Why EHRs Really Haven’t Made Us Healthier: A Response To Glen Tullman

Brian Klepper

Brian Klepper, Health Care Analyst and TDWI Writers' Group

Recently-fired Allscripts CEO Glen Tullman waxed progressive in a self-promotional Forbes article last week, describing the ways past and forward for electronic health records (EHRs) and health information technology (HIT). He may have been trying to recover from a damning New York Times article that clearly illustrated the relationships between campaign contributions, influence over health information technology policy, and business success.

Tullman recalls building EHRs that moved many physicians away from paper and the errors it fosters. He calls out David C. Kibbe, MD as an example of the forces wanting to preserve paper and opposing EHRs, with quotes from a 2008 blog post suggesting that the current crop are “notoriously expensive,” “difficult to implement” and unable to demonstrate care quality improvements. He predicts that, in the future, the industry will leverage open platforms and interoperability, yielding new monitoring and management utilities that can facilitate better care at lower cost.

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An Archipelago of Health Information Islands

Brian Klepper

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.

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Through the Lens of Disruptive Innovation: Why Direct is a Hit and PCAST is an Outcast

Vince Kuraitis

First published 4/18/11 on e-Care Management

Regular readers know that I find Professor Clay Christensen’s theory of disruptive innovation to be a useful lens to explain industry evolution. Let’s look at two recent health IT initiatives and see why one is working and the other is stalled.

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Physician Executives Should Not Ignore How Smartphones Will Transform Healthcare

KENT BOTTLES

Originally published 1/27/11 on Private Views

Physician executives who ignore smartphones and their healthcare applications will miss the most important disruptive technology trend in the next five years. Physician executives who understand how smartphones will transform the industry for providers, payers, patients, and employers will thrive in their careers.

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Health 2.0: Patricia Salber interview | The Doctor Weighs In

Here’s a short interview with my pal Pat Salber, MD MBA at the Health 2.0 conference in San Francisco in early October. Pat was an Emergency Medicine physician at Kaiser Permanente for 20 years before becoming a Medical Director for Managed Health Care Initiatives at General Motors. She went from there to be Senior Medical Director for Blue Shield of California’s CalPERS Business Unit. She was on the original Leapfrog Board. And now she’s a Founder and Principal of Zolo Health Solutions, a consulting group focused on helping health systems develop workable Accountable Care Organizations. So she’s been around the block, and has deep insights into the valences of constantly emerging health care innovations. Regular C&C readers will also recognize that Pat is a prolific columnist with a breezy style that belies her incisive wit and astute understanding of all things health care.