Showing posts with label IT. Show all posts
Showing posts with label IT. Show all posts
Saturday, October 24, 2009
Electronic medical records systems are not classified as medical devices -- This may have serious consequences.
This is an interim post. The promised post on ontologies that benefit from fuzzy or probability-based logic is coming.
"We wouldn't want to go back, but Electronic Health Records (EHR) are still in need of significant improvement."
-Christine Sinsky, an internist in Dubuque, Iowa, whose practice implemented electronic records six years ago.
More than one in five hospital medication errors reported last year -- 27,969 out of 133,662 -- were caused at least partly by computers, according to data submitted by 379 hospitals to Quantros Inc., a health-care information company. Paper-based errors have caused 10,954 errors, the data showed.
Between 2006 and 2008, computer errors also contributed to 31 deaths or serious injuries -- twice as many as were caused by paper errors, although numbers of these serious cases were decreasing, Quantros said.
Legal experts say it is impossible to know how often health IT mishaps occur. Electronic medical records are not classified as medical devices, so hospitals are not required to report problems. In fact, many health IT contracts do not allow hospitals to discuss computer flaws, according to Sharona Hoffman, a professor of law and bioethics at Case Western Reserve University in Cleveland.
"Doctors who report problems can lose their jobs," Hoffman said. "Hospitals don't have any incentive to do so and may be in breach of contract if they do. That sort of secrecy puts the patient at risk."
Click here to see the complete Washington Post article
Friday, June 19, 2009
National Politics, The American Medical Association, Healthcare and IT Funding
In Wednesday's post, I expressed the belief that national politics could have an impact upon the architecture of the upcoming IT-based EHR system. These politics cannot be ignored, I opined, when it comes to the distribution of funds under the HITECH Act (the health IT component of the American Recovery & Reinvestment Act). This rationale is rooted in history.
Twenty years ago this week, I.F. Stone died at the age of eighty-one. He was the premier investigative reporter of the twentieth century, a self-described radical journalist.
The late ABC news anchor, Peter Jennings, paid tribute to I.F. Stone on his evening newscast the day after his death, June 18, 1989.
People may not remember that Meet the Press was originally a radio program before it became a TV program. And when Meet the Press started in the mid-’40s, I.F. Stone was one of the regular panelists on the radio program. He was also one of the regular panelists on the TV program.
He was a very well-known journalist, the sort of person you would expect to see on one of today’s Sunday chat shows.
In December 1949, on Meet the Press, the person he was interviewing was a guy called Dr. Morris Fishbein. Now, in the ’40s, Morris Fishbein was the most famous doctor in America. He was the editor of The Journal of the American Medical Association (an article from which I linked to in my May 13 post), and he was the person that the medical and pharmaceutical industries put up to oppose socialized medicine or a national health insurance. He was the person who coined the phrase “socialized medicine” as a means of discrediting national health insurance.
Fishbein had described the proposals for national health insurance as a step on the road to communism. And so, Stone said to him, “Dr. Fishbein, given that President Truman has already spoken out in favor of national health insurance, do you think that that makes him a dangerous communist or just a deluded fellow traveler?”
I.F. Stone continued by saying that the aircraft industry, at the beginning of the Second World War, was producing about 500 planes a year. And President Roosevelt said that in order to defeat Hitler, they need to produce 500 planes a day. And basically, Stone pointed out that the aircraft industry had this huge backlog. It didn’t suit them to expand production. They wanted to keep things the way they were. They had a monopoly, just like pharmaceutical companies might have today. So Truman knew that some things are too important to be left to private enterprise, and he felt that healthcare was one of them.
But what’s interesting about this argument that Stone was having with Fishbein is two things: first, that that was the last time I.F. Stone was ever on Meet the Press, and secondly, that he wasn’t again allowed to be on national television for eighteen years.
Footnote: Earlier this week, the American Medical Association (AMA) announced that it was "letting Congress know" that it would resist a public plan for health insurance coverage.
Politically, the revelation could be a significant blow to progressive health care reform advocates, who contend that a public option is the best way to reduce costs and increase insurance coverage. The AMA has the institutional resources and the prestige to impact debates in the halls of Congress.
Twenty years ago this week, I.F. Stone died at the age of eighty-one. He was the premier investigative reporter of the twentieth century, a self-described radical journalist.
The late ABC news anchor, Peter Jennings, paid tribute to I.F. Stone on his evening newscast the day after his death, June 18, 1989.
People may not remember that Meet the Press was originally a radio program before it became a TV program. And when Meet the Press started in the mid-’40s, I.F. Stone was one of the regular panelists on the radio program. He was also one of the regular panelists on the TV program.
He was a very well-known journalist, the sort of person you would expect to see on one of today’s Sunday chat shows.
In December 1949, on Meet the Press, the person he was interviewing was a guy called Dr. Morris Fishbein. Now, in the ’40s, Morris Fishbein was the most famous doctor in America. He was the editor of The Journal of the American Medical Association (an article from which I linked to in my May 13 post), and he was the person that the medical and pharmaceutical industries put up to oppose socialized medicine or a national health insurance. He was the person who coined the phrase “socialized medicine” as a means of discrediting national health insurance.
Fishbein had described the proposals for national health insurance as a step on the road to communism. And so, Stone said to him, “Dr. Fishbein, given that President Truman has already spoken out in favor of national health insurance, do you think that that makes him a dangerous communist or just a deluded fellow traveler?”
I.F. Stone continued by saying that the aircraft industry, at the beginning of the Second World War, was producing about 500 planes a year. And President Roosevelt said that in order to defeat Hitler, they need to produce 500 planes a day. And basically, Stone pointed out that the aircraft industry had this huge backlog. It didn’t suit them to expand production. They wanted to keep things the way they were. They had a monopoly, just like pharmaceutical companies might have today. So Truman knew that some things are too important to be left to private enterprise, and he felt that healthcare was one of them.
But what’s interesting about this argument that Stone was having with Fishbein is two things: first, that that was the last time I.F. Stone was ever on Meet the Press, and secondly, that he wasn’t again allowed to be on national television for eighteen years.
Footnote: Earlier this week, the American Medical Association (AMA) announced that it was "letting Congress know" that it would resist a public plan for health insurance coverage.
Politically, the revelation could be a significant blow to progressive health care reform advocates, who contend that a public option is the best way to reduce costs and increase insurance coverage. The AMA has the institutional resources and the prestige to impact debates in the halls of Congress.
Saturday, June 13, 2009
Electronic Health Records (EHR) - Interoperability of Disparate Systems
As suggested in the figure below, there are technical, semantic, organizational, political and economic matters to consider when deciding how to move data and/or exert operations from one place to another. These challenges are present in the recently reinvigorated campaign to adopt and exchange electronic health records.
On February 17, 2009, President Barack Obama signed into law the American Recovery & Reinvestment Act (ARRA). The health IT component of the Bill is the HITECH Act, which appropriates a net $19.5 billion dollars to encourage healthcare organizations to adopt and effectively utilize Electronic Health Records (EHR) and establish health information exchange networks at a regional level, all while ensuring that the systems deployed protect and safeguard the critical patient data at the core of the system.
There are two portions of the HITECH Act -- one providing $2 billion immediately to the Department of Health & Human Services (HHS) and its sub-agency, the Office of the National Coordinator for Health IT (ONC), and directs creation of standards and policy committees; a second that allocates $36 billion that will be paid to healthcare providers who demonstrate use of Electronic Health Records.
The government is focused on two primary goals in this legislation: moving physicians who have been slow to adopt Electronic Health Records to a computerized environment, and ensuring that patient data no longer sits in silos within individual provider organizations but instead is actively and securely exchanged between healthcare professionals. Therefore, the vast majority of the funds within the HITECH Act are assigned to payments that will reward physicians and hospitals for effectively using a robust, connected EHR system.
In short, a great deal of largely-Government-funded IT work is about to be undertaken to enable often-disparate healthcare recordkeeping systems to interoperate. In the next few posts, I will address a number of the issues that need to be considered when planning such projects.
On February 17, 2009, President Barack Obama signed into law the American Recovery & Reinvestment Act (ARRA). The health IT component of the Bill is the HITECH Act, which appropriates a net $19.5 billion dollars to encourage healthcare organizations to adopt and effectively utilize Electronic Health Records (EHR) and establish health information exchange networks at a regional level, all while ensuring that the systems deployed protect and safeguard the critical patient data at the core of the system.
There are two portions of the HITECH Act -- one providing $2 billion immediately to the Department of Health & Human Services (HHS) and its sub-agency, the Office of the National Coordinator for Health IT (ONC), and directs creation of standards and policy committees; a second that allocates $36 billion that will be paid to healthcare providers who demonstrate use of Electronic Health Records.
The government is focused on two primary goals in this legislation: moving physicians who have been slow to adopt Electronic Health Records to a computerized environment, and ensuring that patient data no longer sits in silos within individual provider organizations but instead is actively and securely exchanged between healthcare professionals. Therefore, the vast majority of the funds within the HITECH Act are assigned to payments that will reward physicians and hospitals for effectively using a robust, connected EHR system.
In short, a great deal of largely-Government-funded IT work is about to be undertaken to enable often-disparate healthcare recordkeeping systems to interoperate. In the next few posts, I will address a number of the issues that need to be considered when planning such projects.
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