September, 2008 | Meaningful HIT News

It’s the quality, stupid.

At the risk of sounding partisan—and I do my best to be unbiased in my actual journalism—I have to call out Sen. John McCain for an ad that he’s been running about healthcare. “The problem with healthcare in America is not the quality of healthcare, it’s the availability and the affordability.”

Say what?

Someone had better brief him on the two Institute of Medicine reports, “To Err Is Human: Building a Safer Health System” (1999) and “Crossing the Quality Chasm: A New Health System for the 21st Century” (2001), not to mention the countless other academic studies that have followed in recent years questioning the adherence of physicians and hospitals to established quality metrics.

Watch for yourself.

This sounds like McCain is trying to play the patriotism card by insinuating that we have the best health system in the world simply because we’re the United States of America. Yes, cost and access are huge issues, but so is quality. Ask anyone who has ever been prescribed the wrong medication or acquired a MRSA infection in a hospital.

For his part, Sen. Barack Obama has not really run any commercials related to healthcare, but he does focus on cost in his discussion of quality on his campaign Web site.

Clearly, this issue is more esoteric and less sexy than, say, Hurricane Ike or the Wall Street crisis, but someone needs to explain to both candidates that quality really is a problem in American healthcare. Perhaps these two senators are part of the reason why Congress has done virtually nothing on health IT?

Thanks for the honor

I am humbled to say that this blog has made the list of “Top 50 Health 2.0 Blogs” at the RN Central site. The blogs are categorized, but not really ranked, so I guess I don’t know where I fall in the hierarchy, but that’s OK. Health 2.0 is but one aspect of health IT, but a fast-growing one.

Or is it? A debate has started on some other healthcare blogs (including The Health Care Blog) about the future of health 2.0. Dmitriy Kruglyak wrote on his Trusted.MD site this week that news of the impending sale of Revolution Health highlights the fundamental flaws of health 2.0 as is exists today.

Matthew Holt, writing at THCB, begs to differ—while also promoting his Health 2.0 Conference. Holt and Kruglyak go back and forth in the comments section, and I imagine this is not the last we will hear on this subject. I’ll be in San Francisco next month for the next installment of the conference, and am looking forward to some animated discussion.

And now back to my discussion of blogs that reach beyond a single category. Nick’s Blog, the first public blog by a U.S. hospital president, has migrated to AskAHospitalPresident.com. F. Nicholas Jacobs is stepping down at the end of the year as CEO of Windber Medical Center in Windber, Pa., and, presumably, will turn over the Windberblog site to his successor. I call your attention once again to a podcast he did with me a year ago.

I’ve added Nick’s Blog to my blogroll, along with the Wall Street Journal Health Blog.

Vote Health Wonk Review ’08

The latest installment of Health Wonk Review is up at the Disease Management Care Blog. Host Jaan Sidorov brings us a September Surprise by framing the post in the form of a political convention, and his rousing narrative is more than just putting lipstick on a pig. There’s no debating that the fundamentals of the blogosphere are strong!

Enough with the new bills

Yesterday, Health Data Management had a story about some new health IT legislation coming from Rep. Pete Stark (D-Calif.). I see lots of stories like it every time some member of Congress introduces a bill or even thinks about doing so, and I see just as many stories every time one subcommittee or another holds a hearing or takes a vote on health IT legislation.

The one thing I’m not seeing is actual enactment of health IT legislation, with one notable exception: the Medicare e-prescribing incentive program. That one, of course, was part of a broader bill “rescuing” providers from a 10 percent Medicare fee cut at the 11th hour—and setting up a 20 percent cut on Jan. 1, 2010, unless Congress acts again. But how many health IT bills have we heard hyped over the past four or five years, only to see them die before coming to a vote before the full House or Senate?

I sweated out a midday outdoor press conference in stifling, 95-degree heat on Capitol Hill back in June, listening to politician after politician offer great praise for National Health IT Week and call for various forms of incentives to promote EHRs, PHRs, the NHIN and all the other acronyms we’ve become so familiar with. Most reporters who were there ate that up. But not I.

I pulled aside Rep. Patrick Kennedy (D-R.I.) and Rep. Tim Murphy (R-Pa.) after their speeches, and asked each of them one-on-one about the chance of passing any meaningful health IT bills during a presidential election year. Both laughed and said it was slim to none.

So there you have it, some refreshing honesty from members of Congress. And yet people still seem to get excited whenever someone important utters a word about health IT. My guess is that the majority of Congress still doesn’t grasp the issues. Until that happens, don’t expect anything to reach the president’s desk—no matter who happens to be sitting in the Oval Office.

Medicine 2.0, day two

Travel and deadlines got in the way of me posting about the second day of last week’s Medicine 2.0 Congress in Toronto, but I saved my notes.

Something super-cool I saw there: Medting.com, a “global” repository of medical images, developed in Spain and soon to branch out to the U.S. Is it another YouTube for medicine? Not exactly. Miguel Cabrer, president of the company, sees it as more like a Snomed for multimedia.

In Canada, they’re getting interactive with physicians.

Late last month, the Canadian Medical Association launched a social networking portal called Asklepios—named after the Greek god of medicine—on its site. Access is limited to physicians, but CMA online content director Pat Rich says it’s partially in response to doctors who bemoan the demise of the staff lounge.

In the spirit of Facebook and MySpace, it is more than just a professional site; physicians can use Asklepios for blogging, discussing hobbies, posting photos and even, theoretically, dating.

Rich says the CMA is staying pretty hands-off when it comes to content. He also says the association made sure the site was hosted in Canada and not the U.S. because physicians otherwise might be subject to surveillance under the USA Patriot Act. Really. This is not the first time I’ve heard of Patriot Act concerns in healthcare outside the U.S., and it’s a topic I’d like to explore some more.

Physicians in Ontario specifically have another networking option for professional issues, as the OntarioMD.ca point-of-care resource portal recently added a “groups” function. Groups can create a public Web presence and also set up a private members area for sharing files and calendars. Jason Aprile, web contact manager for the government-run OntarioMD site, says there are 8,400 registered physician users now.

Dr. Chris Paton, a UK native who now is at the University of Auckland, says the Next Big Thing might just be social networking for mobile devices. He’s particularly bullish on the mobile clinical assistant and PDAs and smartphones with Wi-Fi capability. One of the benefits of Wi-Fi is that users can connect to more powerful computers, such as for image manipulation, overcoming one of the long-standing shortfalls of PDAs, Paton says.

Greetings from MaRS

TORONTO—I’m here at the Medicine 2.0 Congress, a very international meeting put on by Dr. Gunther Eysenbach of the Centre for Global eHealth Innovation, a project of the University Health Network and the University of Toronto.

The meeting is in a place called the MaRS Centre, in the heart of what’s being called the Discovery District. It’s at the corner of College and University, right around the corner from several major hospitals, including Toronto General, Princess Margaret Hospital and Mount Sinai Hospital.

According to the Web site: “MaRS is not an acronym. It was originally a file name and the words “Medical and Related Sciences” were later attributed to it. Since we promote the convergence of a full range of science and technology disciplines, we’ve dropped ‘Medical and Related Sciences’ from our name and we’re back to just ‘MaRS.'”

So here we are in the fourth paragraph and I haven’t said a word about the conference itself. You’re going to have to wait a bit longer. I’m humbled to say that I am going to be cross-posting this week with the world-renowned Health Care Blog. It just so happens that at least two other contributors to that site are here: John Sharp and Jen McCabe Gorman—and the latter also blogs in Dutch. Rod Ward made the trip from the UK and is posting to his Informaticopia blog, Maarten den Braber from Amsterdam is Twittering and Denise Silber, who flew in from Paris, also has a blog—en français.

The conference even has its own blog: http://medicine20.crowdvine.com. So I shall try to come up with something original.

OK, paragraph six and we’re finally getting down to business. Eysenbach opened the proceedings this morning with a discussion about what health 2.0 and medicine 2.0 really mean. I’ll just link to an article that appeared in Eysenbach’s Journal of Medical Internet Research earlier this year.

Don’t believe the hype? Peter Murray, the International Medical Informatics Association‘s VP for strategic planning, just put up a slide of this graphic:

Moving along, Eysenbach suggested that Google Health and HealthVault are not personal health records but “personal health applications” or platforms. That should make the marketing folks in Mountain View and Redmond very happy, since they keep denying that they offer PHRs.

Speaking of which, even though PHRs haven’t exactly captured the public’s imagination, Eysenbach said we are moving into the realm of PHR 2.0, where people should be able to disclose information within their own PHR to others to form communities around commonalities. A prime example, he said, is Patients Like Me.

Anyway, there are 180 participants from 19 countries here, with a slant toward the academic side of medical informatics. In fact, there are proceedings of this conference that are freely available. There are some 67 poster presentations for me to peruse at some point.

More to come. If anything, I will lead in links per post.

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It’s the quality, stupid.

Vote Health Wonk Review ’08

Enough with the new bills

Medicine 2.0, day two

Greetings from MaRS

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