Questions For A Sunday Morning

Weight loss: Commercial weight-loss schemes outperform physician recommendations. Does your heart follow where your pocketbook leads? (Chicago Tribune)

Prostate surgery: Risks associated with prostate surgery are lower at academic medical centers. Does practice make, if not ‘perfect,’ at least ‘better?’ (Chicago Tribune)

Quality measures: Will your physician ‘fire’ you to meet standards for incentive-based compensation? Are you a parent who refuses to vaccinate your kids? “You’re fired!” (Advisory Board)

Disease management: Programs for Medicare patients do not improve quality, reduce costs or decrease hospital and ED visits. It’s only one study, but disappointing nevertheless. (NEJM)

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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...

gapingvoid cartoon #378

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"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 ...

Health Care Strategist

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