Guest post by Dr. Andrew Agwunobi, leader of the hospital performance improvement practice at Berkeley Research Group.
Four healthcare reform elements are driving hospital systems to recreate themselves through buying physician groups, attempting to dramatically improve the quality and costs of care, and merging with other hospital systems. These are 1) the new Medicare readmissions payment policy, 2) the Medicare and Medicaid payment bundling pilots, 3) Medicare’s decision to stop paying for hospital acquired conditions, and 4) the American Recovery and Reinvestment Act of 2009 (ARRA).
A fascinating recent report from the HealthLeaders about the supposed scads of errors being associated with HIT, as health systems transition to the age of electronic records. According to the report that features the results of a recent study by ECRI Institute’s Patient Safety Organization, some of the errors “are causing harm and in so many serious ways, providers are only now beginning to understand the scope.”
For example, during the 2012 study at 36 participating hospitals, computer programs truncated dosage fields leading to morphine-caused respiratory arrest; lab test and transplant surgery records sometimes didn’t talk to each other, leading to organ rejection and patient death; and an electronic systems’ misinterpretation of the time “midnight” meant an infant received antibiotics one dangerous day too late.
Dan Rodriques, CEO of Kareo, discusses entrepreneurism, healthcare IT innovation, Kareo’s move into electronic health records and the EHR hangover.
As an entrepreneur, what is your approach to leading and driving innovation?
I have always been driven, and I knew I wanted to be an entrepreneur from a young age. Each of the three companies I have started came about for the same reason. I saw a problem and I wanted to fix it. I am a problem solver at heart and that is what drives innovation for me. I launched my first company, Scour, an Internet search engine, when I was 21. At that time, there wasn’t a way to search the web for multimedia content (photos, music, and video) and we developed Scour in response to that need. I had to learn about running a company on the job. I took what I learned with me on my next endeavor, which was a consulting firm. Each client brought a unique challenge with them and we developed technology solutions to the complex problems within their businesses. It was there that I started with a client in the healthcare industry. As I worked with that client, I began to see all the challenges facing healthcare and particularly small medical practices. This was the birth of Kareo.
Guest post by Dr. Mary C. Burke, an attending physician in emergency medicine at Milford Regional Medical Center in Milford, MA.
From a health IT perspective, patient communication is broken. With more than 20 years of experience as an emergency physician, this point was driven home to me while using physical therapy to recover from a knee injury. The more I looked at information from my physical therapist and tried to remember the instructions he provided, the more I realized that this part of communication in healthcare is flawed.
I couldn’t reproduce my physical therapy exercises, and I quickly became a frustrated patient. I might have just thrown my hands up and hoped to figure it out eventually, but I wanted to be up and around on my two feet soon following a knee injury. Sound familiar? Apparently forgetting instructions and other information is pretty common and is playing out frequently in multiple scenarios. As I looked into information about understanding and remembering provider instructions, I quickly learned that this was not just my own personal experience.
If you love drama, there may be no better time than now to be in health IT. Specifically, the CommonWell Health Alliance movement – spearheaded by vendor giants Allscripts, Athenahealth, Cerner, Greenway and McKesson — to promote health information exchange.
However, as we all know, the one giant in the room not to be invited to the dance, Epic, is crying foul.
Perhaps there’s no better place for a case study on effective use of telemedicine and health IT interoperability than in my native South Dakota.
Avera Health, a network of hospitals, family care practices and specialty clinics located in South Dakota, Minnesota, Iowa and Nebraska, opened an e-care hub in fall 2012 in Sioux Falls as way to shrink care gaps in rural medicine throughout the state and across the Northern Plains. Well, So. Dak is made up of nothing but rural areas, so this is the perfect place for an experiment.
The intent is to use electronic services to help rural patients stay closer to home and to boost small-town economies, but according to The Sioux Falls Argus Leader, officials say it also is creating a model for other systems nationally and beyond.
Guest post by Dr. Jeff Livingston, board certified obstetrician and gynecologist, MacArthur OBGYN.
Recently on The Daily Show, a very interesting topic was covered — the lack of interoperability of electronic health records. This was a huge surprise to me as one would not expect the Comedy Central to cover a topic frequently discussed only by health information technology policy wonks.
During the satirical editorial, John Stewart lambasted the fact that the electronic health records from the VA system are unable to communicate with the electronic health records of the Department of Defense. He pointed out the illogic of having two large departments in the United States government having two different systems that cannot exchange information with each other.
