Of Zombies, Emperor’s New Clothes, Documentation Inertia: LIngering Untrue Diagnoses That Persist in the Electronic Health Record

Jaan Sidorov

Posted 4/04/12 on The Disease Management Care Blog

Every practicing physician using an electronic health record (EHR) has seen them.  Past diagnosis zombies that stumble endlessly through every encounter record.  “Coronary heart disease” that the patient never really had, “diabetes” that was only one possibility among many and a “fracture” that never appeared on any x-ray.

These undead conditions clutter the technology-enabled health system basically because of two EHR value propositions:

Continue reading “Of Zombies, Emperor’s New Clothes, Documentation Inertia: LIngering Untrue Diagnoses That Persist in the Electronic Health Record”

US Doctors Less Sanguine About Health IT’s Benefits

Jane Sarasohn-Kahn

Posted 1/10/12 on Health Populi

To doctors working in eight countries around the globe, the biggest benefit of health IT is better access to quality data for clinical access, followed by reducing medical errors, improving coordination of care across care settings, and improving cross-organizational workflow.

However, except for the issue of health IT’s potential to improve cross-organizational working processes, American doctors have lower expectations about these benefits than their peers who work in the 7 other nations polled in a global study from Accenture‘s Eight-Country Survey of Doctors Shows Agreement on Top Healthcare Information Technology Benefits, But a Generational Divide Exists. Accenture polled over 3,700 doctors working in Australia, Canada, England, France, Germany, Singapore, Spain and the US.

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Digitizing Human Beings

Eric Topol

First posted on The Health Care Blog on 12/26/2011

Our day-to-day lives were reformatted when the consumer mobile wireless device era, beyond cell phones, was ushered in by iPods in 2001 and followed in short order by Blackberries, smartphones, e-readers, and tablets. Nurturing our peripatetic existence, we could immediately and virtually anywhere download music, books, videos, periodical, games and movies. Television is soon to follow. But these forms of digital communication and entertainment are a far cry from digitizing people.

This decade will be marked by the intersection of the digital world with the medical cocoon, which until now have been largely circulating in separate orbits. The remarkable digital infrastructure that has been built—which includes broadband Internet, cloud and supercomputing, pluripotent mobile devices and social networking― is ripe to provide the framework for a most extraordinary upgrade and rebooting of medicine.

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Health IT in 2012: a Dynamic Sector in the Context of a Fiscally-Challenged Health System

Jane Sarasohn-Kahn

Posted 12/20/11 on Health Populi

2012 will be a dynamic year for health information technology (health IT) in the U.S., which I outline in my annual health IT forecast in iHealthBeat, the online publication on technology and health care published by the California HealthCare Foundation. The full forecast can be found here.

The key headlines for you Reader’s Digest abridged fans are that:

  • The Health IT sector will continue to grow jobs in the ongoing Great Depression, particularly in key competencies in data security, analytics, integration, and EHR implementation.
  • There will be more data breaches, and consumers will be justifiably concerned about data security. Government will more consistently implement sharper “teeth” in their punishment of health organizations who leak personal health information.
  • Health IT suppliers will consolidate. The Microsoft-GE combination, announced in December 2011, is a sentinel event in this regard.
  • Health IT start-ups will continue to emerge in 2012, some of which will have sound business models that will be acquired by larger firms to round out their offerings and address, in particular, consumer/patient-facing applications that support health engagement to enhance health outcomes.
  • Connected health, in the form of telemedicine, mobile health, and remote health monitoring to the home will gain traction and business models as health payment moves toward accountable care, medical home, and paying for outcomes.
  • IBM’s Watson is an example of high-powered data analytics, which will get more practical and targeted in 2012. A ripe area for this will be preventing re-hospitalizations, a focus of health reform and Medicare financing.
  • People – patients and providers – live multi-channel, multi-platform lives every day. Thismodus vivendi is translating into health and health care. Patients want online connections with doctors for administration (e.g., Rx refills and appointments), clinical decision making, and communications (e.g., email with practices).

Continue reading “Health IT in 2012: a Dynamic Sector in the Context of a Fiscally-Challenged Health System”

The EHR|HIE Interoperability Workgroup — Potentially Earth-Shattering

Vince Kuraitis

Posted 11/09/11 on the eCareManagement Blog

Yesterday’s announcement of  “Standard Health Data Connectivity Specifications” by the EHR|HIE Interoperability Workgroup (EHR|HIE WG) is potentially earth-shattering.

My mom would not know what I mean by “Standard Health Data Connectivity Specifications,” so I’ll try to write this in plain English.

Who Are These Guys? The EHR|HIE Interoperability Workgroup

The workgroup consists of HIEs (Health Information Exchanges) representing seven of the largest states, eight EHR vendors, and three HIE software/services vendors.

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Why Doctors Don’t Like Electronic Medical Records

Richard Reece, MD

Posted 10/07/11 on Medinnovation Blog. It originally ran in the 9/27/11 issue of Technology Review, an MIT Press publication.

Why are doctors so slow in implementing electronic health records (EHRs)?

The government has been trying to get doctors to use these systems for some time, but many physicians remain skeptical. In 2004, the Bush administration issued an executive order calling for a universal “interoperable health information” infrastructure and electronic health records for all Americans within 10 years.

And yet, in 2011, only a fraction of doctors use electronic patient records.

In an effort to change that, the Obama economic stimulus plan promised $27 billion in subsidies for health IT, including payments to doctors of $44,000 to $64,000 over five years if only they would use EHRs. The health IT industry has gathered at this multibillion-dollar trough, but it hasn’t had much more luck getting physicians to change their ways.

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Avatars, Computers and Robots Are Coming To Primary Care

Kent Bottles

First posted 8/19/11 on Kent Bottles Private Views

Within in five years primary care providers will begin being replaced by sociable humanoid robots, avatars, and computer programs. Within ten years you will no longer hear any complaints about medical students choosing specialty residencies over family practice because the role of the physician will be completely redefined to complement a rules based approach to the diagnosis and treatment of many diseases. This transformation is inevitable because of demographics, economics, and progress in artificial intelligence, but the academic leaders of medical education and health policy are largely ignorant and unprepared for this massive disruption.

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