The Health Care Blog – Page 827 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

A Microsoft EMR: It’s Not Just a Matter of When, It’s a Matter of Who

Apr 16, 2010• 19

By AUSTIN MERRITT

Microsoft Dynamics is largely present in just about every software market but medical. And they’re missing out big time. The United States healthcare IT market is growing at about 13% per year and is expected to reach $35 billion in 2011¹. The biggest opportunity for growth in the industry is among ambulatory care physician practices, partly due to the Stimulus Bill requiring the use of electronic health records (EHR) systems by 2015.

You would think Microsoft would be in such a promising industry, but you won’t find a Microsoft EHR available. The primary reason why is that EHRs are highly specialized, and Microsoft’s main products (Dynamics, CRM, and SharePoint) don’t come anywhere near the needs of physician practices. It would be very difficult for Microsoft to build an EHR from scratch and introduce it to the market.

So what should Microsoft do to enter the industry? Acquire a current player.

Engage with Grace on Decisions Day

Apr 16, 2010

By Leigh Calabrese-Eck & Alexandra Drane

Friday April 16 is National Health Care Decisions Day — a national campaign that aims to encourage people to complete advance directives or living wills to document end-of-life-wishes.

In the sprit of the day, we are asking folks to share The One Slide with at least five friends, family members, or colleagues — and then ask them to do the same. Or spread the word even further, faster by bumping it to the top your Facebook page, blog, or Twitter feed.

Let's keep the momentum going!

Vist here for more information on National Health Care Decisions Day, and please don't forget to visit the Engage with Grace website.

Health 2.0 Europe – Opening Presentation Available!

Apr 15, 2010

Once again, we’d like to thank everyone for making Health 2.0 Europe a smashing success!

In case you missed the event (we’re sure you had a good excuse!) or if you wanted to see our research again, here’s a look at the opening PowerPoint presentation by Matthew Holt, Indu Subaiya and Denise Silber (Health 2.0’s European partner at Basil Strategies).

Health 2 0 Europe Presentation

View more presentations from Health 2.0.

Important: Input on consumer ‘Meaningful Use’ requested and required, Apr 20

Apr 15, 2010• 6

By MATTHEW HOLT

Josh Seidman, now running the meaningful use program at ONC, but formerly of the Center for Ix Therapy writes with an important request:

The Meaningful Use Workgroup of the Health IT Policy/federal advisory committee that advises ONC) is holding a hearing on Tuesday, April 20 in Washington (open to the public in person and virtually) on patient/family engagement. This testimony and other public input will be critically important in laying out the foundational steps for the evolution of Stages 2 & 3 definitions of MU for patient/family engagement.

In addition to the hearing itself, we are now inviting public input in advance of the hearing and follow-up to it on the FACA Blog, and we’d love to get as much thoughtful input as possible.

It goes without saying, but I’m going to say it again anyway, that Josh’s shepherding of the meaningful use criteria plus his earlier lobbying of the process from the outside HHS was very instrumental in making the consumer such a big part of phase 1 of the meaningful use criteria. However, you can be assured that there are lots of people wanting to put the brakes on any expansion of the consumer-facing meaningful use criteria.

We’ve just come back form Europe where the Danes showed us that all their citizens already have access to everything we’re talking about in stages 2–3 of meaningful use. So I believe that we should be shooting for the stars here.

BUT unless the Health 2.0 crowd, the ePatients, and the consumer gets into the commenting mix, there are no guarantees. So please take the opportunity to get involved virtually and in reality if you’re in DC next week.

VAT On the Horizon

Apr 14, 2010• 32

By PAUL LEVY

Several months ago, a friend met with a high government official and expressed concern that the new health care bill would be more expensive than people were saying.

“Oh yes,” said the official, “In several years, the United States will pass a value-added tax.”

After the bill passed, Charles Krauthammer wrote this column in the National Review saying the same thing:

American liberals have long complained that ours is the only advanced industrial country without universal health care. Well, now we shall have it. And as we approach European levels of entitlements, we will need European levels of taxation.Continue reading…

Survey on PHRs: Interesting Data, Wrong Emphasis

Apr 13, 2010• 15

By MATTHEW HOLT

There’s a new study on PHR use out today (although it looks like Brian Ahier ignored the embargo in his good summary! Update–he didn’t, he just posted late PST so it looked like he did. Sorry Brian!) funded by CHCF and done by the (unknown to me) Lake Research Partners. You can follow the Twitter hashtag #phrpoll to see what Jane Sarasohn Kahn and various others think from the live press conference in DC. But I’ve read the data sheet which has the full poll responses, and here are my (admittedly very quick) take.

1) PHR use is apparently at 7% about double from the last time some one asked (Markle, a few years back). It’s still low and it’s an irrelevant number, instead what’s more interesting is where people say they get and they want to get their PHRs from, which leads to…

2) People say they want to get their PHRs predominantly from their doctors and hospitals. Next requested is their insurers. Independent companies (Google & Microsoft were stated in the questions) are only wanted by about 25%, same as employers (q23). Most who have PHRs which deliver data to them now get them from their insurer, although I suspect Kaiser is viewed as an insurer by many people which probably skews that answer.

Get Privacy Right, So We Can Move On Already

Apr 13, 2010• 10

By LYGEIA RICCARDI

A national survey released today by the California HealthCare Foundation shows that 66% of Americans believe we should address privacy worries, but not let them stop us from learning how technology can improve our health care. Amen.

This is particularly heartening news given that the same survey also documents for the first time real consumer benefits from the use of personal health records (PHRs). Seven percent of American now use PHRs, more than double the number in 2008. According to the survey, significant proportions of PHR users feel they know more about their health and health care, ask their doctors questions, feel connected to their doctor, and even take action to improve their health as a result of using a PHR.Continue reading…

Meaningful Use in the Real World — Is the Additional Administrative Burden Worth the Bonus for Small Practices?

Apr 11, 2010• 36

By DAVID C. KIBBE, MD

An article in the April 10, 2010 New York Times entitled “Doctors and Patients, Lost in Paperwork,” brought attention to what may be, in the near term, the Achilles heel of the plan to incentivize doctors for the “meaningful use of EHR technology.” The article cited a study published in the Archives of Internal Medicine this past February, which asked a large cohort of physicians in internal medicine training programs about the time they were spending on clerical work, most of which is documentation in patient charts, both paper and electronic. A stunningly large 67.9% of the respondents reported that they were spending “in excess of 4 hours daily” on documentation, while only 38.9% reported spending an equal amount of time in direct patient care.

Now, I am fully aware that practice in the inpatient, hospital setting is not the same as practice in the office, clinic, or ambulatory care environment. Patients tend to be sicker and require more consistent attention while in the hospital, which often means more documentation is necessary. However, the study and the NYT article point to a real world problem that crosses all medical care settings and impacts physicians and other professional providers of all kinds: the enormous burden of documentation, clerical work, and administrative forms completion that impedes real care giving and makes health care less and less efficient even as we add more and more technology.

APSO needs to replace SOAP in EMRs

Apr 11, 2010• 15

By ED PULLEN, MD

Electronic medical records (EMRs) have a bad reputation among many physicians for generating progress notes that are so verbose and filled with standard phrases that they are nearly useless to other physicians, and even to the physician who produced the note in the first place. This is in part because rather than engineering the EMR to produce a note intentionally efficient and effective for users looking at the note on a computer monitor, many EMR users choose to create a record familiar to them from years of use of paper charts. A note documenting a patient visit really serves only 3 purposes. First it is a clinical note documenting the patient’s history, findings on exam, and the assessment and plan of care. This is ideally efficient to generate, easy to review, and have the information needed in future visits in an easy to see and understand format. Secondly the note is a legal document, providing documentation of care and advice provided, and needs to be useful in case of a legal challenge. Third it needs to document the care done to justify billing and assure payment by third party payers. A good note does all of these things. In many EMR systems the last two are done well, but the clinical usefulness of the note is very poor.

Most EMR notes do a great job of documentation to assure payment. The ability to easily enter the information needed to justify a level of billing is sometimes too easy, and EMR users have been criticized for overbilling as a result. From a physician’s point of view, being easily able to enter the information required by payers without doing a long and costly dictation is a big plus of EMRs.Continue reading…

A song for (Health 2.0) Europe

Apr 10, 2010• 1

By MATTHEW HOLT

On Tuesday and Wednesday this week we completed a remarkable first—Health 2.0 Europe brought the spirit, technology and passion we’ve hosted at Health 2.0 conferences in the US,and married it to all those qualities and many more from all over Europe. I’ll be writing much more about it soon, but all the simultaneous translation reminded me about this multi-lingual classic from Roxy Music (one of the few great songs in many languages)