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 In the News This Week -- Dec. 15, 2006 |
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 By JIM KEVLIN COOPERSTOWN When Merck recalled Vioxx, the folks at Vanderbilt University Medical Center punched “Vioxx” into the search line of the medical records system. The name of every VUMC patient prescribed Vioxx popped up. With a few keystrokes, e-mails were sent to those patients. To those who didn’t have e-mail, letters soon began spitting out of the hospital’s printers. Within hours, most – and within a day or two, every – patient taking Vioxx had been alerted: Stop. “We have a very good information system now,” said Bassett Healthcare’s Dr. Henry F. Weil, but not like VUMC’s – at least for the next few weeks. “There’s another level.” Weil has been the point man on Bassett’s medical staff tasked with exploring that next level, with finding how to take advantage of computerization so that every available piece of medical information about a patient will be at every physician’s fingertips. And Weil’s found what he and Kenneth R. Deans Jr., Bassett Healthcare’s vice president, information technology, and chief information officer, believe is the best in the field: a system VUMC has been developing for 15 years. Monday, Dec. 11, VUMC announced the formation of a new “clinical software and solutions company,” Informatics Corp. of America, and reported that Bassett is its “first client and flagship health system,” and that “rapid implementation” is under way. Parts of it are already fully functioning in some departments. For instance, digital imaging, a precursor to EMR, as the medical people call it, for electronic medical records, was put in place in March, and an X-ray taken in Herkimer can immediately be read by Dr. Steven Heneghan in the radiology department at Mary Imogene Bassett Hospital in Cooperstown. The patient has a dangerously distended appendix, the X-ray shows. In minutes, that patient is en route to Cooperstown where surgeons are already preparing to perform the operation. Nice. But it gets better. Shortly, Heneghan will be able to turn to a nearby laptop – or PC, or electronic “tablet” – and quickly review that patient’s medical history: What operations he’s had, what prescriptions he may be taking, what unusual risk factors may be present. As you might guess, this didn’t just happen. This is part of a three-year, $18 million I-T Strategic Plan that Bassett’s board of directors approved in February 2004, but Bassett CEO William F. Streck and the directors had been looking for such a system as far back as the mid-’90s. They were ahead of the technology. “It just didn’t exist,” said Weil, whose title in all this – he has to pause to remember it – is “medical director of Informatics.” The first goal of the strategic plan was patient safety – easy access to all information helps doctors make the right decisions, and more quickly – and physician satisfaction. Doctors, Weil said, have been frustrated by bulky paper files and X-rays that need to be physically ferried around; information systems that existed were vertical – the gynecologists, pediatricians, opthamologists and so on maintained records within their individual disciplines. When Weil stopped by the surgery clinic the other day, Dr. Jonathan Richman peppered him with ideas on added features for the system, (many of which will be forthcoming.) Finally, Weil asked, would you give it up? “Would I give up oxygen?” was Richman’s reply. Yes, there will be savings. X-ray film costs $4 or so a sheet, and Bassett has used between 100,000 and 130,000 sheets a year. The new system digitizes everything – no more film. But “ROI” – return on investment – “was just not part of the discussion,” said Weil. Instead, he said, it is part of the Bassett continuum, going back to Stephen C. Clark Sr.’s goal of building “the best hospital you could build” staffed with “the best doctors we could get.” Weil’s involvement in the project goes back five years, when he derailed a proposed information system which he felt was lacking; feeling guilty, he got involved in trying to find an alternative. He was introduced to the VUMC system in early 2004 and went to Nashville to see it firsthand. VUMC’s system had been be developing incrementally since 1991. It received a big boost in May 2004, when President George W. Bush and congressional leaders toured VUMC and identified the system as most likely to achieve an administration goal of creating electronic medical records for all patients within 10 years. About that same time, Weil made a site visit to Greenwich Hospital in Connecticut, and spent six hours with the I-T chief there, Kenneth R. Deans Jr. “Do you know any other I-T guys like this?” Weil asked another member of his group when they left. “He knows I-T, but can also talk to people.” As it happened, Bassett’s chief information officer position was opening up. Deans visited Cooperstown and was impressed by Bassett’s ambitions: ts four hospitals and 23 community health centers served an area about the size of Connecticut. As a single entity, it was suited for the kind of initiative he and Weil had in mind. The CEO is a doctor; only a few dozen hospitals in the nation have a physician in charge. Finally, the “level of enthusiasm, motivation, and history of innovation” clinched the deal. “It was a perfect proving ground,” said Deans, who joined Bassett as vice president, information services, and chief information officer in April 2004. Because of the size, spread and variety of the system, “if it works here, it can work anywhere.” Within two weeks of his arrival, Deans was facilitating a retreat with the medical staff, exploring their information needs. Then, “we assessed the entire base of technology at Bassett”; a complete inventory alone took six months. The groundwork for what was to follow had to be laid. Deans shifted all PCs to Microsoft, “face it, it’s the industry leader.” In a few months, his department – there are 50 I-T engineers and applications experts on staff – replaced and upgraded 1,800 computers, installed $75,000 in fiber-optic and copper wiring and began building a central data bank. Walk around any Bassett building, look at the ceiling, and you’ll see plastic disks – 8-10 inches wide – that look a bit like smoke detectors or part of a sprinkler system. Those are wireless entrypoints that connect laptops with the database. Almost 500 of those disks had to be installed around the hospital campus. Next, all the separate systems – the lab system, the pharmacy system, the radiology system, “several dozen” in all – had to be replaced or adapted so they could talk to each other through the standard PCs and a single network feeding into and retrieving data from a central electronic brain. Duplication and errors had to be winnowed out of the new system, which is known as a RHIO, a Regional Health Information Organization. If Informatics is the “glue,” as Weil puts it, that holds the EMR – electronic medical records – together, then cardiology, finance, the lab, and dozens of other entities are already glued. In June, document-imaging began: Inputting of the historical data. “Once all the history is loaded, then doctors will start using it,” said Weil. “We’ll probably start with doctors in early 2007, and roll it out as quickly as we can.” Concerns about the privacy of all this information and “Big Brother” abuses have been been raised about all such mega-collections of information, but both Weil and Deans were unconcerned. “Privacy,” said Weil, “is not a matter of electronic versus paper: That’s a question of statute. Health information is very well protected by the law; it’s the law that protects people.” Beyond that, however, the system is secure, they said. It is accessed by slashcard or, futuristically, fingerprint. And the system has an audit function, keeping a record of everyone who accesses it. Against fears of security breaches, there is the very big plus-side. “If you’re really in trouble health-wise,” Weil said, “you need the people taking care of you to have this information.” In the not-too-distant future, RHIOs will be talking to each other, patients will be accessing their own information and, finally, if you get hit by a taxi in Rome, Italy, physicians there will plug into your health records as seamlessly as they will be able to do in Rome, N.Y.   By JIM KEVLIN COOPERSTOWN Dr. Maria C. Escano, a resident at Mary Imogene Bassett Hospital, was standing in the hall with a 3-inch thick stack of paper. Next to her was Dr. Henry F. Weil, holding a laptop, which will replace the stack of paper over the next several weeks. The advantages are obvious. The paper can be looked at by one physician at a time. The laptop, by as many as need to. The paper has to be moved around at the speed a person walks or a van is driven, or faxed hither, thither and yon a page at a time. The laptop moves data around almost instantaneously. A patient being seen in Bassett’s Primary Care department may have to sit in the waiting room for hours until the paper file shows up. With the laptop, the records are immediately at hand. A few moments later, Drs. Weil and Escano are using the laptop to show a chest X-ray to Mrs. Dorothy Oakley of Hobart, who had agreed to participate in a demonstration for the purposes of this article. “I didn’t believe my lungs were so bad,” Mrs. Oakley observed. “Actually, they aren’t bad at all,” Weil explained. On a lung X-ray, the dark parts reflect air, space, which is what you want in a lung. A few minutes before, Weil had, in a nutshell, described what the Informatics Corp. of America’s universal record-keeping system does: “It takes the strengths of the human mind and augments them,” he said, “and takes the weaknesses of the human mind and mitigates them.” Weaknesses? The human mind is not so great at retaining oodles of facts, particularly over long periods, he said. Strengths? The human mind is great at recognizing patterns and organizing experience. “...in talking to people and finding out what it is the patient wants,” Weil continued. “The mind is good at taking data and making good and compassionate judgments from the data; a computer can’t do that. A mind is good at questioning itself and asking, ‘Is this the best way to do it.’ “The mind is good at caring. Maybe that’s the most important one.” Take sodium, which is key to maintaining blood pressure and other bodily functions, Weil said, punching up a chart on his laptop. If sodium levels are high, it’s probably dehydration. Drink more liquids. But if the levels are low, there could be 10 explanations - or 20. Weil touches his screen again, and those 10 possibilities are detailed for the physician to review. He calls it “just in time learning,” one of the many, many uses of the new EMR system. Once the system is fully installed, each physician can carry a laptop – or an electronic “tablet,” if he or she prefers – from room to room, or use one assigned to each room. The physician swipes a card – or simply runs a finger across a fingerprint readers – and the patient’s chart appears. As was done with Mrs. Oakley, the physician can review an X-ray with a patient, present information through graphics, and instantaneously research any question the patient may ask. In the ceiling of Mrs. Oakley’s room was a smoke-detector-like plastic disk, the entrypoint for wireless laptop into the information system. From that disk, signals from Weil’s computer travels through the wall via copper wire, which connects with larger fiber-optic cables, that in turn flow into the system’s central brain in a basement across the campus. Entering, you feel a bit like Maxwell Smart accessing CONTROL headquarters. From a control booth, three technicians – Loretta Ray, who Bassett CIO Ken Deans describes as “the wizard of Oz” of the operation, plus Glen Miller and Nihah Dhanoo – were monitoring a roomful of metal boxes that bring to mind the mainframes of yore. On one side are racks upon racks of servers stacked on servers. Across a narrow aisle in the temperature-controlled room are “big pools of hard drives” where all the data reside. On the far end, the fiber-optic cables converge. On the wall in the control booth is an electric signal box where the various databases are represented by bright yellow-green buttons. If any one of the machines hiccup, the result is a “red alert.” “We hope that never happens,” said Deans, but with snowstorms, flood, high winds and the like, periodic episodes occur. If one does, Deans points to several large metal chests lined along one wall, the equivalent of a huge car battery. If the power source fails, the battery kicks in 1/16th of a second later. It runs on oil and can be refilled indefinitely. Across the campus again, and there’s a department doing nothing but scanning paper, digitalizing documents that will then be fed into the wireless maw. And finally, on the third floor, is the dinosaur: the medical records room, row upon row of manila files, thousands of them, hundreds of thousands of them. Soon, like dinosaurs, they will be gone. By CHAD WELCH HARTWICK Plans for a Hampton Inn & Suites, the fourth such enterprise in Hartwick Seminary near Cooperstown Dreams Park, appears to be running into hurdles. Several concerns about the project – from traffic congestion to safety issues to the height of the building – came in for criticism when the Town of Hartwick planning board met Tuesday, Dec. 12. “It would stick out like a sore thumb,” stated Fred Thering, planning board co-chairman. The Hampton Inn is being proposed by Rainbow Enterprises Inc., which also operates the adjacent Holiday Inn Express on Route 28. No one was present on Rainbow’s behalf at the meeting, raising questions about the company’s intentions. The height of the building, proposed as a three-story structure, exceeds the town’s two-story maximum. This would present real safety challenges to Volunteer Fire Departments who would need to protect it and would not have the equipment to do so, it was noted. Furthermore, considering the proximity to State Highway 28, the height is also an aesthetic concern that would block many lines of view. Traffic is another dilemma, since this proposal calls for a second curb cut for a new and separate driveway, as opposed to sharing the preexisting entrance from the Holiday Inn. A second driveway could further disrupt safe traffic flow in an already extremely busy section of Route 28 near what’s been considered a dangerous corner with limited visibility. The future ground site for the Hampton Inn would be about 100 feet from the current route of State Highway 28, and with additional turn lanes being discussed by state Department of Transportation for Route 28, the distance from the road is not only a concern now, but potentially an even bigger issue once the building has been completed if the road were to widen. It is also argued that the proposed site is in a drain area, and questions regarding ground saturation were raised, and it was suggested by the Planning Board that a proper hydrologic study of the area be done. In a separate request, Rainbow Enterprises sought a landfill permit for the area to the south of the Holiday Inn,behind the temporary farm stand and bordering the roadway to the Paint Ball Park. The Planning Board decided to table this request, citing concerns that a drinking water well was located on the same site. The possible use of construction fill, containing concrete and other building scraps, as opposed to use of only clean fill also worried the board, and it was believed this landfill permit should be included as part of the complete development project, with more definition in terms of the fill to be used and the intentions for the area to be filled. The areas of concern discussed during the November meeting were drafted into a letter under the direction of Attorney Thomas J. Fucillo. Fucillo, of Menter, Rudin & Trivelpiece, Syracuse, has provided legal counsel for the Town of Hartwick in the past. On Monday, Dec. 11, town board voted to retain his services as representation for the planning board in the Hampton Inn development. Representatives for the Hampton Inn project were especially angered at the order the Planning Board followed in their review of the details of the project, and the length of time it took the board to consider certain areas of the proposal as compared to others. Following the November meeting, Rainbow Enterprises informed Mr. Fucillo of their intent to ursue a lawsuit against the planning board. So far, however, no papers have been filed.  Cooperstown’s Problems Few, Mayor Learns From Her Peers
COOERSTOWN Poughkeepsie Mayor Nancy Cozean reported dealing with Cripps and Bloods who communicate through graffiti. Her public works crew spends hours a day covering up the mess. William Glackens, the mayor of Freeport, on Long Island, reports how Nassau County ran a six-lane highway through his downtown. Pedestrians avoid it in fear of their lives. And Mayor Paul LePage had to rush home from the Mayors’ Institute on City Design in Cambridge, Mass., to Waterville, Maine, when two murders happened. “I couldn’t wait to get back home,” said Cooperstown Mayor Carol Bateman Waller. “How lucky we are here.” Mayor Waller got back Monday, Dec. 11, from three days at MIT at the institute, an entity sponsored by the National Endowment for the Arts, the American Architectural Foundation and the Conference of Mayors that has been helping mayors find solutions to thorny problems since 1986. This year, the 700th mayor went through the training. Seven Northeast mayors participated in Waller’s session - Steve Marchand of Portsmouth, N.H., would have been the eighth, is running for U.S. Senate and didn’t show up - and each prepared a position paper on a daunting challenge their cities are facing. All help each other to develop a plan of attack. After all the crime, blight and vandalism, “I was the closer,” said Waller. “They wanted to end on a bright note, they said.” Her case study has been one of her thorniest issues: the prospective visitors’ parking lot at the end of Linden Avenue. To her surprise, she discovered “we don’t have a parking problem,” that the “blue lot,” (at the end of Linden Avenue off Route 28), the “red lot,” (en route to Fly Creek), and the “yellow lot,” (just beyond the Farmers’ Museum), suffice. “They told me we’re giving our parking away,” she said. “We have plenty of parking, we hust aren’t organizing it correctly.” The mayor, interviewed on Wednesday, Dec. 13, soon after her return, was unwilling to say too much before briefing the village trustees, which she plans to do in January. A report from the institute should arrive at that time, and will be delved into at further length in February. However, she said, it was suggested that it’s a mistake to have the Cooperstown Chamber of Commerce information booth downtown: Tourists get downtown and, instead of driving back to the parking lot on the periphery, look around and try to find a parking place in proximity. Better, she said, would be to capture visitors at the village’s edge, guide them to the information booth, direct them to one of the parking lots, then ferry them downtown on the trolleys. As it stands, the Linden Avenue project would establish an information booth off Route 28 with that strategy in mind. Waller said she found the long weekend very worthwhile, if for no other reason than she can now pick up the phone and chat with a half-dozen of her peers across the region. The mayor was invited to attend; she doesn’t know who nominated her; none of the participants did. But the institute covered all the costs, even reimbursing her for mileage back and forth to Boston. Waller said the other mayors all seemed delighted by what she told them about Cooperstown. In New Bedford, Mass., 50 percent of the downtown storefronts are empty, Mayor Scott Lang reported, and that former whaling town is trying to do things Cooperstown is already doing - from the Pumpkin Fest to the Cooperstown Christmas Stroll - to get people to go downtown. “We make reasons for people to come into the village and feel comfortable here,” the mayor said. In particular, they were incredulous when Waller told them there are 75 volunteers serving on unpaid positions on village committees, and they rolled their eyes when she described the services rendered by the volunteer fire department. "We're a small town," the mayor concluded, "and we care about one another."  COOPERSTOWN As always, there’s the Sleeping Lion, dominating the view north from Five Mile Point today as it has for eons. But in the foreground are skiffs and a woman in a long red skirt and a bustle, and a number of men, some in boaters. It is a painting, done in 1862 by the well-known 19th-century painter of primitives, Thomas Hicks, (1823-1890), and it will may be seen from now on at the Fenimore Art Museum’s fine art gallery on the museum’s first floor. The museum announced Wednesday, Dec. 13, that it had acquired “Otsego Lake, N.Y.,” Dec. 2, at an auction at Hesse Gallery, Otego. It is oil on canvas, and signed and dated by the artist. No price was released, although Thomas Hicks’ paintings auctioned recently have brought sums in the thousands. “Mother & Daughter” went for $6,500 and “Sheep & Shepherd,” for $9,999. “It is exciting to see Otsego Lake so beautifully captured by Thomas Hicks. This painting is a historically significant work, and will fit beautifully into the Museum’s exceptional collection of American art,” remarked Jane Forbes Clark, chairman of The Farmers’ Museum board and a Fenimore patron, who provided the funds to acquire the piece. “This painting is a magnificent panorama of the northern end of Otsego Lake, with Springfield, Sleeping Lion, and Hyde Bay depicted much as they appeared in James Fenimore Cooper’s time,” said Paul D’Ambrosio, New York State Historical Association vice president and the museum’s chief curator. “The artist also paid homage to the importance of the lake in mid-19th-century outdoor recreation, as he depicts a variety of watercraft in use in the foreground. This work is a local visual document of national quality and significance.” Hicks was born in Newtown, Pa., and studied at the Pennsylvania Academy of the Fine Arts and abroad, where he lived for several years. He settled in New York City in 1849 and there became one of the outstanding portraitists of his day. He is also the cousin of famed folk art painter Edward Hicks, who is most recognized for his work, “Peaceable Kingdom.” Edward Hicks did several versions of that painting, one of which hangs at the entrance of the gallery where his cousin’s painting will be hung. Thomas Hicks’ paintings are held in museum collections across the country, including the National Portrait Gallery; Smithsonian Institution; The Museum of Fine Arts, Boston; The Baltimore Museum of Art; Yale University Art Gallery; North Carolina Museum of Art; The Newark Museum; Munson-Williams Proctor Arts Institute; Utica; The Brooklyn Museum of Art; National Academy of Design; New-York Historical Society; and The Metropolitan Museum of Art; among others. By TOM HEITZ COOPERSTOWN Village authorities are questioning the legality of Cooperstown Chamber of Commerce plans announced last week to help owners of private residences rent out space in their homes to baseball fans attending the 2007 Baseball Hall of Fame Weekend, on July 27-29. At the center of the controversy is a policy promulgated by the Zoning Board of Appeals (ZBA) in 1990 which enables owners of private residences in the village to rent their premises out to tourists on specified weekends. Such rentals are not to exceed 15 days a year and no special permit, otherwise required by zoning laws and regulations, is needed. Village authorities are considering whether a law should be adopted in place of the policy, or alternatively, whether any such law is necessary, or if such a law could be enforced rigorously. Last week the Cooperstown Chamber of Commerce unveiled a plan designed to facilitate the rental of private residences as tourist accommodations during the 2007 Hall of Fame Induction weekend. With hotels and motels booked up and charging more than $300 a night, people offering rooms can expect $175 a night for two beds and a private bath; semi-private rooms bring somewhat less, Chamber executive Polly Renckens told the Journal in a front page article in last week’s edition. Under the Chamber’s plan, interested homeowners would get a premises inspection and assistance with Otsego County bed tax forms for a $40 fee. The inspection, to be carried out by Chamber staff, would determine the suitability, cleanliness, and safety of the proposed rental space. If the inspection is approved, the Chamber will post a photo and description of available rooms on a special “induction accommodation” website. Tourists seeking accommodations will make direct contact with homeowners based on the information found on the website. “We’re acting as go-betweens,” Renckens stressed. “We’re not in the booking business.” Renckens added that homeowners must consult with their own insurance agents to ascertain whether their liability policies cover transient rental guests, and if not, what additional coverage and cost is involved. The Chamber’s liability policy will not be in play as participating homeowners are being asked to sign a waiver absolving the Chamber of responsibility. Renckens added that the waiver language was being drafted by the organization’s lawyer. The Chamber’s plans initially came to the attention of village authorities on Thursday, Dec. 7 at a meeting of the Planning Committee, chaired by trustee Jeff Katz. Al Keck, village codes officer, who routinely reports to the committee about the ongoing revaluation of real property in the village, aired the Chamber’s plans and sought guidance as to how he should proceed with enforcement of the 1990 policy. Keck told the committee he had been aware of this policy all during his seven-year tenure as Zoning Enforcement Officer. However, Keck said he had recently reviewed the policy with Village Clerk Terry Barown and the opinion of village attorney John Lambert had been sought. Keck reported that Lambert believes the policy is ineffective and null because the ZBA has no authority to create policies or to amend the zoning law. The ZBA does have power to interpret the zoning law, but the policy in question does not interpret the law and cannot be enforced as such, according to Lambert. “It’s not law, it’s policy,” Lambert confirmed in an interview with The Freeman’s Journal on Wednesday, Dec. 13. | Jan. 04, 2008 | Local Honor Roll | Pages From The Paper | july 6th 2007 | Hall of Fame Friday | Hall of Fame Saturday | Hall of Fame Sunday | Hall of Fame Monday | July282006 Archive | Aug042006 Archive | Aug112006 Archive | Aug182006 Archive | Sept012006 Archive | Sept082006 Archive | Sept152006 Archive | Sept222006 Archive | Sept292006 Archive | Oct062006 Archive | Oct132006 Archive | Oct202006 Archive | Oct272006 Archive | Nov032006 Archive | Nov172006 Archive | Nov242006 Archive | Dec012006 Archive | Dec082006 Archive | Dec152006 Archive | Dec222006 Archive | Dec292006 Archive | Jan052007 Archive | Jan192007 Archive | Jan262007 Archive | February092007 Archive | February162007 Archive | February232007 Archive | March162007 Archive | March232007 Archive | March302007 Archive | March302007 Archive | April132007 News Archive | Chris Gentile | Obituary | April272007 Archive | May112007 Archive | May112007 Archive | May252007 Archive | June 22, 2007 | July 13 2007 | Sept05 2007 | Sept 7th 2007 | Aug 31st 2007 | Local Law Parking | October 26, 2007 | Nov. 2 2007 | Nov. 16, 2007 | Glimmerglass Oct 5,2007 | Nov 16., 2007 | November 30 2007 | Nov. 30, 2007 | Dec. 07, 2007 | Dec. 14, 2007 | Dec. 21, 2007 | Dec. 28, 2007 | Jan. 11, 2008 | Jan. 18, 2008 | Jan. 25, 2008 | Feb 1, 2008 | Feb. 8, 2008 | Feb. 22, 2008 | GlimmerGlass Feb. 15, 2008 | Sports Feb. 15, 2008 | Feb.28, 2008 | March 7, 2008 | March 14, 2008 | GlimmerGlass March 14, 2008 | March 21, 2008 | March 28, 2008 | April 4, 2008 | April 11, 2008 | April 18, 2008 | April 25, 2008 | May 9, 2008 | May 2, 2008 | May 23, 2008 | | Our Services | Contact Us | Great Links | Return Home | Classified Ads | News Archive | Cooperstown Homes | Calendar -Best Bets | Letters to the Editor | |
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