Mary Ellen Schneider

Privacy should be the top priority when developing certification criteria for personal health records, a task force created by the Certification Commission for Healthcare Information Technology has recommended.

Adequate security and interoperability also must be included in certification efforts, according to the task force.

The CCHIT will use these recommendations as it prepares to begin certifying personal health records (PHRs) next summer.

Since the PHR field is still “rapidly evolving,” the task force said that certification requirements should not be so prescriptive that they interfere with the progress of the technology.

The task force recommended that the voluntary certification process should apply to any products or services that collect, receive, store, or use health information provided by consumers. Certification should also apply to products or services that transmit or disclose to a third party any personal health information.

This would allow the CCHIT to offer certification to a range of products and applications, from those that offer a PHR application and connectivity as an accessory to an electronic medical record (EMR), to stand-alone PHRs.

CCHIT hopes that, just as it did in the EMR field, certification will create a floor of functionality, security, and interoperability, said Dr. Paul Tang, cochair of the PHR Advisory Task Force and vice president and chief medical information officer for the Palo Alto (Calif.) Medical Foundation.

The task force called for requirements to maintain privacy in monitoring and enforcement, and for consumer protection that would allow patients to remove their data if certification is revoked. The group also recommended that standards-based criteria be developed that would require PHRs to send and receive data from as many potential data sources as possible, including ambulatory EMRs, hospital EMRs, labs, and networks.

If done right, certification would have significant benefits for both physicians and patients, Dr. Tang said. A PHR could provide physicians with better access to secure, authenticated data that could help them make decisions, while patients would have more control over their own care, he said.

Privacy should be the top priority when developing certification criteria for personal health records, a task force created by the Certification Commission for Healthcare Information Technology has recommended.

Adequate security and interoperability also must be included in certification efforts, according to the task force.

The CCHIT will use these recommendations as it prepares to begin certifying personal health records (PHRs) next summer.

Since the PHR field is still “rapidly evolving,” the task force said that certification requirements should not be so prescriptive that they interfere with the progress of the technology.

The task force recommended that the voluntary certification process should apply to any products or services that collect, receive, store, or use health information provided by consumers. Certification should also apply to products or services that transmit or disclose to a third party any personal health information.

This would allow the CCHIT to offer certification to a range of products and applications, from those that offer a PHR application and connectivity as an accessory to an electronic medical record (EMR), to stand-alone PHRs.

CCHIT hopes that, just as it did in the EMR field, certification will create a floor of functionality, security, and interoperability, said Dr. Paul Tang, cochair of the PHR Advisory Task Force and vice president and chief medical information officer for the Palo Alto (Calif.) Medical Foundation.

The task force called for requirements to maintain privacy in monitoring and enforcement, and for consumer protection that would allow patients to remove their data if certification is revoked. The group also recommended that standards-based criteria be developed that would require PHRs to send and receive data from as many potential data sources as possible, including ambulatory EMRs, hospital EMRs, labs, and networks.

If done right, certification would have significant benefits for both physicians and patients, Dr. Tang said. A PHR could provide physicians with better access to secure, authenticated data that could help them make decisions, while patients would have more control over their own care, he said.

Privacy should be the top priority when developing certification criteria for personal health records, a task force created by the Certification Commission for Healthcare Information Technology has recommended.

Adequate security and interoperability also must be included in certification efforts, according to the task force.

The CCHIT will use these recommendations as it prepares to begin certifying personal health records (PHRs) next summer.

Since the PHR field is still “rapidly evolving,” the task force said that certification requirements should not be so prescriptive that they interfere with the progress of the technology.

The task force recommended that the voluntary certification process should apply to any products or services that collect, receive, store, or use health information provided by consumers. Certification should also apply to products or services that transmit or disclose to a third party any personal health information.

This would allow the CCHIT to offer certification to a range of products and applications, from those that offer a PHR application and connectivity as an accessory to an electronic medical record (EMR), to stand-alone PHRs.

CCHIT hopes that, just as it did in the EMR field, certification will create a floor of functionality, security, and interoperability, said Dr. Paul Tang, cochair of the PHR Advisory Task Force and vice president and chief medical information officer for the Palo Alto (Calif.) Medical Foundation.

The task force called for requirements to maintain privacy in monitoring and enforcement, and for consumer protection that would allow patients to remove their data if certification is revoked. The group also recommended that standards-based criteria be developed that would require PHRs to send and receive data from as many potential data sources as possible, including ambulatory EMRs, hospital EMRs, labs, and networks.

If done right, certification would have significant benefits for both physicians and patients, Dr. Tang said. A PHR could provide physicians with better access to secure, authenticated data that could help them make decisions, while patients would have more control over their own care, he said.

A growing number of working-age Americans are struggling to pay their medical bills, according to a new report from the Commonwealth Fund.

In 2007, 41% of U.S. adults aged younger than 65 years reported having medical bill problems or medical debt, compared with 34% in 2005. The problem is growing across all income groups but is most common among low- and moderate-income individuals, where more than half reported being unable to pay their medical bills, being contacted by a collection agency about an unpaid medical bill, significantly changing their way of life to pay a medical bill, or paying off medical debt over time.

As health care costs have risen, employers have struggled to provide employee health insurance, leading some to drop coverage or increase employee cost sharing, said Sara R. Collins, Ph.D., lead author of the report and assistant vice president at the Commonwealth Fund. At the same time, most Americans are facing relatively stagnant wages and rising prices for other necessities such as food and gas, Dr. Collins said during a press briefing to release the report.

The findings are based on the Commonwealth Fund Biennial Health Insurance Survey, a nationally representative telephone survey conducted in 2001, 2003, 2005, and 2007. The 2007 data come from an analysis of survey responses from 2,616 adults aged under 65 obtained between June and October 2007.

Of the 28% of working-age adults who were paying off medical debt over time in 2007, nearly a quarter of them owed $4,000 or more. About 34% of adults who were uninsured at the time of the survey reported owing $4,000 or more in medical bills, compared with 20% of those who were insured.

Both insured and uninsured Americans are spending more out of pocket for their care, according to the report. For example, in 2007, 48% of Americans aged 19–64 years spent 5% or more of their income annually on out-of-pocket costs and premiums, up from 41% in 2001. And 33% of working-age Americans spent 10% or more annually on these out-of-pocket medical expenses, compared with 21% in 2001.

The report is available at www.commonwealthfund.org

A growing number of working-age Americans are struggling to pay their medical bills, according to a new report from the Commonwealth Fund.

In 2007, 41% of U.S. adults aged younger than 65 years reported having medical bill problems or medical debt, compared with 34% in 2005. The problem is growing across all income groups but is most common among low- and moderate-income individuals, where more than half reported being unable to pay their medical bills, being contacted by a collection agency about an unpaid medical bill, significantly changing their way of life to pay a medical bill, or paying off medical debt over time.

As health care costs have risen, employers have struggled to provide employee health insurance, leading some to drop coverage or increase employee cost sharing, said Sara R. Collins, Ph.D., lead author of the report and assistant vice president at the Commonwealth Fund. At the same time, most Americans are facing relatively stagnant wages and rising prices for other necessities such as food and gas, Dr. Collins said during a press briefing to release the report.

The findings are based on the Commonwealth Fund Biennial Health Insurance Survey, a nationally representative telephone survey conducted in 2001, 2003, 2005, and 2007. The 2007 data come from an analysis of survey responses from 2,616 adults aged under 65 obtained between June and October 2007.

Of the 28% of working-age adults who were paying off medical debt over time in 2007, nearly a quarter of them owed $4,000 or more. About 34% of adults who were uninsured at the time of the survey reported owing $4,000 or more in medical bills, compared with 20% of those who were insured.

Both insured and uninsured Americans are spending more out of pocket for their care, according to the report. For example, in 2007, 48% of Americans aged 19–64 years spent 5% or more of their income annually on out-of-pocket costs and premiums, up from 41% in 2001. And 33% of working-age Americans spent 10% or more annually on these out-of-pocket medical expenses, compared with 21% in 2001.

The report is available at www.commonwealthfund.org

A growing number of working-age Americans are struggling to pay their medical bills, according to a new report from the Commonwealth Fund.

In 2007, 41% of U.S. adults aged younger than 65 years reported having medical bill problems or medical debt, compared with 34% in 2005. The problem is growing across all income groups but is most common among low- and moderate-income individuals, where more than half reported being unable to pay their medical bills, being contacted by a collection agency about an unpaid medical bill, significantly changing their way of life to pay a medical bill, or paying off medical debt over time.

As health care costs have risen, employers have struggled to provide employee health insurance, leading some to drop coverage or increase employee cost sharing, said Sara R. Collins, Ph.D., lead author of the report and assistant vice president at the Commonwealth Fund. At the same time, most Americans are facing relatively stagnant wages and rising prices for other necessities such as food and gas, Dr. Collins said during a press briefing to release the report.

The findings are based on the Commonwealth Fund Biennial Health Insurance Survey, a nationally representative telephone survey conducted in 2001, 2003, 2005, and 2007. The 2007 data come from an analysis of survey responses from 2,616 adults aged under 65 obtained between June and October 2007.

Of the 28% of working-age adults who were paying off medical debt over time in 2007, nearly a quarter of them owed $4,000 or more. About 34% of adults who were uninsured at the time of the survey reported owing $4,000 or more in medical bills, compared with 20% of those who were insured.

Both insured and uninsured Americans are spending more out of pocket for their care, according to the report. For example, in 2007, 48% of Americans aged 19–64 years spent 5% or more of their income annually on out-of-pocket costs and premiums, up from 41% in 2001. And 33% of working-age Americans spent 10% or more annually on these out-of-pocket medical expenses, compared with 21% in 2001.

The report is available at www.commonwealthfund.org

The number of Americans without health insurance coverage dropped to 45.7 million in 2007, down from 47 million in 2006, mainly because of increased enrollment in government-funded health insurance programs, according to new data from the U.S. Census Bureau.

The percentage of uninsured Americans fell from 15.8% in 2006 to 15.3% in 2007.

The Census data also showed that fewer U.S. children went without health insurance in 2007. The number of uninsured children fell from 8.7 million in 2006 (11.7%) to 8.1 million in 2007 (11%).

The new figures, which were released by the Census Bureau, come from the Annual Social and Economic Supplement to the Current Population Survey.

While Census officials are still researching why the number of uninsured Americans has decreased, the data points toward increased enrollment in government-funded health insurance programs.

For example, the number of Americans covered by private health insurance stayed about the same at 202 million, but the number of individuals covered by government health insurance program rose to 83 million from 80.3 million in 2006.

There were statistically significant increases in the percentage of people covered by both Medicare and Medicaid.

The number of people with Medicare coverage increased from 40.3 million (13.6%) in 2006 to 41.4 million (13.8%) in 2007, and the number enrolled in Medicaid increased from 38.3 million (12.9%) in 2006 to 39.6 million (13.2%) in 2007.

"The expansion in public coverage is really what's driving this reduction," said Len Nichols, Ph.D., an economist and director of the health policy program at the New America Foundation, a nonpartisan public policy institute.

As the economy has weakened, more people who previously could not afford private coverage became eligible for public programs, he said. The good news is that the public programs safety net has caught these individuals, Dr. Nichols said, but the downside is that more and more people will drift into government-sponsored coverage if the government remains stalled on health care reform.

A careful analysis of the Census figures shows that the private health insurance system in the United States is "hanging on by its fingernails," Dr. Nichols said, and is in need of reform.

There are worrisome trends in the Census data that could cause the number of uninsured Americans to go back up in the near future, said Mark A. Goldberg, senior vice president for policy and strategy at the National Coalition on Health Care. The organization is a nonpartisan coalition focused on achieving coverage for all Americans.

Even though the number of uninsured Americans declined in 2007, the percentage of individuals who were able to obtain either employer-based or individual coverage also dropped. If the current economic downturn continues, safety net programs like Medicaid will be vulnerable to state-level budget cuts, he said, and could be unable to keep up with demand.

The latest uninsured figures highlight the need to shore up the employer-based health insurance system, said Karen Davis, Ph.D., president of the Commonwealth Fund.

Policy makers need to find ways to make coverage more affordable for employers who want to offer it to their workers and for individuals purchasing their own, she said.

Leaders should consider the range of options for expanding coverage under a mixed public-private system, whether it is requiring employers to offer coverage or contribute to it, or requiring individuals to obtain coverage and offering assistance to pay for it, she said.

"The problem is real and the public wants their leaders to do something about it," Dr. Davis said.

More and more people will drift into government-sponsored coverage if health reform efforts remain stalled. DR. NICHOLS

The number of Americans without health insurance coverage dropped to 45.7 million in 2007, down from 47 million in 2006, mainly because of increased enrollment in government-funded health insurance programs, according to new data from the U.S. Census Bureau.

The percentage of uninsured Americans fell from 15.8% in 2006 to 15.3% in 2007.

The Census data also showed that fewer U.S. children went without health insurance in 2007. The number of uninsured children fell from 8.7 million in 2006 (11.7%) to 8.1 million in 2007 (11%).

The new figures, which were released by the Census Bureau, come from the Annual Social and Economic Supplement to the Current Population Survey.

While Census officials are still researching why the number of uninsured Americans has decreased, the data points toward increased enrollment in government-funded health insurance programs.

For example, the number of Americans covered by private health insurance stayed about the same at 202 million, but the number of individuals covered by government health insurance program rose to 83 million from 80.3 million in 2006.

There were statistically significant increases in the percentage of people covered by both Medicare and Medicaid.

The number of people with Medicare coverage increased from 40.3 million (13.6%) in 2006 to 41.4 million (13.8%) in 2007, and the number enrolled in Medicaid increased from 38.3 million (12.9%) in 2006 to 39.6 million (13.2%) in 2007.

"The expansion in public coverage is really what's driving this reduction," said Len Nichols, Ph.D., an economist and director of the health policy program at the New America Foundation, a nonpartisan public policy institute.

As the economy has weakened, more people who previously could not afford private coverage became eligible for public programs, he said. The good news is that the public programs safety net has caught these individuals, Dr. Nichols said, but the downside is that more and more people will drift into government-sponsored coverage if the government remains stalled on health care reform.

A careful analysis of the Census figures shows that the private health insurance system in the United States is "hanging on by its fingernails," Dr. Nichols said, and is in need of reform.

There are worrisome trends in the Census data that could cause the number of uninsured Americans to go back up in the near future, said Mark A. Goldberg, senior vice president for policy and strategy at the National Coalition on Health Care. The organization is a nonpartisan coalition focused on achieving coverage for all Americans.

Even though the number of uninsured Americans declined in 2007, the percentage of individuals who were able to obtain either employer-based or individual coverage also dropped. If the current economic downturn continues, safety net programs like Medicaid will be vulnerable to state-level budget cuts, he said, and could be unable to keep up with demand.

The latest uninsured figures highlight the need to shore up the employer-based health insurance system, said Karen Davis, Ph.D., president of the Commonwealth Fund.

Policy makers need to find ways to make coverage more affordable for employers who want to offer it to their workers and for individuals purchasing their own, she said.

Leaders should consider the range of options for expanding coverage under a mixed public-private system, whether it is requiring employers to offer coverage or contribute to it, or requiring individuals to obtain coverage and offering assistance to pay for it, she said.

"The problem is real and the public wants their leaders to do something about it," Dr. Davis said.

More and more people will drift into government-sponsored coverage if health reform efforts remain stalled. DR. NICHOLS

The number of Americans without health insurance coverage dropped to 45.7 million in 2007, down from 47 million in 2006, mainly because of increased enrollment in government-funded health insurance programs, according to new data from the U.S. Census Bureau.

The percentage of uninsured Americans fell from 15.8% in 2006 to 15.3% in 2007.

The Census data also showed that fewer U.S. children went without health insurance in 2007. The number of uninsured children fell from 8.7 million in 2006 (11.7%) to 8.1 million in 2007 (11%).

The new figures, which were released by the Census Bureau, come from the Annual Social and Economic Supplement to the Current Population Survey.

While Census officials are still researching why the number of uninsured Americans has decreased, the data points toward increased enrollment in government-funded health insurance programs.

For example, the number of Americans covered by private health insurance stayed about the same at 202 million, but the number of individuals covered by government health insurance program rose to 83 million from 80.3 million in 2006.

There were statistically significant increases in the percentage of people covered by both Medicare and Medicaid.

The number of people with Medicare coverage increased from 40.3 million (13.6%) in 2006 to 41.4 million (13.8%) in 2007, and the number enrolled in Medicaid increased from 38.3 million (12.9%) in 2006 to 39.6 million (13.2%) in 2007.

"The expansion in public coverage is really what's driving this reduction," said Len Nichols, Ph.D., an economist and director of the health policy program at the New America Foundation, a nonpartisan public policy institute.

As the economy has weakened, more people who previously could not afford private coverage became eligible for public programs, he said. The good news is that the public programs safety net has caught these individuals, Dr. Nichols said, but the downside is that more and more people will drift into government-sponsored coverage if the government remains stalled on health care reform.

A careful analysis of the Census figures shows that the private health insurance system in the United States is "hanging on by its fingernails," Dr. Nichols said, and is in need of reform.

There are worrisome trends in the Census data that could cause the number of uninsured Americans to go back up in the near future, said Mark A. Goldberg, senior vice president for policy and strategy at the National Coalition on Health Care. The organization is a nonpartisan coalition focused on achieving coverage for all Americans.

Even though the number of uninsured Americans declined in 2007, the percentage of individuals who were able to obtain either employer-based or individual coverage also dropped. If the current economic downturn continues, safety net programs like Medicaid will be vulnerable to state-level budget cuts, he said, and could be unable to keep up with demand.

The latest uninsured figures highlight the need to shore up the employer-based health insurance system, said Karen Davis, Ph.D., president of the Commonwealth Fund.

Policy makers need to find ways to make coverage more affordable for employers who want to offer it to their workers and for individuals purchasing their own, she said.

Leaders should consider the range of options for expanding coverage under a mixed public-private system, whether it is requiring employers to offer coverage or contribute to it, or requiring individuals to obtain coverage and offering assistance to pay for it, she said.

"The problem is real and the public wants their leaders to do something about it," Dr. Davis said.

More and more people will drift into government-sponsored coverage if health reform efforts remain stalled. DR. NICHOLS

Noncoital Sex Risk Counseling Urged

Physicians need to speak frankly with their patients about sex, including the risks associated with noncoital sexual activity, according to a recent committee opinion from the American College of Obstetricians and Gynecologists. “Noncoital sexual activity is not necessarily 'safe sex,'” according to the opinion issued jointly by ACOG's Committee on Adolescent Health Care and its Committee on Gynecologic Practice. ACOG advised physicians to ask direct questions about oral or anal sex and mutual masturbation, as well as the number and gender of a patient's sexual partners. Physicians should then offer individualized counseling aimed at reducing the risk factors for sexually transmitted infections. For example, some strategies include encouraging correct and consistent use of condoms both for vaginal and anal sex, mutual monogamy, limiting the number of sex partners, and undergoing STD testing before sex with a new partner. The opinion was published in this month's issue of Obstetrics & Gynecology (112:735–7).

YouTube Positive on HPV Vaccine

About three-quarters of video clips about human papillomavirus vaccination on YouTube portray it in a positive way, according to an analysis of videos from the site. Researchers from the University of Tennessee, Knoxville, searched YouTube (

www.youtube.com

Label Changes Proposed for Pregnancy

The Food and Drug Administration's proposed changes to prescription drug labeling regarding risks during pregnancy and lactation could improve treatment decisions and health outcomes, according to the Society for Women's Health Research (SWHR). Current labeling leaves women and health care providers wondering whether a medication poses a risk to the fetus or nursing infant, SWHR said. Under the FDA proposal, issued in May, the agency would do away with the current pregnancy categories of A, B, C, D, and X, and include a risk summary in the pregnancy and lactation subsections of the labeling. The SWHR also called for more research to understand how medical treatments affect pregnant women and their children.

Ethnic Disparities Affect Abortion Rate

The higher rate of abortion among African American and Hispanic women is attributable to racial and ethnic disparities, not aggressive marketing by abortion providers in minority communities, according to an analysis by the Guttmacher Institute. Susan A. Cohen, the report author and director of government affairs at the institute, asserted that the abortion rate is simply a reflection of the high rate of unintended pregnancy among minority groups. Among African American women, for example, the rate of unintended pregnancy is 98 per 1,000 women aged 15–44 years, compared with 35 per 1,000 women for white women. The pattern of abortion rates tends to mirror these figures, according to the analysis. The abortion rate for African American women is 50 per 1,000 women, compared with 11 per 1,000 women among white women. One factor is that minority women have disproportionately low incomes and may be unable to afford prescription contraceptives with high up-front costs such as IUDs, according to the analysis.

Centers Excel in Preventive Care

Community health centers outperform other primary care providers in the use of preventive care, even though they have a more vulnerable patient population, according to a study from George Washington University. The analysis showed that health centers, which primarily serve Medicaid and uninsured patients, achieved significantly higher levels of preventive health care—in some cases up to 22% higher—in key areas, including screening for diabetes, breast cancer, cervical cancer, and hypertension. The study used data from the Medical Expenditure Panel Survey to compare use of preventive services by adults aged 25–64 years who visited community health centers and other sources of care.

Noncoital Sex Risk Counseling Urged

Physicians need to speak frankly with their patients about sex, including the risks associated with noncoital sexual activity, according to a recent committee opinion from the American College of Obstetricians and Gynecologists. “Noncoital sexual activity is not necessarily 'safe sex,'” according to the opinion issued jointly by ACOG's Committee on Adolescent Health Care and its Committee on Gynecologic Practice. ACOG advised physicians to ask direct questions about oral or anal sex and mutual masturbation, as well as the number and gender of a patient's sexual partners. Physicians should then offer individualized counseling aimed at reducing the risk factors for sexually transmitted infections. For example, some strategies include encouraging correct and consistent use of condoms both for vaginal and anal sex, mutual monogamy, limiting the number of sex partners, and undergoing STD testing before sex with a new partner. The opinion was published in this month's issue of Obstetrics & Gynecology (112:735–7).

YouTube Positive on HPV Vaccine

About three-quarters of video clips about human papillomavirus vaccination on YouTube portray it in a positive way, according to an analysis of videos from the site. Researchers from the University of Tennessee, Knoxville, searched YouTube (

www.youtube.com

Label Changes Proposed for Pregnancy

The Food and Drug Administration's proposed changes to prescription drug labeling regarding risks during pregnancy and lactation could improve treatment decisions and health outcomes, according to the Society for Women's Health Research (SWHR). Current labeling leaves women and health care providers wondering whether a medication poses a risk to the fetus or nursing infant, SWHR said. Under the FDA proposal, issued in May, the agency would do away with the current pregnancy categories of A, B, C, D, and X, and include a risk summary in the pregnancy and lactation subsections of the labeling. The SWHR also called for more research to understand how medical treatments affect pregnant women and their children.

Ethnic Disparities Affect Abortion Rate

The higher rate of abortion among African American and Hispanic women is attributable to racial and ethnic disparities, not aggressive marketing by abortion providers in minority communities, according to an analysis by the Guttmacher Institute. Susan A. Cohen, the report author and director of government affairs at the institute, asserted that the abortion rate is simply a reflection of the high rate of unintended pregnancy among minority groups. Among African American women, for example, the rate of unintended pregnancy is 98 per 1,000 women aged 15–44 years, compared with 35 per 1,000 women for white women. The pattern of abortion rates tends to mirror these figures, according to the analysis. The abortion rate for African American women is 50 per 1,000 women, compared with 11 per 1,000 women among white women. One factor is that minority women have disproportionately low incomes and may be unable to afford prescription contraceptives with high up-front costs such as IUDs, according to the analysis.

Centers Excel in Preventive Care

Community health centers outperform other primary care providers in the use of preventive care, even though they have a more vulnerable patient population, according to a study from George Washington University. The analysis showed that health centers, which primarily serve Medicaid and uninsured patients, achieved significantly higher levels of preventive health care—in some cases up to 22% higher—in key areas, including screening for diabetes, breast cancer, cervical cancer, and hypertension. The study used data from the Medical Expenditure Panel Survey to compare use of preventive services by adults aged 25–64 years who visited community health centers and other sources of care.

Noncoital Sex Risk Counseling Urged

Physicians need to speak frankly with their patients about sex, including the risks associated with noncoital sexual activity, according to a recent committee opinion from the American College of Obstetricians and Gynecologists. “Noncoital sexual activity is not necessarily 'safe sex,'” according to the opinion issued jointly by ACOG's Committee on Adolescent Health Care and its Committee on Gynecologic Practice. ACOG advised physicians to ask direct questions about oral or anal sex and mutual masturbation, as well as the number and gender of a patient's sexual partners. Physicians should then offer individualized counseling aimed at reducing the risk factors for sexually transmitted infections. For example, some strategies include encouraging correct and consistent use of condoms both for vaginal and anal sex, mutual monogamy, limiting the number of sex partners, and undergoing STD testing before sex with a new partner. The opinion was published in this month's issue of Obstetrics & Gynecology (112:735–7).

YouTube Positive on HPV Vaccine

About three-quarters of video clips about human papillomavirus vaccination on YouTube portray it in a positive way, according to an analysis of videos from the site. Researchers from the University of Tennessee, Knoxville, searched YouTube (

www.youtube.com

Label Changes Proposed for Pregnancy

The Food and Drug Administration's proposed changes to prescription drug labeling regarding risks during pregnancy and lactation could improve treatment decisions and health outcomes, according to the Society for Women's Health Research (SWHR). Current labeling leaves women and health care providers wondering whether a medication poses a risk to the fetus or nursing infant, SWHR said. Under the FDA proposal, issued in May, the agency would do away with the current pregnancy categories of A, B, C, D, and X, and include a risk summary in the pregnancy and lactation subsections of the labeling. The SWHR also called for more research to understand how medical treatments affect pregnant women and their children.

Ethnic Disparities Affect Abortion Rate

The higher rate of abortion among African American and Hispanic women is attributable to racial and ethnic disparities, not aggressive marketing by abortion providers in minority communities, according to an analysis by the Guttmacher Institute. Susan A. Cohen, the report author and director of government affairs at the institute, asserted that the abortion rate is simply a reflection of the high rate of unintended pregnancy among minority groups. Among African American women, for example, the rate of unintended pregnancy is 98 per 1,000 women aged 15–44 years, compared with 35 per 1,000 women for white women. The pattern of abortion rates tends to mirror these figures, according to the analysis. The abortion rate for African American women is 50 per 1,000 women, compared with 11 per 1,000 women among white women. One factor is that minority women have disproportionately low incomes and may be unable to afford prescription contraceptives with high up-front costs such as IUDs, according to the analysis.

Centers Excel in Preventive Care

Community health centers outperform other primary care providers in the use of preventive care, even though they have a more vulnerable patient population, according to a study from George Washington University. The analysis showed that health centers, which primarily serve Medicaid and uninsured patients, achieved significantly higher levels of preventive health care—in some cases up to 22% higher—in key areas, including screening for diabetes, breast cancer, cervical cancer, and hypertension. The study used data from the Medical Expenditure Panel Survey to compare use of preventive services by adults aged 25–64 years who visited community health centers and other sources of care.

One in five Americans postponed or skipped needed medical care last year because of cost, insurance problems, or difficulty getting an appointment, according to a report from the Center for Studying Health System Change.

Researchers, who compared nationwide survey data from the years 2003 and 2007, found that the number of Americans that reported problems with access to health care increased dramatically during the intervening period. In 2007, more than 23 million individuals (8%) said that they went without needed medical care, compared with 13.5 million (5.2%) in 2003.

There were even more problems with delaying care. In 2007, 36 million (12.3%) reported that they delayed seeking care, compared with about 23.5 million (8.4%) in 2003.

The most recent figures come from the 2007 Health Tracking Household Survey, a nationally representative sample of about 18,000 individuals. The earlier data are drawn from a similar survey with a sample size of about 47,000 individuals.

“The change is not only large, but it is widespread,” Peter J. Cunningham, Ph.D., the lead author of the study and a senior fellow at the Center for Studying Health System Change, said during a press conference. “It's changing for a lot of people.”

Specifically, the researchers found that access problems were increasingly affecting people with and without insurance. In 2007, about 20% of uninsured people and 11% of insured people reported delaying care. In addition, 17.5% of uninsured people and 6.3% of insured people reported unmet medical needs.

But while more uninsured people reported access problems, the rate of increase for unmet medical needs between 2003 and 2007 was higher among people who had insurance. Of the additional 9.5 million people who reported unmet needs between 2003 and 2007, 6.7 million had health insurance, Mr. Cunningham said.

The researchers also found greater unmet medical needs among individuals with fair or poor health and among children from families with lower incomes. For example, unmet medical needs increased from 11.9% in 2003 to 17% in 2007 for people who were in fair or poor health.

And researchers saw the gap in access to care between low- and higher-income children widen in 2007 after having been virtually eliminated in 2003 following expansions of the Medicaid and State Children's Health Insurance Programs. In 2003, 2.2% of children below 200% of poverty experienced unmet medical needs, the same percentage as those children whose family incomes were at 200% of poverty or higher. However, in 2007, 5.4% of children below 200% of poverty had unmet medical needs, compared with 2.9% of children at 200% of poverty or higher.

The most commonly cited reason for access problems remains cost. In 2007, 69% of people who decided to delay or forgo needed medical care said worries about cost were the reason, which was up from 65.2% in 2003. Among insured people, cost worries were cited by 60.8% of people in 2007, compared with 53.7% in 2003.

One in five Americans postponed or skipped needed medical care last year because of cost, insurance problems, or difficulty getting an appointment, according to a report from the Center for Studying Health System Change.

Researchers, who compared nationwide survey data from the years 2003 and 2007, found that the number of Americans that reported problems with access to health care increased dramatically during the intervening period. In 2007, more than 23 million individuals (8%) said that they went without needed medical care, compared with 13.5 million (5.2%) in 2003.

There were even more problems with delaying care. In 2007, 36 million (12.3%) reported that they delayed seeking care, compared with about 23.5 million (8.4%) in 2003.

The most recent figures come from the 2007 Health Tracking Household Survey, a nationally representative sample of about 18,000 individuals. The earlier data are drawn from a similar survey with a sample size of about 47,000 individuals.

“The change is not only large, but it is widespread,” Peter J. Cunningham, Ph.D., the lead author of the study and a senior fellow at the Center for Studying Health System Change, said during a press conference. “It's changing for a lot of people.”

Specifically, the researchers found that access problems were increasingly affecting people with and without insurance. In 2007, about 20% of uninsured people and 11% of insured people reported delaying care. In addition, 17.5% of uninsured people and 6.3% of insured people reported unmet medical needs.

But while more uninsured people reported access problems, the rate of increase for unmet medical needs between 2003 and 2007 was higher among people who had insurance. Of the additional 9.5 million people who reported unmet needs between 2003 and 2007, 6.7 million had health insurance, Mr. Cunningham said.

The researchers also found greater unmet medical needs among individuals with fair or poor health and among children from families with lower incomes. For example, unmet medical needs increased from 11.9% in 2003 to 17% in 2007 for people who were in fair or poor health.

And researchers saw the gap in access to care between low- and higher-income children widen in 2007 after having been virtually eliminated in 2003 following expansions of the Medicaid and State Children's Health Insurance Programs. In 2003, 2.2% of children below 200% of poverty experienced unmet medical needs, the same percentage as those children whose family incomes were at 200% of poverty or higher. However, in 2007, 5.4% of children below 200% of poverty had unmet medical needs, compared with 2.9% of children at 200% of poverty or higher.

The most commonly cited reason for access problems remains cost. In 2007, 69% of people who decided to delay or forgo needed medical care said worries about cost were the reason, which was up from 65.2% in 2003. Among insured people, cost worries were cited by 60.8% of people in 2007, compared with 53.7% in 2003.

One in five Americans postponed or skipped needed medical care last year because of cost, insurance problems, or difficulty getting an appointment, according to a report from the Center for Studying Health System Change.

Researchers, who compared nationwide survey data from the years 2003 and 2007, found that the number of Americans that reported problems with access to health care increased dramatically during the intervening period. In 2007, more than 23 million individuals (8%) said that they went without needed medical care, compared with 13.5 million (5.2%) in 2003.

There were even more problems with delaying care. In 2007, 36 million (12.3%) reported that they delayed seeking care, compared with about 23.5 million (8.4%) in 2003.

The most recent figures come from the 2007 Health Tracking Household Survey, a nationally representative sample of about 18,000 individuals. The earlier data are drawn from a similar survey with a sample size of about 47,000 individuals.

“The change is not only large, but it is widespread,” Peter J. Cunningham, Ph.D., the lead author of the study and a senior fellow at the Center for Studying Health System Change, said during a press conference. “It's changing for a lot of people.”

Specifically, the researchers found that access problems were increasingly affecting people with and without insurance. In 2007, about 20% of uninsured people and 11% of insured people reported delaying care. In addition, 17.5% of uninsured people and 6.3% of insured people reported unmet medical needs.

But while more uninsured people reported access problems, the rate of increase for unmet medical needs between 2003 and 2007 was higher among people who had insurance. Of the additional 9.5 million people who reported unmet needs between 2003 and 2007, 6.7 million had health insurance, Mr. Cunningham said.

The researchers also found greater unmet medical needs among individuals with fair or poor health and among children from families with lower incomes. For example, unmet medical needs increased from 11.9% in 2003 to 17% in 2007 for people who were in fair or poor health.

And researchers saw the gap in access to care between low- and higher-income children widen in 2007 after having been virtually eliminated in 2003 following expansions of the Medicaid and State Children's Health Insurance Programs. In 2003, 2.2% of children below 200% of poverty experienced unmet medical needs, the same percentage as those children whose family incomes were at 200% of poverty or higher. However, in 2007, 5.4% of children below 200% of poverty had unmet medical needs, compared with 2.9% of children at 200% of poverty or higher.

The most commonly cited reason for access problems remains cost. In 2007, 69% of people who decided to delay or forgo needed medical care said worries about cost were the reason, which was up from 65.2% in 2003. Among insured people, cost worries were cited by 60.8% of people in 2007, compared with 53.7% in 2003.

Privacy should be the top priority when developing certification criteria for personal health records, a task force created by the Certification Commission for Healthcare Information Technology has recommended.

Adequate security and interoperability also must be included in certification efforts, according to the task force.

The Certification Commission for Healthcare Information Technology (CCHIT) will use these recommendations as it prepares to begin certifying personal health records (PHRs) next summer.

Since the PHR field is still “rapidly evolving,” the task force said that certification requirements should not be so prescriptive that they interfere with the progress of the technology.

The task force recommended that the voluntary certification process should apply to any products or services that collect, receive, store, or use health information provided by consumers. Certification should also apply to products or services that transmit or disclose to a third party any personal health information.

This would allow the CCHIT to offer certification to a range of products and applications, from those that offer a PHR application and connectivity as an accessory to an HER, to stand-alone PHRs.

CCHIT hopes that, just as it did in the EHR field, certification will create a floor of functionality, security, and interoperability, said Dr. Paul Tang, cochair of the PHR Advisory Task Force and vice president and chief medical information officer for the Palo Alto (Calif.) Medical Foundation.

The task force called for requirements to maintain privacy in monitoring and enforcement, and for consumer protection that would allow patients to remove their data if certification is revoked.

The group also recommended that standards-based criteria be developed that would require PHRs to send and receive data from as many potential data sources as possible, including ambulatory EHRs, hospital EHRs, labs, and networks.

If done right, certification would have significant benefits for both physicians and patients, Dr. Tang said. A PHR could provide physicians with better access to secure, authenticated data that could help them make decisions, while patients would have more control over their own care, he said. “The physician benefits by what benefits the patient,” Dr. Tang said.

In July, the task force made its recommendations and handed over responsibility for PHR certification to a CCHIT work group. That work group will develop the actual certification criteria that will be used to test PHR products starting next July, according to Dr. Jody Pettit, strategic leader for CCHIT's PHR work group.

Offering certification for PHR platforms and applications could help spur consumer acceptance and adoption of PHRs, Dr. Pettit said. “The consumer wouldn't feel so far out on a limb in terms of putting in their data,” she said.

Privacy should be the top priority when developing certification criteria for personal health records, a task force created by the Certification Commission for Healthcare Information Technology has recommended.

Adequate security and interoperability also must be included in certification efforts, according to the task force.

The Certification Commission for Healthcare Information Technology (CCHIT) will use these recommendations as it prepares to begin certifying personal health records (PHRs) next summer.

Since the PHR field is still “rapidly evolving,” the task force said that certification requirements should not be so prescriptive that they interfere with the progress of the technology.

The task force recommended that the voluntary certification process should apply to any products or services that collect, receive, store, or use health information provided by consumers. Certification should also apply to products or services that transmit or disclose to a third party any personal health information.

This would allow the CCHIT to offer certification to a range of products and applications, from those that offer a PHR application and connectivity as an accessory to an HER, to stand-alone PHRs.

CCHIT hopes that, just as it did in the EHR field, certification will create a floor of functionality, security, and interoperability, said Dr. Paul Tang, cochair of the PHR Advisory Task Force and vice president and chief medical information officer for the Palo Alto (Calif.) Medical Foundation.

The task force called for requirements to maintain privacy in monitoring and enforcement, and for consumer protection that would allow patients to remove their data if certification is revoked.

The group also recommended that standards-based criteria be developed that would require PHRs to send and receive data from as many potential data sources as possible, including ambulatory EHRs, hospital EHRs, labs, and networks.

If done right, certification would have significant benefits for both physicians and patients, Dr. Tang said. A PHR could provide physicians with better access to secure, authenticated data that could help them make decisions, while patients would have more control over their own care, he said. “The physician benefits by what benefits the patient,” Dr. Tang said.

In July, the task force made its recommendations and handed over responsibility for PHR certification to a CCHIT work group. That work group will develop the actual certification criteria that will be used to test PHR products starting next July, according to Dr. Jody Pettit, strategic leader for CCHIT's PHR work group.

Offering certification for PHR platforms and applications could help spur consumer acceptance and adoption of PHRs, Dr. Pettit said. “The consumer wouldn't feel so far out on a limb in terms of putting in their data,” she said.

Privacy should be the top priority when developing certification criteria for personal health records, a task force created by the Certification Commission for Healthcare Information Technology has recommended.

Adequate security and interoperability also must be included in certification efforts, according to the task force.

The Certification Commission for Healthcare Information Technology (CCHIT) will use these recommendations as it prepares to begin certifying personal health records (PHRs) next summer.

Since the PHR field is still “rapidly evolving,” the task force said that certification requirements should not be so prescriptive that they interfere with the progress of the technology.

The task force recommended that the voluntary certification process should apply to any products or services that collect, receive, store, or use health information provided by consumers. Certification should also apply to products or services that transmit or disclose to a third party any personal health information.

This would allow the CCHIT to offer certification to a range of products and applications, from those that offer a PHR application and connectivity as an accessory to an HER, to stand-alone PHRs.

CCHIT hopes that, just as it did in the EHR field, certification will create a floor of functionality, security, and interoperability, said Dr. Paul Tang, cochair of the PHR Advisory Task Force and vice president and chief medical information officer for the Palo Alto (Calif.) Medical Foundation.

The task force called for requirements to maintain privacy in monitoring and enforcement, and for consumer protection that would allow patients to remove their data if certification is revoked.

The group also recommended that standards-based criteria be developed that would require PHRs to send and receive data from as many potential data sources as possible, including ambulatory EHRs, hospital EHRs, labs, and networks.

If done right, certification would have significant benefits for both physicians and patients, Dr. Tang said. A PHR could provide physicians with better access to secure, authenticated data that could help them make decisions, while patients would have more control over their own care, he said. “The physician benefits by what benefits the patient,” Dr. Tang said.

In July, the task force made its recommendations and handed over responsibility for PHR certification to a CCHIT work group. That work group will develop the actual certification criteria that will be used to test PHR products starting next July, according to Dr. Jody Pettit, strategic leader for CCHIT's PHR work group.

Offering certification for PHR platforms and applications could help spur consumer acceptance and adoption of PHRs, Dr. Pettit said. “The consumer wouldn't feel so far out on a limb in terms of putting in their data,” she said.

Leavitt Defends Draft Reg in Blog

The debate over a draft federal regulation that would redefine abortion is being played out on the Internet. Recently, Health and Human Services Secretary Mike Leavitt addressed the issue on his blog (

http://secretarysblog.hhs.gov

South Dakota to Vote on Abortion

This November, voters in South Dakota once again will be faced with a choice about the regulation of abortion. On the ballot will be Measure 11, which would ban all abortions in the state except in cases in which the mother's life or health is at risk, and in cases of rape or incest. Under the measure, anyone who performs an illegal abortion could be charged with a Class 4 felony, which has a penalty of up to 10 years in jail and a $20,000 fine. In 2006, voters approved a ballot initiative that repealed a more restrictive abortion law. That law would have banned all abortions, except in cases in which the pregnancy threatened the woman's life. Supporters of this year's measure say that it has broader support because it includes “reasonable” exceptions to the ban. However, opponents blasted the ban and warned it could create a dangerous precedent for other states.

Contraceptive Service Usage Rises

The proportion of women who received some type of contraceptive service from their health care provider rose significantly between 1995 and 2002, according to a recent analysis. About 41% of women reported receiving one or more contraceptive services in 2002, up from 38% in 1995 (Am. J. Public Health 2008 August [doi:10.2105/AJPH.2007.124719]). The findings are based on an analysis of the 1995 and 2002 National Survey of Family Growth. The analysis also showed significant increases in the proportions of women reporting specific contraception services, including birth control counseling (15% to 19%), receiving a birth control prescription or method (28% to 34%), and receiving a pregnancy test (16% to 20%).

CDC: Twice as Many Men Adopt

Nearly twice as many men aged 18–44 years have ever adopted a child, compared with women in the same age group, according to a report from the Centers for Disease Control and Prevention's National Center for Health Statistics. In 2002, about 2.3% of U.S. men aged 18–44 had ever adopted a child, compared with 1.1% of U.S. women. This is the first time that the CDC has reported national estimates on adoption by men and all women, not just married women. The data are based on the 2002 National Survey of Family Growth. Although the data don't reveal why more men have adopted children, the author speculated that it could be due in part to stepfathers who adopt their spouse's children. The report also found that men and women seem to have different motivations for adoption. For example, men who have already fathered a child and women who have not given birth were more likely to adopt than women who already had biological children and men who had never fathered a child. The report is available online at

www.cdc.gov/nchs

Part D Premiums Slated to Go Up $3

On average, Medicare beneficiaries can expect to pay about $28 per month for standard Part D prescription drug coverage next year. The estimates from the Centers for Medicare and Medicaid Services are based on bids submitted for both prescription drug plans and Medicare Advantage drug plans. The estimated monthly premiums are about $3 higher than the average monthly premium costs this year, but are 37% lower than projections that were made when the Medicare prescription drug benefit was created in 2003. Open enrollment for the fourth year of the Medicare Part D program begins in November.

Leavitt Defends Draft Reg in Blog

The debate over a draft federal regulation that would redefine abortion is being played out on the Internet. Recently, Health and Human Services Secretary Mike Leavitt addressed the issue on his blog (

http://secretarysblog.hhs.gov

South Dakota to Vote on Abortion

This November, voters in South Dakota once again will be faced with a choice about the regulation of abortion. On the ballot will be Measure 11, which would ban all abortions in the state except in cases in which the mother's life or health is at risk, and in cases of rape or incest. Under the measure, anyone who performs an illegal abortion could be charged with a Class 4 felony, which has a penalty of up to 10 years in jail and a $20,000 fine. In 2006, voters approved a ballot initiative that repealed a more restrictive abortion law. That law would have banned all abortions, except in cases in which the pregnancy threatened the woman's life. Supporters of this year's measure say that it has broader support because it includes “reasonable” exceptions to the ban. However, opponents blasted the ban and warned it could create a dangerous precedent for other states.

Contraceptive Service Usage Rises

The proportion of women who received some type of contraceptive service from their health care provider rose significantly between 1995 and 2002, according to a recent analysis. About 41% of women reported receiving one or more contraceptive services in 2002, up from 38% in 1995 (Am. J. Public Health 2008 August [doi:10.2105/AJPH.2007.124719]). The findings are based on an analysis of the 1995 and 2002 National Survey of Family Growth. The analysis also showed significant increases in the proportions of women reporting specific contraception services, including birth control counseling (15% to 19%), receiving a birth control prescription or method (28% to 34%), and receiving a pregnancy test (16% to 20%).

CDC: Twice as Many Men Adopt

Nearly twice as many men aged 18–44 years have ever adopted a child, compared with women in the same age group, according to a report from the Centers for Disease Control and Prevention's National Center for Health Statistics. In 2002, about 2.3% of U.S. men aged 18–44 had ever adopted a child, compared with 1.1% of U.S. women. This is the first time that the CDC has reported national estimates on adoption by men and all women, not just married women. The data are based on the 2002 National Survey of Family Growth. Although the data don't reveal why more men have adopted children, the author speculated that it could be due in part to stepfathers who adopt their spouse's children. The report also found that men and women seem to have different motivations for adoption. For example, men who have already fathered a child and women who have not given birth were more likely to adopt than women who already had biological children and men who had never fathered a child. The report is available online at

www.cdc.gov/nchs

Part D Premiums Slated to Go Up $3

On average, Medicare beneficiaries can expect to pay about $28 per month for standard Part D prescription drug coverage next year. The estimates from the Centers for Medicare and Medicaid Services are based on bids submitted for both prescription drug plans and Medicare Advantage drug plans. The estimated monthly premiums are about $3 higher than the average monthly premium costs this year, but are 37% lower than projections that were made when the Medicare prescription drug benefit was created in 2003. Open enrollment for the fourth year of the Medicare Part D program begins in November.

Leavitt Defends Draft Reg in Blog

The debate over a draft federal regulation that would redefine abortion is being played out on the Internet. Recently, Health and Human Services Secretary Mike Leavitt addressed the issue on his blog (

http://secretarysblog.hhs.gov

South Dakota to Vote on Abortion

This November, voters in South Dakota once again will be faced with a choice about the regulation of abortion. On the ballot will be Measure 11, which would ban all abortions in the state except in cases in which the mother's life or health is at risk, and in cases of rape or incest. Under the measure, anyone who performs an illegal abortion could be charged with a Class 4 felony, which has a penalty of up to 10 years in jail and a $20,000 fine. In 2006, voters approved a ballot initiative that repealed a more restrictive abortion law. That law would have banned all abortions, except in cases in which the pregnancy threatened the woman's life. Supporters of this year's measure say that it has broader support because it includes “reasonable” exceptions to the ban. However, opponents blasted the ban and warned it could create a dangerous precedent for other states.

Contraceptive Service Usage Rises

The proportion of women who received some type of contraceptive service from their health care provider rose significantly between 1995 and 2002, according to a recent analysis. About 41% of women reported receiving one or more contraceptive services in 2002, up from 38% in 1995 (Am. J. Public Health 2008 August [doi:10.2105/AJPH.2007.124719]). The findings are based on an analysis of the 1995 and 2002 National Survey of Family Growth. The analysis also showed significant increases in the proportions of women reporting specific contraception services, including birth control counseling (15% to 19%), receiving a birth control prescription or method (28% to 34%), and receiving a pregnancy test (16% to 20%).

CDC: Twice as Many Men Adopt

Nearly twice as many men aged 18–44 years have ever adopted a child, compared with women in the same age group, according to a report from the Centers for Disease Control and Prevention's National Center for Health Statistics. In 2002, about 2.3% of U.S. men aged 18–44 had ever adopted a child, compared with 1.1% of U.S. women. This is the first time that the CDC has reported national estimates on adoption by men and all women, not just married women. The data are based on the 2002 National Survey of Family Growth. Although the data don't reveal why more men have adopted children, the author speculated that it could be due in part to stepfathers who adopt their spouse's children. The report also found that men and women seem to have different motivations for adoption. For example, men who have already fathered a child and women who have not given birth were more likely to adopt than women who already had biological children and men who had never fathered a child. The report is available online at

www.cdc.gov/nchs

Part D Premiums Slated to Go Up $3

On average, Medicare beneficiaries can expect to pay about $28 per month for standard Part D prescription drug coverage next year. The estimates from the Centers for Medicare and Medicaid Services are based on bids submitted for both prescription drug plans and Medicare Advantage drug plans. The estimated monthly premiums are about $3 higher than the average monthly premium costs this year, but are 37% lower than projections that were made when the Medicare prescription drug benefit was created in 2003. Open enrollment for the fourth year of the Medicare Part D program begins in November.

NEW YORK — HIV infection may not be a significant risk even among adolescent populations with a high prevalence of other sexually transmitted infections, according to a study of adolescents at a juvenile detention center in Houston.

Although chlamydia and gonorrhea were relatively common among this group of incarcerated teens—28% among girls and 9% among boys—the prevalence of HIV was low among those tested, with only two cases among boys and no cases among girls.

Researchers at the University of Texas evaluated 6,805 sexually active boys and 1,425 sexually active girls who were incarcerated at the Harris County Juvenile Detention Center in 2006 and 2007. The mean age of the population was 15 years old (range 13–16 years) and all identified themselves as heterosexual, Dr. William Risser said at a joint conference sponsored by the American Sexually Transmitted Diseases Association and the British Association for Sexual Health and HIV.

All of the detainees received a physical examination and health history, and a first-catch urine screening for chlamydia and gonorrhea. They also received an HIV and rapid plasma reagin (RPR) test for syphilis if they had suspicious symptoms, had not been tested for more than 1 year, had another sexually transmitted infection, had sold sex, or requested testing.

Among the 6,805 boys evaluated, 78% were sexually active in the month before admission to the facility, 69% had used a condom at last intercourse, and 29% reported that they had a new partner in the previous month. Nearly 8% of the boys tested positive for chlamydia, 0.68% tested positive for gonorrhea, and 1% tested positive for both organisms. Of the 2,524 boys who were tested for HIV, only 2 tested positive (0.08%). Of those who tested positive for HIV, their only admitted risk behavior was heterosexual intercourse, said Dr. Risser, director of the division of adolescent medicine at the university in Houston.

Among the 1,425 girls evaluated in the study, the rates of chlamydia and gonorrhea were higher, but there were no cases of HIV. About 74% reported that they were sexually active in the month before they were admitted to the facility, 49% said they had used a condom at last intercourse, 19% had a new partner in the previous month, and 9% said they had traded sex for drugs or money.

Overall, 17% of the girls tested positive for chlamydia, 5% tested positive for gonorrhea, and 6% were positive for both organisms. Of the 807 who underwent HIV testing, no one tested positive.

One of the factors in the low rates of HIV infection might have been the small amount of high-risk drug use. Other studies on the same population show that almost none used drugs other than marijuana. “I really believe that's true because culturally these kids don't use IV drugs,” Dr. Risser said.

NEW YORK — HIV infection may not be a significant risk even among adolescent populations with a high prevalence of other sexually transmitted infections, according to a study of adolescents at a juvenile detention center in Houston.

Although chlamydia and gonorrhea were relatively common among this group of incarcerated teens—28% among girls and 9% among boys—the prevalence of HIV was low among those tested, with only two cases among boys and no cases among girls.

Researchers at the University of Texas evaluated 6,805 sexually active boys and 1,425 sexually active girls who were incarcerated at the Harris County Juvenile Detention Center in 2006 and 2007. The mean age of the population was 15 years old (range 13–16 years) and all identified themselves as heterosexual, Dr. William Risser said at a joint conference sponsored by the American Sexually Transmitted Diseases Association and the British Association for Sexual Health and HIV.

All of the detainees received a physical examination and health history, and a first-catch urine screening for chlamydia and gonorrhea. They also received an HIV and rapid plasma reagin (RPR) test for syphilis if they had suspicious symptoms, had not been tested for more than 1 year, had another sexually transmitted infection, had sold sex, or requested testing.

Among the 6,805 boys evaluated, 78% were sexually active in the month before admission to the facility, 69% had used a condom at last intercourse, and 29% reported that they had a new partner in the previous month. Nearly 8% of the boys tested positive for chlamydia, 0.68% tested positive for gonorrhea, and 1% tested positive for both organisms. Of the 2,524 boys who were tested for HIV, only 2 tested positive (0.08%). Of those who tested positive for HIV, their only admitted risk behavior was heterosexual intercourse, said Dr. Risser, director of the division of adolescent medicine at the university in Houston.

Among the 1,425 girls evaluated in the study, the rates of chlamydia and gonorrhea were higher, but there were no cases of HIV. About 74% reported that they were sexually active in the month before they were admitted to the facility, 49% said they had used a condom at last intercourse, 19% had a new partner in the previous month, and 9% said they had traded sex for drugs or money.

Overall, 17% of the girls tested positive for chlamydia, 5% tested positive for gonorrhea, and 6% were positive for both organisms. Of the 807 who underwent HIV testing, no one tested positive.

One of the factors in the low rates of HIV infection might have been the small amount of high-risk drug use. Other studies on the same population show that almost none used drugs other than marijuana. “I really believe that's true because culturally these kids don't use IV drugs,” Dr. Risser said.

NEW YORK — HIV infection may not be a significant risk even among adolescent populations with a high prevalence of other sexually transmitted infections, according to a study of adolescents at a juvenile detention center in Houston.

Although chlamydia and gonorrhea were relatively common among this group of incarcerated teens—28% among girls and 9% among boys—the prevalence of HIV was low among those tested, with only two cases among boys and no cases among girls.

Researchers at the University of Texas evaluated 6,805 sexually active boys and 1,425 sexually active girls who were incarcerated at the Harris County Juvenile Detention Center in 2006 and 2007. The mean age of the population was 15 years old (range 13–16 years) and all identified themselves as heterosexual, Dr. William Risser said at a joint conference sponsored by the American Sexually Transmitted Diseases Association and the British Association for Sexual Health and HIV.

All of the detainees received a physical examination and health history, and a first-catch urine screening for chlamydia and gonorrhea. They also received an HIV and rapid plasma reagin (RPR) test for syphilis if they had suspicious symptoms, had not been tested for more than 1 year, had another sexually transmitted infection, had sold sex, or requested testing.

Among the 6,805 boys evaluated, 78% were sexually active in the month before admission to the facility, 69% had used a condom at last intercourse, and 29% reported that they had a new partner in the previous month. Nearly 8% of the boys tested positive for chlamydia, 0.68% tested positive for gonorrhea, and 1% tested positive for both organisms. Of the 2,524 boys who were tested for HIV, only 2 tested positive (0.08%). Of those who tested positive for HIV, their only admitted risk behavior was heterosexual intercourse, said Dr. Risser, director of the division of adolescent medicine at the university in Houston.

Among the 1,425 girls evaluated in the study, the rates of chlamydia and gonorrhea were higher, but there were no cases of HIV. About 74% reported that they were sexually active in the month before they were admitted to the facility, 49% said they had used a condom at last intercourse, 19% had a new partner in the previous month, and 9% said they had traded sex for drugs or money.

Overall, 17% of the girls tested positive for chlamydia, 5% tested positive for gonorrhea, and 6% were positive for both organisms. Of the 807 who underwent HIV testing, no one tested positive.

One of the factors in the low rates of HIV infection might have been the small amount of high-risk drug use. Other studies on the same population show that almost none used drugs other than marijuana. “I really believe that's true because culturally these kids don't use IV drugs,” Dr. Risser said.

AAN Pushes Congress on NIH, Stroke

The American Academy of Neurology is lobbying lawmakers on the National Institutes of Health's funding and stroke prevention and treatment legislation. In March, the House passed H.R. 477, which would create an educational campaign to promote stroke prevention and early treatment, provide grants for stroke and traumatic injury training programs, and create a 5-year pilot project to improve stroke outcomes via telemedicine. However, a bill containing similar provisions (S. 3297) saw no action in the Senate. AAN is working with the American Heart Association to get the stroke provisions added to any legislation that may move forward in the Senate before Congress adjourns for the year. AAN also is calling on Congress to pass a supplemental funding bill this fall that would increase the current NIH budget.

Mass. Brain Injury Settlement

This summer, brain injury patients and their advocates settled a class action lawsuit that alleged the state was violating the Americans with Disabilities Act by failing to provide adequate community services for individuals with brain injuries. As a result, Massachusetts will create two new waiver programs to help brain injury patients make the transition from nursing facilities to community living. These programs will help 200–250 people move out of nursing facilities each year. The state also will improve community services for brain injury patients.

Wanted: Female Neurosurgeons

Women currently make up only 5.9% of practicing neurosurgeons in the United States, even though women made up more than half of the students accepted to medical school in 2005, according to a paper from Women in Neurosurgery, an advocacy and networking group. The group researched recruitment and retention of female neurosurgeons at the request of the American Association of Neurological Surgeons (doi:10.3171/JNS/2008/109/9/0377). Women in Neurosurgery proposed identifying and eliminating any discriminatory practices in the recruitment of medical students, the training of residents, and the hiring and advancement of neurosurgeons. The group advised promoting women into leadership positions within organized neurosurgery and fostering the development of female neurosurgeon role models.

AAN Pushes Congress on NIH, Stroke

The American Academy of Neurology is lobbying lawmakers on the National Institutes of Health's funding and stroke prevention and treatment legislation. In March, the House passed H.R. 477, which would create an educational campaign to promote stroke prevention and early treatment, provide grants for stroke and traumatic injury training programs, and create a 5-year pilot project to improve stroke outcomes via telemedicine. However, a bill containing similar provisions (S. 3297) saw no action in the Senate. AAN is working with the American Heart Association to get the stroke provisions added to any legislation that may move forward in the Senate before Congress adjourns for the year. AAN also is calling on Congress to pass a supplemental funding bill this fall that would increase the current NIH budget.

Mass. Brain Injury Settlement

This summer, brain injury patients and their advocates settled a class action lawsuit that alleged the state was violating the Americans with Disabilities Act by failing to provide adequate community services for individuals with brain injuries. As a result, Massachusetts will create two new waiver programs to help brain injury patients make the transition from nursing facilities to community living. These programs will help 200–250 people move out of nursing facilities each year. The state also will improve community services for brain injury patients.

Wanted: Female Neurosurgeons

Women currently make up only 5.9% of practicing neurosurgeons in the United States, even though women made up more than half of the students accepted to medical school in 2005, according to a paper from Women in Neurosurgery, an advocacy and networking group. The group researched recruitment and retention of female neurosurgeons at the request of the American Association of Neurological Surgeons (doi:10.3171/JNS/2008/109/9/0377). Women in Neurosurgery proposed identifying and eliminating any discriminatory practices in the recruitment of medical students, the training of residents, and the hiring and advancement of neurosurgeons. The group advised promoting women into leadership positions within organized neurosurgery and fostering the development of female neurosurgeon role models.

AAN Pushes Congress on NIH, Stroke

The American Academy of Neurology is lobbying lawmakers on the National Institutes of Health's funding and stroke prevention and treatment legislation. In March, the House passed H.R. 477, which would create an educational campaign to promote stroke prevention and early treatment, provide grants for stroke and traumatic injury training programs, and create a 5-year pilot project to improve stroke outcomes via telemedicine. However, a bill containing similar provisions (S. 3297) saw no action in the Senate. AAN is working with the American Heart Association to get the stroke provisions added to any legislation that may move forward in the Senate before Congress adjourns for the year. AAN also is calling on Congress to pass a supplemental funding bill this fall that would increase the current NIH budget.

Mass. Brain Injury Settlement

This summer, brain injury patients and their advocates settled a class action lawsuit that alleged the state was violating the Americans with Disabilities Act by failing to provide adequate community services for individuals with brain injuries. As a result, Massachusetts will create two new waiver programs to help brain injury patients make the transition from nursing facilities to community living. These programs will help 200–250 people move out of nursing facilities each year. The state also will improve community services for brain injury patients.

Wanted: Female Neurosurgeons

Women currently make up only 5.9% of practicing neurosurgeons in the United States, even though women made up more than half of the students accepted to medical school in 2005, according to a paper from Women in Neurosurgery, an advocacy and networking group. The group researched recruitment and retention of female neurosurgeons at the request of the American Association of Neurological Surgeons (doi:10.3171/JNS/2008/109/9/0377). Women in Neurosurgery proposed identifying and eliminating any discriminatory practices in the recruitment of medical students, the training of residents, and the hiring and advancement of neurosurgeons. The group advised promoting women into leadership positions within organized neurosurgery and fostering the development of female neurosurgeon role models.

Privacy should be the top priority when developing certification criteria for personal health records, a task force created by the Certification Commission for Healthcare Information Technology has recommended.

Adequate security and interoperability also must be included in certification efforts, according to the task force.

The Certification Commission for Healthcare Information Technology (CCHIT) will use these recommendations as it prepares to begin certifying personal health records (PHRs) next summer.

Since the PHR field is still “rapidly evolving,” the task force said that certification requirements should not be so prescriptive that they interfere with the progress of the technology.

The task force recommended that the voluntary certification process should apply to any products or services that collect, receive, store, or use health information provided by consumers.

Certification should also apply to those products or services that transmit or disclose to a third party any personal health information.

This would allow the CCHIT to offer certification to a range of products and applications, from those that offer a personal health records application and connectivity as an accessory to an electronic health records system, to stand-alone personal health records.

CCHIT hopes that, just as it did in the EHR field, certification will create a floor of functionality, security, and interoperability, said Dr. Paul Tang, cochair of the PHR Advisory Task Force and vice president and chief medical information officer for the Palo Alto (Calif.) Medical Foundation. The task force called for requirements to maintain privacy in monitoring and enforcement, and for consumer protection that would allow patients to remove their data if certification is revoked.

The group also recommended that standards-based criteria be developed that would require personal health records to send and receive data from as many potential data sources as possible, including ambulatory electronic health records, hospital electronic health records, labs, and networks.

If done right, certification would have significant benefits for both physicians and patients, Dr. Tang said.

A personal health record could provide physicians with better access to secure, authenticated data that could help them make decisions, while patients would have more control over their own care, he said.

“The physician benefits by what benefits the patient,” Dr. Tang said.

In July, the task force made its recommendations and handed over responsibility for PHR certification to a CCHIT work group.

That work group will develop the actual certification criteria that will be used to test PHR products starting next July, according to Dr. Jody Pettit, strategic leader for CCHIT's PHR work group.

Offering certification for PHR platforms and applications could help spur consumer acceptance and adoption of PHRs, Dr. Pettit said.

“The consumer wouldn't feel so far out on a limb in terms of putting in their data,” she commented.

Privacy should be the top priority when developing certification criteria for personal health records, a task force created by the Certification Commission for Healthcare Information Technology has recommended.

Adequate security and interoperability also must be included in certification efforts, according to the task force.

The Certification Commission for Healthcare Information Technology (CCHIT) will use these recommendations as it prepares to begin certifying personal health records (PHRs) next summer.

Since the PHR field is still “rapidly evolving,” the task force said that certification requirements should not be so prescriptive that they interfere with the progress of the technology.

The task force recommended that the voluntary certification process should apply to any products or services that collect, receive, store, or use health information provided by consumers.

Certification should also apply to those products or services that transmit or disclose to a third party any personal health information.

This would allow the CCHIT to offer certification to a range of products and applications, from those that offer a personal health records application and connectivity as an accessory to an electronic health records system, to stand-alone personal health records.

CCHIT hopes that, just as it did in the EHR field, certification will create a floor of functionality, security, and interoperability, said Dr. Paul Tang, cochair of the PHR Advisory Task Force and vice president and chief medical information officer for the Palo Alto (Calif.) Medical Foundation. The task force called for requirements to maintain privacy in monitoring and enforcement, and for consumer protection that would allow patients to remove their data if certification is revoked.

The group also recommended that standards-based criteria be developed that would require personal health records to send and receive data from as many potential data sources as possible, including ambulatory electronic health records, hospital electronic health records, labs, and networks.

If done right, certification would have significant benefits for both physicians and patients, Dr. Tang said.

A personal health record could provide physicians with better access to secure, authenticated data that could help them make decisions, while patients would have more control over their own care, he said.

“The physician benefits by what benefits the patient,” Dr. Tang said.

In July, the task force made its recommendations and handed over responsibility for PHR certification to a CCHIT work group.

That work group will develop the actual certification criteria that will be used to test PHR products starting next July, according to Dr. Jody Pettit, strategic leader for CCHIT's PHR work group.

Offering certification for PHR platforms and applications could help spur consumer acceptance and adoption of PHRs, Dr. Pettit said.

“The consumer wouldn't feel so far out on a limb in terms of putting in their data,” she commented.

Privacy should be the top priority when developing certification criteria for personal health records, a task force created by the Certification Commission for Healthcare Information Technology has recommended.

Adequate security and interoperability also must be included in certification efforts, according to the task force.

The Certification Commission for Healthcare Information Technology (CCHIT) will use these recommendations as it prepares to begin certifying personal health records (PHRs) next summer.

Since the PHR field is still “rapidly evolving,” the task force said that certification requirements should not be so prescriptive that they interfere with the progress of the technology.

The task force recommended that the voluntary certification process should apply to any products or services that collect, receive, store, or use health information provided by consumers.

Certification should also apply to those products or services that transmit or disclose to a third party any personal health information.

This would allow the CCHIT to offer certification to a range of products and applications, from those that offer a personal health records application and connectivity as an accessory to an electronic health records system, to stand-alone personal health records.

CCHIT hopes that, just as it did in the EHR field, certification will create a floor of functionality, security, and interoperability, said Dr. Paul Tang, cochair of the PHR Advisory Task Force and vice president and chief medical information officer for the Palo Alto (Calif.) Medical Foundation. The task force called for requirements to maintain privacy in monitoring and enforcement, and for consumer protection that would allow patients to remove their data if certification is revoked.

The group also recommended that standards-based criteria be developed that would require personal health records to send and receive data from as many potential data sources as possible, including ambulatory electronic health records, hospital electronic health records, labs, and networks.

If done right, certification would have significant benefits for both physicians and patients, Dr. Tang said.

A personal health record could provide physicians with better access to secure, authenticated data that could help them make decisions, while patients would have more control over their own care, he said.

“The physician benefits by what benefits the patient,” Dr. Tang said.

In July, the task force made its recommendations and handed over responsibility for PHR certification to a CCHIT work group.

That work group will develop the actual certification criteria that will be used to test PHR products starting next July, according to Dr. Jody Pettit, strategic leader for CCHIT's PHR work group.

Offering certification for PHR platforms and applications could help spur consumer acceptance and adoption of PHRs, Dr. Pettit said.

“The consumer wouldn't feel so far out on a limb in terms of putting in their data,” she commented.