"What We Buy Is Garbage."

It's been said you can learn a tremendous amount from your most unhappy customers. If so, health care needs to pay attention to Dr. Paul Grundy, I.B.M.'s director of health care transformation.

"What we buy is garbage" says Dr. Grundy, expressing his vocal dissatisfaction with a system where costs and quality are totally decoupled - the former rising rapidly, the latter indeterminate.

Now, I.B.M. and UnitedHealth Group have formed a partnership in Arizona to give patients a "medical home" where care can be better coordinated. quality improved and costs reduced.

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Michael Porter On Health Care Reform

Michael Porter, writing in the New England Journal of Medicine, proposes "A Strategy For Health Care Reform - Toward A Value-Based System." His proposals are fundamental, lucid and right-on, meaning they're sure to be opposed by some parties to the debate, the so-called "Yes, but..." crowd. Most important, in my opinion, is this: "... electronic medical records will enable value improvement, but only if they support integrated care and outcome measurement. Simply automating current delivery practices will be a hugely expensive exercise in futility. Among our highest near-term priorities is to finalize and then continuously update health information technology (HIT) standards that include precise data definitions (for diagnoses and treatments, for example), an architecture for aggregating data for each patient over time and across providers, and protocols for seamless communication among systems. "Finally, consumers must become much mor

"An Affordable Fix For Modernizing Medical Records"

...from the Veterans Health Administration and Midland (TX) Memorial Hospital. I know enough about my own strengths and weaknesses to know that I'm no IT expert. But I am acutely interested in examples of people and teams thinking differently to solve long-standing, intractable problems and, for better or worse, there are lots of those to be found in the IT realm. Yesterday, it was a story about a team adding iPhone portability to MEDITECH functionality, delivering to harried physicians better access to clinical data and more productive hours in every work day. (Wow. Apple in the boardroom AND the physician lounge. Has to be an IT traditionalist's worst nightmare. But I digress...) Today, the Wall Street Journal features a story about Midland (TX) Memorial Hospital finding an affordable, open-source alternative to proprietary EMR systems : "In the push to digitize America's hospitals, Midland Memorial faced an all-too-common dilemma: a crying need for information

Are the "Apocaholics" Wrong?

Will society avoid collapse and continue prospering? Yes, thanks to the innovators among us says zoologist and Economist editor Matt Ridley in his new book "The Rational Optimist." "...with new hubs of innovation emerging elsewhere, and with ideas spreading faster than ever on the Internet, (expect) bottom-up innovators to prevail. (Ridley's) prediction for the rest of the century: “Prosperity spreads, technology progresses, poverty declines, disease retreats, fecundity falls, happiness increases, violence atrophies, freedom grows, knowledge flourishes, the environment improves and wilderness expands.” We could still screw things up. We could, for example, stifle innovation and trade while inflating the importance of restrictive bureaucracies. "Our progress is unsustainable...only if we stifle innovation and trade, the way China and other empires did in the past. Is that possible? Well, European countries are already banning technologies based on the preca

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