The Healthcare IT Guy

Geisinger Health Systems is serious about improving the quality of care. This was in the New York Times today:

What if medical care came with a 90-day warranty?
That is what a hospital group in central Pennsylvania is trying to learn in an experiment that some experts say is a radically new way to encourage hospitals and doctors to provide high-quality care that can avoid costly mistakes.
The group, Geisinger Health System, has overhauled its approach to surgery. And taking a cue from the makers of television sets, washing machines and consumer products, Geisinger essentially guarantees its workmanship, charging a flat fee that includes 90 days of follow-up treatment.
Even if a patient suffers complications or has to come back to the hospital, Geisinger promises not to send the insurer another bill.
Geisinger is by no means the only hospital system currently rethinking ways to better deliver care that might also reduce costs. But Geisinger’s effort is noteworthy as a distinct departure from the typical medical reimbursement system in this country, under which doctors and hospitals are paid mainly for delivering more care — not necessarily better care.

Read the rest…

I got a note this morning about $5 Million being made available to “Support Ideas That Transform Markets and Empower Consumers.” Here’s the story:

“Disruptive Innovations in Health and Health Care” is an open source competition to identify ways in which the health and health care marketplace can offer services, tools and choices that consumers want-but are currently out of reach because of cost, complexity or because the right idea hasn’t come along.

We are looking for entrepreneurs both within and outside of the health care field with ideas for new products, services, technologies, business models-or some combination thereof-that enable consumers to manage health and receive care in ways that are more affordable, accessible, simple and convenient.

Examples: Glucose monitors that provide diabetics with the convenience of blood glucose readings in seconds from the comfort of their own home. Walk-in health clinics in retail stores that enable patients to quickly see skilled nurse practitioners who can treat common conditions at lower costs than typical doctor visits.

Enter By: Jul 18, 2007 | Voting Begins: Aug 15, 2007
Winners Announced: Aug 30, 2007

How It Works: Twelve competition finalists will be selected by a panel of judges. You then vote on three winners, who will each receive a $5,000 cash prize from Changemakers. In addition, the Robert Wood Johnson Foundation’s (RWJF) Pioneer Portfolio will review competition entries and may award up to $5 million to support projects that show potential for significant impact!

This sounds very cool. You can submit your idea for “Disruptive Innovations in Health and Health Care” here.

In honor of National Health IT Week (May 14 – 18), a week-long forum dedicated to increasing the awareness and impact of IT for healthcare, QuadraMed compiled a list of the Top 10 reasons consumers should care about medical technology. All the healthcare IT (HIT) vendors are out in force this week pushing their wares but I thought QuadraMed’s focus on why consumers should care was unique.

Consumers and Health Information Technology: A Top 10 List

10. HIT Improves the Quality of Care Received
9. HIT is Critical in the Event of a Nation-Wide Emergency
8. HIT Increases Accountability from Providers
7. HIT Prevents Medical Errors and Saves Consumers’ Lives
6. HIT Can Empower Consumers to Make Smarter Healthcare Decisions
5. HIT Saves Consumers Money
4. HIT Allows Nurses to Spend More Time with Patients
3. HIT Increases the Health of the Entire American Population
2. HIT Keeps Hospitals Profitable
1. HIT Decreases Billing Errors

Now, I’m not sure I agree with all the 10 items but I applaud QuadraMed’s effort to sell this to the consumers. Without consumer action, healthcare IT will be relegated to the backend and won’t really achieve the kinds of results that are possible with consumers in the driving seat. Much as consumers pushed banking and retails systems to open up and has brought auto and home insurance firms kicking and screaming into the 21st century, if consumers really demanded more from their doctors and hospitals we might actually be able to use healthcare IT to do the kinds of things QuadraMed is saying in their top 10 list.

I’ve written previously about PodSlurping and portable storage devices being a security hazard on our healthcare networks.

I ran across this tool called EndPointScan. GFI have just released this online scanner, which is basically a free tool that can show which portable storage devices have been and are being used on an organization’s network, where on the network they’re used and by whom. If you’re in the information assurance or security group in your department or enterprise you owe it to yourself to get a tool like this so you’re not caught off guard. If users know you’re watching (you can send them nice e-mails telling them when they’ve tripped an alarm) they are less likely to carelessly use portable devices on the network.

I ran the tool on a few computers in my office and the scanning worked but reports weren’t properly generated. I think it might have to do with me running Vista instead of Windows XP (but to be fair, Windows Vista is not on their “supported” list). If you give it a shot, drop me a comment here to tell me whether you find it of value or not.

I read this article recently published by American Academy of Family Physicians and found it quite useful. As a health IT professional, I also talk about many of the ideas written up in the article but perhaps coming from a fellow physician (the author an MD), it will mean more to other physicians considering EMRs and EHRs. Here are myths the article debunks (along with some of my own comments):

• Myth 1 - A new EHR system will fix everything. Fact - moving to a new system will create new problems at the same time that it solved old problems. Be ready to adapt.
• Myth 2 - Brand A is the best. Fact - no single software package fits all practices equally.
• Myth 3 - Our software needs to work the way we currently work. Fact - commercial software is not malleable enough to suit your needs. You’ll have to change your workflows to conform to the new technology.
• Myth 4 - Software will eliminate errors. Fact - software can eliminate some rudimentary errors but in fact can propagate real errors even faster.
• Myth 5 - Discrete data is always best. Fact - start with free text and add discrete data where you know you can make use of it. Having tons of data you “could analyze” has a low ROI.
• Myth 6 - The more templates, the better. Fact — maintaining templates is hard work, only do it because it has clinical or business value. Less is more in this case.
• Myth 7 - Electronic records are more legible than paper records. Fact - when you have electronic data, you have a lot more “noise” in the chart (because it’s easier to capture).
• Myth 8 - Mobile is best. Fact - don’t be fooled by fancy gadgets. Mobile is fine but you’ll trade value for convenience and since you don’t really need all the features in your hip pocket go for “minimal mobile” features and “maximal desktop” features.
• Myth 9 - You must have a detailed plan, and stick to it.
• Myth 10 - You can stop planning.

The article is worth reading if you’re considering automating your practice on the clinical side.

I wanted to thank Fred Trotter for sending me this note yesterday:

Now you can download and use an FOSS EHR under the GPL that is CCHIT certified. The days of the proprietary EHR systems are OVER.

I love Fred’s enthusiasm about open source software in healthcare, it’s definitely the direction of the future. While CCHIT certification doesn’t actually improve a product or make it any more applicable to a particular client, it’s great to see that a free and open source solution can no longer be derided as “not being certified” by other vendors.