October 18th, 2013
Cross-Posted 10/18/13 from The Health Affairs Blog
A Health Affairs report on health information interoperability by staffers of the Office of the National Coordinator for Health Information Technology (ONC) provides a good enough summary of the situation. But it also is not news, and falls under the Bob Dylan Rule: You don’t need a weatherman to know which way the wind blows. From the article: “In general, limited interoperability across vendors, low motivation to share information in a fee-for-service payment environment, and the high cost of interfaces remain substantial barriers to widespread health information sharing.”
Two difficult but solvable structural problems block our exchange of health care information. The first is the “transport protocol.” Most health care data transport approaches lack the strong privacy and security safeguards that other industries now consider essential. The same industry that is moving toward clinical applications of mobile health, genomics, and nanotechnology still primarily relies on cumbersome, expensive faxes to transmit clinical information between organizations.
Continue reading “Facilitating Interoperability”
Posted 12/27/12 on Medscape Connect’s Care and Cost Blog
My wife Elaine was hospitalized for 6 days recently with an array of ailments related to her advancing cancer, so diagnosing and addressing her problems required a multidisciplinary approach. In addition to the nursing and support staffs, she was tended by an emergency physician, two hospitalists, three gastroenterologists, a pulmonologist, an infectious disease physician and an interventional radiologist. With the exception of one specialist who had performed a procedure on her two weeks earlier, this episode was the first time any had met Elaine.
Each clinician was familiar with her status before visiting her, because the health system has an enterprise-wide electronic health record (EHR) that aggregates information into each patient’s chart. The hospitalists coordinated the care process and also touched base with Elaine’s primary care physician and her oncologist.
In other words, the system worked exactly like we hoped it would but often doesn’t. Especially in complex cases like this, the likelihood of a positive result is enhanced if the team members have access to the same complete information, and if someone – in this case the hospitalists – quarterbacks the activity.
Continue reading “An Archipelago of Health Information Islands”
Posted 12/11/12 on Medscape Connect’s Care & Cost Blog
An organization’s ability to learn, and translate that learning into action rapidly, is the ultimate competitive advantage.
Physicians and medical societies in all specialties would do well to take a look at this article, published in the November issue of The Journal of Oncology Practice. Authored by Elaine Towle, Thomas Barr and James Senese of Oncology Metrics (a subsidiary of the oncology electronic health record firm Altos Solutions), this year’s National Oncology Practice Benchmark Report aggregates and analyzes data on a wide variety of clinical, operational and financial business metrics. There are 89 charts in categories – work units, patient visits, revenue, practice expense, pharmacy operations, clinical trials, and staffing/productivity – from oncology practices around the country. The focus here is on the practice. The report does not delve into relative patient quality or cost.
The authors have deep experience with oncology practice, and they note that the cornerstone of their firm’s approach is “to promote the discovery and adoption of best practices.” Towle and Barr previously ran oncology practices in New Hampshire and Ft. Worth. This is their 7th annual report, meaning they have had the benefit of years of immersing in and refining their work product.
Continue reading “Putting Physician Practices Into Context”
Posted 5/6/12 on Health Blawg
Meaningful Use Stage 2 regulations were released in March by CMS and ONC. Over the past month or so, I’ve been working with other members of the Society for Participatory Medicine (thank you, all) to prepare comments on these regulations from the patient perspective. Last Friday, we filed two comment letters on the proposed regulations. One letter to the ONC on Meaningful Use Stage 2, and one letter to CMS on Meaningful Use Stage 2. Each letter opens like this:
Continue reading “Nothing About Me Without Me: Participatory Medicine, Meaningful Use and the American Hospital Association”
Posted 5/5/12 on The Health Care Blog
The protest organized by Regina Holliday over a patient’s right to access their medical information is not quite the same magnitude as agitating for integration in 1950s-era Alabama. Yet there are intriguing similarities between the crusade Rosa Parks launched then and what Holliday is attempting today. Both involve a refusal to accept second-class status and a resolve to push back against entrenched institutions.
Continue reading “Will Regina Holiday Become Health Care’s Rosa Parks?”
Posted 5/1/12 on Health Populi
You can now carry a doctor with you in your pocket. Two top telehealth companies that support online physician-patient visits have gone mobile. This upgrade was announced this week at the 2012 American Telemedicine Association conference, being held in San Jose, CA.
Continue reading “A Doctor’s Appointment on your Phone: Out of Beta and Into Your Pocket”