The Health Care Blog – Page 453 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

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What Do I Do If I Don’t Have a Template?

Nov 3, 2014• 6

By VAL JONES, MD

Electronic medical records (EMRs) now play a part in the daily documentation routine for most physicians. While improvements in access to patient data, legibility of notes, and ease of order entry are welcome enhancements, there is a significant downside to EMRs as well. Although I’ve blogged about my frustrations with nonsensical, auto-populated notes and error carry-forward, there is a more insidious problem with reliance on EMRs: digital dependency.

The idea of digital dependency first occurred to me during a conversation with a young medical resident at a hospital where we share patients. I was bemoaning the fact that I was being forced to use hospital-designed templates for admission notes, rather than a dictation system or carefully crafted note of my own choosing. She looked at me, wide-eyed and said:

“You’ve worked without templates? How do you even know where to begin? Can you really dictate an entire note off the top of your head? I couldn’t live without templates.”

As I stared back at her with an equal amount of bewilderment, I slowly realized that her thinking had been honed for drop-down menus and check boxes.

California’s Proposition 46: Trial Attorneys Behaving Badly

Nov 3, 2014• 131

By CALIFORNIA DOCTOR

After more than a year of conspiratorial planning that would make Francis Underwood proud, California’s trial attorneys got a number assigned to an opaquely worded ballot initiative on Drug and Alcohol Testing of Doctors. Medical Negligence Lawsuits Initiative Statute. As a result, “Proposition 46” could give California voters an unwitting hand in doing what this attorney group has been unable to accomplish after 40 years of inept legislative lobbying and dubious court challenges: undermine the state’s Medical Injury and Compensation Reform Act, or MICRA.

MICRA was passed in 1978 by a Democratic-dominated legislature and signed into law by then-governor Jerry Brown in response to the collapse of the state’s medical professional liability insurance market. MICRA didn’t change the right of injured patients to obtain unlimited economic damages for all medical costs, lost wages and lifetime earnings. What it did was limit was non-economic “pain and suffering” damages to $250,000. Up until 1978, California’s trial attorneys had used this highly speculative class of damages to rake in a third of the multi-million jackpot jury awards. That made California physicians’ malpractice insurance unavailable at any price, leading many doctors to close their practices and leave the state.

That ended with the passage of MICRA. The market stabilized and in the decades that followed, billions in health care savings from lower professional liability costs were passed through to California’s patients.

Early last year, California’s physicians had heard rumors that a ballot initiative to undo MICRA’s non-economic cap was being planned. Little did they know that California’s trial attorneys would take their cue from political consultant-bully Chris Lehane by opening their campaign with a mass mailing of anti-MICRA cadaver toe tags. That was quickly followed by the neighbors of pediatrician and then California Medical Association President Paul Phinney receiving deceptive postcards implying he was a drug dealer.

Months later, the ballot initiative – that was 100% underwritten by the trial attorneys and their allies at a cost of $2.85 per signature – landed on California Attorney General Kamala Harris’ desk. The initiative’s authors cleverly disguised its quadrupling of the MICRA cap to more than $1 million (“to account for inflation”) and cynically camouflaged it between two conversation-changers: 1) mandatory physician drug screening and 2) mandatory uploading of the narcotic prescription history of every California patient to an online database. Naturally, Ms. Harris rewarded her trial attorney donors by making a mockery of the state’s single-subject rule and okayed it.

Fast Medicine

Oct 31, 2014• 15

By RICHARD GUNDERMAN, MD

Americans tend to like fast things: instant coffee, sports cars, and speed dating. Many share a fascination with record holders, such as the world’s fastest runner or texter. And increasingly, the same goes for medicine. The number of minute clinics is exploding. Some emergency rooms now post their current wait times on roadside billboards. And increasingly, physicians and other health professionals are under pressure to increase the speed at which they see patients.

A friend of mine, a family physician, was recently advised by the new manager of his practice that he will be penalized if he doesn’t increase the number of patients he sees each day in clinic. A thorough and compassionate physician who is known for the quality of the relationships he builds, he asked the man, “How am I supposed to work faster and still provide good care?” The practice manager thought for a moment and responded, “Why don’t you stop asking open-ended questions?”Continue reading…

Eat Less. Eat Less Crap.

Oct 31, 2014• 21

By VIK KHANNA

Eating advice in the United States has taken leave of its senses. It is no wonder that Americans are perpetually on diets.

It is only in the last 20 years that eating, a task we do quite naturally, has become so complex that you apparently need professional spin from nutritionists and dietitians, or worse, from doctors, on how to do it.

Spend a little time on the web (and especially social media) and your head will spin from all the contradictory healthy eating advice: eat organic…no, wait, don’t waste your money; eat less salt…wait, too little salt might be worse for you than too much salt; don’t eat fat…oh, sorry, eating too little fat will actually make you fat because you’ll eat too many poor quality carbs; eat foods that have a low glycemic index…wait, we meant a low glycemic load, er, well maybe eat foods that are both; eat breakfast every day because it will help you control your body weight except when it doesn’t.

Partnership, Collaboration, and Success Between Vendors and Hospitals — it is possible!

Oct 31, 2014• 2

By FRANK FORTNER

This week, I have had the pleasure of attending the CHIME Fall Forum event in San Antonio, Texas. What I like most about this event is being able to talk to CIOs and hear their thoughts on this rollercoaster world of healthcare IT – to hear first-hand what challenges they face, what keeps them up at night, and what they are doing to solve these issues. As a vendor, we always strive to provide the best solutions and the best services possible that meet the needs of our customers. In this hectic world of regulations, deadlines, and competing priorities, it’s easy to lose sight of what is important and why we all do this in the first place. Ultimately, it comes down to doing what is right for the patients.

Although not all of the vendors attending CHIME offer the same solutions, nor do the attendees from different hospitals have the same challenges, there is one common theme among healthcare IT vendors, hospital CIOs, government officials, etc. At some point in our life, either ourselves, or someone we know, will be a consumer of the healthcare system seeking care. You want to be assured that the hospital or healthcare provider has done everything they can to be efficient and give you or your loved one the care that is deserved

So how do we, as a vendor, play a role in this? By listening to our customers about the challenges they are facing, and working with them to solve them. The greatest reward as a leader in a healthcare IT company is when we can grow a relationship and collaborate with a CIO to come up with the right solutions to their problems which ultimately benefits the patients. This may include streamlining a process so the patient gets results faster, or safe-guarding their medical information, or making the jobs of the clinicians easier so they can focus on the patient. These results make all the hard work worthwhile.

Big (Box) Medicine

Oct 30, 2014• 36

By MICHAEL PAINTER, MD

Let’s see a show of hands. Who among us, doctor, nurse, patient, family member, wants to give or get health care inspired by a factory—Cheesecake or any other?

Anyone?

I didn’t think so.

True confession: I have never actually eaten at a Cheesecake Factory (hereinafter referred to as the Factory). My wife, Mary, and I did enter one once. We were returning from a summer driving vacation. Dinnertime arrived, and we found ourselves at a mall walking into a busy Factory.

It seemed popular. The wait was long—really long. We got our light-up-wait-for-your-table device. We perused the menu. There was a lot there. Portions seemed gigantic. We looked at each other and, almost without speaking, walked back to the hostess, returned our waiting device and left.

You got me—I cannot say 100 percent that I wouldn’t love Factory food. We were so close that one time!

A young woman in our small New Jersey town recently opened a new restaurant here. We tried it the other night. She and her business partner tended us and all the other patrons with such attention and care. We waited some, true, but she seated us near the bar while we waited—brought over pieces of cheese (no light-up device) for us to enjoy. The menu was ample and varied—not enormous. It’s also true that two items on the menu—including my first choice—were no longer available that evening. The chef however crafted the dishes that we did select with flare and pride. Dinner was a delicious, wonderful, relaxing experience—made better because of the human touch.

It’s probably not fair to contrast my one near-Factory dining experience with this other. Big chain restaurants have clearly figured out a way to provide a consistent meal for millions of satisfied customers. But the Factory way is not for everyone. People, I think, crave customized, attention-to-detail service experiences—in their dining choices. And—I’ll go out on a limb—in their health care too.

The Self-Health Era

Oct 29, 2014• 18

By CECI CONNOLLY

If you’re wearing a wristband that counts your steps, a patch that monitors your vital signs or a watch that tracks your heart rate, you are in the minority. And if you paid $300 or more for any of those items, you are among the nation’s quantified self-health elites.

Judging by the chatter streaming across our social media feeds, one would think every man, woman, child is sporting a health “wearable.” But in reality, these are the early days of the devices that promise to help us live longer, healthier, more active lives.

Despite the buzz, just 21% of Americans own a health wearable, according to a new consumer survey by PwC’s Health Research Institute, and only 10% of them use it daily. Even fewer consumers – 5% of respondents — expressed a willingness to spend at least $300 for a device. Many wearables today are a passing fancy – worn for a few months then tucked away in a drawer awaiting a battery charge or fresh inspiration to get up and get moving again.

As Genentech CEO Ian Clark recently put it, health wearables are “a bit trivial right now.”[1] And it seems even the folks claiming to be wearing the devices can’t be trusted – reports have begun circulating of employees enlisting their more active coworkers to wear the device and collect fitness points on their behalf.

Yet wearables present remarkable opportunities for a nation and industry grappling with the twin challenges of improving health and controlling healthcare spending. Across the board, consumers, clinicians, insurers and employers express high hopes for the power of these new devices.

Health 2.0 Announces Agenda Highlights for WinterTech

Oct 29, 2014

Health 2.0 announces the inaugural event, WinterTech: The New Consumer Health Landscape on January 15th, 2015 during JP Morgan Week in San Francisco, CA. Industry leaders Walmart, Samsung, Target, Qualcomm Life, MyFitnessPal and many others will discuss major digital health themes in the marketplace such as: investing in consumer health, the new role of retail environments in health care, new platforms and interfaces for personal health, the informed health care consumer, and how consumer data is contributing to new clinical insights.

Participating organizations and speakers at WinterTech include:

Ben Wanamaker (Walmart)
Bakul Patel (United States Food and Drug Administration)
Rick Valencia (Qualcomm Life)
Tara Montgomery (Consumer Reports)
Karan Singh (Ginger.io)

Agenda highlights include:Continue reading…

Ebola and the Information Flow Challenge

Oct 28, 2014• 3

By TODD ROTHENHAUS

The Ebola crisis in Texas has tested our nation’s health care system in many ways, exposing weaknesses and potential breakdowns. In particular, the incident with the first diagnosed Ebola patient at Texas Health Presbyterian underscores a fundamental issue with information liquidity between providers, their care teams, and across the continuum of care. The ability to share information effectively is critical not just in responding to health care crises like Ebola — but also in delivering great, cost-effective care.

As athenahealth CEO Jonathan Bush said in an interview with CNBC earlier this month:

“The worst supply chain in our society is the health information supply chain. It’s just a wonderfully poignant example, [a] reminder of how disconnected our health care system is. … The hyperbole should not be directed at Epic or those guys at Health Texas. The hyperbole has to be directed at the fact that health care is islands of information trying to separately manage a massively complex network.”

A Shout Out To Our Sponsors

Oct 28, 2014• 1

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InterSystems. Our technologies enable healthcare organizations to rapidly connect processes, applications and people – and clinicians to make decisions with complete information.

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