Special Edition XTRA XTRA!

While I  was gone, my feeds have updated. Lots of interesting news, and opinions.

Let's start with iHealthbeat

150 Billion dollars !! to implement Health IT, says Dr Robert Miller from UC San Francisco

Dr Miller quoted these figures at a recent meeting of The Institute of Medicine

Dr. Miller is a Professor of Economics at UCSF.

Government Health IT  elaborates further on the Feud that is breaking out regarding the ultimate costs of implementing Health IT.

Ladies and Gentlemen.....the ship is sinking, let's not fight over which side of the ship to jump off.

 

I am going back to my sleep number bed

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Another Post with No Title

I need to find another title. One that is catchy and is tagged well so that the search engines rank me up there with The Health Care Blog. How does Matt do it? My ratings have never crashed,, largely because I have never soared into a  gleaming takeover possibility.  I was hoping to become  " a cult blog". Perhaps I need a better research department.  I secretly dream that readers are so enthralled with my writings, and meanderings that they are struck by 'shock and awe' and are dumbfounded into silence. Now and then I find snippets or complete ideas on other blogs several days or weeks after I post the same opinion. Are they reading my blog, and not admitting it?  Is there such a thing as mental telepathy?  I will have my legal department investigate.

Besides I have notice my reimbursement rate has declined much llike my fees for seeing patients. Perhaps a new business model is necessary, such  as:

Besides I started blogging to relax and freely associate with my writings.  Now I have to get up and first thing is read my  'prayer for the day' check the weather forecast to see if it will be 95 or 105 degrees, sunny or more sunny, and read the ozone levels, followed by reading all my relevant blogs.

I am up too early this A.M. The  blog feeds are not in, and this is getting to be too much like med school, and residency. It reminds me of morning rounds at 5:30 am walking around seeing sleeping patients (and nurses), cruising empty hallways.

I am going back to my sleep number bed, I may be back today again.

Quote of the day:
To achieve the impossible dream, try going to sleep. - Joan Klempner

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A Post with No Title

Quote of the day:
I was born not knowing and have had only a little time to change that here and there. - Richard Feynman

 

Several comments and studies regarding the National Effort for Health Information Technology.  The Heartland Institute and the Center for Consumer Directed Health Care published an opinion piece regarding how government is failing and will establish a non working and instantly obsolete health IT network.

"Any system that is imposed today will be obsolete in five years," Greg Scandlen, director of the Heartland Institute's Consumers for Health Care Choices, said, adding, "Yet the federal government is woefully incapable of changing or eliminating outdated rules and regulations. So we will be stuck for all time with whatever they come up with today."

The Heartland Institute describes itself as a national not-for-profit research and education group that is unaffiliated with any political party, business or foundation (Monegain

  Many feel the government should perhaps set an interoperability standard, and then butt out.  They and I feel private companies would be better suited in our market to accomplish this task

It remains my opinion from the onset of the furor over EMRs, RHIOs that the best route is to go to those who already know more about networking than anyone else....the telecommunications industry.  The solution is to contract with these entities to set up this network..

Some things are better left to those who specialize in telecommunications.   There have only been a few health entities that have developed regional HIEs that are operating successfully.

Much of the work thus far has been local with "boots on the ground", with voluntary workers. 

They do this as a "love" effort for health care, knowing this is necessary.  At the end of the day there are few stakeholders.  Yes there are some isolated, disconnected  demonstration projects.

There are also false illusions about making this a patient centric network.  That sounds alluring, and does peak the public interest and involvement.

Let's distill that idea down to the idea of the public setting up and operating there own  ATM network.

Patients do need transparency, should be running the business of your office or your hospital?

If anyone believes the government can or will fund these 'mandates' then I have this bridge I will sell to you for $1.00.

 

We do need system changes, perhaps EMR and/or RHIOs will play a part.

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Health Train Engines

Today's New York Times carries an article by Natasha Singer, "The Price of Beauty".  It points out how this has become the 'Engine for Success" in many dermatology, ophthalmology, and ENT practices. It however failed to point out that this is ocurring in non surgical practices such as family medicine, and yes, even OB/GYN.  Reader's comments range from understanding and commiseration to outright condemnation of these practices.

Cosmetic laser treatments, botox injections, collagen filling procedures, vein removal procedures, ophthalmologic procedures such as laser refractive surgery, premium multifocal intraocular lense cataract procedures offer the opportunity to stay afloat or drown in a sea of rising cost, and reductions in reimbursement.

For most physicians who practice without these cosmetic procedures, it is an easy step into this realm, at first noting that the economic pressure is reduced, then gradually it begins to take over the practice....It is not an admirable occurence, and those who do it cringe at what they have become.

There is no doubt that the 'engine for health care' should and must be caring for those who are ill.  When and if money is removed from the equation is a very doubtful prospect....communism tried it.....and failed.  Would socialized medicine, or universal payor solve the problem? 

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Sights, Sounds and ......

Quote of the day:
That which has always been accepted by everyone, everywhere, is almost certain to be false. - Paul Valery

Today I discovered while editing my blog that my list of blog links over to the left sidebar was totally missing. 

I spent part of today re-posting it, and it looks a bit ragged, but I will clean it up later this week. 

You may note I have a new link on the left sidebar  http://www.healthpolcom.com/blog/

Mike Miller M.D. contacted me via Sermo.  After reading several of his posts I can recomend  him without hesitation for quick and pithy observations that are not verbose and to the point.

Mike, thank you for contacting me.

My brain is tired tonite. It's been a long week.  I have added some video and sound links to the site as well.  Let me know if you experience problems.

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Toot-Toot on the Health Train Express

embargoed until  July 24,2008
Quote of the day:
My definition of an expert in any field is a person who knows enough about what's really going on to be scared. - P. J. Plauger

The horns are blowing at the health train express hurtles down the track, first leaning to the right, then the left travelling along tracks laid in 1960 or even further back than that.

Who is blowing the horns? Is it the government, health insurance plans, consumer advocacy groups, employers, or some hidden

Demonic Forces TRAILER - For more of the funniest videos, click here

demonic forces

 

Here are several relevant news articles in regard to health information technology.

iHealthbeat reports the following:

PHR Networks Better Model Than RHIOs To Exchange Health Data

Speakers at the Third Annual Leadership Summit on the Road to Interoperability in Boston on Tuesday said personal health record networks likely will provide a better model for health data exchange than regional health information organizations, Healthcare IT News reports.
R. Tim McNamar -- founder and CEO of e-certus, a software company, and former member of the Reagan administration -- said PHR platforms offer hope for the exchange of health data sooner than could be achieved through RHIOs. McNamar criticized President Bush for not pushing interoperability. He added, "There's no viable model for RHIOs."
David Kibbe, senior adviser to the American Academy of Family Physicians, said, "We can't expect government to build a network. Government didn't build the Internet. Government didn't build PCs."
Vince Kuraitis, a lawyer and principal of Better Health Technologies, predicted that companies would begin developing applications for PHR platforms such as Google Health, Microsoft's HealthVault and Dossia (Monegain, Healthcare IT News, 7/23

There actually are models for RHIOs, that will work. The technology is there, but the financing is not. I am not at all sure how consumers, or employers or whomever are going to build a PHR  that would work for providers, or hospitals.  PHRs as they now stand do not address the issue of P4P, management of chronic diseases and many other important issues. 

This is a little like asking the consumers to design their own ATM network for banking , or a computer inventory system for their local supermarket.

iHealthbeat goes on:

House Committee Passes Revised Health Care IT Legislation

Today, the House Energy and Commerce Committee approved health IT legislation (HR 6357) aimed at driving widespread adoption of electronic health records, Health IT Strategist Alert reports.
The legislation also is intended to strengthen federal patient security and privacy laws.
The bill would authorize more than $560 million in grants and loans for health care providers (Health IT Strategist Alert, 7/23).

Changes to Bill

On Tuesday, House Energy and Commerce Committee Chair John Dingell (D-Mich.) and ranking member Joe Barton (R-Texas) released a revised version of the bill.
According to CongressDaily, the lawmakers significantly changed the legislation's information-sharing and privacy provisions to address recent concerns from health care, high-tech and consumer advocacy stakeholders (Noyes, CongressDaily, 7/22).
Under the revised bill, patients would give their consent only once to health care companies that want to access health care records without identifying information for HHS-approved purposes, such as hospital audits or fraud and abuse allegations. The bill previously would have required patient consent each time the records were accessed.

Comments

Mary Grealy, president of the Healthcare Leadership Council -- who on Monday sent a letter to Dingell and Barton stating her concerns about the proposed bill's effect on the Confidentiality Coalition -- said, "They did make improvements in those provisions we had some concerns about, so I do feel like we're making progress." However, she added, "Do I think they have completely addressed all the issues? No" (Young, The Hill, 7/22).
A spokesperson for America's Health Insurance Plans said the provision that would allow patients to access their medical records and require them to provide consent for third-party access could restrict health care providers from developing wellness, disease management, quality assurance and other essential programs (CongressDaily, 7/22).
A spokesperson for Patient Privacy Rights said the revised bill is being reviewed and declined to comment (The Hill, 7/22).

It is apparent there are many hands in the cookie jar. Health data exchanges will undoubtedly be heterogeneous and probably never be fully integrated, nor should they be.

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BEAM ME UP SCOTTY

 

This phrase from Star Trek, and others such as "More power to the warp engines, Scotty", might also be applicable to health care.

Although we can't quite de-materialize and rematerialize elsewhere, the advent of telemedicine, email, and some forms of HIT does allow us to be intellectually present in two places simultaneously...

I was reading several blogs yesterday and came across several eponyms, EBM (Evidence Based Medicine) and Ix.  Ix really threw me.  I thought I was fairly current on my blogging CME but apparently I am lagging.  I think we should all received CME credits for our work in the blogosphere.  I wonder what Edwin Leap or Kevin MD think about that one.  They have been off at summer camp, hiking or some other non-productive activity while I have been chained to my keyboard. At least Dr Reece at Medinnovation has been at work.....but then who can call it work when one lives in Old Saybrook, CT.

If I remember correctly from a far distant place Old Saybrook is where the movie  " was filmed.

This epic cult film from the early 1960s portrays a young Sandra Dee playing the role of the weekend or summer fraternity party, frolicking at the beach and other pursuits of the androgenous and estrogenic late adolescent phase of life in college.  During my more youthful days I made several attempts to duplicate "Summerplace" one week when I was in charge of social activities for my  fraternity.  I was quite successful from what I can remember.

Anyway, back to Ix....This eponym coined by Josh Seidman stands for Information Therapy, not to be confused with IT.

Josh Seidman and his Center for Information Therapy  (Center for Ix) form a focus group 

"  The Center for Information Therapy (IxCenter) is an independent, 501(c)(3) tax-exempt, not-for-profit that aims to advance the practice and science of information therapy to improve health, consumer decision making and healthy behaviors.

The Ix Center acts as a catalyst for health care delivery innovation by diffusing Ix strategies through research, education and collaboration. A core function of the IxCenter is engaging with Ix proponents and industry leaders through its IxAction Alliance. "

Well, if you have followed my "drift", then set a course at warp 9  for Omicron 9 and make it so.

That being said, and also that it is quite a mouthful I would recommend clicking on my link to the source.

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