Archive for May, 2009

EMRs: “Would you take it if it were FREE?”

May 15, 2009 · Filed Under medical records, policy issues, trends & principles · 10 Comments

Blogger John at the “EMR (EHR) and HIPAA” blog posted a musing that caused my business antennas to twitch. A vigorous discussion has started in the comments.
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Next stage in mapping my hospital’s clinical data to PHRs

May 13, 2009 · Filed Under found on the net · Comment

John Halamka’s blog has a new post today announcing that the National Library Medicine has mapped 93% of his hospital’s “problem list” codes to the SNOMED CT set of clinical data codes that’s widely used.

For more info on data formats see our post on data vocabularies.

Consumer Partnership for eHealth’s thoughts on Meaningful Use

May 13, 2009 · Filed Under medical records, policy issues, positive patterns, reforming hc, trends & principles · 3 Comments

Precursor posts: The “meaningful use” debate (my thoughts); the Markle Foundation’s work on the subject

Thanks to Josh Seidman of the Information Therapy Blog for steering me to the “meaningful use” work that’s been done by the Consumer Partnership for eHealth – another great group I’d never heard of. I’m loving the way Web 2.0 lets us discover, and help each other discover, new allies and resources.

Here are some highlights of CPeH’s view. Meaningful use is when:

Care is comprehensive, coordinated, personalized and planned
Patients and their caregivers are full partners in their care, assisted with management of chronic illnesses and health care decision making
Transitions between settings of care are smooth, safe, effective and efficient
Patients can get care when and where they need it
Patients’ experience of care is routinely assessed and improved
Care is connected to and integrates community resources
Continuous quality improvement and the elimination of disparities are a top priority

Don’t you love it? Wouldn’t you love to have that be LAW??

If you’re into this stuff, please read the rest of Josh’s post. More important info on CPeH and on Markle. Good contribution.

PLEASE, No More Magical Thinking in HIT!

May 12, 2009 · Filed Under general, hc's problem list, medical records, policy issues, reforming hc · 17 Comments

Magical thinking: the ability to draw conclusions that are based on a person’s desire for what reality should be, not necessarily upon what reality actually is.

Cargo Cult HIT: Concepts in HIT that follow all the apparent precepts and forms of evidence-based methodologies, but are missing something essential, because no one has checked the real end-user needs and capacities.

Washington is abuzz with ARRA and HITECH, meetings & hearings are incessantly happening to define “Meaningful Use”. But where is the patient voice in all of these conversations? Not including strong patient representation at the center of the current and future deliberations increases the risk of implementing a number of magical thinking concepts in EHR and in the development of the National Health Infrastructure. If you doubt my statement read on!
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Participatory Medicine as Revolution! Think Critically! Communicate!

May 11, 2009 · Filed Under e-patient stories, e-pts resources, general, policy issues, pt/doc co-care, pts as teachers, reforming hc, trends & principles · 20 Comments

My son graduated from college last year and is now in Nepal, visiting schools and writing about rural education under the Maoist regime. He was excited to tell me, when I visited him recently in India, about how a classic book on education, Pedagogy of the Oppressed by Brazilian Paulo Freire, radically influenced and inspired him to readjust his career goals.

The book postulates that real revolution can occur only when the playing field is leveled between teacher and student, whereby critical thinking is infused in education and where ‘teachers become students’ and ‘students become teachers.’ Communication amongst students (i.e., social networking) is equally important in this equation. While in India I read this short book, substituting doctor for ‘teacher’ and patient for ‘student’ and indeed, feel better equipped for the PM agenda.

The Markle Foundation’s work on Meaningful Use

May 10, 2009 · Filed Under e-pts resources, general, medical records, policy issues, positive patterns, pt/doc co-care, reforming hc · 8 Comments

Last night I posted my own thoughts on the definition of “meaningful use,” a term that will have significant impact on our next-generation medical records systems. To me it’s vital that the term be defined to include full access for you and me (patients) to our own medical data.

I’ve come to the conclusion that we have a terrific ally in this conversation, the Markle Foundation. They recently released a paper that I think is a great contribution to this effort.
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“Meaningful Use”: a pivotal definition for new-wave medical records systems

May 10, 2009 · Filed Under medical records, policy issues, pt/doc co-care, reforming hc, trends & principles · 26 Comments

I’ve struggled with what to say about this subject for two weeks, because I want to “get it right” but it’s vast. So I’m giving up any hope of being comprehensive, and I’m just going to say what little I know, and what I think, and let any discussion happen from there.
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Democracy and Healthcare

May 6, 2009 · Filed Under found on the net · Comment

At boingboing, Doug Rushkoff posted a video from C-Span of the Senate Hearings on Healthcare Reform, including a half dozen “peaceful and very articulate” protesters “demanding a seat at the table (where 15 witnesses wait to testify, not one representing the single-payer option).”

AHRQ embraces Participatory Medicine.
The President? Not So Much!

May 6, 2009 · Filed Under general, key people, policy issues, positive patterns, pt/doc co-care, pts as teachers, reforming hc, trends & principles · 10 Comments

Clinicians, the Government, and many other groups are working hard to improve health care quality, but it’s a team effort. You can improve your care and the care of your loved ones by taking an active role in your health care. Ask questions. Understand your condition. Evaluate your options.

Some may think this is the new mission statement of the Society for Participatory Medicine. It could, but the truth is, frankly, much more amazing. It is the opening statement of a new public service campaign to educate health citizens on conversing with doctors, launched by AHRQ . (Thanks to Jane Sarasohn-Kahn – @healthythinker – for mentioning it.)

Open Access to Publicly-Funded Research: Let Them Eat Cake?

May 5, 2009 · Filed Under policy issues · 42 Comments

Marketplace aired a story last week entitled, “Publicly funded research for a price,” which echoed the story of Edwin Murphy, who in 1994 had to impersonate his doctor in order to read the risks and benefits of a medical procedure he was considering. (Hat tip to Carol Torgan for alerting me to the story.)
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