November 16th, 2010 by DavedeBronkart in Better Health Network, Health Policy, News, Opinion
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Last Friday the board of the American Medical Informatics Association (AMIA) published a position paper in its journal saying that the “hold harmless” clause is unethical. One of the paper’s authors is Dr. Danny Sands, currently President of the Society for Participatory Medicine. I hope to write more about it this week, after attending the AMIA conference in DC, but here’s the basic issue:
— For ages, makers of electronic medical record systems (EMR) have insisted on a “hold harmless” clause in the contracts a system buyer must sign. It says, in essence, that if any harm comes to anyone because of a system problem, the buyer (the hospital) will hold the manufacturer harmless.
— In other words, if anything goes wrong with the system and someone gets hurt, it’s not the manufacturer’s fault. The reasoning has been: “Hey, you doctors are smart. If our system displays a wrong value, you’re supposed to notice it.”
I’m told this policy has been one big impediment to adoption of EMR systems, because it removes all motivation for vendors to fix things that make their product hard to use: If there’s a bug or the system slows someone down, and a patient gets hurt, the hospital gets sued, not the vendor.
If you were a hospital, wouldn’t that make you eager to buy? What would that do to your trust of the vendor? Patients, how do you feel about that? Providers? Read more »
*This blog post was originally published at e-Patients.net*
August 25th, 2010 by DrRob in Better Health Network, Health Policy, Opinion, True Stories
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My recent post on the subject of email from patients raised more eyebrows than I expected. It also put me in a position I’m unfamiliar with: Looking like a luddite.
Perhaps I’m not forward-thinking enough in my reluctance to embrace this advance. Perhaps I’ve gotten conservative as I’ve grown grey. Electronic communication is a great idea (I’m doing it right now), so why not apply it to my medical practice? Has Ned Lud gotten into my circle of influence?
This is, of course, extremely ironic. I lived so much on the cutting edge that my butt developed calluses. The calluses, however, were not just put there by the edge, they also came from occasional kicking.
The problem is I have an addiction: I’m addicted to change. I’m constantly looking for new and perhaps better ways to do things, then impatiently going after anything new and shiny. This served us well in the sense that I got us on EMR, got it working well, and have continued to keep us away from repeating mistakes too often. If something doesn’t work, I’m quick to look for the cause, and more importantly, how to fix it. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
August 16th, 2010 by DavidHarlow in Better Health Network, Health Policy, News, Opinion
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The Queen of Soul famously wailed about being a link in a “chain of fools.” The lead story in the August 13th Boston Globe tells us about another sort of link in the chain — the weakest link in the chain of custody of patient records.
In brief, a pathology billing service bought out by another service apparently dumped all records more than a year old in a town dump. A Globe photographer taking out his own trash noticed that the paper records (which he was looking at because he thought they ought to be recycled rather than dumped) had identifiable patient data and represented at least four hospitals from across Eastern Massachusetts. Clearly, these records ought to have been shredded or otherwise destroyed before disposal. Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
July 19th, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion
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One doesn’t usually look to the Federal Register to define meaning or purpose (philosophers, yes, but bureaucrats?), but the federal government has officially ruled on what constitutes “meaningful use” — for the purposes of distributing dollars to clinicians for electronic health records.
The Wall Street Journal’s health blog has an excellent synopsis of the rule and the reaction from different interest groups and experts, and the New England Journal of Medicine has a very clear explanation and summary of its key elements by David Blumenthal, M.D., F.A.C.P., the federal government’s coordinator of health information technology. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
June 15th, 2010 by DrRob in Better Health Network, Health Policy, Opinion
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Quiz: What does the term “meaningful use” mean?
A. Using something in a way that gives life purpose and leads to carefree days of glee.
B. It depends on your definition of the word “term.”
C. It’s not mean. It’s really nice.
D. A large number of rules created by the government to assess a practice’s use of electronic medical records (EMRs) so that they can spur adoption, give criteria for incentive rewards, and have physicians in a place where care can be measured.
E. Job security for those making money off of health IT.
The answer, of course, is D and E. Read more »
*This blog post was originally published at Musings of a Distractible Mind*