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”
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.
Continue reading “US Doctors Less Sanguine About Health IT’s Benefits”
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”
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.
Continue reading “The EHR|HIE Interoperability Workgroup — Potentially Earth-Shattering”
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.
Continue reading “Why Doctors Don’t Like Electronic Medical Records”
First published 6/2/11 on Health Populi
The past year has seen a huge jump in the number of hours that physicians spend online; at the margin, the increase is due to physicians’ use of online via mobile platforms.
Meredith Abreu-Ressi, President of Manhattan Research, shared her insights into the firm’s study,Taking the Pulse (v. 11), with me today. The top-line finding of the annual survey is that health professionals have quickly adopted mobile platforms in health — with special attention paid to Apple products, the iPhone and the iPad.
Continue reading “The Advances That Accompany Physician’s Adoption of Tablets”
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.
Continue reading “Through the Lens of Disruptive Innovation: Why Direct is a Hit and PCAST is an Outcast”
First published 2/17/11 at Simon Bramfitt Blog.
Brian’s Note: A pal passed this along. It struck me as a little geeky, though a good read, until I realized the author was talking about a revolution in how IT in small and mid-sized physician practices is underway. If you’re a doc or a practice manager, then I’d urge you to take a few minutes, bear with the author, and read this through.
Back in 1987 I spent a while working for a PC dealership, what we now call a Value Added Reseller. I don’t actually recall that the term VAR had been coined at that point, and besides the people I worked for tended to be referred to as “that bunch of bloody cowboys” more often than not.
Continue reading “Adapt or Die: How Desktop Virtualization Will Reshape the Value-Added Reseller”
First published 3/21/11 by the Office of the National Coordinator for Health IT
As an internal medicine physician, I know how hard it was to coordinate patient care across diverse healthcare systems. Primary care providers struggle to keep up with the flow of information coming in and going out of their offices on faxes, couriered documents and hand carried patient notes. The Direct Project was created to address this problem head-on by creating a simple, secure way to send this information electronically, so that providers can concentrate on what counts: excellent patient care.
Continue reading “Direct Project Specifications Achieving Widespread Adoption”
First published on e-CareManagement on 2/26/11
After attending the largest annual health IT conference of the year —HIMSS 11 – John Moore reported that “nearly every EHR vendor has an iPad App for the EHR [electronic health record], or will be releasing such this year.”
Doctors love iPads…not surprising? But, how might you explain this?
There are at least two different possibilities:
- Coincidence Theory
- Conspiracy Theory
Continue reading “Doctors Love iPads. What Does It Mean? What Does It Mean?”
First published 3/14/11 on Common Sense MD
Here is a brief excerpt from a narrative piece by internist Tasneem Bader-Omarali, MD in the February 25th issue of Medical Economics that encapsulates the limitless potential of integrating health information technology with patient-centered health care:
I was driving home after work one day when the answering service sent me a text. Mrs. Smith [a patient with chronic heart failure] was short of breath. I pulled over to the side of the road and, using my smartphone, logged on to my electronic health record. Mrs. Smith’s house was just a mile down the road at a nearby senior mobile home facility. On an impulse, I made a U-turn and drove to her house. Mrs. Smith opened the door and was taken aback. She invited me in.
Continue reading “Patient Centered Care and Health IT In A Nutshell”
First published 2/15/11 on The Doctor Weighs In
If you want to see the future of health information technology, take a look at the dueling visions of two Thomas Watsons that are on display this month in a game show and a trade show. The juxtaposition unintentionally demonstrates what doctors and patients will be doing together and also what they can do separately.
Continue reading “Health IT’s Future: A Tale of Three Watsons”
Privacy has always dogged the quest for practical health information exchange. PCAST marks the second (after the Privacy & Security Tiger Team) real effort by ONC to get ahead of the privacy problem with technology that allows the patient granular control over both the information they share and, more important, how that information is aggregated across multiple providers.
Continue reading “PCAST – Is ONC Embracing Health Information Exchange from the Patient Perspective?”