October 27th, 2010 by JessicaBerthold in Better Health Network, Health Policy, News
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Dr. Jay Anders, the CMIO of EHR vendor MED3000, offered a few tips during a Medical Group Management Association (MGMA) session on implementing an EHR successfully:
1. Make a clear communication pathway. Everyone needs to know what’s going on, from the physicians to the receptionist.
2. Clearly identify the needs of every physician who is going to use the EHR. The needs of an internal medicine doctor aren’t the same as a dermatologist. Make sure the EHR meets those needs.
3. Get a physician champion for the EHR who will be responsible for talking about the project to peers and answering questions, and be the first person to implement it. Pay that person for his or her time spent in championing duties.
4. Some people need more time than others. Don’t let a resistant doctor stop the implementation. Develop a plan for dealing with resisters that includes how you’ll respond to negative comments, how to implement other colleagues despite the resister, and how to sell the benefits of the EHR to the resister.
5. Expect the EHR implementation to be time-neutral. Most EHRs don’t save time; their value is in improved patient care and documentation, which leads to better reimbursement.
*This blog post was originally published at ACP Internist*
October 26th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Opinion, True Stories
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PalMD over at The White Coat Underground recently asked: “When did you really feel like a doctor?” Interesting question that I could answer in a number of ways.
While I didn’t know it at the time, I felt like a doctor around 4am during my first night on call. I was an intern on the hematology ward at Texas Children’s Hospital. I was fresh out of medical school, I had chosen a residency known for its mind-boggling volume, and the kids were really sick. I had hit a point where I simply couldn’t keep up with what was in front of me. I stole away into the 6th-floor stairwell in the Children’s Abercrombie building, put my face into my hands, and began to cry.
My first call night was a metaphor for my career. I had no idea at the time that the idea of simply keeping up would be a theme that would follow me through my training and into my day-to-day work.
While I can’t remember the last time I cried at the hospital, I continue to struggle with input. I work to keep up with inbound information and professional social dialog. How I handle information or how I appear to handle it defines me as a physician. Harnessing this attention crash through technology will represent a major defining moment for the next generation of physicians.
*This blog post was originally published at 33 Charts*
October 26th, 2010 by Jennifer Shine Dyer, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
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When it comes to understanding medical information, even the most sophisticated patient may not be “smarter than a fifth grader.”
In one of the largest studies of the links between health literacy and poor health outcomes, involving 14,000 patients with type 2 diabetes, researchers at the University of California San Francisco and Kaiser Permanente found that more than half the patients reported problems learning about their condition and 40 percent needed help reading medical materials. The patients with limited health literacy were 30 to 40 percent more likely to experience hypoglycemia — dangerously low blood sugar that can be caused if medications are not taken as instructed — than those with an adequate understanding of medical information.
Now, federal and state officials are pushing public health professionals, doctors, and insurers to simplify the language they use to communicate with the public in patient handouts, medical forms, and health websites. More than two-thirds of the state Medicaid agencies call for health material to be written at a reading level between the fourth and sixth grades.
A new federal program called the Health Literacy Action Plan is promoting simplified language nationwide. And some health insurers, doctors’ practices, and hospitals have begun using specialized software that scans documents looking for hard-to-understand words and phrases and suggests plain-English replacements. Read more »
October 25th, 2010 by Debra Gordon in Better Health Network, Health Policy, Opinion, Research
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I spent last week in Gothenburg, Sweden covering the European Committee for the Treatment of Multiple Sclerosis (ECTRIMS) meeting. Lots of good science, lots of excitement over the new oral and targeted therapies coming on the market to treat this awful disease. But what I want to write about isn’t the science, but about how it will play out in the brave new world of healthcare in which we all live in today.
For instance, consider the first oral therapy to hit the market: Gilenya (fingolimod), which the FDA approved in September. Last month Novartis announced the price: $48,000 a year.
This is not a rant against the high cost of drugs, however. It is a rant against the inability of our healthcare system to take the long view of the impact of such drugs, a view that is particularly important with a chronic disease like MS that strikes healthy young adults in their early 20s and 30s. Read more »
*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*
October 25th, 2010 by DavedeBronkart in Better Health Network, Health Policy, Health Tips, News, Opinion, Quackery Exposed, Research
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There’s an extraordinary new article in The Atlantic entitled “Lies, Damned Lies, and Medical Science.” It echos an excellent article in our Journal of Participatory Medicine (JoPM) a year ago by Richard W. Smith, 25-year editor of the British Medical Journal, entitled “In Search Of an Optimal Peer Review System.”
JoPM, Oct 21, 2009: “….most of what appears in peer-reviewed journals is scientifically weak.”
The Atlantic, Oct. 16, 2010: “Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong.”
JoPM 2009: “Yet peer review remains sacred, worshiped by scientists and central to the processes of science — awarding grants, publishing, and dishing out prizes.”
The Atlantic 2010: “So why are doctors — to a striking extent — still drawing upon misinformation in their everyday practice?”
Dr. Marcia Angell said something just as damning in December 2008 in the New York Review of Books: “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” (Our post on Angell is here.)
What’s an e-patient to do? How are patients supposed to research if, as all three authorities say, much of what they read is scientifically weak? Read more »
*This blog post was originally published at e-Patients.net*
