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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.

Groopman explains patient empowerment to Colbert

The public is slowly getting the message that the doctor doesn’t always know best. Dr. Jerome Groopman, chief of experimental medicine at Beth Israel Deaconess Medical Center in Boston and a staff writer for The New Yorker, is out hawking his new book, “Your Medical Mind: How to Decide What Is Right for You.” Last night, he explained the idea of patient empowerment to a skeptical Stephen Colbert, or at least a skeptical character played by Colbert.

Colbert did make the common mistake of confusing health insurance with healthcare when he asked Groopman if the Harvard doc would testify before the Supreme Court on the upcoming case regarding the individual mandate in the Patient Protection and Affordable Care Act. People, they are two different things!

 

The Colbert Report Mon – Thurs 11:30pm / 10:30c
Jerome Groopman
www.colbertnation.com
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October 4, 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 better term than PHR?

I’ve occasionally explored some of the nomenclature in health IT, particularly how the term “personal health record” is something distinct from “electronic health record” and how some news reports confuse the two. I’ve been known to laugh at the use of “personal electronic health record,” which I think was an uninformed reporter’s way of saying that each person should have an EHR.

Over the weekend, I saw a distinct term from, I believe, Australia: “patient-controlled health record.” That makes a lot more sense to me and tells me the purpose of the record. A Google search on that term actually turned up a Harvard Medical School meeting on “personally controlled health record infrastructure” target”= new” that took place in 2006 and 2007. But the term seems to have disappeared from the U.S. radar.

June 14, 2010 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.

Scott Wallace resurfaces

I learned a few weeks ago, almost by accident, that former National Alliance for Health Information Technology CEO Scott Wallace had moved on to the University of Virginia‘s Darden Graduate School of Business as a Batten Fellow. Wallace co-authored a July 3 column in the Financial Times on value-based healthcare purchasing. (He collaborated with Darden professor Elizabeth Teisberg and Michael Porter of Harvard Business School.)

Today, NAHIT, which is going through a reorganization—its Web site is just a place-holder right now—decided to publicize Wallace’s fellowship with a press release. That suggests Wallace left on good terms and likely will stay involved in the promotion of health IT.

August 7, 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.