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.
Above the Fold
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
By
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.
Verb-alizing
One of my interns was “running the list” with me last week (giving me a thumbnail update on the plans for each of our inpatients). It was standard stuff until he got to Ms. X, a 80ish-year-old woman admitted with urosepsis who was now ready for discharge. “I stopped her antibiotics, advanced her diet, called her daughter, and YoJo’ed her.”
Say whaa?
I’m pretty sure that the most valuable thing I’ve done in my 15 years running UCSF’s inpatient service has been to convince the hospital to hire a discharge scheduler, Yolanda Jones, a delightful woman with a big smile and the world’s most thankless job. When a patient is ready for discharge, the interns send Yolanda a note with a list of follow-up appointments, radiology studies, and other outpatient tests that need to be scheduled. She makes all the appointments, then calls the patient and intern with the info. Our hospital would cease to function if not for Yolanda; she is the unsung hero of the medical service.
And now, the process of asking Yolanda Jones to schedule discharge appointments had become a verb.
RememberItNow! and Prezi
RememberItNow! is a feisty little start-up that’s aiming at the medication reminder/management space. I like the feature set and the approach, and I hope the Pam Swigley the engaging CEO gets some traction. It’s launching officially on Friday
But what I really like is their use of this cool presentation software called Prezi to give their demo. So to kill 2 birdies with one stone, here it is — click the arrow and enjoy.
Glen Tullman, Allscripts
Allscirpts’ CEO Glen Tullman has had a good year. Allscripts’ stock is up four-fold, sales are going well and some people think that ARRA/HITECH’s fillup to the healthcare IT industry is mostly his doing–he was an early fundraiser for Obama. Any clouds on the horizon? You’ll have to watch the interview I did with him at HIMSS to find out.
Innovation, Not Legislation: Venture Capital is the Path to Improving Patient Safety and Reducing Waste and Error in the U.S. Healthcare System
All eyes are on Toyota’s recall of 8.5 million vehicles due to faulty gas pedals and brakes. The recall has sparked congressional hearings, a probe by the U.S. Department of Transportation, possible criminal charges stemming from a federal grand jury investigation and numerous civil lawsuits, all in the name of driver safety.
This aggressive response to Toyota’s mistakes is appropriate, even though the human toll from its miscues has been, thankfully, relatively modest – 34 alleged deaths and a few hundred injuries. Not to downplay this misery, but in stunning contrast, consider this: More than 100,000 Americans die annually in U.S. hospitals because of avoidable medical errors, according to the Institute of Medicine (IOM), which also says that medical errors rank as America’s eighth leading cause of death. This is higher than auto accidents (about 45,000) and breast cancer (about 43,000). And the problems don’t end here. Studies show that approximately 19% of medications administered in hospitals are done so in error, injuring about 1.3 million each year, according to the FDA.
