Free Healthcare IT Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Get all the latest Health IT updates from Neil Versel for FREE!

Podcast: Anthelio’s Rick Kneipper on why current EMRs don’t improve quality

Why are physicians still resisting EMRs? Maybe it’s because systems aren’t easy to use and lack interoperability. That’s the hypothesis of Rick Kneipper, co-founder and chief strategy officer of Anthelio Healthcare Solutions, a Dallas-based business process services firm that until February was known as PHNS.

In my latest podcast, Kneipper joins me to discuss the shortcomings of current EMRs and current EMR policy, and offers his remedies for the problems. Give it a listen, then share your thoughts, too.

Podcast details: Interview with Rick Kneipper, co-founder and chief strategy officer, Anthelio. MP3, mono, 64 mbps, 12.7 MB. Running time 27:50

1:05 Why he thinks current EHRs aren’t meeting their promise of improving safety, quality and efficiency of healthcare
2:00 Money for meaningful use is starting to flow
2:30 Lack of interoperability in lower levels of in HIMSS Analytics EMR Adoption Model
3:35 Similar problems in meaningful use standards
4:15 No “silver bullet”
5:15 Per PCAST report, many EMRs create electronic versions of patient charts
6:25 Systems for creating billing documentation, not for improving care
7:05 Anthelio’s approach on workflow
7:55 Why aren’t we reengineering workflows?
9:10 Process doesn’t end when EMR goes “live”
10:05 Ultimate objective of meaningful use
10:43 Some physicians are just doing it for the money
12:15 Limitations of certification
12:45 Waiting on Stage 2 requirements
14:20 Caveat emptor and the rush to book revenue
15:33 Interoperability missing from Stage 1
16:00 Physician engagement in EMR selection
18:55 Usefulness of EMR data
20:45 Clinical decision support in MU
23:00 Patient safety compared to aviation safety
25:00 Public apathy toward patient safety
26:20 Advice to vendor community

June 7, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality fast $5000 loans-cash.net with bad credit, hospital/physician practice management and healthcare finance.

Bosworth: PHRs need to do more than just store data

You may have heard news of Google essentially putting its Google Health PHR platform in cold storage. Whether it’s true or not, the “untethered” PHR—one not connected to a health system’s EHR—has been a non-starter for years. I’ve been particularly critical of the undeserved attention Google Health and Microsoft HealthVault have received, when many smaller companies have been working on PHRs for much longer.

The original head of the Google Health project, Adam Bosworth, left the company in 2007 under suspicious circumstances—did he quit or was fired?—prior to the way overhyped 2008 introduction of this vaporware. Bosworth has gone on to start a new company, Keas, that produces a PHR that incorporates care plans. Keas got some undeserved hype itself, in the form of an October 2009 story in the New York Times that, from what I understand, was suggested by a Times editor who also was advising Keas. (That editor is no longer with the Times.)

Keas itself hasn’t gained much traction, either. I reported in September 2010 that Keas abandoned its original plans to sell direct to consumers in favor of partnering with insurance companies and large employers. That was the last I had heard about Keas until last week, when TechCrunch TV posted the following short interview with Bosworth, entitled, “Adam Bosworth On Why Google Health Failed”:

Bosworth said that Google simply didn’t offer anything the public really wanted. “They basically offered a place to store data,” he said. “Our data shows people don’t really want a place to store data per se. They want to do something fun and engaging. If it’s not fun, if it’s not social, why would they do it?” Yes, that makes sense.

Bosworth said that people need encouragement and even peer pressure to practice healthy behaviors. Bosworth said he lost 22 pounds in 18 weeks by walking 4 miles each way to and from his downtown San Francisco office four times a week, and he credited the encouragement he got from checking in on Keas.

That’s a great sign, but I wonder how many other stories like his there are out there? My guess is, not many. I’m thinking online communities of like-minded people or those facing similar health issues have been far more successful. Last night’s post is a prime example.

Feel free to prove me wrong.

June 6, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality fast $5000 loans-cash.net with bad credit, hospital/physician practice management and healthcare finance.

Founder of British interactive patient sites dies

The driving force behind popular British interactive patient sites HealthTalkOnline and YouthHealthTalk has died.

Dr. Ann McPherson, 65, died May 28 after a four-year struggle with pancreatic cancer. Dr. McPherson, a general practitioner at Oxford University, came up with the idea for a patient-experience site 15 years ago while fighting her own battle with breast cancer, E-Health Insider reports.

Dr. McPherson and Dr. Andrew Herxheimer, a former editor of the Drug and Therapeutics Bulletin, founded predecessor site DIPEx in 2001, long before the phrase “health 2.0” gained acceptance. Their organization, the DIPEx Charity, divided the site into HealthTalkOnline for adults and YouthHealthTalk for teens, children and their families in 2008. Numerous British celebrities, including actor Hugh Grant and Radiohead singer Thom Yorke, have become public supporters of the charity.

She co-authored the 1987 book, Diary of a Teenage Health Freak, which has sold more than 1 million copies worldwide, according to an obituary in The Guardian. The book spawned a TV show in the U.K. in the early 1990s, and later, the still-active Teenage Health Freak Web site.

Dr. McPherson won the BMJ’s 2011 Healthcare Communicator of the Year award in April.

 

June 5, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality fast $5000 loans-cash.net with bad credit, hospital/physician practice management and healthcare finance.

Not so elementary, my dear Watson

In just the last few hours, I’ve seen a huge wave of pushback and doubt about Watson, the IBM supercomputer, being used for clinical decision support.

Yesterday, I covered a “healthcare leadership exchange” at IBM’s new Healthcare Innovation Lab in downtown Chicago. I posted some of my observations on the EMR and HIPAA blog, and made the case for diagnostic decision support.

I also wrote a story for InformationWeek, but that hasn’t run. Instead of posting my story, InformationWeek healthcare editor Paul Cerrato wrote a column about Watson already being “beaten in the medical diagnostics race” by Isabel Healthcare, a diagnostic decision support tool that’s been available for years. I have to admit, he’s right. I first interviewed Isabel founder Jason Maude probably in 2002 or so, and I first blogged about the company in 2005. I mentioned Isabel in a 2007 post that, interestingly, also alluded to the work of Don Berwick and Larry Weed.

Cerrato mentioned Jerome Groopman’s 2007 book, “How Doctors Think,” which discussed, in part, how IT could help doctors avoid many types of cognitive errors. “[D]octors tend to lean toward diagnoses that are most available to them in their day-to-day routine,” Cerrato wrote (emphasis in original). That’s exactly what Weed has said for decades, and exactly what Atul Gawande talked about in his groundbreaking book, “Complications.” Computers should not make decisions for physicians, but rather should help them reach the right conclusions, particularly when they see rare cases.

Wouldn’t you know, “e-Patient” Dave deBronkart commented on my EMR and HIPAA post to say he just finished reading Groopman’s book. He tweeted a link to my post, which a few of his 6,500 other Twitter followers noticed. They also noticed EMR and HIPAA grand poobah John Lynn’s comment that the example in yesterday’s Watson demo, a 29-year-old pregnant woman being prescribed doxycyline was “pretty weak.” (He’s right, by the way.) Aurelia Cotta, who blogs about issues such as infertility and adoption, started this thread that also got South Carolina nurse Sunny Perkins Stokes interested:

[blackbirdpie url=”http://twitter.com/#!/AureliaCotta/status/76775042503028737″]

[blackbirdpie url=”http://twitter.com/#!/AureliaCotta/status/76775279565090816″]

[blackbirdpie url=”http://twitter.com/#!/sunnystill/status/76776486119555072″]

[blackbirdpie url=”http://twitter.com/#!/AureliaCotta/status/76782462893699072″]

[blackbirdpie url=”http://twitter.com/#!/AureliaCotta/status/76782822198743040″]

[blackbirdpie url=”http://twitter.com/#!/AureliaCotta/status/76783250663682048″]

[blackbirdpie url=”http://twitter.com/#!/sunnystill/status/76783933106307072″]

[blackbirdpie url=”http://twitter.com/#!/AureliaCotta/status/76784835267534848″]

[blackbirdpie url=”http://twitter.com/#!/AureliaCotta/status/76785122996789248″]

 

Well, there’s a reason why I call myself a “healthcare” reporter and not a “medical” reporter. I don’t know the science, and I do occasionally get myself in trouble when I start talking about things like whether doxycycline is contraindicated during pregnancy. (To my credit, I did attribute the statement to IBM’s chief medical scientist, Dr. Marty Kohn.)

As I was reading the above tweets and contemplating this blog post, I came across a link to some tongue-in-cheek pushback against Watson in healthcare. An anonymous radiologist who blogs about PACS as “Dr. Dalai” compared Watson to HAL, the diabolical mainframe in “2001: A Space Odyssey.” Dr. Dalai wrote: “Watch out, boys and girls, Watson is headed to a hospital near you, and he (it?) may challenge you as much as he did Ken Jennings.” Jennings, of course, is the Jeopardy! champion whom Watson beat earlier this year.

At first glance, I thought Dr. Dalai was yet another whiny physician clinging to the status quo. But he hit on the real issue: application of knowledge. Quoting from an interview with one of Watson’s programmers, Dr. Dalai noted that the supercomputer is being loaded with all kinds of medical reference material in preparation for “learning” human physiology and ultimately gathering experience in medicine. “This isn’t fair!  If I could just take a text book, stick it up my, ummmm, brain, and have it instantly memorized, I would be whiz, too!” he wrote.

Yeah, isn’t that the whole point of clinical decision support?

June 3, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality fast $5000 loans-cash.net with bad credit, hospital/physician practice management and healthcare finance.

Bet on videoconferencing growth before PHR ubiquity

Last week, I reported in InformationWeek on a Manhattan Research study showing that 7 percent of U.S. physicians were chatting with patients via videoconference. What the research didn’t say is how many consultations actually take place by videoconferencing. My guess is that it’s minuscule, but virtual visits will soon become commonplace.

According to Australian online healthcare community eHealthSpace, technology vendor Siemens is forecasting that 20 percent of all medical consultations in Australia will take place online by 2020. Much of that growth will come from rural and remote areas of a vast country that’s full of remote, sparsely populated areas.

I find that much more believable than another Siemens prediction that 90 percent of Aussies will have a “personally controlled electronic healthcare record” (whatever that means) by 2020. I’m guessing that videoconferencing with doctors will boom long before there’s widespread adoption of any health record controlled by patients.

 

I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality fast $5000 loans-cash.net with bad credit, hospital/physician practice management and healthcare finance.