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Podcast: Scot Silverstein talks health IT safety risks

In a sidebar to the September cover story I did for Healthcare IT News, I reviewed some of the work of Scot Silverstein, M.D., who has long been chronicling problems with EHRs and other health IT systems. Unfortunately, he wasn’t available for an interview in time for that report, but he was last week, so I got him for a new podcast.

Silverstein, a professor of health informatics at Drexel University in Philadelphia, considers EHRs to be experimental and, sometimes, less safe than paper records and would like to see health IT subjected to the same kind of quality controls as aerospace software or medical devices. “Suboptimal system design could lead even careful users to make mistakes,” Silverstein said in this interview.

During this podcast, we refer to a couple of pages that I promise links to, so here they are. Silverstein writes regularly for the Health Care Renewal blog, a site founded by Roy Poses, M.D., a Brown University internist who runs the Foundation for Integrity and Responsibility in Medicine. His definitions of good health IT and bad health IT appear on his Drexel Web page.

Podcast details: Scot Silverstein, M.D., on health IT safety risks. MP3, mono, 128 kbps, 33.8 MB. running time 36:59.

1:10 How this interest came about
3:05 His blogging
3:45 His 11 points demonstrating why he believes the FDA should be concerned about health IT risks
5:00 IOM, FDA and ECRI Institute statements on health IT safety
5:50 Comparing EHRs to medical devices and pharmaceuticals
8:35 Lack of safety testing in health IT
9:25 Issues with EHR certification
10:00 Safety validation of software
10:35 EHR’s role in Texas Health Presbyterian Hospital’s initial discharge of Ebola patient
11:50 EHR failure causing medical harm to a close relative
13:10 Poor design vs. poor implementation
14:35 Who should regulate?
15:55 Billions already spent on EHRs
16:45 Threat of litigation
17:40 “Postmarket surveillance” of “medical meta-devices”
18:50 EHRs now more like “command and control” systems
19:30 Movement to slow down Meaningful Use
20:17 Safety issues with interoperability
21:40 Importance of usability
22:30 His role at Drexel
24:18 “Critical thinking always, or your patient’s dead”
25:05 Lack of health/medical experience among “disruptors”
29:30 Training informatics professionals and leaders
31:15 Concept vs. reality of “experimental” technology
32:50 Advice for evaluating health IT
33:55 Guardians of the status quo
35:10 Health IT “bubble”
36:10 Good health IT vs. bad health IT

 

October 20, 2014 I Written By

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

Infographics: Health IT leadership and salaries

It’s infographic time! In fact, it’s time for two infographics.

The first is from HIMSS, celebrating 25 years of the organization’s annual health IT leadership survey. Some interesting findings, as pointed out by a HIMSS publicist:

  • 1991- 75 percent say their institution’s financial health is helped by computers
  • 1994 – 14 percent predict that digital patient information will be shared nationwide in 1-3 years
  • 2000 – 70 percent of respondents say HIPAA is a top business issue.

 

The second infographic comes from HealthITJobs.com. Not surprisingly, the most lucrative jobs are in consulting, and those with experience get paid significantly more than newbies.

September 18, 2014 I Written By

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

Adelphi U ad spreads health reform fallacy

The following ad has popped up several times on my mobile Facebook app recently:

Adelphi Facebook ad
That’s from Adelphi University in Garden City, N.Y., and the first sentence of that ad is absolutely false, not to mention poorly written. There is no government mandate for any healthcare facility to go paperless at all, much less by 2015.

As people in health IT and in healthcare management probably know, the federal Meaningful Use EHR incentive program calls for Medicare penalties starting next year for any provider that hasn’t achieved at least Stage 1 of Meaningful Use. But that’s not a mandate; hospitals and other providers still have the option of participating. Those who don’t see Medicare patients don’t face penalties anyway.

Even those that are able to meet all the Meaningful Use requirements still don’t have to be paperless, at least not according to the Stage 1 and Stage 2 rules. Nor have I seen any evidence that Stage 3 would contain such language, and even if it does, that phase does not start until 2017.

There are plenty of reasons why those who start work on a master’s in health informatics this year will be very much in demand next year. Why does Adelphi need to mislead people in an apparent attempt to create demand for its program?

June 29, 2014 I Written By

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

Healthcare Scene buys Healthcare IT Central and Healthcare IT Today

Healthcare Scene, the blog network of John Lynn and of which this site is a part, has purchased job-finder site Healthcare IT Central and the related Healthcare IT Today blog, founded by Gwen Darling. I don’t think this transaction will directly affect my blog, but John offers this on his EMR and HIPAA blog: “If you asked me a month ago what I could do for organizations looking for healthcare IT talent or individuals seeking healthcare IT jobs, I wouldn’t have much to offer beyond advertising. Today, that all changes.”

We all know about the high demand for health IT jobs and the shortage of qualified people to fill all the jobs available. Healthcare IT Central features:

-9000+ recent and relevant healthcare IT resumes
-14,000+ e-newsletter subscribers
-16,000+ registered job seekers (Upload Your Resume)
-750 Registered Employers (Post Your Jobs)

For more, read the press release at Healthcare Scene’s EMR and EHR News site and see what Darling has to say about the acquisition at Healthcare IT Today.

November 13, 2013 I Written By

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

Attending Health 2.0? Donate your old smartphone

If you’re planning on attending the Health 2.0 conference in San Francisco next Monday and Tuesday, Health eVillages, a program of the RFK Center for Justice and Human Rights, will be collecting used Apple iOS and Android mobile devices. Health eVillages, of which I am a member of the advisory board, will refurbish your device and load it with medical reference materials, clinical decision support tools, drug dosage calculators and other mobile health tools and deploy it to a clinician working in a developing country, helping to bring higher-quality care to that community.

Current Health eVillages sites are in Haiti, China, Kenya, Uganda, with more to come.

If you have a used iPhone, iPod Touch, iPad, Android phone or and tablet (sorry, no BlackBerrys, which is what I happen to have), drop it off at the Health 2.0 registration desk or at the Physicians Interactive booth (No. 37) in the exhibit hall.

If you want to learn more about Health eVillages, founder Donato Trumato, CEO and vice chairman of Physicians Interactive, will be speaking for about 5 minutes on the main stage the morning of Tuesday, Oct. 9, and then will lead a lunchtime presentation at 12:50 p.m. PDT in the Imperial B ballroom at the Hilton San Francisco.

I will be there, too, participating the “3 CEOs” session Tuesday at 8:10 a.m. I will be interviewing Phytel CEO Steve Schelhammer live on stage. Am I nervous? Only about having to get up that early.

 

October 2, 2012 I Written By

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

Hyperbole doesn’t work in health IT

I’m still rather slammed with work, but I might as well take a few minutes to post on a Friday afternoon to call out someone else who’s pumping up the health IT hype beyond reasonable levels.

A publicist for UnitedHealth Group wanted me to attend yesterday and today’s New York eHealth Collaborative Digital Health Conference in New York City. Never mind the fact that I live in Chicago and the invite came in two days ago. To be fair, though, I was offered phone interviews. I declined based on the second paragraph in the e-mail:

This event is the first and only national summit dedicated specifically to advancing the role of health information technology (HIT). Hundreds of leading stakeholders and thought leaders from across the HIT space will gather under the same roof to discuss the latest technologies, achievements and challenges impacting the industry. HHS Chief Technology Officer Todd Park is the keynote speaker.

This is the first and only national summit dedicated specifically to advancing the role of health information technology, huh? Other than HIMSS, AHIMA, AMIA, AMDIS, CHIME, ANIA-CARING, iHT2, Health Connect Partners, HL7 and a few more, that is absolutely a true statement. Let’s not leave out the dearly departed TEPR, either.

I hope others didn’t fall for that ridiculous statement.

December 2, 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.

Anthelio to hire thousands in Michigan

Editor’s note: This was written for a national publication, but rejected because it was too localized. I have permission to post it here. Don’t get used to me writing a lot of news stories for this blog.

Healthcare business process services firm Anthelio Healthcare Solutions will open a “center of excellence” in or near Detroit, a move that could bring thousands of IT-related jobs to an economically depressed area. The Dallas-based company, formerly known as PHNS, also announced that it is working with community colleges across Michigan to develop and hire in-state talent.

“This is mostly about private industry stepping up,” Anthelio Chairman and CEO Richard S. Garnick said. “These are not part-time or short-term jobs,” Garnick said. He added that the company did not receive any government assistance or subsidies for this expansion.

“We want to create jobs for Americans and leverage our existing capabilities,” Garnick said.

The 50,000-square-foot center of excellence will serve as a “physical location that clusters skills and expertise,” Garnick explained. Anthelio has not chosen the actual site yet, but Garnick said the company has narrowed its options to two, one in Detroit proper and one in an unspecified suburb.

There will be some consolidation of services from Anthelio offices in Detroit and Flint, Mich., but most of the people working at the center of excellence will be new hires, Garnick said, and the company would keep the existing locations open. The two current Michigan offices help Anthelio support major clients McLaren Health Care Corp. in Flint, and Nashville, Tenn.-based Vanguard Health Systems, owner of Detroit Medical Center.

Garnick did not indicate exactly how many employees Anthelio was looking for, but said it was in the thousands. “We are hiring people as we speak,” Garnick said. He added that Anthelio will support tuition reimbursement for new employees who are completing health IT training in programs of three to six months at community colleges. Current Anthelio employees also are eligible for tuition assistance.

The company is looking for expertise in health information management, computer-assisted coding, business process improvement, and other back-end healthcare functions, according to the CEO. “We have a broad set of needs, he said.

Last week, Anthelio announced a partnership with speech recognition technology vendor MedQuist Holdings to improve clinical documentation for healthcare providers and promote computer-assisted coding. The Michigan center for excellence will handle some of this work, according to Garnick, as well as analytics-related activities with another Anthelio partner, OptumInsight, a subsidiary of UnitedHealth Group that was formerly known as Ingenix.

Much of the ramp-up is intended to prepare clients for the October 2013 transition from ICD-9 to ICD-10 coding. Garnick likened the change to the scope of preparations IT departments made for Y2K more than a decade ago, with one major difference. “It doesn’t end on Jan. 1, 2000,” Garnick noted. “This will be the new platform for reimbursement for healthcare.

October 14, 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.