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Medical harm explained, in graphics and Farzad style

INDIAN WELLS, Calif.—Still think the United States has the “best healthcare in the world?” You clearly haven’t been paying attention.

Last month, the Wall Street Journal ran this excellent commentary from Johns Hopkins surgeon Dr. Marty Makary about how the broken culture of medicine is harming people. An excerpt:

I encountered the disturbing closed-door culture of American medicine on my very first day as a student at one of Harvard Medical School’s prestigious affiliated teaching hospitals. Wearing a new white medical coat that was still creased from its packaging, I walked the halls marveling at the portraits of doctors past and present. On rounds that day, members of my resident team repeatedly referred to one well-known surgeon as “Dr. Hodad.” I hadn’t heard of a surgeon by that name. Finally, I inquired. “Hodad,” it turned out, was a nickname. A fellow student whispered: “It stands for Hands of Death and Destruction.”

Makary went into a discussion of checklists, à la Gawande, and reporting of adverse events. “Nothing makes hospitals shape up more quickly than this kind of public reporting,” he said. Yep, a little shaming can be good for consumers. And shocking.

Now playing in a fairly small number of theaters and available on DVD, on demand and through iTunes is a new movie called “Escape Fire,” which takes its title from the Don Berwick book of the same name. I have not been to see it yet — soon — but the trailer is compelling. So is this graphic, which the movie’s producers are circulating on social media:

 

Still think we don’t have a problem with patient safety in this country? Not only haven’t you been paying attention, you also haven’t heard Dr. Farzad Mostashari tell the heart-wrenching story of accompanying his mother to an emergency department shortly after he joined the Office of the National Coordinator for Health Information Technology in 2009.

He couldn’t get answers about his mother’s condition from anywhere in the department, and not because the doctors and nurses didn’t want to do the right thing. “The systems are failing them,” Mostashari said Wednesday at the College of Healthcare Information Management Executives (CHIME) CIO Forum, where I am now.

Even as a physician, he felt like he would be imposing on the doctors and nurses on duty if he requested to look at his mother’s paper medical record to see what might be wrong. “There was something rude about trying to save my mom’s life by asking to see the chart. That’s messed up,” Mostashari said.

Yes, yes it is. And Mostashari later told me he shared that story for me, because I had told him right before he went on stage about the suffering my dad needlessly suffered in a poorly managed hospital in my dad’s last month of life. Journalists don’t often say this, but thank you, Farzad.

As it turns out, the CIO of the health system that owns the hospital that mistreated my dad is here. I introduced myself and gave a brief synopsis of what happened, in a non-confrontational way. I intend to follow up. The hurt of losing my dad is still fresh, but I feel inspired by the media soapbox I have.

I want to honor my dad’s legacy in a positive way. I want to help this hospital fix its terrible processes and toxic culture so others won’t have to suffer the way he did.

October 18, 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.

HIMSS12 sets record for tweets

The folks at HIMSS are claiming that the 2012 conference in Las Vegas a couple months ago set a world record for the most tweets at a health conference. (I’m checking to see who keeps such records.)

By the numbers, according to HIMSS:

  • The #HIMSS12 hashtag was used 28,434 times.
  • HIMSS12 averaged 167 tweets per hour.
  • HIMSS12 was mentioned 33,247 times in social media, more than double HIMSS11 (which itself was more than double HIMSS10).
  • The keynote by Twitter co-founder Biz Stone generated 7,595 tweets, beating out the 7,047 tweets from Dr. Farzad Mostashari’s keynote.

This infographic from HIMSS tells more of the story about the whole conference.

 

I am not surprised Brian Ahier and Regina Holliday had so much influence on social media at the conference. Ahier moderated the Meet the Bloggers panel I was on.

I was, however, surprised to the breakdown of mobile devices accessing the HIMSS conference’s mobile site. Apple with 70 percent sounds right, particularly when you consider how many iPads were in evidence, but I would have guessed Android would have more than 14 percent share because it’s so popular for smartphones and BlackBerry more than 2 percent because a lot of enterprises still use that platform. I guess I’m one of the few people left in health IT with a BlackBerry.

UPDATE, Friday, April 27: It was healthcare social media consulting firm Symplur that tracked the tweets and announced the record. There’s more data here, though my head starts spinning when someone discusses stuff like slopes of equations.

April 26, 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.

Video: Jonathan Bush at HIMSS12

As has become custom, I carved out some time at HIMSS to interview Jonathan Bush, the always outspoken and insightful CEO of athenahealth. This time, instead of meeting in some sterile conference room, we got together just before the start of athenahealth’s annual HIMSS party, which happened to be at Ghostbar at the top of the Palms hotel in Las Vegas.

The setting, on the balcony of the 55th floor, tied into the company’s embrace of the cloud. The staff of both the bar and of athenahealth did a great job finding a single spotlight on the balcony, overlooking the bright lights of the Strip. Yeah, there’s a shadow on Bush’s face and you can hear the wind at times, but I think it adds to rather than disrupts the vibe.

As usual, we joke around a lot, but we also get into some serious discussions about ICD-10, meaningful use, health IT innovation and even my involvement with Health eVillages, a subject that came up because athenahealth has a health IT charity effort of its own in India. (Speaking of HealtheVillages, co-founder Donato Trumato is presenting a case study at HIMSS Thursday morning. It’s at 9:45 a.m. PST in Marco Polo 803 on the first floor of the Venetian. I’ll probably be waiting for the media availability of Dr. Farzad Mostashari at that time. Something about meaningful use Stage 2.)

Enjoy the video. I know I did.

Jonathan Bush at HIMSS12 from Neil Versel on Vimeo.

 

February 23, 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.

Learn about Health eVillages at HIMSS12

Remember Health eVillages, the program launched last fall to bring mobile medical reference and decision support technology to clinicians in underserved parts of the world, including poor communities right here in the U.S.? You know, the project of the Robert F. Kennedy  Center for Justice and Human Rights and mobile medical content provider Physicians Interactive, the one I am serving on the advisory board of?

You probably haven’t heard too much of late, but you will be able to learn more about Health eVillages at the upcoming HIMSS conference — slightly more than a week away, if you can believe it. That’s because co-founding partner and Physicians Interactive CEO and Vice Chairman Donato Tramuto will be presenting about Health eVillages a week from Thursday, Feb. 23. Here are the details:

Title: “No Power, No Internet, No Problem:  Mobile HIT Improves Care Worldwide” (Session #138)

Description: This session will use real cases to explore how “Health eVillages” brings mobile medical technology to challenging rural clinical environments around the world, helping clinicians deliver safer, more effective healthcare.

Date/Time: Feb. 23, 9:45 a.m. to 10:45 a.m. PST

Location:  Venetian-Palazzo-Sands Expo Convention Center, Las Vegas

Room:  Marco Polo 803

Objectives:

  • Describe how Health eVillages and the Robert F. Kennedy Center for Justice and Human Rights have partnered to improve patient care via mobile technology and medical information
  • Recognize the value of easily adaptable mobile devices deployed in remote areas
  • Discuss the unique needs and challenges of rural medical environments in developing nations
  • Outline how you can help Health eVillages enable practitioners to deliver safer and more efficient medical care worldwide

If you are interested at all in how mobile technology is having an incredible impact on healthcare and health education in low-resource communities all over the world — perhaps even a greater effect than in wealthier areas — you will want to attend the session. This is taking place immediately after the keynote address by national health IT coordinator Dr. Farzad Mostashari. You’ll probably be pretty energized after Mostashari speaks, and Donato’s session is sure to be eye-opening and uplifting. That’s not a bad morning, if I do say so myself.

By the way, Health eVillages is seeking additional sponsors and sources of funding. Drop me a line or speak with Donato at HIMSS if you are interested. Thanks.

I hope to see you in Las Vegas.

 

February 12, 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.

Mostashari, Chopra get down to ‘Meaningful Yoose’ rap

Now it makes sense.

A couple weeks ago, I got the latest update from fictional EHR vendor Extormity:

Extormity to Federal Health IT Leaders – ‘Take a chill pill, fellas.’

Brantley Whittington, fictional CEO of make-believe electronic health record vendor Extormity, is urging Aneesh Chopra, Farzad Mostashari and Todd Park to tone down their optimism and exuberance about the clinical benefits and cost savings associated with implementing health information technology.

Whittington, speaking to reporters from the offices of a K Street lobbying firm in Washington, D.C., expressed dismay at the unbridled enthusiasm exhibited by White House, ONC and HHS officials. “For years, vendors like Extormity have worked hard to cultivate a healthcare IT culture that combines complexity with closed-mindedness, creating a pervasive and stifling sense of futility.”

“Instead of the sober and staid leadership we are accustomed to, these gentlemen are inspiring new models of industry development,” added Whittington. “The Direct Project is a great example of supercharged public/private collaboration designed to simplify the flow of health information without spending a dime of taxpayer money. This may benefit patients and providers, but the lack of convoluted infrastructure does little for the Extormity bottom line.”

“While I have been known to muster up some counterfeit fervor for shareholder meetings, the consistent passion and zeal demonstrated by these officials is proving disruptive to those of us dedicated to proprietary and expensive solutions,” added Whittington. “I suggest dialing back the levels on the gusto meter to preserve the status quo, stifle meaningful innovation and ensure consistent and sizable returns to a handful of large healthcare IT vendors.”

Chopra, Mostashari and Park are exuberant, that’s for sure. The first time I saw Park and Chopra share a stage together, I labeled them the “anti-bureaucrats.” I have since added Mostashari to that category. But it was only over the weekend that I learned that Mostashari and Chopra were getting down to the “Meaningful Yoose” rap from Dr. Ross Martin at a recent ONC meeting.

Here is the video of that spectacle, courtesy of John Lynn. (Unfortunately, I cannot find an embeddable version.)

Perhaps this is why Mr. Whittington wants the anti-bureaucrats to tone it down. Or perhaps (more likely) extormity feels threatened by innovation. Yeah, let’s go with the latter.

N.B. I am writing this while 33,000 feet above northeastern New Mexico, just about to cross into the Texas Panhandle, on a flight from Tucson to Chicago. I love me some Wi-Fi in the sky!

December 19, 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.

Health Wonk Review, unadorned but chock full of health IT

In the latest edition of Health Wonk Review, hosted by Chris Fleming on the estimable Health Affairs blog, there’s not much in the way of a fun theme, but that’s OK. It’s still full of some good perspectives, including more than the usual share of health IT.

My post that aggregated a bunch of tweets from the Health 2.0 Conference made the biweekly blog carnival, as did a much longer-form way of covering the event, David Harlow’s series of video interviews. Harlow got 18 different people on camera, including HHS gurus Todd Park and Dr. Farzad Mostashari.

Elsewhere, patient advocate Jessie Gruman,  president and founder of the Center for Advancing Health, took on mobile apps as a means of changing patient behavior, Tom Lynch of the Workers’ Comp Insider blog discussed predictive modeling in healthcare claims administration and Healthcare Economist blog author Jason Shafrin wonders why patients don’t seem to care much about healthcare quality.

In particular, I invite you to share Shafrin’s short post, if for nothing more than a conversation starter.

October 13, 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.

Mostashari named new national HIT coordinator

Farzad Mostashari

Farzad Mostashari, M.D. has been named the new national coordinator for health IT, effective today. Though HHS has not put out a press release or other statement, it appears this is a permanent rather than an interim appointment. I had been hearing since February that Mostashari, who previously was deputy national coordinator, would be in charge of ONC at least on an interim basis when David Blumenthal, M.D., returned to Harvard.

UPDATE, 3:25 p.m. CDT: The appointment is permanent. You can find this and more details in the story I wrote for InformationWeek today.

April 8, 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.

Poll for new national coordinator is rather laughable

Leave it to those in the ivory tower of Modern Healthcare to screw up something as simple as an unscientific poll about who should be the next national coordinator for health IT.  The poll lists a whopping two dozen names, ranging from the obvious—Dr. John Halamka, Dr. Paul Tang, current deputy national coordinator Dr. Farzad Mostashari—to the dark horse—Dr. Robert Hitchcock of T-System, Paula Gregory of the “Philadelphia College of Osteopathic Medicince” (sic)—and even a few laughable listings.

For one thing, Dr. David Brailer is on the list. The first national coordinator (2004-06) left Washington because he wanted to be with his family in San Francisco. He’s currently running a $700 million equity investment firm and couldn’t possibly want to get back into the political game, could he? Besides, he’s a Republican. Dr. William Hersh, CMIO of Oregon Health and Science University, would make a good choice, but he’s already said he doesn’t want the job.

Another choice is current CMS Adminstrator Dr. Donald Berwick. Dirty politics is about to force him out, and if that happens, you can bet he won’t want to be within 400 miles of Washington. (Hey, that just happens to be the distance to his home in the Boston area.) I’m really steamed about the Berwick situation, and am preparing  a separate post that hopefully will go up tomorrow.

Modern Healthcare also includes Janet Marchibroda, who’s identified as chief healthcare officer of IBM. Sorry, but Marchibroda, former CEO of the eHealth Initiative, left IBM last year. My sources tell me she’s now working at ONC, serving as de facto chief of staff to current coordinator Dr. David Blumenthal. (Blumenthal, as you no doubt know, is leaving in April.)

Missing from the long list of names is Johns Hopkins CIO Stephanie Reel, who won in a landslide the equally informal, unscientific poll that HIStalk ran a couple weeks ago. HIStalk did report, though, that Allscripts effectively stuffed the ballot box. Also not included is Blumenthal’s predecessor, Dr. Robert Kolodner, but he doesn’t want to go back, either.

I’m not going to run another survey here (hey, I doubt I have the readership to make it worthwhile anyway), but I’m curious if people think a non-physician could or should be national coordinator.

March 10, 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.

Mainstream Media watch, part 200 and counting

Tuesday’s Chicago Tribune had a feature story in the main news section about health IT. With health IT drawing $19.2 billion from the federal stimulus legislation, stories are popping up all over the mainstream media of late.

What struck me, though, is that the reporter went to a medical practice in Vero Beach, Fla., and talked to consultants and experts all over the country, when there’s so much health IT activity and expertise right here in the Chicago area. Notably, NorthShore University Health System in suburban Evanston is the only organization not named Kaiser Permanente to reach Stage 7 on the HIMSS Analytics EMR Adoption Model scale.

To his credit, though, reporter Noam Levey did quote New York City Assistant Health Commissioner Farzad Mostashari, M.D., a rising star in health IT circles.

Also, I recently read a March 3 New York Times story about pharmaceutical-related conflicts of interest among Harvard Medical School faculty. My immediate reaction was that this nothing unique to Harvard, and the story doesn’t even get into the growing controversy about another cash stream flowing from medical device makers.

It also got me thinking that we’ll start to see donations pick up from healthcare software companies once the economic stimulus kicks in. I wonder if the big academic health systems have ethics rules regarding gifts from IT vendors?

March 18, 2009 I Written By

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