.Out-of-state law firms and attorneys may be subject to any of the following taxes: business registration and franchise taxes, corporation net income tax, personal income tax on partnership and S-corporation income, consumer sales and service tax, local hotel/motel tax, personal income tax on employees, and the withholding tax.

Health Care Top 10 of 10

If you like top 10 lists and you're involved in health care - then check out Tony Chen's Healthcare Top 10 list of Top 10 lists at Hospital Impact.

I've scanned a few of the links and can't wait to check out more when I have some time.

Tony's a health care innovator and one of my favorite health care blogging colleagues. He is in my top 10 list of health care bloggers.