I’m still catching up with my HIMSS interviews. This is Chris Sullivan and Mike Raymer from Microsoft who are talking about the evolution of the Amalga product—the business intelligence engine—and the current state of HealthVault.
Above the Fold
Unstable Public Opinion
By
Joseph White, a professor of politics at Case Western Reserve University, made this interesting observation in his weekend column in The Fiscal Times:
“On most issues, there is no such thing as a stable “public opinion.” People do have general attitudes, beliefs that they can use to evaluate a choice. But often voters hold different attitudes that would lead to different evaluations of the same choice. How they answer a question depends on which considerations have been raised in their minds most recently.”
Therefore the analysts who predict Democratic defeats in November based on negative survey responses about health care reform now are making a fundamental error. The Republicans have shown great ability to raise considerations that push the evaluation in one direction. Yet some of that effort has been encouraged by the concerns conservative Democrats raised during the debate as they tried to make legislation better fit their preferences. They will not be making those arguments as they run for reelection. In the election campaign there would be far more spending on ads to defend the legislation. The press coverage may focus more on the actual provisions of the bill as opposed to the GOP charges. But focusing on the actual specifics will only be possible if there is a law that passed and can be defended. Democrats have to be able to point to something and say: “this is what we did, this is the truth about it, this is how it would help you.”
The Democrats also have to remember that the “losers who can’t deliver” consideration will be far more prominent in November if they pass nothing now. In short, the battle over interpretation of the health care reform effort has only begun. We do not know how it will turn out in November, but there are good reasons to believe the Democrats are better off fighting it with a new law in hand.”
Merrill Goozner has been writing about economics and health care for many years. The former chief economics correspondent for the Chicago Tribune, Merrill has written for a long list of publications including the New York Times, The American Prospect and The Washington Post. His most recent book, “The $800 Million Dollar Pill – The Truth Behind the Cost of New Drugs ” (University of California Press, 2004) has won acclaim from critics for its treatment of the issues facing the health care system and the pharmaceutical industry in particular. You can read more pieces by Merrill at Gooznews.com.
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The Surprise
Check out this March 3rd article – ( click here ) – from the recent HIMSS conference, in which Dave Garets, President and CEO of HIMSS Analytics,“gazes into the future and predicts major trends for the next 12 months.” HIMSS Analytics is the research and consulting arm of the health IT vendors’ association, and presumably on Health IT’s leading edge.
From the article:
“Q: What will constitute the surprise of 2010 – the one technology or policy or X-factor that no one saw coming.”
“A: Clinical groupware in the ambulatory market that may be the disruptive innovation of ambulatory EMRs.”Continue reading…
Aneesh Chopra on txting in Haiti
Here’s a quick video I took at the end of Aneesh Chopra’s (the Federal CTO) talk at HIMSS. It’s a remarkable story of the role of SMS, tools and crowdsourcing in aiding in a disaster zone. A mash-up of the military, a silicon valley start-up called Crowdflower and creole speakers across the world.
Crowd Sourcing Comes Through Again
I have written before about the incredible power of crowd sourcing, using the reach and scope of social networking on the Internet to solve a complex problem. Here’s a play-by-play about a difficult question. It demonstrates how the asynchronous participation of many participants inevitably converges on the right answer in less than 24 hours. You just have to be patient and let the truth emerge.
I posted the following problem on Facebook:
Query — what makes some Facebook status updates stay put on the top of your page until cleared, while others appear as one-time updates? (Yesterday at 12:22pm.)
Luba:
I think it’s an algorithm that has to do with how often you comment on other people’s posts. Facebook tries to be smart about which people you actually care about seeing. I often find it wrong and look at both top stores and most recent to get a full picture of what is going on.
It’s Not About Meaningful Use …
With the impending comment deadline for Meaningful Use (MU) fast approaching, many organizations, from CHIME to AHA to AAFP and others are asking for some form of relaxation of MU criteria in the final version. Now it is not to say these concerns are not justified, it just may be that they are misplaced for the vast majority of those who currently do not use an EHR, small physician practices and clinics. It is within these small practices, which are really just small businesses, that the majority of patient care occurs and where possibly the biggest benefit may be derived in the use of EHRs. It is also here where we may find the highest adoption hurdles, and those adoption hurdles are not so much about MU criteria, but more about productivity losses in adopting an EHR.
This past weekend I spent some time with a nurse who works in a primary care/pediatrics clinic in Vermont. There facility, part of a network of several clinics, recently adopted and went live with a new EHR system (about 18 months ago). According to the nurse, this EHR, from one of the big names in ambulatory systems, has been a complete disaster for the clinic. Productivity is way down, countless glitches have occurred, whole system crashed during a recent upgrade and the list goes on. For 2009, this clinic, which has been in operation for a few decades, had its first ever loss last year, the year they went live with this EHR. The clinic puts the blame squarely on the EHR, which has severely constricted their ability to see patients and as all readers know, clinicians get paid for seeing patients, not trying to use a complex and difficult to use EHR.
It is stories like this that concern me.
This is a clinic trying to do the right thing, trying to use an EHR in a meaningful way (note, did not say meaningful use) and they are struggling. Yes, they do want to deliver the best patient care, but at the end of the day, they, like any business have bills to pay. They are losing money far in excess of what HITECH Act incentives will provide. This story is, unfortunately, not unique, though few EHR vendors will come clean on the productivity hit to a practice. Maybe instead of guaranteeing that their application(s) will meet MU criteria, EHR vendors should guarantee that the productivity hit of using their solution will not exceed HITECH incentive payments. Now that would be an interesting value proposition.
Thanks to Michael Jahn of Jahn & Associates for the MU cartoon.
John Moore is an IT Analyst at Chilmark Research, where this post was first published.
Program Director Healthcare IT
Since its inception, the New England Healthcare Institute has been committed to the identification, assessment and promotion of valuable health care technologies with the potential to improve the quality of care while reducing cost. The Fast Assessment and Adoption of Significant Technologies (FAST) initiative, conducted in partnership with the Massachusetts Technology Collaborative, has been at the core of our work to promote innovation in health care and, among others, has resulted in the identification of computerized physician order entry (CPOE) and tele-ICU programs as key elements of health information technology policy at the private, state and federal levels.
Position Summary
NEHI is seeking a Program Director – Technology with rich experience in the health care technologies to play a critical role in the continued development of NEHI’s portfolio of health care technology projects. As health care technology receives greater attention for its ability to significantly improve health care quality and lower costs as part of state and national health reform effort, the Program Director – Technology has the opportunity to catapult the promise of FAST to the national stage and brand NEHI as a national thought leader in the advancement of promising, underused innovations.
This is a full-time position and an outstanding opportunity for candidates with strong health information technology experience to work with senior leaders from all across the health care community to drive change in a fast-paced, team-oriented environment. Ideal candidates bring a blend of skills – problem solving, intellectual curiosity, collaboration – to their work at NEHI. Download job description. (PDF)
MedApps on TV
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Kent Dicks from MedApps does a very nice job on Fox Business News. Kent explains what his company’s cell(phone)-based transmission solution does, why it’s not a privacy threat, who else is in the market, and what the upside is—cheap consistent device data from patients stored in Healthvault or other record systems.
Here’s the link
Meanwhile can anyone tell me why every business anchor these days is an incredibly hot model type?
Epocrates–reference present and EMR future
I met with Bob Quinn the CTO and Geoff Rutledge, the CMO, of Epocrates at HIMSS last week. The company has a big footprint in mobile (and web) reference content for physicians. The big news is that it’s looking to move into an EMR product. Bob and Geoff explain what they do and where they’re going.
Epocrates from Health 2.0 on Vimeo.
