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Telemedicine on ‘House’

Like most TV medical dramas, paper charts, handwritten prescriptions (usually for Vicodin) and lots of trial-and-error have been hallmarks of “House MD” since Day 1. Sure, there’s always a lot of advanced diagnostic equipment, but this week I finally find myself compelled to blog about one particular episode of one of my favorite shows.

A special episode airing Sunday night right after the Super Bowl (approximately 10 pm EST) features what looks to be some really cool, high-definition telemedicine. Specifically, House has to treat a researcher at the South Pole, played by Mira Sorvino. Go here and click “Watch Video” for three clips.

Now if only someone could convince Dr. House to try clinical decision support. Then again, the show wouldn’t be nearly as entertaining.

January 31, 2008 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 Wonk Review …

… is at the e-Care Management blog this time. Vince Kuraitis, a health IT guy (woohoo!) hosts. I’ve already commented on kangaroo spam.

There is a good amount of discussion of both IT and quality in this rundown. That makes me happy.

January 23, 2008 I Written By

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

My HIMSS wish list

2008 had not even started when I got the first e-mail asking for an appointment at the HIMSS conference the last week of February. As I was scrambling to finish stories due Dec. 26, Dec. 31 and Jan. 2 (unbelievable, I know, but it’s a good time to get work done), people wanted to know if I had time for them two months later. The feeling of dread was setting in.

At least a half-dozen additional requests followed the first week of the new year. What to do?

Ordinarily, I start thinking about HIMSS maybe a month ahead of time. But after the scramble for hotel rooms at the 2006 conference in San Diego, I got wise to that. I didn’t have to stay in La Jolla like some people, but I got stuck at an aging Super 8 motel about a mile and a half from the convention center and at least 3 blocks from the nearest conference shuttle stop.

This year, I reserved my hotel room in November, though I still have not booked a flight. I’m hoping to take a mini vacation in Florida after the conference, and a lot of that depends on the schedules of certain friends and relatives who live there. Good thing I live in Chicago, since no less than four airlines have nonstop service to Orlando, so I’m not worried.

More importantly, I have not taken a good look at the conference schedule yet. That’s something I often leave until just a couple of weeks before, which sometimes proves to be a mistake. By that time, the vendors have been hounding me for more than a month and the ones I actually want to meet with may not have the time slots I want.

This year I hope to make much better use of my time there—and make the planning a lot smoother. Thus, I present my HIMSS wish list:

1. It looks as if my focus is going to be on physician practices rather than hospitals, given two major assignments I now have. As I mentioned a couple of months ago, I am writing the new, monthly Physician Office Technology Report supplement to Part B News. Readers are managers of office-based practices, mostly in primary care, but many in specialties like cardiology, orthopedics and urology. Obviously HIMSS is fertile ground for IT-related stories of all kinds.

The other major job I have this winter and spring is the July-August issue of Doctor’s Digest, entitled, “Technology for Patient and Practice.” The description on the editorial calendar reads as follows: “Healthcare information technology (IT) solutions offer not only business applications but solutions to help enhance patient care, both at the point of care delivery and beyond. But can applications like web-based patient portals, electronic medical records, telemedicine, clinical decision support and mobile systems deliver on their big promises? Can they truly enhance the patient experience and make the practice run more smoothly? This issue will explore these questions.”

You may recall that I also wrote the January-February 2006 issue of Doctor’s Digest. It really is like writing a book, since I am responsible for five chapters of 6,000 to 7,000 words apiece. My deadline this time around is May 1. That means I have about 14 weeks to crank out all that copy on the subject of IT for physician practices.

HIMSS falls right when I expect to be doing most of my reporting, so I intend to use the conference to knock of many interviews, so there’s a good chance I will have to turn down most requests to meet with enterprise systems vendors.

2. With the exception of the HIMSS press briefing on Monday morning, I do not intend to schedule anything that conflicts with the educational sessions. I tend to get more from hearing the presentations and talking with the presenters after the sessions than I do from walking the exhibit floor. That’s not to say I will avoid the exhibition completely, just that I prefer to schedule meetings at other times. This is why I spend so much time perusing the conference agenda (notice I said “conference” and not “show”) before piecing together my schedule each year.

That said, I do hope to be ready to schedule appointments before the end of January. The bigger the conference gets, the scarcer time slots become for everybody.

3. I will not schedule meetings back-to-back. It usually takes at least 10 minutes to get from one end of the exhibit hall to the other, and that’s if I walk fast. I don’t remember the Orlando layout, but I’m sure it’s a minimum of 15 minutes between the meeting rooms and the far ends of the hall. I learned this the hard way in past years. It’s not good being late to appointments.

4. I need to reassert the fact that I am a journalist first and a blogger second (or third). Several people of late have been under the impression that they were giving me information for this blog. I wish I could work on my own terms all the time, but the fact is that this blog does not pay the bills. I have earned exactly $104.54 since I started putting Google AdSenseads on this site in July 2005. I’m not exactly Matt Drudge.

5. Perhaps most importantly, I need a new pair of walking shoes that can pass for casual-dressy. Last year, I wore a pedometer and clocked at least 12 miles during the conference.

January 22, 2008 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 Wonk Review

For the first time, I’ve participated in a blog carnival called Health Wonk Review. (Actually, it’s the second time I’ve submitted something but the first time they’ve included my post.) This is a biweekly rundown of what various health bloggers are saying. I sent my post from Wednesday on two federal health IT issues and the prospects for Medicare reform.

Today’s edition has been compiled and hosted by Washington pundit Bob Laszewski, on his Health Care Policy and Marketplace Review.

You will notice that mine is the only IT-related post. I am not going to whine about this fact, however. Matthew Holt of The Health Care Blog was one of the founders, and Shahid Shah, the Healthcare IT Guy, is a regular participant. Vince Kuraitis, author of eCare Management, is scheduled to host the next HWR on Jan. 24. It’s up to each blogger to submit an entry each time, and I guess the others just didn’t participate this week. I’m going to try to do this again. The exposure benefits everyone.

That’s a lot of links above. Here again is the link to the current edition.

January 10, 2008 I Written By

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

Update

In my Dec. 27 post, I referenced a letter from HHS Secretary Mike Leavitt to members of Congress regarding EHRs and the planned 10.1% Medicare physician fee cut for 2008 that eventually was postponed for six months.

I said that the letter was not available online. I was wrong. Here it is.

It seems I confused that letter, from Leavitt to Senate Finance Committee leadership, with another one from members of the Senate regarding e-prescribing. In the latter correspondence, 19 senators asked Attorney General Michael Mukasey to push the Drug Enforcement Agency to revisit its ban on electronic prescribing of controlled substances.

Sen. Sheldon Whitehouse (D-R.I.) issued a press release about that Dec. 17 letter. The letter followed a Dec. 4 hearing on the topic in front of the Senate Judiciary Committee. In the interim, on Dec. 10, the Justice Department included electronic prescriptions for controlled substances on its semi-annual regulatory agenda (see page 70083). That means expect a proposed rule change within the next six months.

As the Washington regulatory machine plods along and the presidential primary season kicks into high gear, please don’t ask me to make any predictions on the EHR/Medicare issue, or, for that matter, on the Medicare fee debate now on hold for a few months.

I will say again, however, that I believe Congress seems to have the will to make major changes to Medicare about once a decade, and that already happened this decade with the Medicare Prescription Drug Improvement and Modernization Act of 2003. Call me cynical (and many have), but I don’t see anything big happening in a presidential election year.

Meanwhile, I’m trying to arrange something super cool: a ride-along in an all-digital ambulance. Hopefully not as a patient. Stay tuned.

January 8, 2008 I Written By

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

Global health 2.0

I don’t want to jump on any bandwagons just yet, since plenty of what I’ve seen in health 2.0 so far is bluster. Sure, there are some interesting ideas, but whether they actually help in the provision of care remains to be proven. I am a big fan of disclosure, however, and I am becoming a big fan of social networking. The latter has helped me reconnect with several people I’d lost touch with.

On that note, here are a couple of interesting links I picked up recently:

A hospital rating site in Ireland called RateMyHospital.ie seems to be attracting a lot of activity. As of this writing, the counter indicates that 9,896 surveys have been completed. I’m not sure when the site started, but we’re talking about a country with just 4.2 million people.

RateMyHospital is part of a privately run site called IrishHealth.com, which looks to have all the trappings of a WebMD or Revolution Health, from consumer health information to personal health records. I don’t know the PHR usage rate, but let’s assume it’s low.

As Facebook continues to explode in popularity, so does the number of groups related to health IT. The latest one I’ve come across is the IMIA group. So far, it only has 23 members, including a high school student from Egypt and a healthy contingent from Argentina.

January 4, 2008 I Written By

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