We don’t win anymore in health care. After repeatedly drilling in our heads that America’s sick care system is a disaster, that those who care for the sick are incompetent and stupid, and that the sick themselves are losers, Meaningful Use was advertised as the means by which technology will make health care great again.
The program has been in place for 5 years and the great promise of Meaningful Use is just around the same corner it was back in 2011. The only measurable changes from the
Read More
EHRs are Oppressive Straitjackets for the Practice of Medicine
Editor's Note: Margalit Gur-Arie is the founder, BizMed. She writes regularly about the intersection of healthcare & technology on her site: On Health Care Technology. Follow her on Twitter at @margalitgurarie
It was a dark and stormy night. My computer didn’t catch fire while typing the previous sentence. No alarms were triggered warning me about the quality of such opening. I wasn’t prompted to select subjects and predicates from dropdown lists. I typed the entire sentence, letter by
Read More
4 C’s of the Quantified Doctor-Patient Relationship
So far the doctor-patient relationship escaped rigorous quantification, because “relationship” is largely a nostalgic quantity, and because “communications” was deemed to be a reasonable substitute. There are various tools and instruments for subjective measurement of communications with one’s doctor, with the most common being the ubiquitous patient experience survey. However, if we accept a broader definition of the doctor-patient relationship, such as the 6C’s proposed by Dr. Emanuel, a more
Read More
Can A Patient Experience Survey Truly Measure the Doctor-Patient Relationship?
Can we infer from a highly scored experience survey that the patient has a useful relationship with her doctor? Not really.
Sixty years ago, before he became a controversial figure in the field of psychiatry, Dr. Thomas S. Szasz co-authored an article for the Archives of Internal Medicine (now JAMA Internal Medicine) on “The Basic Models of the Doctor-Patient Relationship”, which is well worth reading today, particularly for those who believe that patient empowerment/engagement is a novel and
Read More
DoD EHR Contract: Will It Impact the Larger EHR Market?
How will the DoD EHR contract affect the orders of magnitude in the larger commercial EHR market. Will Cerner leapfrog Epic and become the EHR of choice for large health systems?
The health information technology (HIT) world has been hit by a watershed event like no other. The Department of Defense (DoD), widely respected for its indiscriminate generosity to contractors, has awarded the most coveted prize in recent HIT memory – the Defense Healthcare Management Systems Modernization (DHMSM)
Read More
A Proposal for Disruptive Regulation of EHRs
The latest salvo in the interoperability and information-blocking debate comes from two academic experts in the field of informatics, and was recently published in JAMIA. In the brief article, Sittig and Wright are endeavoring to describe the prerequisites for classifying an EHR as “open” or interoperable. I believe the term “open” is a much better fit here, and if the EHR software happens to come from a business dependent on revenues, as opposed to grant funding from the government, bankrupt
Read More
Will Interstate Telemedicine Further Accelerate the Exodus of Physicians?
Did you know that you are a “telemedicine provider”? No? I can’t blame you for not knowing, but you are, and always have been. Well, maybe not always, but certainly since Alexander Graham Bell invented the telephone. Better yet, you provide free telemedicine services. Here is an idea: on the home page of your practice website, you should add a big huge flashing banner saying “Free Telemedicine Services!” Still hesitating because you are not using fancy monitors when you take calls from
Read More
The Death of Fee-for-Service in Healthcare
On April 16, 2015, President Obama signed into law H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015(MACRA), effectively sentencing Fee-for-Service (FFS) to death. The best explanation for how FFS is destroying the nation comes from Charles Munger, vice-chairman of Berkshire Hathaway and ad-hoc health luminary, who is equating what American doctors do, to raising rattlesnakes so they can collect the bounty for dead rattlers offered by the government in an effort to combat a
Read More
Is Machine Interoperability the Next Unusable Level of Meaningful Use?
As the HIMSS15 extravaganza is getting under way, and every EHR vendor flush with cash from the Meaningful Use bonanza is preparing to take its unusable product to the next level, machine interoperability is shaping up to be the belle of the ball.
Interoperability in health care is all the rage now. After publishing a ten year interoperability plan, which according to the Federal Trade Commission(FTC) is well position to protect us from wanton market competition and heretic innovations, the
Read More
Meaningful Use Stage 3 Proposed Rule: 5 Takeaways for Physicians
On March 20, 2015 the stars aligned to produce four simultaneous events that will never again coincide during the life of human civilization. The first three, the vernal equinox, a total solar eclipse and a new supermoon, were brought to us by the stars themselves, and the fourth one was thrown out there by the government. The regulations for Meaningful Use Stage 3 were finally published. Meaningful use of electronic health records (EHR) was presented to us back in 2009 as part of a stimulus
Read More
