"electronic health records" entries
Challenge to Meaningful Use by House leaders highlights difficulty of asking incumbents to be innovators
Working too closely with an industry can undercut innovation
Four leading members of the House Ways and Means Committee tore away last Thursday at the polite, cautious, incremental approach that the Department of Health and Human Service has been taking toward key goals of HITECH act that was meant to drag health care into the 21st century.
Specifically, the House leaders signaled their disappointment at the Stage 2 Meaningful Use rules, promulgated last August by the Office of the National Coordinator and the Center for Medicare & Medicaid Services. The Congressmen isolate certain rules that appear to be less stringent than Stage 1, point out that the key goals of interoperability and data exchange are weak, and most notably ask for a total stop to payments made to health care providers under Meaningful Use.
Harvard Medical School conference lays out uses for a health data platform
This week has been teaming with health care conferences, particularly in Boston, and was declared by President Obama to be National Health IT Week as well. I chose to spend my time at the second ITdotHealth conference, where I enjoyed many intense conversations with some of the leaders in the health care field, along with news about the SMART Platform at the center of the conference, the excitement of a Clayton Christiansen talk, and the general panache of hanging out at the Harvard Medical School.
SMART, funded by the Office of the National Coordinator in Health and Human Services, is an attempt to slice through the Babel of EHR formats that prevent useful applications from being developed for patient data. Imagine if something like the wealth of mash-ups built on Google Maps (crime sites, disaster markers, restaurant locations) existed for your own health data. This is what SMART hopes to do. They can already showcase some working apps, such as overviews of patient data for doctors, and a real-life implementation of the heart disease user interface proposed by David McCandless in WIRED magazine.
Report from the field by Tony McCormick
The concept of an Accountable Care Organization (ACO) reflects modern hopes to improve medicine and cut costs in the health system. Tony McCormick, a pioneer in the integration of health care systems, describes what is needed on the ground to get doctors working together.
Highlights from the full video interview include:
- What an Accountable Care Organization is. [Discussed at the 00:19 mark]
- Biggest challenge in forming an ACO. [Discussed at the 01:23 mark]
- The various types of providers who need to exchange data. [Discussed at the 03:08 mark]
- Data formats and gaps in the market. [Discussed at the 03:58 mark]
- Uses for data in ACOs. [Discussed at the 5:39 mark]
- Problems with current Medicare funding and solutions through ACOs. [Discussed at the 7:50 mark]
You can view the entire conversation in the following video:
Data as a platform, patient control, and partnerships are key
The quantum leap we need in patient care requires a complete overhaul of record-keeping and health IT. Leaders of the health care field know this and have been urging the changes on health care providers for years, but the providers are having trouble accepting the changes for several reasons.
What’s holding them back? Change certainly costs money, but the industry is already groaning its way through enormous paradigm shifts to meet current financial and regulatory climate, so the money might as well be directed to things that work. Training staff to handle patients differently is also difficult, but the staff on the floor of these institutions are experiencing burn-out and can be inspired by a new direction. The fundamental resistance seems to be expectations by health providers and their vendors about the control they need to conduct their business profitably.
Health care track draws a small and passionate core
There has been enormous talk over the past few years of open data and what it can do for society, but proponents have largely come to admit: data is not democratizing in itself. This topic is hotly debated, and a nice summary of the viewpoints is available in this PDF containing articles by noted experts. At the Open Source convention last week, I thought a lot about the democratizing potential of data and how it could be realized.
The letter conveys a rather sorrowful message about the state of health IT in the United States. One request–to put brakes on the requirement for hospitals to let patients see their own information electronically–has received particularly strong coverage and vigorous responses.
Realistic conclusions and opportunities in health care.
Despite the disappointments I've undergone in learning about health care, I expect the system to change for the better. Those who want a better system need to look at the areas where change is most likely to make a difference.
Recalcitrant instincts that depressed me and progressive suggestions that restored me. Details DICOM, Watson, and other interesting projects.
Two key pillars of the Stage 2 announcement are requirements to use the Direct for data exchange and HL7's consolidated CDA for the format.
HIMSS has promoted good causes, but only recently has it addressed cost, interoperability, and open source issues that can allow health IT to break out of the elite of institutions large or sophisticated enough to adopt the right practices.