The Health Care Blog – Page 913 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Cats and dogs on film–Tullman, Leavitt, Bush

Apr 13, 2009• 2

By Matthew Holt

Anyone who’s been following along on THCB will realize that there’s a huge divide about whether the HITECH act should pay for and dictate a specified, certified type of EMR product use OR pay for data and outcomes and not specify how providers get there. The “cats” support certification and EMR mandating (more or less). The “dogs” think that existing EMRs are often counterproductive and that a mix of other data sources, processes, and patient outreach technologies will get us where we need to in terms of improving outcomes much quicker. And now there’s an extra $20 billion in the mix, just to add some fun.

Rather than write more about that at HIMSS this week I got detailed interviews on film with leading “cats”, Glen Tullman, CEO of Allscripts, and Mark Leavitt, Chair of CCHIT. And then a response from the always highly caffinated dog-lover Jonathan Bush, CEO of AthenaHealth. And no, they don’t agree with each other…..although there is some common ground.

If you’re at all interested in how Health IT & EMRs will play out, these three are must-sees. (I’d view them in the order I took them).

MH Interview with CCHIT head Mark Leavitt. (24:51)

MH Interview with AthenaHealth CEO Jon Bush (23:29)

Interview with Mark Leavitt

Apr 13, 2009• 1

Interview with Jon Bush

Apr 12, 2009• 4

A liberal is a conservative exposed to the NHS

Apr 12, 2009• 31

By Matthew Holt

The old adage is that a conservative is a liberal who’s been mugged. So I was much amused by this letter from a Republican to the local paper (Salt Lake Tribune) in the most conservative state in the nation (Utah). I particularly love the line I’ve bolded below because that—not all the right wing BS about effectiveness of cancer care or waiting lists—is the difference between universal health care and what America has—MH

After being laid off, I joined the 300,000 Utahns too poor to pay for health insurance. There are 47 million uninsured Americans and millions more are underinsured. Being a staunch Republican, I always resisted the notion of universal health care. But after having spent time with my son’s family in London, I’ve had an awakening.

My son’s old back injury got prompt and thorough attention. My daughter-in-law received comprehensive care for her challenging pregnancy. My new granddaughter was attended to by skilled nurses and physicians. In virtually every other civilized nation, no one fears losing everything due to some medical catastrophe. (MH emphasis added)

Americans deserve better than what we now have. Choice is an important American tradition. Let people choose between the for-profit insurance they have and a public health-care option like Medicare. A public health-care option is the only way to guarantee health care for all Americans. Any legislation without it is just more of the same broken system.

Insurance companies are afraid of a public health-care option because they will have to provide better service at lower cost to compete. But if President Barack Obama’s health-care plan gets changed to exclude a public option, then it is not health-care reform.

Ty Markham Torrey

A Self-Fulfilling Prophecy: The Continuity of Care Record Gains Ground As A Standard

Apr 10, 2009• 23

By BRIAN KLEPPER

Brian Klepper We live in a time of such great progress in so many arenas that, too often and without a second thought, we take significant advances for granted. But, now and then, we should catalog the steps forward, and then look backward to appreciate how these steps were made possible. They sprung from grand conceptions of possibilities and, then, the persistent focused toil that is required to bring ideas to useful fruition.

We could see this in a relatively quiet announcement this week at HIMSS 09. Microsoft unveiled its “Amalga Unified Intelligence System (UIS) 2009, the next generation release of the enterprise data aggregation platform that enables hospitals to unlock patient data stored in a wide range of systems and make it easily accessible to every authorized member of the team inside and beyond the hospital – including the patient – to help them drive real-time improvements in the quality, safety and efficiency of care delivery.”

Around the Web in 60 seconds

Apr 10, 2009• 2

Carl Hiaasen on efforts to block Florida's new cigarette tax:

"Ellyn Bogdanoff, the Fort Lauderdale Republican who chairs the
Finance and Tax Committee in the House … strongly opposes a
cigarette tax because fewer smokers would be bad for business. The woman is dead serious, folks. In
particular, Bogdanoff worries about the impact that a cigarette tax
would have on convenience stores — not exactly the bedrock of our
economy, but these are the establishments where most young smokers buy
their Marlboros and Camels.

''Twenty-two percent of all sales in
convenience stores are cigarettes,'' Bogdanoff said. “We need to look
at everything. If they don't go in to buy cigarettes, they don't buy
the Coke. They don't buy the chips.''

And if they don't buy the chips, then they don't buy the beef jerky! God help us!"

Op-Ed: Surgeon Shortage Worries Rural Doc

Apr 9, 2009• 6

By ANNE WILLIAMS, MD

Now that I’ve reached my mid-50s, I sometimes think about retirement, and to be honest it worries me.
I’m not talking about the typical things you worry about pre-retirement, such as the loss of income or lifestyle changes. I worry about what will happen to my patients.

Why? For the simple reason that it will be hard to replace me. This isn’t my ego talking: there simply aren’t nearly enough new surgeons coming along to replace me – or my other contemporaries, for that matter.

I work in Glasgow, Montana, a town of 3,500 in northeastern Montana that is about as rural as it gets. I serve more than 20,000 patients in an area that runs 100 or more miles in every direction except north past the Canadian border. I’ve been on call essentially every hour of every day since I came to Montana over 20 years ago.

Health 2.0 NYC Chapter Meetup

Apr 9, 2009• 2

By EUGENE BORUKOVICH

Back in 1995-96, I ran a site out of
my dorm room called Mac-o-mania. It was a collection of interesting

products and tidbits for the Macintosh community. I initially gathered
content myself but as the site's popularity grew I became highly dependent
on people to send me comments, tips and links to keep the site going.

I am a huge believer in the unique ability
of people to take their experiences (failures as well as successes)
and place them, along with other content, onto shelves in their brain.
Innovation is the combination of all those pieces of content in a social
environment shared and combined with other like-minded individuals.

Last June I went to Scott Heiferman’s
Tech meetup and shortly thereafter created the New York Healthcare Technology
Organization using meetup.com platform (thanks Scott!!! – its worth
every penny).

CLASSIFIED: Valida Primary Care – Investors in Primary Care Practices

Apr 9, 2009

The healthcare marketplace is changing dramatically – at Valida Primary Care we believe these changes create significant and exciting opportunities for primary care practices. We are a group of healthcare executives and investors with years of experience growing and improving provider organizations. Currently, we are seeking mid to large size primary care practices in New England in which to make majority equity investments. To learn more about Valida Primary Care visit. www.validapc.comInterested in reaching a national monthly audience of 75,000 healthcare-obsessed readers? ****@***************og.com“>Drop us a line.
We'll get back to you with rates and options. Want to impress your boss
and amaze your friends? Consider becoming a THCB corporate supporter.

Building Health into the Delivery System, Take Two

Apr 9, 2009• 7

By Rushika Fernandopulle

The following is a guest post from Rushika Fernandopulle, MD, MPP, Co-Founder of Renaissance Health. This is part of a continuing series of blog entries cross-posted here, on the Center for Information Therapy Blog, and the Health Affairs Blog, the conference’s Media Partner in advance of the first-ever “Health 2.0 Meets Information Therapy” Conference in Boston on April 22-23.

Rushika provides another physician perspective on the same question answered by John Halamka this week,
“How do we build Health 2.0 into the delivery system?” Both Rushika and
John will participate in a debate on this topic in Boston.

I am an internist who has been working for the last 5 years to
design, build, and test radically new models of delivering primary care
to improve experience, outcomes, and affordability of care. I currently
serve as Medical Director of one of our redesigned practices in
Atlantic City, NJ. Yesterday afternoon, Mr. Santos, a 53 year old
Hispanic doorman at a local hotel, came in to see me quite visibly
distraught. His prior primary care doctor had without asking him or
discussing the issue checked a PSA (Prostate Specific Antigen) as part
of his “routine” blood tests and the results were mildly positive
(6.5). He was told, “Your screen for Prostate cancer was positive, you
need to see a urologist right away to have it taken care of.” All he
heard, of course, was “cancer” and “positive” in the same sentence.
Before Mr. Santos had time to even form the first of the dozens of
questions he had, the doctor had already strode out the door. Over the
next few weeks, Mr. Santos went online to read about PSA and prostate
cancer (which yielded over 6 million pages on Google), and started
talking to his friends at work about the issue. What he surmised, quite
correctly, is that the way forward for him was not at all clear, and
that instead of finding answers he only had more (but better)
questions. What really was his chance of having Prostate Cancer? If he
did what really were the benefits of catching it so early? Were the
risks of the biopsies worth this benefit? What were his other choices?