The Centers for Disease Control and Prevention (CDC) has awarded $10.9 million to seven accredited schools of public health for the establishment of Preparedness and Emergency Response Research Centers (PERRCs). The seven schools will conduct research that will evaluate the structure, capabilities, and performance of public health systems for preparedness and emergency response activities.

"This is yet another way to expand the efforts by our nation's schools of public health to enhance state and local emergency preparedness efforts," said Richard E. Besser, MD, director of CDC's Coordinating Office for Terrorism Preparedness and Emergency Response. "These research centers will connect public health with scientists involved in business, engineering, legal and social sciences to incorporate multiple perspectives into preparedness and response research, which can be used to strengthen our nation's response capability."

Since 2000, CDC has been working with schools of public health after it funded and established the Centers of Public Health Preparedness, which strengthens terrorism and emergency preparedness by linking academic expertise to state and local health agency needs, especially around the development, delivery and evaluation of preparedness education. The establishment of the new research centers is mandated by the Pandemic and All-Hazards Preparedness Act of 2006, which calls for research to improve federal, state, local, and tribal public health preparedness and response systems.

The World Health Organization (WHO) warned that the global financial crisis is likely to cause increased mental health problems and even suicides as people struggle to cope with poverty and unemployment, Reuters reported.

Hundreds of millions of people worldwide are already affected by mental problems such as depression and bi-polar disorders and the current market meltdown could exacerbate feelings of despair among people vulnerable to such illnesses, according to Reuters.

The United Nations agency told Reuters the impact could be especially marked for those living in low- and middle-income countries where access to treatment is often limited.

"We should not be surprised or underestimate the turbulence and likely consequences of the current financial crisis. As it is, we are seeing a huge gap in taking care of people in great need," WHO Director General Margaret Chan told a meeting of mental health experts.

Poverty and its associated stresses including violence, social exclusion and "constant insecurity" are linked to the onset of mental disorders, she said.

"It should not come as a surprise that we continue to see more stresses, suicides and mental disorders," Chan warned.

Chan denounced the "abysmal lack of care" for some mental health patients, especially in low- and middle-income countries, home to three out of four sufferers, Reuters reported. Governments must make mental health a vital part of primary health care, she said.

The Bronx RHIO, representing 80 percent of the providers in a borough of 1.36 million residents, went "live" in July 2008, becoming the first regional health information organization in New York City to begin exchanging patient data. To date, the Bronx RHIO has received consent forms from over 4,000 patients; and has trained 79 "early-adopter" clinicians. There are now 55 care locations in the Bronx whose patients' clinical data can be accessed with appropriate patient consent. Those inpatient, outpatient and long-term care locations treat 500,000 patients. An additional 70 care sites belonging to other Bronx RHIO participants have "view-only" access to patient data.  

"The Bronx RHIO is slowly, but steadily, breaking new ground in the improvement of patient care in New York," said Barbara Radin, executive director. "While other RHIOs in the metro area are under development, we are the first to go live and roll out our system to the benefit of patients. The Bronx represents a very large population by any measure. It is the equivalent of the tenth largest city in the nation, so we are very excited about the scale and the number of patients it will help." 

The initial patient data being exchanged by the Bronx RHIO's hospitals, outpatient clinics, physicians' offices, nursing homes and home care agencies, includes: laboratory results, prescribed and dispensed medications, diagnoses, procedures, encounters and demographic information. If patients do not sign the consent form, the Bronx RHIO cannot exchange their private health information and physicians will not have a complete picture of the patient's condition and prior treatment.

Once a patient signs a consent form allowing the Bronx RHIO participants access to his or her private health information, the Bronx RHIO has a number of policies and administrative checks to ensure the information remains secure. 

The Bronx RHIO funding, since its inception in 2006, has come from three main sources: a $4.1 million start-up grant from New York State in 2006; an additional $8.9 million state grant in 2008; a $132,288 grant from U.S. Health Resources and Services Administration; and contributions from participating member organizations. 

Care Communications, Inc. announced a new qualitative study that will analyze leadership in the U.S. health information management (HIM) industry to better understand the changing role of HIM leaders. The research study, "HIM Leadership through the Lenses of Bowen Theory and Complex Systems Leadership Theory," is funded in part by the Foundation of Research and Education of the American Health Information Management Association (AHIMA) and Care Communications, Inc.

"HIM professionals contribute to organizational success in many ways at health care organizations across the country. We expect to gain a better understanding of the roles, characteristics and activities of HIM leaders, as well as the role of HIM in the broader context of the organization," said Patty Thierry Sheridan, MBA, RHIA and president of Care Communications. "This study will serve as a springboard for future research on HIM leadership and put in place a structure for ongoing research on the topic."

The research findings of this pilot study will be applied to develop:

• case studies that provide insights into the leadership behaviors and characteristics, roles, and activities of HIM leaders;
• quantitative and qualitative tools developed for use in future surveys; and
• an HIM leadership research agenda, mapping out plans for continued research in HIM leadership.

Health care systems throughout the United States responded to the study's request for participation. Nine health care systems have been selected for inclusion in the study, which is being conducted October 2008 through January 2009. Two leadership frameworks will be used to examine data and provide various ways to think about leadership.

Blogs allow African Americans to discuss HIV and AIDS in an unfiltered way that is both public and private, according to a Penn State researcher, and this exploration may lead to another way to distribute health messages to the African-American community.

Lynette Kvasny, PhD, associate professor of information sciences and technology (IST), an avid blog reader, noticed an interesting conversation on a blog following an August 2006 ABC News story, "Out of Control: AIDS in Black America."

"I was really surprised by some of the things I was reading.these were things that I'd never seen discussed in a public forum before," Dr. Kvasny said.

Dr. Kvasny and C. Frank Igwe, a recent IST PhD recipient, analyzed 128 responses to the ABC News story posted from Aug. 24 to Aug. 26, 2006. They separated the comments into themes, including ineffective Black community leadership; the influence of prison and hip-hop cultures; religion; sexual taboos; and African Americans in the media. These categories provided a basis to analyze how ethnic identities are conveyed through technology, according to the researchers.

The television show pointed to five reasons why AIDS is out of control in Black America: Those in charge do not see the problem; the government fails to control street drugs and the large African-American prison population; the skewed ratio of men to women in the African-American community leads to multiple partners for men; a hidden African-American homosexual population on the "down low;" and the failure of leadership in the Black community to make AIDS a priority.

"Online conversations provide an opportunity to examine how this community uses language to express their unique position as subjects in HIV/AIDS discourse," the researchers noted in "An African-American Weblog Community's Reading of AIDS in Black America," published recently in the Journal of Computer-Mediated Communication. "The relationships among identity, language and computer-mediated communication are not straightforward."

Dr. Kvasny also noted the varying levels of community that exist within the blog, saying that while individual users are anonymous, they are all united by a common language and a desire to speak out about HIV/AIDS and other issues affecting the Black community. Blogs and message boards also allow people to voice their own opinions, rather than being spoken for by one or several people in the mass media.

"Communities like this give people a place to talk about things they couldn't talk about elsewhere," Dr. Kvasny said. "The affordances of technology allow people to become members of a virtual community while still remaining anonymous and being able to freely express their thoughts."

The researchers looked at two aspects of the online conversation. First are the factors that the blog members thought contributed to the spread of AIDS in the African-American population. Included in this were members' presentation of opposing, alternative views to the television report and how they presented those views. Second, the researchers looked for indications of Black communication styles including signifying, emotional intensity and computer-mediated communication techniques like emoticons and turn taking.

An analysis of the blog suggested that three things -- ineffective leadership, Black cultural practices and individual behaviors -- were the risk factors for the Black community.

Also, analysis of how ideas were expressed showed communication interaction used call-and-response conventions such as acknowledging prior comments by naming the speaker or co-signing the previous comments. The community of bloggers developed shorthand terms for AIDS that were used by the group. In addition, emotion, in the form of capitalized comments and other verbal scolding, appeared frequently.

The use of screen names and family terms showed communal support. The acts of advising, consoling and testifying through stories create a community of support through the discussion. The final style element of this African-American blogging community involves movement, if only virtual. This included describing actions that would normally be acted out through dances, singing and laughter.

The researchers suggest that African Americans form virtual communities with ethnic identity through the use of language. "These self-avowed identities suggest that ethnicity is an essential characteristic that finds expression in a public realm," the researchers noted.

While realizing that the online community does not reach the entire African-American community, the researchers believe discussions online may impact the larger community as well through interactions with friends and relatives who are not online and provide an alternative approach to community health education.

Dr. Kvasny said she hopes to continue this research and examine whether blogs are an effective medium for medical practitioners to distribute messages about HIV/AIDS prevention and education.

Mistakes should be considered shared commodities and used for all they're worth, researchers recently reported.

We can learn from our mistakes, but how willing are we to talk about them? And what happens when those making mistakes are physicians, who are often expected to be infallible?

A new University of Iowa study shows that most general practice doctors in teaching hospitals are willing to discuss their own patient care errors with colleagues, but about one in four do not. At the same time, nearly nine of 10 doctors said that if they wanted to talk about a mistake, they knew a colleague who would be a supportive listener. The findings are reported in the Oct. 1 issue of the Journal of Medical Ethics.

The results suggest that it is important to ensure that learning occurs not just in the person who made the mistake but also among peers, said the study's lead author, Lauris Kaldjian, MD, PhD, associate professor of internal medicine at the University of Iowa Carver College of Medicine.

"Discussing medical errors can be a form of professional learning for doctors. Mistakes should be considered shared commodities and used for all they're worth," said Dr. Kaldjian, who also is director of the college's Program in Bioethics and Humanities. "The findings also point to some challenges for physicians seeking emotional support after making an error."

The study results were based on surveys of 338 faculty and resident physicians at teaching hospitals in the United States. Previously published findings by Dr. Kaldjian and colleagues, based on the same data set, showed that doctors' actual communication of medical errors to hospitals and patients seems to occur less than it should when compared to physicians' positive attitudes about communicating such errors.

The two earlier studies also found that the more serious the outcome or harm from a hypothetical error, the more likely a doctor said they would communicate it to patients or hospitals. Similarly, the current study used hypothetical scenarios to reveal the likelihood of doctors discussing an error that results in no harm at 77 percent, minor harm at 87 percent, and major harm at 94 percent.

Dr. Kaldjian pointed out there is much value in sharing all errors. "Sometimes you make a mistake and nothing happens. Other times, something bad happens," he said. "But in both cases, we need to focus on the mistake because near-misses -- where no harm was done -- are also valuable learning tools."

The most harmful types of errors trigger automatic institutional reviews. However, other errors may not. "Along with helping improve patient care, discussing both types of medical errors can provide important opportunities for learning and emotional support for physicians," Dr. Kaldjian said. "However, the formal settings in which shared learning takes place are unlikely to be optimal for providing the individual support needed by the physician who made the mistake.

"Physicians can go through a lot of turmoil when they make a mistake, even if it hasn't caused serious harm to a patient. While there are some formal group settings in the profession for learning from mistakes, emotional support may require the privacy and reassurance that are found in one-on-one conversations with trusted colleagues," he added.

More than half of the physicians in the study (57 percent) said they had tried at least once to promote the value of discussing errors by discussing one of their own errors in front of students or physicians in training.

"It's encouraging that physicians try to be role models, especially for medical students and younger physicians, and some hospitals even have peer-support teams to help physicians in the aftermath of an error, though such teams appear to be rare," Dr. Kaldjian said.

Dr. Kaldjian also noted that doctors who consider themselves their "own worst critic" and do not discuss their errors with others lose out on additional perspectives.

"There can be wisdom and comfort in the words of our colleagues, especially when we have reason to trust their insights," he said. "Medical science also encourages an investigative attitude about errors and can motivate us to be as objective as possible about errors and their circumstances without denying the profound need for emotional support."

Overall, Dr. Kaldjian said, increased discussion of errors amongst medical professionals is extremely important for professional learning and emotional support. Such discussions may also help physicians encourage each other to disclose errors to patients as part of patient care and to report them to institutions to improve patient safety.

Blue Cross & Blue Shield of Louisiana compromised the personal data of about 1,700 insurance brokers via an e-mail recently, exposing Social Security numbers, phone numbers and addresses, according to a Blue Cross spokesman, Business Insurance magazine reported.

The breach occurred Sept. 25 when a document was accidentally attached to a general e-mail being sent out to brokers notifying them of a software upgrade. The brokers who received the e-mail were the same people whose information was exposed. The spokesman said no customer data was involved.

Blue Cross immediately recalled the e-mail, the spokesman said, but the message still made its way to the brokers. The health insurer notified them of the error, apologized and requested recipients delete the information and confirm with Blue Cross that they had done so.

The company is offering free credit monitoring to the affected brokers for 12 months and has taken steps with its technology systems to ensure that such errors do not occur again, the spokesman told the magazine.

Scott McNealy, founder and chair of Sun Microsystems, will address the possibilities of open-source technology in health IT systems at the World Healthcare Innovation and Technology Congress (WHIT 4.0), Dec. 8-10, in Washington, D.C.

McNealy will join 400 senior health technology leaders and a keynote roster including Newt Gingrich, founder of the Center for Health Transformation; Tom Burns, COO of Alcatel-Lucent Enterprise Business Group; George Halvorson, CEO of Kaiser Health Plans and Hospitals; Colin Angle, CEO of iRobot; and Peter Neupert, vice president of the Microsoft Health Solutions Group.

Since founding Sun more than 25 years ago and serving as its CEO until 2006, McNealy predicted the rise of business models based upon free open-source software. Now McNealy is turning his sights to health care, advocating how open-source technology can lead to cost reductions and better health care outcomes. McNealy will speak at WHIT 4.0 on Wednesday, Dec. 10 at 8:30 a.m.

Programs such as OpenVistA, the U.S. patient information system used by the Veterans Administration, have used open source in positive ways. Electronic medical records, regional health information organizations, physician groups, hospital and health systems, clinics and IT executives are seen as the potential beneficiaries of the proliferation of open-source solutions in health care.

Watch for ADVANCE's coverage of WHIT 4.0 on our Web site in December.

A computer is as good as a second pair of eyes for helping a radiologist spot breast cancer on a mammogram, one of the largest and most rigorous tests of computer-aided detection (CAD) found, according to an Associated Press (AP) report.

Like spell-checkers looking for mistakes, the computers flag suspicious areas on X-rays for a closer look by a radiologist. In the U.S., the X-rays are read by a single radiologist and cancers are sometimes missed.

Computer-aided detection was developed to help radiologists pick up more cancers. Approved a decade ago, these computer programs are now used for about a third of the nation's mammograms, AP reported. But the value and accuracy of the technology has continued to be debated.

Now, British researchers are reporting results from a randomized study of 31,000 women. Mammograms in Britain are routinely checked by two radiologists or technicians, thought to be better than a single review. Researchers wanted to know if a single expert aided by a computer could do as well as two pairs of eyes.

They found that computer-aided detection spotted nearly the same number of cancers, 198 out of 227, compared to 199 for the two readers, according to the news source.

In places like the United States, "Where single reading is standard practice, computer-aided detection has the potential to improve cancer-detection rates to the level achieved by double reading," the researchers said. Their findings were published online Oct. 1 by the New England Journal of Medicine.

Privately held online health sites Revolution Health Network and Waterfront Media agreed to merge in a deal that could challenge WebMD Health Corp's dominance in the health care space, according to a Reuters report.

The companies did not disclose the financial terms in a joint statement, but the New York Times said on Oct. 3 the deal was worth $300 million.

The combined company is projected to have more than 20 million unique users, the companies said, citing a comScore Media Metrix report.

The New York Times said the combined entity would have enough traffic in the United States to compete with WebMD, now the market leader in the online health category.

"We think we have the wind at our back and can pass them," Steve Case, Revolution's founder, told the paper referring to WebMD. Case is also the co-founder of AOL, a Time Warner Inc unit.

The combined company will keep the name Waterfront Media and remain headquartered in Brooklyn, N.Y. Waterfront Media chief executive and co-founder Benjamin Wolin will remain the CEO of the new company, Reuters reported.

The reliance of restaurant chains and retail stores on outside companies to handle credit card processing and other information technology functions is partly to blame for consumer data breaches over the last few years, according to Verizon Communications, the Associated Press (AP) reported.

Even a chain with thousands of restaurants might have only 100 employees in IT, so it uses outside vendors for many IT functions, Bryan Sartin, director of the investigative response team at Verizon Business, told the AP.

"What happens is there's a lack of accountability on the third party," Sartin told the AP.

Verizon investigates a quarter to a third of the big, publicly announced data breaches that occur each year, and hundreds of smaller cases, the AP said.

In recent years, restaurant and retail chains have accounted for more than half of Verizon's 230 to 250 cases per year, according to a Verizon report. It often finds that insiders at service vendors are part of the heists.

Organized data-stealing gangs "go to the call centers, the Web development companies, the content development companies, the business partners, the people who pick up the back-up tapes," Sartin told the AP. "They say ... if you hate your boss and you're in financial straits, we're your solution. Give us access to your customers. Better yet, give us your data."

The deadly AIDS virus first began spreading among humans at the turn of the 20th century in sub-Saharan Africa, just as modern cities were emerging in the region, U.S. researchers told Reuters.

The finding pushes back the origin of the human immunodeficiency virus (HIV) by several decades, they reported in the journal Nature.

Researchers think the growth of cities -- and high-risk behavior associated with urban life -- may have helped the virus to flourish, Reuters reported. There is no cure for AIDS, which is most commonly transmitted through sexual contact.

Prior estimates put the origin of HIV at 1930. But Michael Worobey of the University of Arizona in Tucson now believes HIV began infecting humans between 1884 and 1924, according to Reuters.

The research is based on 48-year-old gene fragments dug from a wax-embedded lymph node from a woman in Kinshasa in the Democratic Republic of Congo, formerly Zaire, Reuters said.

The 1960 sample is the second-oldest genetic sequence of HIV-1 group M, the main strain of the virus responsible for the AIDS pandemic.

The oldest sequence came from a 1959 blood sample given by a man in Kinshasa, formerly known as Leopoldville, Reuters reported.

"Once you have two you can line them up and compare them," Worobey said in a telephone interview with Reuters.

"Once you do that, you see these two sequences are very different. That means the virus had already been there for a long time even by 1959 or 1960."

Chuck Christian, chairman of the HIMSS board, and H. Stephen Lieber, president and CEO of HIMSS, sent a letter on behalf of HIMSS to representatives Pete Stark (D-CA) and Dave Camp (R-MI) in response to the newly introduced "Health-e Information Technology Act of 2008," H.R. 6898. This letter referred to legislation introduced on Sept. 15 by Stark, chairman of the House Ways and Means Committee's Subcommittee on Health.

According to the letter, HIMSS believes that with some modifications to the legislation, common ground can be made to meet stakeholders' goals. HIMSS has concerns with the potential discounting of "AHIC 2.0," and believes the federal government should not develop or provide for an open-source health information technology system.

HIMSS stated that its response is not an opposition to open-source software; rather, its members believe the federal government should not develop or provide for an open-source health information technology system.

HIMSS said it encourages readers to learn more about the volunteer work groups and task forces focused on open source, including the HIMSS HIE Open Source Task Force. This task force released a white paper in June 2008, "Evaluating Open Source Software for Health Information Exchange," which is considered a primer on current open source in health information exchange environments, applicable across all sectors of the health care industry.

The National Institutes of Health (NIH) will begin implementing changes to enhance its peer-review system, after an extensive, year-long review. While the peer-review system is a cornerstone of NIH, the increasing complexity and interdisciplinary nature of modern research has created a number of new challenges and demands on the system that merit enhancements in critical areas.

NIH undertook a comprehensive approach: Working groups deliberated on challenges and recommendations, and input was sought and received, with significant dialogue, from both NIH scientific staff and the grantee/reviewer communities.

"These changes help ensure that NIH continues to be the world-renowned peer-review system," Elias A. Zerhouni, MD, NIH director said. "We did the review through a deliberative process, and we are going to implement the changes in a similar way -- carefully, with a phased approach, [evaluating] the impact of these changes in real time."

Although many changes of the priority areas are currently in the planning process, the first set of key changes for the 2009-2010 calendar years include the following:

· Reducing administrative burden on reviewers and applicants. Both external and internal communities voiced concern over lengthy research applications -- currently 25 pages are permitted -- and a key recommendation was to shorten and restructure applications. Over the next year, NIH will undertake measures to implement shorter applications to 12 pages for January 2010 receipt dates.

· Improving system efficiency and decreasing the need for applicants to have to submit multiple amended applications in order to get funded. NIH is looking at options that will ensure that the largest number of high-quality and meritorious applications receive funding earlier in the process.

Beginning in 2009, NIH will increase flexibility of reviewers' tour of duty and will consider using high-bandwidth support for review meetings as an alternative for in-person meetings. As the NIH implements changes, critical training will be available to reviewers as well as scientific review officers.

Microsoft said Aug. 29 it has reached a deal to acquire Greenfield Online, the owner of consumer shopping sites, for about $486 million, according to a CNET report. Greenfield's properties include Munich, Germany-based Ciao, which owns price-comparison and online-shopping sites in Europe.

Ultimately, Microsoft said, Ciao's technology platform, online community and merchant relationships will be integrated with Microsoft's Live Search.

Ciao features consumer reviews and ratings. Microsoft said that, according to comScore, Ciao has more than 26.5 million unique visitors per month across seven countries, who have generated more than 5 million product reviews.

The deal calls for Microsoft to commence a cash tender offer to purchase all of the outstanding shares of Greenfield for $17.50 per share, or roughly $486 million, CNET reported.

Wilton, Conn.-based Greenfield, which acquired Ciao in 2005, also owns an Internet survey business, which Microsoft plans to sell off. Microsoft said it has already secured an unnamed buyer for that unit. Both transactions are expected to close during the fourth quarter, CNET reported.

Microsoft's offer for Greenfield trumps an earlier deal. In June, Greenfield said it was in takeover discussions with the Quadrangle Group and had secured an agreement to be acquired for $15.50 per share, according to the news source. In connection with the termination of that deal, Greenfield said it is required to pay Quadrangle a $5 million fee.

The tropical storm bearing down on the Gulf Coast could be a test for the country's wireless carriers, which faced criticism and a regulatory push after Hurricane Katrina took out networks, according to an Associated Press (AP) report.

Tropical Storm Gustav was near Jamaica on Aug. 29, and forecasters said it could hit the Louisiana coast at the beginning of next week as a major hurricane.

If so, wireless networks would have two main vulnerabilities. The cell towers may be unhurt by the buffeting winds of a hurricane, but to keep working, each one needs electrical power and a connection to the larger network, usually via landline, AP reported.

Sprint, Verizon Wireless and AT&T have been boosting their hurricane preparedness in disaster-prone areas by readying back-up batteries, generators and stand-by portable cell towers, the report stated.

Gustav could be a communications challenge for emergency responders, who remain split up on incompatible networks. The FCC wanted to tackle that problem by setting aside radio spectrum to be operated by a private company for a national emergency network, but the spectrum band failed to find a bidder in an auction this year, AP reported.

A pilot study launches this fall to test whether hand-held devices such as the iPhone can improve the educational experience of students.

"We want to give students involved in this project an opportunity to gain experience integrating new technology into their studies," said University of Maryland Provost Nariman Farvardin. "We want to know if the devices can make a difference."

150 new students at the university have been selected to receive their choice of either an iPhone or iPod Touch device during move-in that took place the last week in August.

"This pilot test is a wonderful opportunity for us to see how equipping students with advanced mobile devices will improve their educational experience," said Jeffrey Huskamp, University of Maryland vice president and CIO.

"Students are increasingly tech-savvy, mobile technology is advancing rapidly and a world-class research university should be prepared to exploit the educational possibilities," Huskamp added. "If the technology will help make a large university smaller and more accessible, that's important. If it can enhance learning, then we need to find out."

"We've done extensive planning so that the technology we give our students will help enrich their college experience," said Barbara Gill, University of Maryland director of admissions. "The technology has a great many possibilities, and we're much more likely to discover them if we go about this in a systematic way."

Planning for the initiative began at Maryland a year ago, and is being sponsored by the provost's office. The pilot program is designed to answer questions such as whether professors can use mobile technology to enhance the classroom learning experience in some settings.

Kent Norman, an associate psychology professor, is a member of the university's Mobility Initiative Steering Committee. He said the concept of learning "anytime, anywhere" is becoming a reality and hand-held devices such as the iPhone and iPod Touch can make a difference. "The Mobility Initiative will provide students with a unique way to access campus resources and course materials and to communicate with others. If nothing else, it will at least prepare students for the world of mobile computing in which they will live and work when they graduate."

In the largest multi-institutional study to date examining the impact of positron emission tomography (PET) in changing disease management of individuals with suspected recurrent colorectal cancer, researchers found that treatment plans were changed for more than half of patients, according to an article published in the September issue of The Journal of Nuclear Medicine.

The study was conducted at four sites throughout Australia and included 191 patients who were divided into two groups. Group A consisted of symptomatic patients who had residual structural lesions suspicious for recurrent tumor after initial therapy. Group B consisted of patients with pulmonary or hepatic metastases that were potentially operable. The results were compared with findings from conventional imaging (such as computed tomography or CT), and participants were followed for 12 months.

"Designed with an evidence-based approach, this study confirmed the important role PET plays in the decision-making process of patients with colorectal cancer and the impact of PET on both the management and outcome of disease," said Andrew M. Scott, MD, director of the Centre for PET and the Ludwig Institute for Cancer Research, Austin Hospital, Melbourne, Australia. "These results are compelling and indicate that PET should be made more widely available to patients."

Based on the extent and progression of disease revealed by the scans, treating physicians changed the planned management in more than 65 percent of patients in group A and nearly 50 percent in group B. The researchers also found additional disease sites in 48 percent of group A and 44 percent in group B, providing valuable prognostic information about patients that allowed their stratification into curative or palliative groups, the report stated

"PET was able to identify those patients who had potential for long-term, progression-free survival and even a potential cure," said Scott. "Just as important, it identified those patients with aggressive disease, enabling them to avoid unnecessary treatment, such as surgery."

In the United States, imaging results from PET scans have also changed clinicians' decisions in the treatment and care of more than one in three cancer patients, according to data collected by the U.S. National Oncologic PET Registry.

Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) recently filed an application for conversion from a not-for-profit health service corporation to a for-profit company within the State of New Jersey in accordance with state law.

This is the first time Horizon BCBSNJ has filed an application for conversion since the law permitting a health services corporation to convert to a domestic stock insurer was enacted in 2001.

In a public statement, Horizon BCBSNJ President and CEO William Marino said the move was exploratory. "Through the application process, we will be able to determine whether conversion is practical and whether it can be accomplished on satisfactory terms for our members and company.

"Our board of directors has decided to reconsider conversion at this time because our nation's health care system is undergoing a rapid transformation. Many reform proposals at the state and federal levels are calling for significant changes in the near future. As the state's oldest and largest health insurer, we have an obligation to our more than 3.6 million members to be prepared to meet their needs as our health care system changes," Marino said.

Marino said that Horizon BCBSNJ's conversion would provide New Jersey residents with an opportunity to improve the state's health care system without raising taxes. "Under the law governing conversion, an independent charitable foundation must be created to receive 100 percent of the value of Horizon Blue Cross Blue Shield of New Jersey upon conversion, which could be more than $1 billion. This independent foundation is required by law to use this money solely for the purposes of expanding access to quality, affordable health care," he said.

Marino said that Horizon BCBSNJ members and New Jersey hospitals and health care providers can also benefit from such a conversion. "As a public company with access to the capital markets, Horizon Blue Cross Blue Shield of New Jersey will have greater flexibility to invest in and acquire new capabilities and technologies to better serve the changing needs of our members and network physicians and hospitals," he said.

State law requires a public review process to evaluate the conversion. "We look forward to those public deliberations as a unique opportunity to objectively consider what is best for our members, our health care system and the people of New Jersey," Marino said.

New Jersey's neighbor, the Commonwealth of Pennsylvania, is considering granting the merger of two Blues plans being sought by Pittsburgh-based Highmark and Philadelphia-based Independence Blue Cross. Public hearings wrapped up last month and the Pennsylvania Insurance Department is reviewing the proposed merger with a final decision expected by the end of the year.

The College of Healthcare Information Management Executives (CHIME) Foundation recently announced the creation of a new membership level for companies interested in joining the foundation. Incorporated as a separate non-profit organization in 1994, the CHIME Foundation is structured to support CHIME's programs and activities.

The CHIME Foundation's associate-level membership provides a new option for suppliers of health information system products and services that want to directly support the educational initiatives of CHIME.

Created in response to overwhelming interest in membership, the CHIME Foundation associate membership allows companies to enjoy some of the same benefits of the member-level firms.

"There has been a lot of interest in joining," said Rich Correll, executive director of the CHIME Foundation. "Associate memberships allow additional organizations to become involved with CHIME and support the important work it does while gaining valuable access to top CIOs in the health care industry."

As an associate member, companies qualify for two online focus groups with CHIME member CIOs, attendance at CHIME's CIO Forums, access to the CHIME Foundation Web site, and exposure to CHIME CIOs on the CHIME member Web site. In addition, associate members will have the opportunity to upgrade to the premier level of the CHIME Foundation as space becomes available.

"The CHIME Foundation board is pleased to offer this new membership tier," said Rick Schooler, Foundation board chair. "We believe it satisfies our desire for controlled growth of Foundation membership while introducing a fair and equitable application process. As an associate member, organizations will have a first-in, first-up chance to move to the premier member level as opportunities arise through attrition or board-approved expansion. Additionally, associate members will enjoy a portion of member benefits at a significantly reduced cost. We're seeing early interest in the offering that I believe will increase over time."

"CIOs are bombarded daily with so many mixed messages and an organization like CHIME brings clarity by providing a forum for learning, leadership and networking," said Michael E. Donner, vice president at IntelliDOT Corporation, one of the newest CHIME Foundation associate members. "Here, CIOs and vendors can work together and have meaningful dialogue that can lead to new and innovative solutions. As a bedside barcode point-of-care provider and a new associate member of the CHIME Foundation, we look forward to sharing our expertise about interfaces and integrations to pharmacy and health care information systems to help members with their patient safety initiatives."

In carefully managing the growth of the Foundation while ensuring new associate membership opportunities, associate membership terms require associates to upgrade their membership to the premier level when a premier membership becomes available. Premier membership is scheduled to re-open Jan. 1, 2009. The number of available slots will be determined by 2008 renewals. If a company chooses not to upgrade, its associate membership becomes non-renewable.

Visit www.chime-foundation.org for full details.