The Insider's Guide - Tech - The Business of Health Care - Physicians - Subscribe Asking the Wrong Questions About the Electronic Health Record
By ASHISH JHA, MD
The wrong question always produces an irrelevant answer, no matter how well-crafted that answer might be. Unfortunately the debate on health information technology seems to be increasingly focused on the wrong question. An Op-Ed in the Wall Street Journal argues that we have had a “Major Glitch” in the use of electronic health records (EHRs). This follows on a series of recent studies that have asked the question “do EHRs save money?” Or “do EHRs improve quality?” with mixed results. While the detractors point to the systematic review from McMaster, boosters point to the comprehensive review published in Health Affairs that found that 92% of Health IT studies showed some clinical or financial benefit.
The debate, and the lack of a clear answer, have led some to argue that the federal investment of nearly $30 billion for health IT isn’t worth it. The problem is that the WSJ piece, and the studies it points to, are asking the wrong question. The right question is: How do we ensure that EHRs help improve quality and reduce healthcare costs? Read more. The Art of Diagnosis
By MAGGIE MAHAR AND CLIFTON MEADOR, MD
A young doctor and his wife had just moved to the mountains of eastern Kentucky, near the border of West Virginia. The small town was nestled among the coal mines of the region. Nearly all of his patients would be coal miners or family members of a miner. Bill would practice family medicine. His wife, a veterinarian, hoped to build a small-animal practice.
Liz McWherther, the forty-seven-year-old wife of a miner, came to see the young doctor. Over several weeks, she had developed a curious set of complaints. Each morning she woke with a dry mouth and slurred speech. She also noted blurred vision and difficulty urinating. Within a couple of hours of waking, she was completely free of any symptoms. These symptoms had been occurring each morning and going away by afternoon. Read more.
How ObamaCare Could Cause Nonprofit Hospitals To Lose Tax-Exempt Status
By DAVID WHELAN
Affordable Care Act (ObamaCare) has been knocked for its alleged unintended consequences. The bill’s attracted speculation that workers will lose their health plans, college grads will stop looking for jobs, and even that fewer people will get married. Those are just the effects related to insurance regulations. Less attention has been given to how hospitals and health systems might change after ObamaCare.
The most common theory is that reform causes consolidation. But what if the effect on hospitals is even more radical? What if the legislation changes the largely nonprofit nature of the industry? Read more.
Are You Still Wasting Your Time on Twitter?
By RONAN KAVANAGH, MD
What surprised me was that this (rhetorical) question was put to me, not by an elder lemon colleague approaching retirement, but a freshly minted colleague in his early thirties. Then I saw this Tweet from the Med2.0 conference: "Audience member says 86% of docs surveyed in a large medical practice feel social media is a waste of time."
As someone who spends a lot of his time on Twitter, it hurts to think that the majority of my colleagues might think I might be wasting my time. Engaging in health related activities on social media channels is the most important thing I have done for my medical life since completing my specialist training. It has renewed my fascination for healthcare in a way I haven’t felt since I was a medical student and doing so, has undoubtedly quelled a mid-life ennui with my career. It has transformed the way I learn (where I had all but stopped learning) and introduced me to new an interesting friends. Read more.
The Doctor-Patient Relationship. Is Over.
By ROB LAMBERTS, MD
Probably the hardest part of making the change from a traditional to a direct-care practice is the effect it has on relationships. I am only taking a maximum of 1000 patients (less at the start) and will be no longer accepting insurance. These changes make it impossible for me to continue in a doctor-patient relationship with most of my patients.
For some, this transition will be more hassle than anything. Some people do everything they can to avoid my office, and so are not going to be greatly affected by my absence. They will simply choose another provider in our office and continue avoidance as always. There are others who see me as their doctor, but they haven’t built a strong bond with me (despite my charm), so the change may even be a welcome relief, or a chance to avoid initiating the change to another doctor. Read more.
Morganthaler's Picks: The Top Thirteen Health IT Startups
By MISSY KRASNER
Today we announced the 13 startup finalists for the 2012 DC to VC contest. DC to VC is a nation-wide contest to find the most promising health IT startups looking for Seed and Series A ($2-5M+) funding. An annual event started by Morgenthaler Ventures over a 3 years ago to help close the gap between what was going on in Washington D.C. (at ONC, CMS and the White House) and aligned interests in the Silicon Valley on health IT investing, the event has now grown into a large health IT startup competition. Moregenthaler Ventures got interested in this space when they invested in Practice Fusion over 3 years ago (they just invested in Doximity – see funding announcement). I joined as an Executive in Residence (EIR) in January after leaving Google Health and asked Matthew at Health 2.0 to combine forces with us to make the event even bigger--given he was our featured MC last year and will be again this. Read more.
Folly To Forecast Startup Performance?
By DAVID SHAYWITZ, MD
Several days ago, Paul Graham, co-founder of noted Silicon Valley accelerator Y-Combinator (YC), wrote an exceptional post, “Black Swan Farming,” observing how crazy difficult it is to predict success in the startup space, and noting that just two companies – Airbnb and Dropbox – account for about 75% of the total value created by all YC-associated companies.
Yesterday, Dave McClure (the white-hot seed-stage Silicon Valley investor, familiar to readers of this column – see this discussion of his small bets style in connection with digital health) responded in a post titled (what else?) “Screw the Black Swans” that his investment model (at 500 Startups) is slightly different. Read more.
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NEW RELEASES
The Health Care Handbook The American health care system is vast, complex and confusing. Books about it shouldn’t be. The Health Care Handbook is your one-stop guide to the people, organizations and industries that make up the U.S. health care system, and the major issues the system faces today.
How to Live Forever *Results May Vary. Nominee Palm Springs International Film Festival. Nominee Hamptons International Film Festival. How to Live Forever Director Mark Wexler embarks on a worldwide trek to investigate just what it means to grow old and what it could mean to really live forever. But whose advice should he take? Does 94-year-old exercise guru Jack LaLanne have all the answers, or does Buster, a 101-year-old chain-smoking, beer-drinking marathoner?
Why Nobody Believes the Numbers Ever wonder if those wellness, disease management, medical home and other programs imposed on your medical practices really work? Answer that question for yourself by reading Why Nobody Believes the Numbers, the first population health outcomes measurement book not infused with THC.
The Great Experiment is about much more than a single state experiment, or the immediate questions the presidential primary may raise regarding Mr. Romney’s term as governor of Massachusetts. Rather, Pioneer assembled some of the best thinkers to outline the options before state and federal officials. The Great Experiment aims to lay out a market-oriented blueprint for the next decade. Download free chapters, including an introduction by Dr. Jeffrey Flier, Dean of Harvard Medical School, or purchase a copy at greatexperiment.org.
True Medical Detective Stories by Clifton Meador, MD 2012. Modern technology has given rise to electronic medical records, remote monitoring systems, and satellite-enabled real-time examinations in which patient and physician might be separated by thousands of miles. Yet, when it comes to diagnosing difficult cases, the clinician’s strongest asset might just be one of the oldest tools of the medical profession — careful listening. True Medical Detective Stories is a fascinating compendium of nineteen true-life medical cases, each solved by clinical deduction and facilitated by careful listening. These accounts present puzzling low-tech cases—most of them serious, some humorous—that were solved either at the bedside or by epidemiological studies.
FILM & VIDEO
MONEY AND MEDICINE As rising health care costs threaten to bankrupt the country, MONEY AND MEDICINE tackles the medical, ethical, and financial challenges of containing runaway health care spending. In addition to illuminating the so-called waste and overtreatment that pervade our medical system, this timely documentary explores promising ways to reduce health care expenditures while improving the overall quality of medical care. MONEY AND MEDICINE captures the painful end-of-life treatment choices made by patients and their families, ranging from very aggressive interventions in the ICU to palliative care at home. The film also investigates the controversy surrounding diagnostic testing and screening as well as the shocking treatment variations among patients receiving a variety of elective procedures.
CONFERENCES
AARP Health Innovation@50+ LivePitch
Sept. 21, New Orleans Convention Center
Please join us for AARP Health Innovation@50+ LivePitch, Friday, September 21 at the New Orleans Convention Center. Health Innovation@50+ is the premier showcase featuring the most exciting companies in the “50 and over” health technology and innovation sector. The pitch event offers the venture capital and angel investor community as well as the media, the opportunity to connect with outstanding startups in the field of health technology and innovation.
Health Innovation@50+ takes place at the annual Life@50+ AARP National Event & Expo, which is attended by 20,000+ members and guests from across the U.S. and the globe. This is the best opportunity of the year for entrepreneurs and investors to capitalize on the world’s largest and fastest-growing consumer market. Register now at http://Health50.org
Health 2.0 San Francisco
October 7-10, Hilton San Francisco
The groundbreaking conference series returns to San Francisco. Keynotes by Joe Flower and Aetna CEO Mark Bertolini. Speakers from Qualcomm, AT&T, Mayo Clinic, National Cancer Institute, ZocDoc, OptumHealth and RedBrick Health, along with presentations from top health care startups changing the field and many more.
The First Annual Open Source EHR Summit and Workshop
October 17-18, Gaylord National, National Harbor, MD
It is projected that more than 200 hospitals and 1000 clinics, within the federal sector alone, will be managing and maintaining their EHRs using open source codes within the next few years. An increasing number of state agencies are deploying open source solutions as well. In recent months, many private sector health care communities facing the unsustainable high costs of health IT have started calling for alternate approaches to maintain and manage traditional proprietary electronic health records. These open source activities create a huge market opportunity for both private and public sectors.
REAL ESTATE 61,000 Square-Foot Building Available For Lease Near Boston
Ideal for Medical Offices, Back Office Uses
A 61,000 SF building that can be easily converted to medical use is available for lease just 17 miles from downtown Boston. Located in Hingham Technology Park 3 on a 9-acre parcel in Hingham, Mass., and there is close proximity to numerous hotels and conference centers, and easy access to Rtes. 3, 93, 128 and 95. The site is a quick drive to Plymouth and Cape Cod.
For more information, contact Richard McKinnon at 617-472-2000, or email richmck@grossmanco.com. To learn more about the additional development potential of this site, visit www.HT3park.com.
THE FINE PRINT
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