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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 in Research and 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.

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.

CMIOs wanted in the UK

I’m getting ready to head west for, among other things, the annual AMDIS Physician-Computer Connection in Ojai, Calif., a high-level gathering of chief medical information officers. After years of fighting for a seat at the table, CMIOs now are being held up as a model, at least overseas.

Specifically, my friends at E-Health Insider in the UK have embarked on a mission to have every NHS hospital hire a chief clinical information officer, the British equivalent of the CMIO. Read more about the British perspective on the American CMIO here.

July 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.

Gates Foundation to fund global informatics training

The American Medical Informatics Association will announce Monday that it has received a $1.2 million grant from the Bill and Melinda Gates Foundation to promote health informatics and biomedical education and training worldwide, particularly in developing countries.

This will be the first project of a new program called 20/20, in which the International Medical Informatics Association and its regional affiliates, including AMIA, will attempt to train 20,000 informatics professionals globally by 2020. This is an outgrowth of the AMIA 10×10 program to train 10,000 people in informatics in the U.S. by 2010. IMIA and its partners will discuss details of 20/20 this week at the Wellcome Trust in London.

AMIA will use the Gates Foundation money to develop “scaleable” approaches to e-health education, including a replicable blueprint for training informatics leaders, including physicians, medical records professionals, computer scientists and medical librarians.

“We envision the program will train leaders in low-resource nations by linking them and their institutions to partner institutions affiliated with AMIA to build capacity for managing and improving high-quality, low-cost healthcare in the less-developed economies,” AMIA explains in a statement. AMIA President and CEO Don Detmer, M.D., says this element of 20/20 is aimed at career informaticians “so there won’t be a brain drain.”

Other elements of 20/20 will include individual and degree-track courses at colleges and universities—similar to existing 10×10 curriculum—and skills training, not necessarily specific to medical informatics. “We’re also looking at ways of creating seminars and executive training for people to advocate for this in their home countries,” Detmer says.

Detmer, who is retiring at the end of the year, says the skills training will happen in “bits and bites” to help build incremental capacity in the global e-health workforce. Some planning in this area has been supported by the Rockefeller Foundation as part of a $500,000 grant the charity gave to AMIA to lead one of the Making the eHealth Connection conferences last summer in Bellagio, Italy.

The 20/20 program is chaired by N.T. Cheung, head of IT for the Hong Kong Hospital Authority. Other confirmed or likely participating organizations include the European Federation for Medical Informatics, the Asia Pacific Association for Medical Informatics and the Health Informatics Society of Australia.

December 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.

Scoop: AMIA’s 10×10 going global

CHICAGO—This is just a quick post to draw your attention to a story posted on Digital Healthcare & Productivity this morning: The American Medical Informatics Association is expanding its 10×10 program internationally, with the goal of training 20,000 informatics professionals outside the U.S. by 2020.

AMIA chief Dr. Don Detmer will make the announcement during his annual “state of the association” speech at 12:30 pm CST today. But you heard it here (or at DHCP) first.

Also coming in today’s DHCP newsletter is news from today’s American Health Information Community meeting here in Chicago that the Federal Communications Commission will award $400 million in grants over the next three years to connect small and rural healthcare facilities in 42 states and three territories.

November 13, 2007 I Written By

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

Podcast: Dr. Bill Bria on CMIOs and medical informatics

WASHINGTON—Live from the World Health Care Congress, here’s an interview with Dr. Bill Bria, chief medical information officer of Shriners Hospitals for Children and president of the Association of Medical Directors of Information Systems. We talk about the increasing importance of CMIOs as hospitals align their IT strategies with overall institutional goals, including quality improvement, and we discuss the similar growth of AMDIS. Bria also plugs the annual AMDIS Physician-Computer Connection, which is OK with me since I’ve been shameless in plugging my article in Red Herring.

Podcast details: Interview with Dr. Bill Bria on CMIOs and medical informatics. Recorded April 23, 2007, in Washington, D.C. MP3, mono, 64kbps, 8.6 MB, running time 18:56.

April 23, 2007 I Written By

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