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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 fast $5000 loans-cash.net with bad credit, hospital/physician practice management and healthcare finance.

Podcast: Greenway Health CEO Tee Green on interoperability, consumerism and more

Health IT vendor Greenway Health recently finished its rollout of a cloud-based EHR to all 8,200 Walgreens stores in the U.S. When I was offered the chance to interview CEO Wyche T. “Tee” Green III about this, I decided to take it a step further.

In all my years of covering health IT, I’ve never met nor even spoken to Green, so I figured a podcast was in order. After all, I had written a piece for Health Data Management earlier this year about how pharmacies are reshaping themselves as true healthcare companies. (This interview also comes in the wake of CVS Caremark ending its sale of tobacco products and changing its name to CVS Health.)

I also had a lot of questions about interoperability issues in health IT and the many criticisms that lately have been heaped on both EHR vendors for perceived usability problems and the federal Meaningful Use EHR incentive program. The timing couldn’t have been better.

Podcast details: Interview with Greenway Health CEO Tee Green, recorded Sept. 8, 2014. MP3, mono, 128 kbps, 25.5 MB. Running time 27:51

1:00 Walgreens rollout and EHRs for “retail health”
3:20 Future expansion to Walgreens Healthcare Clinic locations
4:15 My own experience with lack of interoperability at a CVS MinuteClinic
5:30 Achieving EHR interoperability
7:30 Frustration with slow progress on Meaningful Use
10:30 Data liquidity
12:30 Update on CommonWell Health Alliance
14:25 Addressing criticisms that vendors are hindering interoperability
16:30 EHR usability
18:10 Greenway Marketplace app store
22:15 Patient engagement and slow start to Stage 2 Meaningful Use
24:10 Dealing with the rise of consumerism in healthcare

I’ve been kicking around in my mind the idea of hosting a regular podcast, perhaps as frequently as weekly. If so, what day of the week would you prefer to hear a new episode?

September 12, 2014 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.

A new HIT comic, and perhaps a Google fail?

Healthcare Technology Online reports this week that there is a new comic strip online called Hacking N’ Healthcare. “Hacking N’ Healthcare is a comic strip that takes a humorous look at the challenges often associated with implementing health information technology,” the magazine says. Here’s what appears to be the first edition, taking a swing at user experience design, but also, perhaps inadvertently, mocking personal health records and gamification in healthcare. (The timing is interesting. In a MobiHealthNews column that should be published Friday, I take the most measured, hopeful look at PHRs that I have since about 2007.)

Hacking ‘N Healthcare (from Health Technology Online)

 

I can’t determine if Healthcare Technology Online or Pathfinder Software is the source of this comic, or if it’s going to be a regular feature in either place. I Googled “Hacking ‘N Healthcare” and found nothing relevant. And speaking of fails, there is no word in the English language spelled “sceptor.” It’s “scepter” in American English and “sceptre” in the Queen’s English. Did I mention I’m available for all your editing needs?

 

August 8, 2013 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.

Comprehensive coverage of WTN Media’s Digital Health Conference

As you may know from at least one of my earlier posts, I was in Madison, Wis., last month for a great little health IT event called the Digital Health Conference, a production of the Wisconsin Technology Network and the affiliated WTN Media. In fact, WTN Media hired me to cover the conference for them, so I did, pretty comprehensively. In fact, I wrote eight stories over the last couple of weeks, seven of which have been published:

I still have an overview story that should go up this week.

Why do I say it’s a great little conference? The list of speakers was impressive for a meeting of its size, with about 200 attendees for the two-day main conference and 150 for a pre-conference day about startups and entrepreneurship.

Since it is practically in the backyard of Epic Systems, CEO Judy Faulkner is a fixture at this annual event, and this time she also sent the company’s vendor liaison. Informatics and process improvement guru Dr. Barry Chaiken came in from Boston to chair the conference and native Wisconsinite Judy Murphy, now deputy national coordinator for programs and policy at ONC, returned from Washington. Kaiser Permanente was represented, as was Gulfport (Miss.) Memorial Hospital. IBM’s chief medical scientist for care delivery systems, Dr. Marty Kohn, flew in from the West Coast, while Patient Privacy Rights Foundation founder Dr. Deborah Peel, made the trip from another great college town, Austin, Texas. (Too bad Peel and Faulkner weren’t part of the same session to discuss data control. That alone would be worth the price of admission.)

July 2, 2013 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.

Ode to EMRs, in song format

Two North Carolina physicians have decided to have a little musical fun with their EHR-related frustrations. Pediatrician Ken Roberts , M.D., and hematologist-oncologist Jim Granfortuna, M.D., at Moses Cone Health System in Greensboro, N.C., have produced this little ditty entitled, “Ode to Electronic Medical Records, or Our Song of Epic Proportions.” Cone Health just happens to have an Epic Systems EHR.

Roberts and Granfortuna don’t seem like they’re anti-EHR, just anti-EHR that makes their work more difficult. From the song: “Now we ain’t saying the EHR is bad/When all the bugs are fixed I know we’ll all be glad/It’s just by then us pioneers will all be dead.”

May 21, 2013 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.

Hotels open up for HIMSS13

Here’s a quick travel update for those of you still making plans for HIMSS13 in New Orleans next month. Today, OnPeak, the travel service that HIMSS has contracted with, seems to have released a number of hotel rooms for the week of the conference.

I had been waiting to book for a few weeks since I first heard that rooms would open on Jan. 30 or so after vendors, which apparently claimed big blocks of rooms months ago, had to give their final numbers. That didn’t happen, and I was starting to sweat a bit. But I made my reservation today, and am near enough to the Morial Convention Center that I don’t have to worry if I miss the last shuttle of the evening, which I’ve done plenty of times in past years. I feel bad for anyone staying out by the airport in Metairie or Kenner, because that’s a good 10-13 miles away. From my experience in other HIMSS cities, those bus trips can easily take 45 minutes to an hour during rush hour, and the buses don’t run all that frequently. HIMSS won’t be going back to San Diego anytime soon because so many people had to stay out by La Jolla the last time the conference was there in 2006, and that is closer to the San Diego Convention Center than the airport hotels are in New Orleans.

Back then,  seven years ago, attendance had swelled to a then-record 25,000, and stayed in that range for a couple of years. But then came the HITECH Act and meaningful use in 2009, and interest in health IT has soared. Last year, more than 37,000 people came to HIMSS12 in Las Vegas, where hotels are plentiful. The Big Easy might not be as big a draw as Sin City, but it might be for some people who prefer authentic culture to the manufactured kind. (For the record, I like both places.) I’ve heard registration was slower this year than last, but I didn’t get that directly from HIMSS.

If you do find yourself stuck, I did notice in the last couple of weeks that there are a good number of hotels with vacancies across the Mississippi River in Gretna and Marrero and points east, such as Chalmette and New Orleans East. But there is no HIMSS shuttle to those places, and good luck finding a car to rent unless you’re willing to spend $90 a day. Go ahead, search for a car rental with airport pickup and try to find one for less during the week of March 3. (You can get one from an off-airport location for about $31 a day if you’re willing to take a taxi into town first to pick it up.)

This leads me to wonder if this might be the last time for a while that HIMSS meets in New Orleans. I think a couple of extra shuttle routes could fix the problem. And if attendance does level off or even drop a bit since we’ve probably passed the peak of the Gartner Hype Cycle, then it’s all good. Given some of the recent pushback against the direction of meaningful use and the efficacy of current EHR technology, I think it’s safe to say we are in or headed to the trough of disillusionment this year.

I’ll have more later this week about HIMSS, including what I’m trying to get from the conference. Vendors, please pay attention. I’m finally about to start working on my schedule, but I will have specific objectives.

 

February 11, 2013 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.

EHR disadvantages disappear from Wikipedia

According to the Health Care Renewal blog, which chronicles some of the myriad problems in American healthcare, editors of the Wikipedia page for “electronic health record” keep deleting or changing the section about EHR disadvantages. Drexel University medical informatics professor Scot Silverstein, M.D., who contributes to the Health Care Renewal blog, says that the following text has been removed from the Wikipedia page in the past week: Read more..

January 29, 2012 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.

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.

A nurse speaks out against bad EMR software

Every Thursday, the Chicago Tribune’s “Play” section runs a little feature called “Love/Hate.” The paper picks three or four things that readers love and three or four things that readers hate. This week, EMRs entered the picture. This appeared in the “I hate …” category:

… being a slave to computer programs to document my care as a nurse. It’s so ridiculously time-consuming.

— Sheila Young, Orland Park

That must be one terrible EMR—or perhaps a hodgepodge of disconnected legacy systems—if Young not only considers herself a slave to the computer programs, but feels compelled to share her disdain for the technology with a light-hearted feature section of the local newspaper. That’s quite a statement against the quality of the system design?

On further inspection, it could be a function of not wanting to change old habits. According to Illinois state records, the only Sheila Young from Orland Park who’s a registered nurse (indeed, the only Sheila Young in the whole state with an active RN license) was first licensed in 1967. That means she’s been in nursing practice for at least 44 years. Old habits die hard.

Ms. Young, if you happen to read this, please contact me. I’d love to get the whole story.

May 27, 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.