Smashing myths & assumptions on PHR use (Chilmark)

John Moore of Chilmark Research has another great post, this time on the realities being discovered about PHR use among the urban poor – something most observers considered unlikely. It’s aptly titled Smashing Myths & Assumptions: PHR for Urban Diabetes Care. Give that man an Emmy, or something.


Posted in: medical records | positive patterns | pt/doc co-care | trends & principles | Why PM




7 Responses to “Smashing myths & assumptions on PHR use (Chilmark)”

  1. Annie Stith says:

    Hey, Dave!

    I would have posted a comment at the site of this article, but it would have been, at the very least, rude.

    Here’s my rant.

    I understand that physicians, healthcare centers and hospitals need to look at whether they can be fiscally secure while dealing with initial costs of implementing PHR systems. Everyone has a right to earn a living. I get that.

    What I don’t understand, though, are some of the comments for posts like this one that show a positive change in patients’ health and reduced ER visits that are so “me” focused.

    Are we really still there, stuck in a “me millenium” rather than having outgrown our “me generation?” Is that what healthcare has been reduced to: a “business” of health, where there’s no longer any “care”?

    Cost/benefit analyses should (IMO) include more than the bottom line financial profit, but whether or not the system provides any health “gains” by the patients, which are priceless.

    End of rant.

    (I’m so glad this blog is here!)


  2. e-patient dave says:

    Annie, you seem to still have a wee disempowered “I am not worthy”streak. Your comments are not only as worthy there as here, they’ll also each new ears there.

    Rants labeled as rants are fair game where, imo. Just remember it’s useful to bear in mind that readers elsewhere may not yet have heard your POV, so it can be productive to teach more than bashing.

    Or, as somebody put it, dispense energy in the form of light, more than heat.

    Whatever you do, for heaven’s sake be yourself.

  3. Annie Stith says:


    “…a wee disempowered ‘I am not worthy’ streak,'” eh? That pot’s been simmering on the hearth of the women of my family for… well, forever.

    I’ve come a long way, baby. (;

    (But, thanks for the gentle reminder I still have a bit farther to go.)


  4. GOSH this Droid is not serving me well as a typing device – there are typos all over the place, where formerly I had none. Apologies to all.

  5. John Moore says:

    Please, do not hesitate to provide a comment over on the original post – your voice needs to be heard as well.

    And while I agree with your point from a fundamental, why are we here, why do we practice medicine/deliver care POV, there is still the need to prioritize projects w/in an organization. If, as a developer of say a PHR platform you go to a hospital’s CIO and say: You need to adopt our solution because its the right thing to do, the CIO may agree with you on principle but not commit due to other, more pressing priorities.

    Now if instead you went to the CIO, or better yet the CFO and CMIO and said: Providing your Medicaid patients with an ability to better manage and control their chronic disease via access to their PHI and improve compliance, then they can connect the dots and raise the issue/need to a more strategic, high priority level.

    • Annie Stith says:

      Hey, John!

      Thanks for the encouragement. I can still be intimidated by all those initials after someone’s name, even when they’re two: MD. I’m working on it.

      I do undertstand the issue of cost/benefit analyses, especially when it’s a new budget item, there’s a considerable initial investment and everyone’s running around with their own idea about the “proof” of whether it works. Dating myself here, but I remember the same thing about Manual Typewriters v. Electric Typewriters v. “Selectric” Typewriters v. Magnetic Card Readers v. the first dedicated Electronic Word Processors v. Networked Word Processors with software on the mainframe … Totally new tech each time that freaked out the bosses and “moneymen” back then, too.

      I worked as an Eng Tech for a few different local governments, and we literally reworded the justification at each stage of the approval process for our road projects, more carefully the higher the cost. It was like that child’s game “Telephone,” where a whispered phrase repeated from child to child rarely sounded the same at the beginning and end. The in-house justification wasn’t the same as that we finally presented to the public. We didn’t want John Q. Public knowing the starting justification was a political debt being paid.

      I believe everyone has the right to a decent salary or organizational profit. As a chronic pain patient, though, I just sometimes feel so angry. I have no choice as to whether or not I see doctors. I have to see doctors. I’m not powerless by any means. I have a lot of other choices, including which doctors, which conventional treatments, what home therapy I can do to support my health, alternative treatments, etc. Sometimes, though, that first “if” I don’t have a choice about makes it difficult for me emotionally when someone else approaches the subject of healthcare with little or no emphasis on the “care.”

      Goodness! I’ve rambled again. But I’m not going to edit and re-edit. Someone else recently reminded me I should be myself. When it comes to my passions, I ramble.


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