December 9th, 2009 by KevinMD in Better Health Network, Health Policy, Opinion
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Have electronic medical records made a difference in patient care?
According to a study looking at digital medical record adoption of 3,000 hospitals, electronic records have made little difference in cost or quality of care.
That’s discouraging, considering that the government is investing billions of dollars into the technology.
Very few physicians use electronic record systems effectively. For instance, many are simply scanning paper records into a computer, which provides minimal benefit. It’s difficult to track quality improvement data doing that. The problem is further compounded by the archaic interfaces that the current generation of EMRs have, which is akin to a user interface circa Windows 95.
It’s no wonder that most doctors find electronic medical systems actually slows them down. The next generation of systems needs to focus on facilitating the doctor-patient encounter, rather than being an impediment. Taking a few lessons from Google, and improving the user interface would be a good start.
Only then can EMRs realize the potential relied upon by the government and health reformers.
*This blog post was originally published at KevinMD.com*
December 4th, 2009 by Dr. Val Jones in Opinion
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As I sit here in a medical innovation conference – I find myself becoming more and more angered by one of the speakers. A man with an MBA and fancy title from PriceWaterhouseCoopers is lecturing us about how doctors are essentially money-grubbing, change-resistant, quality-care avoiding “pains in the you-know-what,” obstructing progress in healthcare reform and blocking technology adoption.
His lack of understanding of the complexity of medical care was breathtaking. And yet, he expresses a sentiment that I’ve witnessed all too many times. Here are a few choice quotations: Read more »
December 2nd, 2009 by Happy Hospitalist in Better Health Network, Health Policy, Opinion, True Stories
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It’s official. Happy has now earned his CMS physician pay for performance PQRI Bonus for 2008, a direct deposit into Happy’s bank account. PQRI stands for Physician Quality Reporting Initiative. How much was my PQRI Medicare pay for performance bonus for calendar year 2008? A $2,500 check written out directly to Happy by the Medicare National Bank. CMS gives a wonderful overview of the history of PQRI . PQRI is the Medicare pay for performance program for physicians that was initiated by Congressional mandate in the latter half of 2007. Doctors have an opportunity to earn back 2% of their gross Medicare collections (which the government calls a bonus but which I call legalized theft) by submitting a grotesque amount of quality performance paper work to the Medicare National Bank. It’s one giant PQRI guideline game.
PQRI reporting is currently voluntary, but legislation in future years will certainly mandate reductions in payment for not submitting data, all but making this program a punitive standard. Many physicians failed to meet the requirements to get paid under CMS pay for performance program guidelines in the latter half of 2007, the first year for PQRI measures. Read more »
*This blog post was originally published at The Happy Hospitalist Blog*
November 8th, 2009 by Richard Cooper, M.D. in Better Health Network, Opinion
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Is poverty the major factor underlying geographic variation in health care? It assuredly is. There is abundant evidence that poverty is strongly associated with poor health status, greater per capita health care spending, more hospital readmissions and poorer outcomes. It is the single strongest factor in variation in health care and the single greatest contributor to “excess” health care spending. It should be the focus of health care reform but, sadly, many provisions in the current bills will worsen the problem.
Much of this is discussed elsewhere on this blog and in our recent “Report to The President and The Congress.” In this posting, I would simply like to tap into your common sense. We all know that poverty is geographic. There are wealthy neighborhoods and impoverished ones, rich states and poor ones, developed countries and developing ones. Sometimes poverty is regional, as in Mississippi, but sometimes it’s confined to “poverty ghettos,” as in the South Bronx. Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
November 4th, 2009 by Happy Hospitalist in Better Health Network, True Stories
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When a patient comes in with an infection related diagnoses, efforts are often undertaken to keep that pathogen from spreading to other patient rooms. In British hospitals they’ve banned ties and long sleeves. At Happy’s hospital we place a dedicated stethoscope in the patient’s room which is then shared by all health care workers caring for the patient. And that stethoscope shall remain forever in that patient’s room.
At Happy’s hospital, the dedicated stethoscopes look like they were made in a Chinese toy factory. Read more »
*This blog post was originally published at A Happy Hospitalist*
