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Happy Memorial Day, or, for some docs, Call Day

I hope everyone in the U.S. is having a great Memorial Day holiday. After two months of seemingly endless rain and unseasonable chill, it’s gorgeous here today along the shore of Lake Michigan, so I won’t be here long. I did, however, want to share a video from ZDoggMD (“Slightly Funnier Than Placebo”) for those of you stuck on call on this holiday Monday. Actually, even if you’re not on call, it’s worth sharing.

ZDoggMD, an actual hospitalist, parodies teen Interwebz sensation Rebecca Black’s highly parodiable (is that even a word?) song “Friday” with his take, “Call Day.” He’s got close to 36,000 hits already.

For ZDoggMD’s all-important production notes, click here.  Then go out and enjoy the day.

May 30, 2011 I Written By

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

A nurse speaks out against bad EMR software

Every Thursday, the Chicago Tribune’s “Play” section runs a little feature called “Love/Hate.” The paper picks three or four things that readers love and three or four things that readers hate. This week, EMRs entered the picture. This appeared in the “I hate …” category:

… being a slave to computer programs to document my care as a nurse. It’s so ridiculously time-consuming.

— Sheila Young, Orland Park

That must be one terrible EMR—or perhaps a hodgepodge of disconnected legacy systems—if Young not only considers herself a slave to the computer programs, but feels compelled to share her disdain for the technology with a light-hearted feature section of the local newspaper. That’s quite a statement against the quality of the system design?

On further inspection, it could be a function of not wanting to change old habits. According to Illinois state records, the only Sheila Young from Orland Park who’s a registered nurse (indeed, the only Sheila Young in the whole state with an active RN license) was first licensed in 1967. That means she’s been in nursing practice for at least 44 years. Old habits die hard.

Ms. Young, if you happen to read this, please contact me. I’d love to get the whole story.

May 27, 2011 I Written By

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

Do you trust the cloud for EHRs?

Do you trust the cloud for EHRs? That’s the question I ask in my weekly post for EMR and HIPAA. Check it out, and share your opinion.

May 26, 2011 I Written By

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

ONC HIT competency testing

Late last week, the Office of the National Coordinator for Health Information Technology opened six exams to test the competency of health IT professionals who have completed short-term training programs. I’m not quite sure how I feel about this. Is it a good thing for the federal government to offer these voluntary exams? After all, ONC is funding the development of HIT training curriculum for community colleges and providing lots of scholarship money. Shouldn’t the government expect to get a return on its investment? Or should the feds stay out of the testing process?

May 25, 2011 I Written By

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

Mobile health events for 2011

David Doherty of 3G Doctor does it again. On his company’s aptly named mHealth Insight blog, Doherty has a list of dozens of mobile health events and conferences planned throughout 2011, all over the world.

3G Doctor, a telemedicine service, is based in beautiful County Kerry, Ireland, and serves Ireland and the U.K., but Doherty is plugged in to the mobile and wireless health industries worldwide. It looks like he’ll next be in the U.S. this October, for Wireless Health 2011 in San Diego.

May 20, 2011 I Written By

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

News and notes: Cool healthcare tech, telemed pushback and more

It’s Friday afternoon, and I realize it’s been days since I’ve posted here. (Make sure you catch my posts on EMR and HIPAA every Thursday, including my latest on Dr. Larry Weed and his critiques of current health IT systems.) I think it’s time for a rundown of some interesting developments this week.

Weed apparently is not the only one who’s disappointed in the pace of change in healthcare. Dr. Bill Crounse, senior director of worldwide health for Microsoft, was at the World of Health IT conference in Budapest, Hungary, to deliver some scathing remarks at about North American health IT. According to Canadian Healthcare Technology, Crounse called the U.S. and Canada the “worst of the worst in the industrialized world in the use of IT in healthcare.”

He explained: “I see physicians in perhaps less developed countries bypassing all that legacy technology and using commodity off-the-shelf contemporary solutions, using tablets and speech recognition and doing their discharges, all with technology that costs pennies on the dollar, and then I come home to America and look at these $150 million systems and say, ‘wouldn’t we be better spending that on patient care instead of IT?’”

EMRs just store health information, Crounse said. “It’s really what you do next that counts. Once we have information digitized, that doesn’t buy you value. It’s what you do with the information, how you use it to manage care, and to collaborate.”

While we’re talking about overseas events, Hello Doctor, a telemedicine service in South Africa, apparently is on hold less than a month after its April 17 launch. In an e-mail newsletter (not available on the Web, as far as I can tell), Telemedicine & E-Health reported:

Under fire from South Africa’s healthcare bureaucracy, Hello Doctor has suspended its telemedicine services, pending a meeting between representatives of the company and the Health Professions Council of South Africa (HPCSA). The council referred to its undesirable business practice committee Hello Doctor and two companies that have announced plans to offer a joint telemedicine service later this year, MTN Group and Sanlam. HPCSA has alleged that the companies violated rules that require a healthcare practitioner to do a physical examination and assess a patient before a diagnosis can be made. [News Alert, May 6 ]. HPCSA is drafting its own guidelines for telemedicine, an emerging competitor to nationally-licensed doctors.

The South African Medical Association also is fighting the service. “”It is no different from blind-dating. How sure are you whether you are getting the real doctor or not?” SAMA Chairman Dr. Norman Mabasa told Independent Online. Hmm, aren’t these the same kinds of objections we see in America? When will the medical establishment wake up and see that telemedicine is not a threat to their authority?

Well, at least some physicians are embracing new technologies. That’s the subject of a feature I just had published on Medscape,  “10 Totally Cool and Incredibly Useful Medical Gadgets: Technology That’s Changing Medical Care.” Feel free to argue with me and add your own.

And speaking about telehealth and arguing with me, I was the victim of intimidation of the media this week. A certain story I wrote about a telemedicine technology vendor was pulled from the Web yesterday after the company threatened to sue the small company that published it. The company accused me of writing a “defamatory” story and wondered if a competitor didn’t actually help me write the piece. Sorry, but I have a lot more integrity than that. I also was accused of mischaracterizing the state of the deactivated ambulance telemedicine service in Tucson, Ariz., which I said was “failed.”

The accuser referred to an April article in Telemedicine & E-Health written by Dr. Rifat Latifi, one of the driving forces behind Tucson ER-Link, and several colleagues that showed the efficacy of ER-Link in performing remote intubation. That’s great, but there needs to be a working network to support the “videolaryngoscope.” Tucson, unfortunately, no longer has one.

 

I Written By

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

Not just an EMR, but an HIE for mental health

Last month, I asked if anyone has been successful with an EMR for mental health. I wondered if an iPad might make it easier for a psychotherapist to take electronic notes during a session without making the patient feel like the computer was getting in the way, because a desktop PC certainly would be a distraction. I also wondered about where mental health fits in the realm of truly comprehensive EHRs.

(Yes, I make a distinction between EHR and EMR here, since, while it’s important to have a complete medication list to avoid harmful interactions, there’s little reason why an orthopedist or dermatologist would need to know whether a patient had been diagnosed with a mental illness. The same goes for records of sexually transmitted diseases or any other condition that patients may not want a lot of people to know about.)

I got a partial answer on Monday, when I interviewed Justin Bayless, president of Bayless Behavioral Health Solutions, which just launched a portal to share patient records with other caregivers, insurance companies, case managers, educators, probation officers and skilled nursing facilities. (See my story about this in InformationWeek.)

EMRs do indeed have a role in mental health, even if it’s mostly administrative. “It saves therapists a lot of time because it automatically generates forms,” Bayless said of the Credible Behavioral Health Software EMR that Bayless MHS clinicians carry on laptops to treatment sites such as assisted living facilities, nursing homes, schools and community centers. (That’s a quote you won’t see in the InformationWeek story.)

And segmentation of behavioral health information from other parts of a comprehensive EHR won’t be too much of an issue for a while—Bayless believes it could take 10-15 years—since so many providers still use paper right now.  Remember, psychologists, addiction counselors, licensed clinical social workers and any other mental health professionals that aren’t psychiatrists (i.e., anyone without an M.D. or D.O. degree) don’t count as eligible providers for “meaningful use” purposes.

 

May 16, 2011 I Written By

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

Skype for ‘redneck telehealth’?

Kudos to Barbara Duck of The Medical Quack blog for coining a new term: “redneck telehealth.”

A friend of hers had an outbreak of gout while getting ready to board an overseas flight. “He had called his doctor who was not set up with any of the new telehealth programs and software that is just now becoming available so I said ‘get your doctor on Skype and put your foot up there for him to see,’” Duck explained in a post over the weekend. “Obviously this is not a perfect situation for either side for a real diagnosis, but as the old saying goes a picture is worth a 1000 words and that’s what this would do.”

Actually, I’ve heard that because a picture is worth 1,000 words, a video is worth 1 million words. Since laptops tend to have built-in webcams these days and a lot of 3G smartphones can transmit live, mobile video (hey, even some 2.5G phones can do so over a Wi-Fi connection, like you might find in say, an airport), why not fire up Skype or FaceTime or similar videoconferencing program and show your foot to your doctor? If you don’t like the term “redneck,” just call it a video call or an ad-hoc network.

Or are we expecting far too much by assuming that the doctor would one, be available on short notice, and two, voluntarily share his/her mobile number or Skype screen name with a patient?

I Written By

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

EMR and HIPAA: HIE, ACOs the ‘fast-moving train’ of health reform

I’ve just finished my latest post for EMR and HIPAA, based on a session I moderated this week at the the Institute for Health Technology Transformation health IT summit in Fort Lauderdale, Fla. Here’s a taste:

The panelists did great job of articulating some of these conundrums and strategies to overcome them, but none better than Kevin Maher, director of clinical innovations for Horizon Healthcare Innovations, a new affiliate of Horizon Blue Cross Blue Shield of New Jersey tasked with testing new care models, and Victor Freeman, M.D., quality director in the Health Resources and Services Administration‘s Office of Health IT and Quality.

The patient-centered medical home is a great idea for managing care, promoting prevention and, ultimately reducing costs. “We view the base of the ACO as the patient-centered medical home,” Maher said. But what exactly does an ACO look like? “An ACO is like a unicorn,” Maher said. “We can all describe it, but we’ve never seen one.”

Click here to read the whole post.

May 12, 2011 I Written By

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

Blogging by Twitter?

Oh man, I’ve been busy. I filled in as writer of the Midwest edition of Payers and Providers the last two weeks because regular editor Duncan Moore, a former colleague, had been hospitalized. (Get well soon, Duncan.) I’ve been at the Institute for Health Technology Transformation health IT summit in Fort Lauderdale, Fla., since yesterday, and I’ve also had my regular deadlines for InformationWeek and MobiHealthNews.

I moderated two IHT2 conference sessions yesterday, on how health IT underpins Accountable Care Organizations and how business intelligence can create a framework for health information exchange. I haven’t had time to blog about those, but several people seem to have tweeted during those sessions. I therefore present a rundown via Twitter.

@narmi91 #iHT2 FMA #HIE strategy: Simple HIE gives physicians instant value, allows them to dip their tow in the water.

@narmi91 #iHT2 #HIE strategy: Adopt exchange before adopting #EHR. Which would you choose Internet (HIE) or PC (EHR)?

@narmi91 #iHT2 #HIT for #ACO: Primary care medical home is a must for ACO. Paying patients to perform. Also focus on medical assistants & nurses.

@narmi91 #iHT2 #HIT for #ACO: Changing patient behavior: need to engage patients. BCBS has new benefit plan $300-700 cash for manage health and qual.

@narmi91 #iHT2 #HIT for #ACO: Fed/state gov are more on the side of privacy but security always comes down to human behavior.

@narmi91 #iHT2 #HIT for #ACO: Pace of tech adoption in healthcare is much slower than other industries: Privacy & security, care coord, social sci.

@ICALeader Dr Freeman says healthcare is more focused on quality assurance than quality improvement, need multi-disciplinary groups to achieve QI #iHT2

@narmi91 #iHT2 #HIT for #ACO: Quality improvement process can help identify clinical decision support.

@narmi91 #iHT2 #HIT for #ACO: Victor from HRSA – HIE challenges include security issues and not enough discrete data. Most #EHR not designed for qual

@ICALeader Kevin Mather says upside & downside risk must be high & metrics must be measured for quality & cost monthly for ACO success #iHT2 #HIE #ACO

@ICALeader Dr. Freeman reminds #ACO & #HIE not to forget federal healthcare DOD, VA & IHS agencies in effort to coordinate care @ #iHT2 FTL

@bhparrish: Patient-centered #HIE with secure communication will be essential infrastructure for #ACO development. <RT @ICALeader> #iHT2


May 11, 2011 I Written By

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