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Podcast: Dr. David Kibbe on personal health information, medical homes, value in healthcare and more

This podcast pretty much covers the entire field. Dr. David Kibbe, senior advisor to the Center for Health Information Technology of the American Academy of Family Physicians, weighs in on health IT in primary care, consumerism, data standards, value-based healthcare purchasing and national IT policy, among many topics we cover in just over half an hour. We recorded this at the 2007 TEPR conference in Dallas last week.

Podcast details: Interview with Dr. David Kibbe at 2007 TEPR conference. MP3, mono, 64kbps, 16 MB, running time 35:09

0:40 Background on AAFP’s Center for Health IT and what he’s doing.
1:40 Personal health records and mobilization of personal health information
2:10 Continuity of Care Record
4:11 Continuity of Care Document and Clinical Document Architecture
5:25 CCR, PHRs and the Internet
6:20 Growth in CCR interest
7:00 PHRs based on XML
7:40
Google‘s healthcare plans
8:55 Reliability of health information on the Internet
10:00 Consumers having access to the same information as health professionals
10:45
Revolution Health
11:50 Web information and the physician/patient relationship
12:45 Higher expectations among patients
13:45 Consumerism and retail health clinics
15:00 AAFP’s involvement in retail clinics
16:28 Concept of the medical home
18:00 Health information and the elderly
19:12 Model of information homes in other service industries
20:20 Asynchronous communication to help manage patient care
20:46 Reimbursement problems with asynchronous care
21:20 Employers becoming more aware of value in healthcare
22:15 Advice to major healthcare purchasers
23:00 When major changes might happen
23:45 Framing the national debate
25:15 Stark exemption and primary care
26:57 AAFP advice to small practices on the Stark exemption
28:40 Awareness of Stark exemption
30:30 Awareness of the benefits of EHRs
31:42 Certification
33:57 Are products improving because of certification?

May 30, 2007 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Learning from others’ mistakes

I’ve had a theory for a while, that developing countries may have an easier time adopting IT in healthcare than rich nations that have a long history of inefficient, paper-based practice. It’s worked that way in telecommunications, in that many African countries had underdeveloped phone systems for decades, but quickly adopted mobile phones because it’s easier to put up some cell towers than to string wires to remote villages and urban slums.

Today, I came across this story about efforts to build electronic health systems. “Information technology is no longer a luxury purchased at the expense of other needs, but a basic tool, heard an annual pan-African government ministerial information technology summit last week,” the story says.

Would you believe that wireless, handheld computers are catching on with doctors in Uganda or that clinics in Mozambique have electronic scheduling systems to ensure that HIV/AIDS patients get regular care?

I’ve heard from World Health Organization officials that millions upon millions of people in places like India would rather have access to basic health services than advanced technology, so don’t expect EMRs to proliferate across the developing world any faster than they are in North America and Europe. But if you have a chance to build from the ground up, why not go with something modern and efficient instead of creating isolated silos of incomplete information?

Yes, I have an interest in Africa because my uncle has worked in economic development over there for years. I visited him in Senegal a couple of years ago and was fascinated by what I saw and experienced—though I had no real contact with what passes for a health system.

And Wednesday at the TEPR conference in Dallas, I heard a presentation from a Brazilian health official about some ambitious plans to wire her country’s health infrastructure. I’ll try to write about that another time.

May 23, 2007 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Hey Salu, where are you?

In rifling through my paper files (hey, I’m a journalist, not a doctor, and I don’t type quickly enough to take my notes on the computer), I came across a company called Salu, a physician specialty hub from early this decade. The company, at one point headed by Jim Steeb, hosted sites called Dermdex for dermatologists and plastic surgeons, and NeuroHub for neurologists.

I have a report that said in January 2002, the company built research panels from among the various sites’ membership to study physician attitudes. My undated notes from a phone interview with Steeb said that Salu also offered secure online messaging, Web sites for practices within each hub’s specialty and a prescription writer that worked on either PocketPC (now Windows Mobile) or Palm platforms. (It was not true e-prescribing because back in the pre-RxHub and SureScripts era, it didn’t transmit information to pharmacies.

Also, from what I could gather from searching the Internet, Salu had partnerships with Healthwise, Payerpath (now part of Misys Healthcare Systems) and a few others.

But what ever happened to Salu and its brands? If the company went out of business, did someone else take over the sites? I found no sign that either Dermdex or NeuroHub was still active. Help, please!

May 18, 2007 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Top 10 for healthcare consumers

From revenue-cycle management vendor QuadraMed comes this “Top 10″ list of reasons why consumers should care about health information technology (drumroll, please):

10. Health information technology improves the quality of care received.

9. Health information technology is critical in the event of a nation-wide emergency.

8. Health information technology increases accountability from providers.

7. Health information technology prevents medical errors and saves consumers’ lives.

6. Health information technology can empower consumers to make smarter healthcare decisions.

5. Health information technology saves consumers money.

4. Health information technology allows nurses to spend more time with patients.

3. Health information technology increases the health of the entire American population.

2. Health information technology keeps hospitals profitable.

1. Health information technology decreases billing errors.

A PDF of this list is available here.

As always, I invite your comments.

May 16, 2007 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Just how personal?

I’ve been writing quite a bit of late about personal health records, as have many of my peers. I’ll be writing some more in the next few weeks (though you won’t see the result for at least a couple of months). It’s clearly a hot topic in the realms of consumer empowerment and the push toward interoperability. But the general consensus is that a PHR, which can take many forms, is merely a subset of a true EHR.

Is that thinking wise when trying to empower patients with control of their health information? An American in Paris, namely blogger and consultant Denise Silber, doesn’t seem to think so. She notes in a post that’s now a few months old that “personal” has carried the day in France, where the EMR is called dossier médical personnel, or “personal medical file.”

Silber writes, “Why? Because one of the most important aspects of the French EMR is that the information belongs to the patient.”

Contrast that to the French Canadian term, dossier de santé électronique, which essentially means “electronic health record.”

Say what you want about the French—and many Americans do—but they may actually be on to something here. (And keep in mind not only that France’s new president-elect Nicolas Sarkozy is an Americophile, but that Americans apparently think more highly of the French than the French think of themselves.)

Yeah, so I’m going out of my way to practice the only foreign language I ever studied. Admit it, you still liked this post. And if someone wants to fly me to Paris to check up on my reporting, I’ll meet you at the airport in an hour.

May 14, 2007 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Just wondering

I had a conversation yesterday with a vice president of a major national health insurer, and this person mentioned that it would be a while before health plans started listing in their provider directories whether physicians and hospitals had electronic health records. Uh, why don’t they just start asking the question now when they update the provider directories?

If payers are serious about consumer-directed health plans, they need to offer as much relevant information as possible for consumers to make informed decisions. This sounds like it should be a fairly simple step, no?

May 11, 2007 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

On Google

Is it the worst-kept secret in healthcare, the idea that Google wants to offer some sort of consumer-centric product in the near future? Google VP Adam Bosworth has made a few speeches in recent months on the need for better health information to empower consumers, but the company isn’t talking otherwise. In fact, every healthcare person I’ve talked to that’s had any contact with Google personnel is under some sort of non-disclosure agreement.

Lucky for us, the notes in the program from last month’s World Health Care Congress offered this: “As Google’s architect of the soon-to-be-unveiled health vertical, Mr. Bosworth imparts his compelling vision for providing timely, relevant information to consumers via content providers and health care institutions to create a robust solution.” (Emphasis mine.)

If you have a copy of the full program—the thick, spiral-bound one—it’s on page 14.

May 4, 2007 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.