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Health IT Roundup 12/10/10

Robert S. Miller, MD, FACP, FASCO

10 Dec 2010 1:05 AM

While everyone else is learning about breast cancer in San Antonio this week, for those of us left behind in the freezing Mid-Atlantic, here are a few articles and links about health IT that I found interesting:

  1. Top 10 IT Implications of Healthcare Reform – from Life As A Healthcare CIO, blog of John Halamka, MD, Chief Information Officer of Beth Israel Deaconess Medical Center and Harvard Medical School. As expected, most revolve around how health IT will be the engine for Accountable Care Organizations (ACO’s), but IT solutions for home care to prevent hospital readmissions and patient-reported data on individual wellness and symptoms facilitated by IT may be two less obvious examples.
     
  2. The Validity of Personal Experiences in Evaluating HIT in Applied Clinical Informatics – Australian informaticist John Patrick, PhD, defends the use of testimonials in recounting unsatisfactory or negative stories of health IT, pointing out that those who reject the use of anecdotes are often individuals or institutions so heavily invested in such systems that, “they find it hard to accept the possibility of negative criticism.” He even uses the analogy of the Kubler-Ross grief model to describe the stages that workgroups burdened by poorly designed IT must suffer through. While I think that is a bit of a stretch, I would have to agree that some overly zealous defenders of all things IT too quickly dismiss the reliability of the recounting of legitimate personal experience as a way of highlighting software defects and improving poor usability of IT systems.
     
  3. HIMSS, the Healthcare Information and Management Systems Society, has an encyclopedic and free collection of resources on EHR selection and implementation and Federal Meaningful Use incentives called the Meaningful Use OneSource. It has lots of great information about standards and certification, quality reporting, privacy and security, and related items. Also, don’t miss the excellent ASCO primer on Stage I Meaningful Use measures for eligible professionals.
     
  4. Physicians vs. Health IT: The EMR Culture War – from the Wired EMR Practice blog by Dr. Michael J. Koriwchak, an otolaryngologist from Georgia. This is one of the most thoughtful and balanced essays I have ever read on this topic. Dr. Koriwchak points out that IT professionals need to recognize that physician workflows are inherently inefficient and not easily suited to automation and standardization, while physicians need to understand that the uniqueness of the doctor-patient relationship does not excuse rigidity and inflexibility.
     
  5. The President's Council of Advisors on Science and Technology (PCAST) released a report entitled “Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward.” Announced with some fanfare by HHS Secretary Kathleen Sebelius and National Healthcare Coordinator David Blumenthal at a DC press conference on December 8, the report calls for the “development and adoption of a robust information-sharing infrastructure to facilitate the exchange of data among institutions” by managing and storing data using metadata tags for the attributes and security requirements of each individual data element, similar to Extensible Markup Language (XML), which is a set of rules for encoding documents in a form understandable by a computer. Privacy controls can be user-customized since metadata are tagged to individual data elements instead of entire documents. Geeky-sounding yes, but pretty radical and insightful in my opinion. John Halamka does a much better job describing this in today's blog post than I. The whole document is worth a read, or at least check out the Executive Summary on pages 1-6.
Posted in: EHR, Practice

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Robert S. Miller, MD, FACP, FASCO