April, 2011 | Meaningful HIT News

Topol’s talk at TEDMED 2009

If you saw my presentation to Meharry Medical College earlier this month either live or on video, you know I referenced Dr. Eric Topol’s talk at TEDMED 2009, in which the Scripps Health cardiologist predicted the demise of the stethoscope by the 2016, the 200th anniversary of that old standby. If you were curious, there is video available of Topol’s session. In fact, it’s right here.

You don’t actually get to see Topol throwing his stethoscope in the trash. I understand that happened right when he took the stage. This video starts a little after then.

EMRs for mental health?

I’ve been wondering, has anyone in mental health truly had success with an EMR? I can’t imagine any psychotherapist sitting at a computer typing notes while there’s a patient on the couch. That would be particularly bad for a patient with self-esteem issues.

I imagine that tablets like the iPad may make this a little easier, but what psychotherapists really need is something like a pen tablet (with a stylus rather than touch-screen) or digital ink to mimic taking notes on a pad of paper.

The other issue related to EMRs in mental health is the exchange of notes with other physicians. Will an electronic note from therapist back to the primary care physician wind up in the electronic chart that might get sent, say, to an orthopedist or gastroenterologist? The only thing other specialists really would need to know is the patient’s medication list, not a psychiatric diagnosis or treatment history, right? Segmenting out sensitive parts of an EMR like treatment for mental health and sexually transmitted diseases is something vendors and CIOs have struggled with for years, and I believe continue to struggle with.

In both cases, I’d love to hear your anecdotes here.

My week in review

Since I’m starting to write a lot of daily/breaking news, I’m going to try something new today that might become a regular Friday feature: posting my week in review. It will consist of a quick rundown of stories I’ve written this week. Here goes:

Monday

“Patient Safety Initiative To Leverage Health IT: The $1 billion federal Partnership for Patients initiative aims to cut $35 billion in healthcare costs, save 60,000 lives, and decrease hospital-acquired conditions by 40% by 2013.” (InformationWeek)

Tuesday

“Medicare Opens EHR ‘Meaningful Use’ Attestation” (InformationWeek)

“How mobile health can abide by HIPAA” (MobiHealthNews)

“State of mobile and wireless healthcare” (video/slides of my recent presentation to Meharry Medical College)

Wednesday

“CMIOs to begin testing BlackBerry PlayBook” (MobiHealthNews)

Thursday

“More Unrealistic Expectations From the Public, This Time Involving CDS” (EMR and HIPAA)

I’ve got another InformationWeek story to crank out this afternoon that may or may not get posted until Monday, and a podcast in the works, too. Bring on the weekend!

CDS commentary on EMR and HIPAA blog

I’ve just written my first post for the well-established EMR and HIPAA blog, one of the flagship sites for the Healthcare Scene network. (This site belongs to Healthcare Scene as well.) My post is a commentary about public perceptions of clinical decision support and a critique of failures by health IT developers, the healthcare industry and the media to design easy-to-use technology and communicate the purpose of CDS to the public. I’ll be writing weekly for that site, usually on Thursdays.

I quote Dr. Larry Weed in that post. If you want more on this pioneer in health informatics and healthcare quality, check out some of my previous posts and stories about him:

A must-read from Dr. Weed (April 2009)
‘Isabel’ as a verb? (February 2007)
“Realizing the Vision for IT in Healthcare” (Digital HealthCare & Productivity/Bio-IT World, December 2006)
“Dr. Weed’s Software Cure” (Health-IT World/Bio-IT World, July 2004)

State of mobile and wireless healthcare

As I previously mentioned, I was invited to speak last week at Meharry Medical College in Nashville, Tenn., on the subject of mobile and wireless healthcare. Unlike past presentations I’ve given, this time I have video. But it’s not easy posting 65 minutes of HD video (a 4.5-GB file). YouTube limits uploads to 15 minutes. Vimeo has no time limit, but restricts file size. Finally I got some software to downsize my video to an acceptable size, so here it is via Vimeo.

I actually gave the same presentation twice, first to about 50 people in an auditorium for Meharry’s grand rounds (plus a few more by videoconference from the local VA hospital), and later in the day to an audience of about 20 people in the Department of Family & Community Medicine. This is the latter, taken with my own video camera set up on a tripod with no camera operator and no external microphone, so the sound level might be a little low. Meharry’s A/V staff recorded the morning session, and I’ll post that professionally shot video if and when I get a copy.

Healthcare and Healthcare IT: Here, There and Everywhere from Neil Versel on Vimeo.

Since some of the slides are hard to read after I lowered the video quality, here’s a PDF of my slides so you can follow along.

I’d like to thank Paul Talley, M.D., director of Medical Grand Rounds at the school, for having me, and Fatima Mncube-Barnes, Ed.D., Meharry’s library director, for inviting me to speak and setting everything up.

Check out the latest Health Wonk Review

The newest edition of the blog carnival Health Wonk Review is up, courtesy of David Williams and his Health Business Blog. My podcast with Peter Waegemann of the mHealth Initiative made this biweekly review of healthcare commentary from across the blogosphere. This Health Wonk Review seems to have more on health IT and healthcare quality than most editions, and that makes me happy. One post also rightly takes aim at some of the shortfalls in healthcare journalism.

More on mobile

I haven’t blogged in a couple of days because I’ve been preparing for a speaking engagement at Meharry Medical College in Nashville, Tenn., on the subject of mobile healthcare. It’s about the fifth time I’ve spoken on this subject, but this presentation was longer than any of the previous ones, a little more than an hour.

I gave my first talk earlier this morning and will repeat it after lunch for a different audience. I’ll post my slides after I’m done and I expect to have video at some point. I’ll put that up, too, once I get it.

10 years later, there’s still a quality chasm, and Senate Dems are wusses

It’s been a full decade since the Institute of Medicine published the second volume in its landmark series on patient safety and quality of care, Crossing the Quality Chasm. We appear to be not much closer to achieving a high-quality health system as we were 10 years ago.

Last week, as you may have already heard, a paper in Health Affairs from researchers at the University of Utah concluded that adverse events may be 10 times more prevalent than previously believed and that errors may occur in an astounding one-third of all hospital admissions. The research team, which included such luminaries as Dr. David Classen, Dr. Brent James and the Institute for Healthcare Improvement‘s Frank Federico, also said that their estimates probably were on the conservative side.

Patient-safety advocate Regina Holliday finagled her way into the Health Affairs briefing on the subject on Thursday, and was disappointed by her observation that patients were almost an “afterthought” in a discussion on how to close the gaping chasm. Holliday, a sometimes painter, expresses her frustration in words in this interesting blog post and on canvas. Note that she depicts Accountable Care Organizations as a unicorn.

Do I have to remind you of who used to be the driving force behind the IHI? That of course would be Dr. Donald M. Berwick, the administrator of CMS that Republicans want to kick to the curb because they think they can score political points against the Obama administration. For that matter, the Obama administration and Democrats in the Senate are willing to sacrifice Berwick because they clearly lack the cojones to stand up for better healthcare. Yes, I said cojones. Sue me.

Please read and share my series of posts on Berwick if you haven’t done so already.

Berwick political saga is a tragic attack on better healthcare (March 14)

More reasons why CMS needs Berwick (March 20)

Slams on Berwick getting pathetic (March 23)

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.

Podcast: mHealth Initiative’s Peter Waegemann

In 2009, after 25 years of moving “Toward an Electronic Patient Record” (TEPR), the Medical Records Institute disbanded and its founder, Peter Waegemann, shifted his focus to mobile healthcare by creating the mHealth Initiative.

TEPR had grown into a rather substantial event, peaking at 3,800 attendees in 2004, when newly appointed national health IT coordinator Dr. David Brailer was the featured speaker. But attendance and vendor square footage rapidly declined after that, as much of the action in the realm of EMRs either moved to medical specialty societies or the huge HIMSS conference.

Taking a more content-driven than vendor-driven approach, the mHealth Initiative has tried its hand at conferences since last year. (I spoke and served on a panel at the organization’s 2nd mHealth Networking Conference last fall.) A week ago, the group held its third such event in that paradise for lovers of jet noise, Rosemont, Ill., and I sat down with Waegemann to record this podcast.

Podcast details: Interview with Peter Waegemann, chairman and founder of the mHealth Initiative. Recorded March 30, 2011, at the mHealth Initiative’s 3rd Networking Conference in Rosemont, Ill. MP3, mono, 64 kbps, 6.0 MB. Running time 26:02.

0:20     Transition from e-health to m-health after 25 years of running TEPR
1:50    “Total paradigm shift” for documenting and accessing information at the point of care
2:20     No country he’s seen has a complete, effective EMR yet
2:40    Movement from an industrial society to an “information society” of knowledge workers
4:40    Beyond voice communications
6:20    Behavior change in healthcare and adapting to technology
7:20    Lack of connectivity among mobile devices and shortcomings in current technology
8:55    The politics of standards for m-health devices and systems
10:40    Always “five years away”
11:20    Searching for the iPhone of home monitoring
12:00    iPad’s role in healthcare and its shortcomings
13:00    Apps
14:20    EMR vendors discovering mobile devices
15:25    Distinctions between wired health, wireless health and connected health
15:50    “Three pillars” of m-health
16:40     “Communication-enhanced healthcare”
17:35    Better care for less money
19:05    Cell phones in hospitals
20:30    Integration issues
21:00    Patients and younger physicians driving change
22:00    “Unified communications”
22:42    Payment for home monitoring
24:30    European approaches to m-health

Topol’s talk at TEDMED 2009

EMRs for mental health?

My week in review

CDS commentary on EMR and HIPAA blog

State of mobile and wireless healthcare

Check out the latest Health Wonk Review

More on mobile

10 years later, there’s still a quality chasm, and Senate Dems are wusses

Mostashari named new national HIT coordinator

Podcast: mHealth Initiative’s Peter Waegemann

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