The infrastructure is now in place to use new informational technologies in the American health care system effectively. But a former White House official tasked with improving health care technologies said the challenge is to ensure that innovations do not deepen existing disparities in health care, and instead provide care more effectively across communities.David Blumenthal, who until last month was national coordinator for health information technology, outlined the potential and the pitfalls of additions such as electronic health records as part of the Reede Scholars’ Second Annual Health Equity Symposium on May 12.His was “not a program about technology, although health technology is in the title; this is a program about health care,” said Blumenthal, the Samuel O. Thier Professor of Medicine at Harvard Medical School, during the program on “eEquity: Leveraging Technology to Achieve Health Equity.”“It operates under the assumption that information is the lifeblood of medicine and that we are only as powerful as the information we have, whether we are a nurse practitioner, a physician, or a respiratory therapist.”Still, “there is the enduring observation that new technologies do not disseminate evenly in our society,” Blumenthal said. From imaging devices to new asthma treatment, such innovations reach some vulnerable populations later than others. Yet Blumenthal emphasized the progress made. A significant market in producing health information technology programs has emerged, sparked by a new incentive program, he said.This has “created a market where there hadn’t been a market before for the use of health information technology,” Blumenthal said.In early spring, 260 providers, mostly under Medicaid provisions, have received $84 million in “meaningful use payments,” Blumenthal said. About 67,000 registered providers, mostly primary care doctors in small practices, will receive help from 62 new technical centers. “That’s a substantial penetration,” he said.About 7,000 students have been enrolled in 84 community college programs to receive training that will support new medical information technology, he added, saying, “There is increasing coordination between this high tech agenda and the health reform agenda.”Even with the explosion of new products, Blumenthal warned that minority groups may be slower in reaping the benefits of such innovations as electronic medical records.“We can make these efforts through central governmental intervention, but the best long-range solution … is to level the playing field in the health care system as a whole,” he said. “What we need is more of the kind of leadership that brought us health reform.”During a question-and-answer period, Blumenthal made a key observation: “What you have to realize is that everyone you run into who has been paying taxes, has put $100 toward the adoption of electronic health records. Every man, woman, and child in the U.S. is paying $100 for this to happen.“I think that’s a pretty good deal for providers. I think this is a unique investment and an amazing commitment that is really up now to providers to deliver.”The symposium, which was moderated by Lenny Lopez, an internist trained at Brigham and Women’s Hospital, featured remarks by Joseph R. Betancourt, director of the Disparities Solutions Center. There were presentations by Quyen Ngo-Metzger, data branch chief in the Bureau of Primary Health Care at Health Resources and Services Administration; by oral surgeon Elsbeth Kalenderian on improving links between medical and dental practices; and by John Moore, a Ph.D. candidate in the New Media Medicine group at the MIT Media Lab, on possible new devices.Moore wowed the audience with a peek at emerging technology aimed at educating and empowering patients by, for example, letting them see and manipulate visual data on the effect of medication in their bloodstream, or by a stethoscope that would let doctors and patients hear heartbeats. The goal — something underscored by questions from the audience — was to replace the scenario of a doctor staring at a computer screen to one in which physician and patient look at data together to develop medical regimens.
By Gary WadeUniversity of GeorgiaJust a glimpse of the bright, true-blue flowers of perennialplumbago and it will be love at first sight. It’s easy to see whythe Georgia Plant Selections Committee chose this durable,gorgeous flowering groundcover as the 2006 Georgia Gold Medalwinner for herbaceous perennials. Perennial plumbago (Ceratostigma plumbaginoides) growsjust 6 to 10 inches tall and spreads 1 to 2 feet wide. It’s agreat choice for filling spaces between shrubs, creeping overrocks in a rock garden, adding a splash of blue to the perennialborder or spilling over walls.Drought and deer tolerance and a long bloom period are otheroutstanding qualities of this award-winning plant.BackgroundPerennial plumbago, also called leadwort, belongs to a group ofdeciduous perennials and shrubs from eastern Africa and Asia. It’s a semiwoody, mat-forming perennial that spreads by rhizomes,or shallow underground stems. It thrives in hardiness zones 5 to9.The plant dies back to the ground each year. Then it leafs outlate in the spring. So, plant it where it won’t get damaged byearly spring cultivation.The late spring green-up makes perennial plumbago an excellentplant for interplanting with spring-flowering bulbs. Its leaveswill be emerging just as the foliage of the bulbs is dying back.When they emerge, the shiny green leaves are up to 2 inches long.They turn bronze-red in the fall.True-bluePerennial plumbago’s medium-blue flowers resemble those ofwoodland phlox. They emerge in terminal clusters in late summerand continue to emerge until the fall frost. It’s anexceptionally long bloom period. Each flower is one-half tothree-quarters of an inch across and has five petals.The plant prefers a sunny site. But it will tolerate someafternoon shade. Once you get it established, it’s quitedrought-tolerant. Plant it in the spring so you’ll be sure to getit established before the summer bloom. The spring planting willenable it to become hardier next winter, too.Fertilize perennial plumbago lightly in the spring and again inearly summer, if you need to encourage more rapid cover. Waituntil new leaves emerge to prune out any dead wood from theprevious season.Summer cuttings, spring division, root cuttings and seeds are allcommon methods used to propagate the plant. And you’ll want moreof this Georgia Gold Medal winner.(Gary Wade is a Cooperative Extension horticulturist with theUniversity of Georgia College of Agricultural and EnvironmentalSciences.) Volume XXXINumber 1Page 21
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