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Year-end thoughts

Ah, another long delay between posts. Some people blog for fun. When you write for a living, you do other stuff when you need to take a break. Like sleep in or watch too much TV.

I have just a couple of things to say before the end of the year. So here goes.

Everyone’s offering a personal health record. Few are using them. I’ve written about that plenty this year. I’m now declaring a personal moratorium on PHR stories until someone gives me evidence that patients and physicians are actually using PHRs. There, I said it. Hopefully I’ve just saved myself from a dozen more HIMSS meeting requests. But not likely.

Secondly, I thought it was remarkable that HHS Secretary Mike Leavitt wrote to members of Congress, asking that any legislation to address the 10 percent Medicare fee cut for 2008 include incentives for EHRs and give CMS the authority to require e-prescribing in the future. Could it be that a the Bush administration was asking Congress for something close to a mandate? Not exactly, but it sure got my attention. (Unfortunately, I could not find a copy of it online, but I have a paper copy around here somewhere that perhaps I’ll scan and post as soon as I find it.)

As it turned out, the impetus for the letter came from the American Health Information Community, as detailed in my Digital HealthCare & Productivity story from a couple weeks ago. I had an interview with AHIC member Lillee Gelinas, chief nursing officer of VHA, who gave me a nice play-by-play of the surprisingly quick process.

And as it turned out, the letter didn’t do much on Capitol Hill. Congress postponed the Medicare day of reckoning for six months, offering yet another year-end Medicare Band-Aid and setting up the possibility of a midyear Band-Aid next summer. That legislation didn’t have any health IT provisions, which isn’t surprising, given that Congress already has denied a funding increase for the Office of the National Coordinator for Health Information Technology in 2008.

Is it me, or did 2007 actually mark a regression in health IT on the federal level?

I’ve observed that Washington seems to gather the political will for serious Medicare reform about once a decade, and it already happened this decade, with the 2003 Medicare Prescription Drug Improvement and Modernization Act. Meanwhile, 2008 is a presidential election year, so don’t expect any major revisions to the Medicare payment structure next year either. That means there won’t be any incentive money for EHRs beyond the small-scale demonstration projects already in place, as authorized by the 2003 MMA.

Pessimistic? Perhaps. Realistic? I think so.

Health IT might get some lip service in the presidential campaign, but as I wrote in November, it hasn’t been a top-tier issue for the candidates.

As I post this entry, I see that the odometer has just turned over to 30,000 visitors to this site since I started tracking more than three years ago. Thanks for reading, and happy new year.

December 27, 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.

Health 2.0 slight?

“Health 2.0″ seems to be everywhere in this insular world of health IT we live in, and even in a lot of places on the outside. But not in the Wired Geekipedia.

This directory of “The Wired World From A to Z” includes entries on Web 2.0 and even the vaporware-heavy (or is it concept-light) “Web 3.0,” whatever Web 3.0 really means. But nothing on health 2.0.

It still might be too early for health 2.0 to have any meaning in the wider world outside healthcare, but the “wired world” changes fast. Published in September, the Geekipedia already is out of date. In its current iteration, Geekipedia lists Fake Steve Jobs as still under a cloak of anonymity. Of course, FSJ (“Dude, I invented the friggin iPhone. Have you heard of it?”) has since been outed as Forbes senior editor Daniel Lyons.

Any volunteers to be Fake Bill Gates? He’d surely want a piece of the healthcare market. Oh, wait. Someone’s already done it. Dude, he created the Blue Screen of Death! Have you seen it?

December 6, 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.

Are the mainstream media starting to get it?

A few weeks ago, I wrote kind of a throwaway post about whether if it’s proven to be true that the death of hip-hop star Kanye West’s mother, English professor Donda West, was due to a medical error, if the general public would start paying more attention to the issue of patient safety. The post received two comments, one saying it was an interesting question and another suggesting that the real wake-up call for the public should have been the death of sportswriter Dick Schaap in 2002.

Then I read an entry on Jane Sarasohn-Kahn’s Health Populi blog, dated a week after my post, that mentioned not only West’s death, but a dosing error that affected two children of actor Dennis Quaid, and said the news “focuses this health care paparazzi’s lens squarely on the role of information technology in health care.” (Jane, you’re a great writer, but n.b., a single member of the group collectively known as “paparazzi” is a “paparazzo.” I’m not sure if there are separate masculine/feminine versions. Anyone care to assist my half-hearted attempt at being pedantic?)

In the West case, Sarasohn-Kahn links to piece by syndicated columnist Susan Estrich calling for greater transparency in health information, particularly when it comes to doctor quality. So apparently someone was paying attention.

Meanwhile, right there above the nameplate at the top of the front page of Sunday’s Chicago Tribune was a teaser that asked “Is your doctor Internet savvy?” As it turns out—surprise—many are not. The story, by health and fitness reporter/columnist Julie Deardorff, whom I do not know, does a good job spelling out the issues. “Unlike the banking, restaurant and travel industries, the medical profession has been slow to embrace the Internet’s potential customer service benefits,” the story says.

Deardorff also quotes some people I’ve used as sources before, including Dr. Ed Fotsch of Medem and Forrester Research analyst Elizabeth Boehm.

The more stories like this that get teased on the front page of a major big-city newspaper’s Sunday edition, the more the general public figures out that the solution to the nation’s healthcare crisis is a lot more complicated than just throwing more money at the existing system, mandating insurance coverage or making Wall Street happy by passing along insurance costs to employers.

December 3, 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.