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TECH: Just another EMR puff piece….on Cerner?

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Anyone who’s ever read Fast Company won’t be surprised at the slightly breathless tones used in one of their typical "business gets new process, struggles a little at first, then succeeds beyond its wildest dreams" plot line. After all this was the magazine that was aped by a certain not quite so polite web-site also ending in "company", and beginning with an F.

What’s a little different is that this article, Record Time, is about a simple ObGYN adopting an ambulatory EMR, and then having all the usual crises of seeing his practice more or less collapse because of the extra time it took to figure out how to use it.

But apparently in this case the vendor sent donuts, and someone who built him templates and showed him how to use it. Repeat with me–a practice barely alive, but we can rebuild it, we have the technology, we can create the world’s first bionic physician’s office….it will be gooder than it was before…and all for slightly less than $6 million! (Look here if you’re too young to get it…)

Given that the vendor in question is Cerner, notorious for its not always quite as smooth as silk implementations, you’d be entitled to a little cynicism here. (and if you think I’m just relaying industry tattle here from HISTalk, you are of course right!). However, last year a very sharp IT consultant told me that his shop had done a real life performance comparison of the major ambulatory EMRs and Cerner’s Powerchart product (which was new and had little market penetration) had actually beaten out the big boys. So better product, with better customer service? Can it be true? Or is this just more "pie in the face for Neal Patterson" ammo?

Of course it would be nice if the article told us a little more about exactly how the physician got from near chaos to everything running as smooth as silk without avoiding total financial collapse. Several of his colleagues reported on in Medical Economics recently weren’t so lucky.

POLICY/PHYSICIANS: Another crazy doc in favor of single payer

Yet another crazy doctor decides that the hassle of dealing with 301 separate insurers is just too much and that he, was well as everyone else but the insurance industry, would be better off with a national single payer system. Nothing that hasn’t been heard before from a minority of docs.

The only noteworthy thing about this one is that the doc in question is Benjamin Brewer, who writes The Doctor’s Office column in that filthy commie rag The Wall Street Journal. Wonder how long he keeps that job?!

POLICY/THE INDUSTRY: Ethics 101, we’ve failed

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Fred Goldstein, a health care veteran who believes in the free market, calls a spade a spade in a hard hitting call for ethical improvement in health care over at HealthLeaders. Go read his list of transgressions which we all know about individually but are hard hitting when read together. Bonus points if you can name the guilty. His point is that it’s pervasive because we’ve collectively let it happen. Here’s his conclusion.

Unethical behavior exists among healthcare organizations and professionals of all types. Organizations that try to do the right thing are often outmaneuvered by those that do not. Self-interest is often hidden behind a facade of patient concern. “We do this for the patient. If you withhold our services, you will hurt the patient.”Worse, these self serving behaviors have become so common that professional outrage has been dulled. But to save healthcare, we can’t just take these acts for granted. The prevalence of inappropriate actions in healthcare drives additional margins in the industry’s supply, delivery and financing sectors. It is at the root of our cost explosion and our healthcare crisis. And, it is based on an ingrained acceptance of unethical behaviors.The recent movement toward transparency and quality reporting will shine a bright light on some of these practices, and should tone down the environment of opportunism. But many of these behaviors have been well known for years. I have little faith that, with so much money at stake, any reforms can be substantial enough to turn around the industry. This is especially true if change does not support and engage much more participation from payers and consumers.

PHARMA/POLICY: Libby on the war on Pain Doctors

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Ron Libby, a political scientist at University of North Florida, is one of the few academics looking at the war on drugs. He has amassed an array of evidence showing that the incredible and pernicious behavior of the DEA has led to an epidemic of untreated pain. His piece is available here—Treating Doctors as Drug Dealers: The Drug Enforcement Administration’s War on Prescription Painkillers.

Meanwhile lunatic politicians continue to spout crap on the subject. The real number of people in Florida dying from Oxycontin overdoses may, just may, have been as high as 71.  Not the 500 that a series of totally discredited articles in the Orlando Sentinel published. But just yesterday this rubbish ran in the Fort Myers News Press.

Sgt. Lisa McElheney, who heads Broward County’s
drug diversion unit, said even when law enforcement are tipped off
about a doctor over-prescribing drugs like Oxycontin, they often don’t
have the manpower to follow all their leads. “Most of these drugs are going through legal channels,” she said. Six
people a day die in Florida from prescription drug abuse, according to
the Florida Office of Drug Control. House and Senate versions of the
bill are still in committees.

Tell me that the average reader looking at that wouldn’t think that 6 people a day or 2,000 a year are dying from Oxycontin in Florida. 2,000 a year may be dying from prescription drugs in Florida, but not from Oxycontin–more likely from drug-drug interactions and medical errors related to them (assuming that the IOM’s 100,000 patient deaths number is correct).

This is more shameful hysteria with real and bitter consequences.

 

THCB: Light today

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I just got in late due to a big storm in the Sierra (but I got some powder in!) and have the joy of a 7 am plane tomorrow. As mentioned I’ll be blogging from the World Health Care Congress in DC on Tuesday and Wednesday.

And then there’s that small matter of finding a checkbook to send in my guestimate taxes…

So don’t expect too much here today…

Happy Easter

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See you next week when I’ll be the official bloggist at the WHCC Conference

Meanwhile, congrats to John who actually runs this blog, and became a Daddy to Lilly on Tuesday!

BLOGS: Report on health care blogs

Fard Johnmar has written a report on health care blogs. It’s available from his site for around $37, rather less than the $3,000 analysis Datamonitor was offering on the same topic a few weeks back. Despite the fact that my ego is still recovering from the act that in over 100 pages he only mentions THCB twice, I thought I’d let him tell you about it! Here’s Fard:

"One of the reasons that I wrote this report was to acknowledge the hard work of the bloggers who take the time everyday to collect, analyze and debate the politics, practice and social aspects of healthcare. It’s not easy, and everyone in the healthcare blogosphere deserves tremendous respect. Another reason I developed this report was to provide those of you out there looking for ways to explain the value of blogs to your colleagues, employers and others with cogent and well-referenced arguments for why blogs are a useful and powerful communications medium. However, I believe that blogs are not right for every organization, so I provide reasons not to start one. So, pick up a report, if you feel you will gain from it. Whatever you decide, lets continue having this conversation about how blogs can benefit healthcare."

POLICY/PHYSICIANS: Mother of all comment threads

If you haven’t been reading, there are now some 46 long detailed and excellent comments in the article called Can the real HSA fan, please stand, please stand up?.

Speaking as someone who’s been through the academic mill, this comment thread provides about a semester and more’s worth of education on the entire topic of health management and health policy. Note Steve Beller’s excellent summary of the conversation so far at around comment #30!

Fantastic work—my hat is off to all the commenters

 

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