Author Archives

Matthew Holt

Interview: John White, Director IT, AHRQ

Sep 25, 2009

By Matthew Holt

Last week I got to spend some quality time in Washington DC including moderating a panel looking at new research behind physician-patient communication at the annual AHRQ conference. AHRQ will play a significant role in comparative effectiveness research, as it basically is channeling the $1 billion or so in the stimulus package for that. But AHRQ is also pretty active in trying to figure out what works and what doesn’t in health care IT, and has an online resource center about that too.

The man running AHRQ’s initiatives in IT is John White, who’s affable, amusing and has an interesting point of view or two. So to let you know a little more about the mysteries of government, here’s my interview with John.

Regina Holliday: Fred’s life & death at 73 cents a page

Sep 24, 2009• 5

By MATTHEW HOLT

If you ever wonder why the efforts to make it easier for patients and families to get information and be treated as equals in their care by the medical care system matter….

If you need convincing that the concept of participatory medicine is important enough for its own society, advocates & journal….

If you wonder whether it’s OK to wait to phase in the possibility of patients actually having rights to their own data….

Read Regina Holliday’s story about Fred’s illness and the way she and he were treated.

Commentology: Obama and End-of-Life Care

Sep 24, 2009• 9

THCB reader Molly Holmes wrote us to say:

As a member of a hospital geriatric emergency team, I’m on the front lines of a major health care issue that need immediate attention. The costs of keeping a person barely alive during their last few weeks of life easily run into the millions. The procedures undertaken at such times are painful and poorly thought out, and do not at all increase the quality of one’s life. The unfortunate senior who falls into the end-of-life emergency medical cycle can expect his or her final days to be miserable and lonely, with family relegated to the sidelines, while medical people rush around administering “care.” Such a person is robbed of dignity, and robbed of the right to die with loved ones nearby.

The reason why medical teams are pressured to perform endless procedures on our most ill seniors is because the legal and ethical issues at stake are in limbo. That’s because the questions raised are not just for individuals to answer, but for society as well. They are questions for a nation.

Protest Music at AHIP meeting

Sep 24, 2009• 8

By MATTHEW HOLT

This is much more fun and better sung than traditional protests! And given that AHIP would benefit from a public option, I suspect Karen Ignagni hired them. It looks like it happened in the closing session of this AHIP conference on Friday although having sat in many of these conferences I do need to tell the protestors that no plotting is done in these Forums. That happens elsewhere…

A Remedy for Healthcare Organizations

Sep 23, 2009

By PAUL LUNDY, VP, Xerox Global Services

The switch to electronic health records can be a daunting task. To make the shift less painful, healthcare organizations should first consider taking control the number of documents flowing through the organization – and the costs associated with printing, sharing and updating them. Developing proactive ways to better manage both hard copy and electronic documents will better equip these organizations for the 2014 EHR deadline.

A recent survey of healthcare professionals found that nearly half (46 percent) of respondents chose document and records management as the most inefficient area within healthcare organizations.1 In fact, the survey revealed that document inefficiencies trump traffic woes – 58 percent said that searching for information at work is worse than being stuck in traffic.

“Reform” Means Higher Costs, Not Lower

Sep 21, 2009• 4

By JOE FLOWER

A reader asks: “If the current bill passes are my health insurance costs likely to go up, down, or remain about the same?”

If the form that I believe most likely to pass actually passes (insurance reforms, individual mandate, weak or no public option or co-ops), I believe that they will continue to go up. There simply is nothing in the bill that would make things more affordable. In health care markets, for a convoluted nest of reasons, more competition causes prices to go up, not down.

Health Care Outlook Not Improving

Sep 21, 2009• 58

By ROBERT LASZEWSKI

Sen. Max Baucus (D-Mon) released his much-anticipated healthcare proposal Wednesday morning.

The next big test for a health care bill in 2009 (notice that I did not call it health care reform) will come in Senate Finance.

The
final vote in that committee will tell us a lot about whether the
Democrats have any chance for 60 votes in the full Senate. So far, it
does not look good.I have the greatest respect for Senators
Baucus and Grassley and their good faith efforts to find a bipartisan
health care solution. But I also think their efforts were fatally
flawed from the beginning.I think the problem is that Baucus
and Grassley were trying to bridge the wide chasm between liberal and
conservative ideas. Finding the fine balance necessary has created an
unwieldy compromise—no one is happy. Most striking, the compromise
reached between cost and premium subsidies has yielded an $880 billion
bill that requires middle class people to buy health insurance they will in no way will be able to afford. On top of that, the policies have big deductibles and out-of-pocket costs.

Limited English Proficiency Shouldn’t Mean Limited Health Care

Sep 21, 2009• 8

By CHANIN BALLANCE

It’s impossible to know exactly what shape healthcare will take for Americans as Congress and President Obama struggle with reform measures in the coming months. But one thing is certain: Those who have limited English proficiency will continue to have more health care services they can understand. Though the U.S. has prohibited discrimination, including language access for limited English proficient persons, since the passage of the Civil Rights Act of 1964, the reality in the healthcare industry is very different. Whether insured or not, those who don’t speak or read English “very well” tend to have care that’s not as good as those who do. The Agency for Healthcare Research and Quality (AHRQ) reported that in 2005 only 54 percent of Latinos experiencing an injury or illness had timely access to healthcare, compared to 65 percent of whites. And if uninsured, Latinos got care in only 27 percent of cases.

Commentology: Government vs. Corporate Bureaucrats

Sep 20, 2009• 14

Bob Bourque of Los Alamos writes:

Do I want government bureaucrats deciding on my health care? You bet I do! Because the other choice is to have corporate
bureaucrats deciding on my health care. I have some control over the
government bureaucrats: I can vote out their bosses who tell them what
to do. I have no control over the corporate bureaucrats. They can do
what they please, and pay off politicians to stay out of the way.

Government bureaucrats will charge a few percent for the administrative
work they would do, which is like what they do for Social Security and
Medicare. Corporate bureaucrats now charge 30% to pay their CEOs
hundreds of millions of dollars and billions to their investors.

Medical Students Want You to Know

Sep 20, 2009• 1

By MICHELLE SNYDER

How many of us can remember a world without cell phones? Today’s medical students would undoubtedly be among that group. So it is no wonder these future physicians rely heavily on technology as they embark on their career path. We surveyed more than 1,000 medical students who are Epocrates subscribers about technology (software, hardware and EMRs) and other pressing industry topics.

The survey found 45% of respondents currently use an iPhone or iPod touch, followed by Palm and BlackBerry devices. Even prior to the launch of the iPhone, Apple has connected with this younger generation and continues to play to its strengths. Our survey did not address carrier preference, but it appears students may be more device focused; nearly 60% of non-smartphone users planning to purchase an iPhone within the next year. It is also worth noting that students may be looking at what device residents or attending physicians are using as well. In the first year of availability, over 100,000 physicians are actively using Epocrates software on an iPhone/iPod touch. We still see a significant number of physicians using BlackBerry and Palm devices, so we expect those respective populations to grow as well.Continue reading…