Grand Rounds: Health 2.0 Explosion At Diabetes Mine

Amy Tenderich of Diabetes Mine explores the Health 2.0 Explosion in this week's edition of Grand Rounds, Vol. 4, No 20. If you are interested in health care social networking and health 2.0 topics don't miss reading this week's edition.

Great job Amy!

Hospitals and Anonymous Blogging: An Update of the Paris Regional Medical Center Lawsuit

Just pick up the latest news from Greg Piche of the Holland & Hart Healthcare Law Blog about the pending libel lawsuit against an anonymous blogger filed by Paris Regional Medical Center, a subsidiary of Essent. For some background on the case check out Jeff Drummond's past post Hospital Sues Blogger.

The libel lawsuit filed last year by Paris Regional Medical Center seeks the unmasking of an anonymous blogger and nine other anonymous contributors or commentators on his/her blog.

The hospital sought the identity of the anonymous bloggers from Suddenlink who balked at disclosing the identity of the anonymous blogger until he/she was given notice and an opportunity to object. As a result the anonymous blogger appeared through an attorney and objected which were rejected by the trial court.

However, on appeal to the Court of Appeals for the Sixth Appellate District of Texas at Texarkana, In re: Does 1-10, No. 06-07-00123-CV (Dec 12, 2007) followed the standard set out in Doe. V. Cahill, 884 A 2d 451 (De. 2005), granted the writ of mandamus and ordered the trial court to vacate its order requiring Suddenlink to disclose the name and address of the anonymous blogger. Basically, the court sustained the anonymous bloggers First Amendment rights of free speech until such time as the hopsital can show in a hearing at the trial court level that it has actually been damaged by the content of the blog.

The court analyzed the situation as follows:

The cases that have decided this issue range from placing an extremely light burden (indeed, virtually no burden at all) on the plaintiff, to requiring the plaintiff to tender proof of its allegations that would survive a summary judgment, or even more stringent requirements. At least one case has essentially concluded that the mere allegation of libel is sufficient. Alvis Coatings, Inc. v. John Does One Through Ten, No. 3:04CV374-H, 2004 U.S. Dist. LEXIS 30099 (W.D.N.C. Dec. 2, 2004). Other cases have articulated requirements that are so weak as to essentially require no more than allegations made in good faith (or not in bad faith), with some evidence to support the allegations. See Polito, 2004 Pa. Dist. & Cnty. Dec. LEXIS 340.

We cannot agree that either of these formulations is sufficient to survive any form of constitutional balancing. Thus, the question becomes the degree of actual proof that must be provided before the balance tips in favor of piercing the constitutional shield and disclosing the identity of the anonymous blogger.

We find ourselves more in alignment with the formulations set out in Cahill, 884 A.2d at 458-61. See extensive discussion about the application of this standard in Best W. Int'l, 2006 WL 2091695. The court in Cahill described the test as: "[B]efore a defamation plaintiff can obtain the identity of an anonymous defendant through the compulsory discovery process he must support his defamation claim with facts sufficient to defeat a summary judgment motion." Cahill, 884 A.2d at 460. This standard does not require a plaintiff to prove its case as a matter of undisputed fact, but instead to produce evidence sufficient to create issues that would preclude summary judgment.

West Virginia E-Prescribing Regulations

On January 4, 2008, the West Virginia Board of Pharmacy filed a Notice of Emergency Rule amending CSR 15-1, Licensure and Practice of Pharmacy, implementing the requirements of SB 1001 (See SB 69 and HB 2289) passed during the 2007 Legislative Session permitting electronic prescribing (e-prescribing) of legend drugs in West Virginia, including through the use of electronic data intermediaries.

The Board also filed on January 4, 2008, the Notice of a Comment Period on a Proposed Rule amending CSR 15-1, Licensure and Practice of Pharmacy. Comments on the Proposed Rule must be submitted before February 8, 2008.

The summary and statement of circumstances included in the notice reads:

SB 1001, passed during the First Special Session, 2007, and duly enacted into law, permits electronic prescribing (e-prescribing) of legend drugs in this State, including through the use of electronic data intermediaries as defined therein. SB 1001 contains the following directive to the West Virginia Board of Pharmacy as set forth in West Virginia Code Section 30-5-12C(d): "The board shall promulgate emergency rules pursuant to the provisions of article three, chapter twenty-nine-a of this code to implement and enforce the provisions of this section." E-prescribing is already being done by prescribers around the state, with the amount and frequency of electronic prescriptions being received by pharmacies increasing each day as the technology becomes more accepted and available in the industry. While the current rules allowed for electronic transmission of prescriptions, SB 1001 states that e-prescribing may not be done in this State until emergency rules are promulgated, and further sets additional parameters defining this growing area. As such, the e-prescribing currently being done in this State is being done without appropriate legislative rules in place to protect the integrity, privacy, security and confidentiality of the prescription orders. In addition, prescription drug diversion is an ongoing problem in this State and nation; e-prescribing done correctly is one method to combat the problem often perpetrated through passing fraudulent written prescriptions. Finally, e-prescribing aids in the accuracy of prescriptions by more timely presenting them electronically from the prescriber's office to the pharmacy in a clearly legible format, thus reducing fill-errors and facilitating patient compliance with the prescribed treatment.

Given these factors, the Legislature, through its deliberative process, has determined that an emergency exists requiring the need for emergency rules to govern the use of e-prescribing and electronic data intermediaries in this State for patients to access prescription medications in a safe and efficient manner. Therefore, in accordance with that directive, the purpose of this emergency rule is to revise existing rules governing issuance of prescription orders to set specific standards to govern e-prescribing in West Virginia, thereby protecting the public health, safety, and welfare with regard to restricted drugs which may only be obtained by patients with a proper prescription.

Results of Tech President Primary

Want to know where the presidential hopefuls stand on technology?

Check ou the result of the TechCrunch Tech President Primaries. You can see where the candidates stand on 10 key tech issues. Based on the results the TechCrunch endorsements goes to Barack Obama and John McCain.

Great information if you are concerned about the level of knowledge our leaders must have regarding the importance of technology on the economy and our culture.

Grand Rounds . . . Revolution

Grand Rounds Volume 4, No. 19 is up over at my favorite nurse blog, Emergiblog. Kim has wonderful vision into the world of health care and is a creative writer to boot.

I've gotten out of the habit of submitting posts to Grand Rounds. Never enough time in the day. However, I wish I would have submitted my Guitar Hero Health Care post from this week -- it would have fit well in her Beatles theme. Find the Beatles link in my post.

Maybe I'll email Kim as see if she will give me a Grand Rounds postscript note.

West Virginia Educational Social Network

The State Journal reports that West Virginia University with the backing of a grant from Verizon will create a social network for middle and high school students focused around education (with emphasis on the energy sector) to get a head start on career decisions.

Partners in the project include WVU's College of Engineering and Mineral Resources, College of Human Resources and Education and The EdVenture Group.

A description of the project from the WVU press release:

Unlike Facebook.com and other social networking sites, the new site, once developed, will not be open to the general public. Rather, a network of representatives from participating companies and schools will serve as experts and mentors for students who join the site.

Along with Web-based interaction within groups, the site will host discussion groups, chats and blogs on relevant topics and an “Ask the Counselor” section where students can ask questions concerning academic or career issues. Other activities may include contests based on career knowledge, virtual career fairs and group visits to employer or educational facilities.

Interesting concept and I'm excited to learn more about the project. Based on my experience with social networking and the use of blogs in the legal industry I think the application of these technologies in education can be powerful. The added plus is that the platform will be familiar and attractive to the way that middle and high school students communicate. Anyone aware of similar projects like this happening around the country?

I will be interested to hear what Lee Kraus, the guru on education focused social networking, has to say about the pilot project. This reminds me of a concept that I previously discussed with Lee.

WVU press release has more details.

Newsweek Features Amy Tenderich of DiabetesMine

Great to see Newsweek run a story on Amy Tenderich and the success of her blog, DiabetesMine. Amy's efforts are a great example of how blogs can be used to creatively share valuable information with a patient community.

Here is a taste of the article and how Amy got started,

I've been writing my Web site for three years now, and some amazing things have happened. First, I learned all sorts of facts about my own health that doctors never told me. I learned that thousands of other people out there have been diagnosed with type 1 diabetes later in life, like me—a condition called LADA (latent autoimmune diabetes in adults). From other patients I also learned essential basics about related conditions, like gluten intolerance (celiac disease), and Raynaud's syndrome, a circulation disorder in the hands—both of which I suffer from, along with the diabetes.

Second, a whole community of "patient bloggers" has grown up around me—hundreds of other people sharing their health challenges on the Web. We exchange treatment and insurance tips, hold online chats, link to each other's sites, and even manage to meet in person sometimes.

Congrats Amy on a great article.