By Adrian Gropper, MD

Transparency, in the form of a complete, patient-centered and accessible health record is a policy principle that can drive the next wave of health care innovation. Investing exclusively in institutional EHRs will further stifle efficiency, innovation and improvement. Web-based clinical summaries (CCR+DICOM+PDF) that are available for patient control foster patient-centered care, clinical collaboration, and research, and must be included in health care reform if we are to effectively improve provision of health care for patients and clinicians.We’ve been stuck on interoperability long enough to realize that EHRs are a tool and not a solution. To frame the problem, the National Research Council weighs in with a timely assessment and vision. A great summary by David Kibbe highlights the caution: “that current efforts aimed at the nationwide deployment of health care IT will not be sufficient to achieve the vision of 21st century health care, and may even set back the cause if these efforts continue wholly without change from their present course.”  In the same vein, a recent Booz, Allen, Hamilton report, sponsored by the Federation of American Hospitals, reminds us that “Other countries experience shows that EHR adoption does not automatically lead to interoperability.”

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By Alicia White

If you’ve just read a health-related headline that’s caused you to spit out your morning coffee (“Coffee causes cancer” usually does the trick) it’s always best to follow the Blitz slogan: “Keep Calm and Carry On.” 

On reading further you’ll often find the headline has left out something important, like “Injecting five rats with really highly concentrated coffee solution caused some changes in cells that might lead to tumors eventually. (Not to mention that the study was funded by The Association of Tea Marketing)The most important rule to remember: “Don’t automatically believe the headline.” It is there to draw you into buying the paper and reading the story.  Would you read an article called “Coffee pretty unlikely to cause cancer, but you never know?” Probably not. Before spraying your newspaper with coffee in the future, you need to interrogate the article to see what it says about the research it is reporting on.  Bazian (the company I work for) has interrogated hundreds of articles for "Behind The Headlines" on the NHS health news Web site, and we’ve developed the following questions to help you figure out which articles you’re going to believe, and which you’re not.

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By Bob Wachter

The pilot of the US Airways flight that crash landed safely in the Hudson River earlier this month after taking off from Laguardia Airport is rightly being praised as a hero. But how significant of an accomplishment was it, really? In 1977, the pilot of a KLM flight  on the runway at Tenerife's Los Rodeos Airport faced a similar test of his decision-making skills. The outcome was very different.

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By Don Kemper

The virtual health home is
the “other half” of the patient-centered medical home. Some might
say it’s the better half. Though related in purpose, the two “homes”
differ dramatically in perspective. While both place the patient at
the center of care:

• In the medical
  home the perspective is that of health professionals who are looking
  and managing in toward the patient.
• In the virtual
  health home the patient is looking and managing out from the center.

The difference is astounding.

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By Matthew Holt

The BBC (British Band of Communists) has created an appalling piece of propaganda suggesting that the American health care system is an unfair mess. And they’re not exactly too polite about the rest of America, including setting up some doubtless fake multi-millionaire with a spendthrift wife to look ridiculous while saying that we shouldn’t be sharing the wealth.

And if you want to watch it, luckily it won’t be shown here on TV. But those communists have now invented something call YouTube, so you can see it there. But I’m sure none of you realists will want to watch it, and instead will join my call to make sure that these tax-subsidized radical extremists are banned from these shores.

And of course, these are the fools who claimed that spaghetti grows on trees.

Rating hospital quality
Healthgrades.com
released findings today from a national study that identified 270
hospitals, out of 5,000, where patients are on average 27 percent less
likely to die and 8 percent less likely to suffer a major complication (adjusting for hospital case mix).

Open philanthropyBill Gates writes a 10-page letter discussing progress of his health care foundation and future challenges to reducing the global burden of disease.

The future of researchObservational studies using electronic medical record databases offer significant promise for future research, according to a study published today in The British Medical Journal. The University of Pennsylvania researchers replicated randomized controlled trials using the databases and found the results were mostly similar, particularly when applying a new statistical method to control for confounding.

Major Pharma mergerPfizer's plan to buy Wyeth Pharmaceuticals for $68 billion would create the fourth largest company in the U.S. The NY Times explores the impact, management changes and golden parachutes.

OctupletsA California woman gave birth to eight babies at once. The six boys and two girls are alive and said to be doing well. Wow.

By Roger Collier

Although details of their 2008 health care reform plans vary, there is significant consensus among the new Washington heavyweights—Obama, Daschle, Baucus, and Clinton. Their common proposal: we should expand Medicaid and offer an under-65 version of Medicare to compete with private insurance.

It seems a seductive idea.  Medicaid and its little cousin, SCHIP, provide coverage to more than forty million low-income people, most of whom would otherwise have no insurance, while Medicare is an essential part of the lives of 45 million seniors.  It’s hard to imagine American health care without these programs, and understandable that there should be demands for their expansion to cover many of our forty-seven million uninsured.

Seductive it may be, but could the proposal also be the siren song that might lead to the wreck of reform?

A brief classical digression: in Homer’s Odyssey, the song of the two
sirens (who were not named Medicaid and Medicare), proved so attractive
to ancient mariners that they drove their vessels onto the rocks upon
which the sirens sat.

—So what risks could Medicaid expansion pose to the future of our health care ship?

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