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About that Friedman editorial

Did you happen to catch Thomas Friedman’s commentary in Sunday’s New York Times entitled, “Obamacare’s Other Surprise”?

On first read, I gave it a big “Duh!” for the explanation that the Patient Protection and Affordable Care Act (that’s how the law is officially known, Mr. Friedman) creates a “new industry” of innovation by encouraging the federal government to release of terabytes of health data — information already legally in the public domain — and then allowing the private sector to figure out how to structure, interpret and use the data. As you probably are, I’m well aware of digital health, Health Datapalooza, federal CTO Todd Park and some of the companies Friedman mentions. (Health Datapalooza IV is less than a week away.)

But on second read, I realized Friedman needed to write that column because America needs a lot of education about the Affordable Care Act, education that the Obama administration and its supporters don’t seem all that willing to provide. The public still thinks of Obamacare largely in terms of health insurance coverage. It’s much more than that, including, as Friedman points out, an attempt “to flip this fee-for-services system (which some insurance companies are emulating) to one where the government pays doctors and hospitals to keep Medicare patients healthy and the services they do render are reimbursed more for their value than volume.”

Coupled with the 2009 American Recovery and Reinvestment Act, which created the $27 billion EHR incentive program for “meaningful use” of electronic health records, the ACA takes some steps toward actual reform of actual care, not just insurance coverage. Friedman does not discuss Accountable Care Organizations, an experiment in realigning incentives around care coordination, nor does he mention the Medicare policy, dictated by the ACA, of not reimbursing for preventable hospital readmissions within 30 days of initial discharge for certain specific conditions, currently heart attack, congestive heart failure and pneumonia. Likewise, he fails to bring up outcomes research, another component of Obamacare. But at least he gets something out there that’s not about insurance coverage.

Unfortunately, many of the online comments posted in response to Friedman’s commentary predictably focus on insurance coverage or government control, but some actually discuss EHRs, population health, healthy behaviors and payment incentives. That’s good. Still, those are just people who read Friedman and the Times. Hyperpartisan conservatives — probably even some hyperpartisan liberals, even though the ACA is more centrist than a lot of folks wish to admit — and the less-educated won’t read the column and won’t comment on the Times site. Those are the people who misunderstand this imperfect but occasionally reform-minded law the most.

 

May 27, 2013 I Written By

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

Is this Cisco commercial reflective of the real world?

Cisco Systems is running this commercial about the “Internet of everything,” with a focus on connected healthcare.

 

It all sounds great, but how much of this is grounded in the real world today and how much is wishful thinking? I mean, connected medical records? It sounds so idealistic.

May 19, 2013 I Written By

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

Guest podcast: Suzanne Leveille from OpenNotes

I now present the latest health IT-related podcast from Sivad Business Solutions, an interview with Suzanne Leveille, research director of OpenNotes, a project to give patients online access to the entirety of their own medical records, including the visit notes from clinicians. Leveille describes a trial at Beth Israel Deaconess Medical Center, Geisinger Health System in Pennsylvania and Harborview Medical Center in Seattle. She reported that not one of the 105 participating physicians asked for the access to be shut off after a year. In some cases, patients even discovered errors and prevented adverse events.


Here is the description from Sivad:

A pleasure to welcome Suzanne Leveille to the program today. Suzanne is a professor of nursing at The University of Massachusetts-Boston, and the research director for OpenNotes.

OpenNotes is an initiative that invites patients to review their visit notes written by their doctors, nurses, or other clinicians.

As a patient, you have the right to read the notes your doctor or clinician writes about you during or after your appointment. Having the chance to read and discuss them with your doctor or family member can help you take better control of your health and health care.

As a healthcare professional, you may build better relationships with your patients and take better care of them when you share your visit notes. Our evidence suggests that opening up visit notes to patients may make care more efficient, improve communication, and most importantly may help patients become more actively involved with their health and health care.

Some highlights from the conversation include: the dramatic improvement between patient and doctor communications; how they overcome potential push back and resistance from physicians; patients became more engaged in their personal health care; OpenNotes has been pleasantly surprised at the patient engagement; how advanced technologies and mobile technology are going to impact the future of this idea; and how they are planning to spread the word and get more patients and doctors improving communications and care with OpenNotes!

 

May 16, 2013 I Written By

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

Health Wonk Review: money talks, but IT helps

The latest edition of Health Wonk Review is hot off the digital presses, with Joe Paduda taking hosting duties on his Managed Care Matters blog. And managed care does matter in this trip around the health blogosphere, with most of the attention on healthcare costs and insurance coverage.

On the quality front, which is my primary interest these days, there is some interesting discussion about  whether the new Medicare hospital readmissions policy truly will produce better care or will prod some into providing the minimum level of service to readmitted patients.

(Frankly, hospitals have been overtreating for years. If a minimal level of service gets the job done for the patient, that’s a good thing. And the policy is supposed to cause hospitals to do the right thing in the first place, knowing that they will lose out later if they don’t. I’m all for that.)

My post on consumer ignorance of telemedicine is in there, as is a good one from Vince Kuraitis and Leslie Kelly Hall about the duty providers have to share information with patients. EHRs and wearable sensors also make this edition of HWR. Not bad from an IT perspective.

May 10, 2013 I Written By

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

So many types of telehealth

Here’s a short video (720p HD) I put together from the just-concluded American Telemedicine Association’s annual conference in Austin, Texas. No wonder it’s so hard to get a real sense of the size of the telehealth and telemedicine market when there are so many components and so many different definitions. This is a row of banners outside the meeting rooms highlighting the various types, not to mention some of the ATA’s constituencies and important topics at the conference. I did the voice-over at 1:30 in the morning.

May 8, 2013 I Written By

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

Breaking down ignorance about telehealth

AUSTIN, Texas — I’m at my very first American Telemedicine Association annual conference, which starts later this afternoon. This morning, I gave a short presentation to the ATA’s Industry Council, made up of technology vendors, about trends in the telehealth industry.

My slides are here: ATA 2013 presentation.

I want to draw your attention in particular to slide 9, which is a letter to the editor of the Kearney (Neb.) Hub newspaper. Honestly, it’s one of the most ignorant, poorly argued pieces of garbage I’ve seen in a long time, and I can’t believe the editor actually accepted it and published it with such a weak argument. (Really, there’s “no scientific way to diagnose a patient with a mental illness,” but it’s OK to make a diagnosis in person?) Unfortunately, I can believe that someone would be so misinformed about telehealth and healthcare in general (“doctors are being paid millions to visit with patients for five minutes …”).

Thankfully, a commenter took the author, Kearney resident Kristyn Drahota, to task. I took her to task this morning, too. I hope you will join me in helping to combat such ignorance about telehealth.

 

May 5, 2013 I Written By

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