The Health Care Blog

The Myth of Prevention and EHR’s?

By SCOTT SHREEVE I was just referred this article which I found to be thoughtfully crafted. Abraham Verghese is a Professor and Senior Associate Chair for the Theory and Practice of Medicine at Stanford University. I found the article interesting,...
June 30, 2009 in Electronic Medical Records, PHRs, Physicians | Permalink | Comments (10)

How Relevant is the American Medical Association?

By RAHUL PARIKH, MD Like most doctors, I was busy seeing a full schedule of patients when President Obama addressed members of the American Medical Association at their annual meeting in Chicago. The speech was billed as a crucial confrontation...
June 20, 2009 in Obama administration, Physicians, Policy/Politics, Reform | Permalink | Comments (18)

The Story of Dr. Sidney R. Garfield

By JON STEWART “It’s about time,” declares Jay Crosson, MD, a recently retired physician executive at Kaiser Permanente, in his foreword to The Story of Sidney R. Garfield – The Visionary Who Turned Sick Care into Health Care (Permanente Press,...
June 13, 2009 in Physicians | Permalink | Comments (3)

Op-Ed: How I've Missed the AMA....

By Matthew Holt Over at Dr Val’s Get Better Health site Evan Falchuk from Best Doctors is very grumpy about Steve Pearlstein’s column in the WaPo. Pearlstein rewrites Gawande’s rewrite of Shannon Brownlee’s Overtreated. Not much surprise here—everyone is doing...
June 13, 2009 in Matthew Holt, Physicians, Policy, Policy/Politics | Permalink | Comments (17)

Data-Driven Health Care: An Interview with Jerry Reeves, MD

An under-the-radar debate is occurring in health care between those who say data shows that practice variations across the land are “unwarranted” and those who maintain that such variation is inevitable given socioeconomic population differences and cost of practice differences...
June 8, 2009 in Dartmouth Atlas, Economics, evidenced-based medicine, Health Plans, Obama administration, Patient Safety, Physicians, Policy/Politics, primary care, Quality, The Industry, Transparency | Permalink | Comments (17)

Beyond Wikipedia

By NAOMI FREUNDLICH No surprise, these days more and more doctors are searching online for medical information. What is surprising, however, is that in a recent study, nearly 50% of physicians indicated that they use Wikipedia—the open-access encyclopedia that allows...
May 23, 2009 in Physicians, Technology | Permalink | Comments (19)

Op-Ed: The True Measures of a “Good Doctor”

By CHRISTOPHER J. WHITE, MD, FSCAI Measuring patient outcomes is one way to determine how “good” a doctor is – but it is far from the only way. In our obsession with measuring performance, we seem to have forgotten that....
May 20, 2009 in Physicians | Permalink | Comments (17)

Mayo & Microsoft--a big name collaboration, with even more potential to come

By Matthew Holt Mayo Clinic and Microsoft are today launching a combined product called the Mayo Clinic Health Manager (and they’ll be showing it Thursday 23rd at the Health 2.0 Meets Ix conference). What this product does is essentially combine...
April 21, 2009 in Physicians, Technology | Permalink | Comments (7)

Following the Science To A New Era In Medicine

By WILLIAM BESTERMANN, MD "The current care systems cannot do the job. Trying harder will not work. Changing systems of care will." Crossing the Quality Chasm, Institute of Medicine, 2001 Medical leadership in the United States has not yet come...
April 20, 2009 in evidenced-based medicine, Physicians, prevention, primary care, Quality, The Industry | Permalink | Comments (4)

Five Recommendations for an ONC Head Who Understands Health IT Innovation

By David C. Kibbe, Brian Klepper and John Moore. Now that the legislative language of the HITECH Act -- the $20 billion health IT allocation within the economic stimulus package -- has been set, it's time to identify a National...
March 6, 2009 in Brian Klepper, Current Affairs, David Kibbe, Electronic Medical Records, evidenced-based medicine, Health 2.0, Physicians, Policy, Policy/Politics, primary care, public health, Quality, reform, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (14)

Google Health sharing--simple but potentially important

By Matthew Holt Today late afternoon PST Google flipped the switch on an important change/add to Google Health. Recently they’ve been adding more and more little features, such as printing & graphing, and in the last month getting CVS retail...
March 4, 2009 in Consumers, e-patients, Electronic Medical Records, Google, Health 2.0, Matthew Holt, Physicians, Technology | Permalink | Comments (11)

Frances Dare explains HITECH, really well

By Matthew Holt Frances Dare from Cisco is a buddy of mine who has more and more been their student of what's going on in Washington. Given that we just saw the biggest piece of health care IT legislation ever...
March 4, 2009 in Electronic Medical Records, Health 2.0, Matthew Holt, Physicians, Podcasts, Policy, Policy/Politics, Technology | Permalink | Comments (0)

Getting "the CCHIT question" wrong

By Matthew Holt There’s been a lot of blather from one commenter (who may or may not be a front for a group of malcontents) on the WSJ Health Blog and lots of other blogs about CCHIT and whether it...
February 24, 2009 in Electronic Medical Records, Health 2.0, Matthew Holt, Physicians, Policy, Policy/Politics, Technology | Permalink | Comments (8)

Podcast: Blues VC fund invests in Phreesia

By MATTHEW HOLT I’ve been following Phreesia since it was two guys in an apartment trying to figure out how to make the patient check-in at the doctors office a better and more useful experience. Today they announced an $11m...
February 17, 2009 in Consumers, Health 2.0, Physicians, Technology | Permalink | Comments (7)

Dr. George Lundberg for Surgeon General

By Brian Klepper The report that Mr. Obama's Surgeon General choice might be neurosurgeon and CNN medical correspondent Dr. Sanjay Gupta produced an upwelling of strong opinion, particularly in the medical community. Some argued that Dr. Gupta has clearly demonstrated...
January 25, 2009 in Brian Klepper, Current Affairs, JAMA, Physicians, Policy/Politics, public health, reform, The Industry, Transparency | Permalink | Comments (17)

Rationing -- how will it be spun?

By Sarah Arnquist The House of Representatives' $825-billion stimulus package proposed last week included $1.1 billion to fund comparative effectiveness research -- research that evaluates two or more medical technologies or treatments to see which is most effective. This is...
January 23, 2009 in Obama administration, Physicians, Policy/Politics, reform | Permalink | Comments (11)

Five "Shovel-Ready" Health Care Reforms

By Brian Klepper & David C. Kibbe Microsoft Health Vault's leader Peter Neupert has a wonderful blog post that makes two important points really well. One message is that health care reform is about the outcomes, not the technology. We...
January 21, 2009 in Brian Klepper, David Kibbe, evidenced-based medicine, Health Plans, Marketplace, Obama administration, Physicians, Policy, Policy/Politics, primary care, Quality, reform, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (18)

As Medical Tourism Grows, Hold On We're In For a Wild Ride

By Bob Wachter Until now, medical tourism has been a curiosity, iconic “Wow, Look How Flat the World Is Becoming,” fodder for stories on 60 Minutes. But as health insurers and employers get into the act, get ready for some...
January 17, 2009 in Bob Wachter, Health Plans, International, Physicians, The Industry | Permalink | Comments (24)

Confessions of a Cultural Anthropologist: The Cause and Cure of High Health Costs

By Richard Reece Today’s medical students are being inducted into a culture in which their profession is seen increasingly in financial terms. Add in such pressures as the need to pay off enormous debts, and it is not surprising that...
January 13, 2009 in Marketplace, Physicians, primary care, Quality, Technology, The Industry, Web/Tech | Permalink | Comments (13)

The Connected Medical Home: Health 2.0 Says "Hello" to the Medical Home Model

By David Kibbe & Joe Kvedar The concept of participatory medicine is taking hold, fueled, at least in part, by what we see as two complementary forces, these being the patient-centered medical home (PCMH) and Health 2.0. Health 2.0 is...
December 22, 2008 in Electronic Medical Records, Health 2.0, Physicians, Policy/Politics, Technology | Permalink | Comments (17)

Washington, Please don't bail out the health care industry

By Rick Peters A health care Marshall Plan -- $50 Billion stimulus to get electronic health records (EHRs) in every doctor’s hands or $50,000 to each physician -– what an incredible marketing job. Detroit, are you listening? Stop whining to...
December 19, 2008 in Economics, Electronic Medical Records, Obama administration, Physicians, Policy, Quality, Technology | Permalink | Comments (41)

An Open Letter to the Obama Health Team

By David C. Kibbe & Brian Klepper It seems likely that the Obama administration and Congress will spend a significant amount on health IT by attaching it as a first-order priority to the fiscal stimulus package. We take the President-elect...
December 19, 2008 in Obama administration, Physicians, Technology, The Industry, Web/Tech | Permalink | Comments (47)

Jack says cover the uninsured & spend less!

By Matthew Holt It’s no secret what the Dartmouth group’s solution for the health care system has been — reduce practice variation, get surgery and physician resource use rates similar to the Mayo Clinics' of the world, and take the...
December 18, 2008 in evidenced-based medicine, Health Plans, Physicians, Policy, Policy/Politics | Permalink | Comments (5)

The Hospitalist as Bed Czar: Indispensability, But At What Cost?

By Bob Wachter In last week’s Annals of Internal Medicine, Eric Howell and colleagues describe an innovative experiment in which the hospitalists at Johns Hopkins Bayview became the institution’s bed czars. It worked. So should my program and yours take...
December 18, 2008 in Hospitals, Nursing, Physicians | Permalink | Comments (0)

Low tech ways to improve patient care: sleep and manners

By Michael Miller, MD A few recent reports point to ways for improving the quality of physician delivered care that has little to do with technology or complex interventions. The first involves how physicians interact with patients, and the second...
December 17, 2008 in Patient Safety, Physicians, Quality | Permalink | Comments (2)

EMR use: on the steep part of the S curve, or being replaced by a new idea?

By Matthew Holt Ten plus years ago, I was giving talks suggesting that at some point relatively soon the EMR was going to become a reality. In 1999, at Harris Interactive I actually got the chance to launch a study...
December 14, 2008 in Electronic Medical Records, Health 2.0, Matthew Holt, Physicians, Technology | Permalink | Comments (14)

The Medical Home Bandwagon and the One-Hoss Shay: Expectations and Assumptions

By RICHARD REECE, MD Have you heard of the wonderful one-hoss shay that was built in such a wonderful way? Logic is logic. That’s all I say. Now in building of a chaise, I tell you there is always somewhere...
December 10, 2008 in Electronic Medical Records, Physicians, Policy/Politics, primary care | Permalink | Comments (11)

Transforming medicine and saving lives

By Sarah Arnquist This week, Don Berwick will announce the results of the 5 Million Lives Campaign before thousands of people in Nashville attending the National Forum on Quality Improvement in Health Care. Twenty years ago, it was almost heretical...
December 9, 2008 in Electronic Medical Records, Hospitals, Patient Safety, Physicians, public health, Quality | Permalink | Comments (5)

Resident Duty Hours and Patient Safety: Did The IOM Get It Right?

By Bob Wachter The Institute of Medicine just released its long-awaited report on trainee duty hours. It is well researched and balanced, and its recommendations appropriately reflect what we know vs. what we believe. Now the fun begins. Let’s start...
December 9, 2008 in Bob Wachter, Hospitals, Patient Safety, Physicians, Quality | Permalink | Comments (1)

Confessions of a Physician EMR Champion

By David Kibbe Starting this month and continuing for the next year or so, I'll be presenting a standard talk to physician audiences entitled "Confessions of a Physician EMR Champion," subtitled "A Conversation with American Physicians About How to Save...
December 8, 2008 in Electronic Medical Records, Physicians, Policy, Technology | Permalink | Comments (101)

Who Will Speak for Independent Physicians at the Reform Table?

By Richard Reece Talk to the chief executives of American’s prominent health –care institutions, and you might be surprised what you hear: When it comes to medical care, the United States isn’t getting its money’s worth…A high-performance 21st century health...
December 4, 2008 in Physicians, reform | Permalink | Comments (15)

Embracing palliative care as mainstream medicine

By Bob Wachter I’m on clinical service now and my patients are dying left and right. And I’ve never been prouder of my own care, and that delivered by my colleagues and hospital. When I was in training, a patient’s...
November 30, 2008 in Hospitals, Physicians, Quality | Permalink | Comments (11)

Rethinking compassion in medicine

By Michael Miller Two recent events made me think about how traditional medical care and medical education address the issue of compassion. The first was at the annual dinner for the Kenneth B. Schwartz Center when they gave out their...
November 26, 2008 in Physicians, Quality | Permalink | Comments (5)

MD Rating Sites: Current State of the Space and Future Prospects

By Ruth Given Ruth Given has spent the last few months doing an exhaustive study of the physician ratings business. Ruth is an independent health economist and consultant who has in the past worked for Kaiser, the California Medical Association...
November 10, 2008 in Health 2.0, Physicians, Technology | Permalink | Comments (18)

Daniel Palestrant, CEO, Sermo at Health 2.0

By Matthew Holt Sermo has very quickly become the big Kahuna in the physician social network space. So big in fact that its rivals trumpet how different they are from it in their models and approach. Yet it was only...
November 7, 2008 in Health 2.0, Physicians, Technology | Permalink | Comments (0)

Can Health Plans Explain Why They Aren't Re-Empowering Primary Care?

By Brian Klepper & David Kibbe Sometimes a whisper is more powerful than a shout. Here's a cartoon from Modern Medicine that shows a Medical Home counseling session between a primary care physician (PCP), a specialist and the health plan....
October 30, 2008 in Brian Klepper, Economics, Physicians, prevention, primary care, The Industry | Permalink | Comments (29)

Shout out to Adam Singer, physician entrepreneur of the year

By Bob Wachter Modern Physician just named Adam Singer, the founder of IPC -- The Hospitalist Company, its first annual Physician Entrepreneur of the Year. Adam and I don’t always see eye to eye, but I want to congratulate him...
October 7, 2008 in Bob Wachter, Physicians, Technology | Permalink | Comments (1)

EMR implementation -- a saving grace or year of hell?

By Shahid Shah A friend of mine sent me this link - "Beware of the EMR ‘Ponzi scheme,’ warns physician leader" — earlier this week. The article starts off by saying: Healthcare IT does not necessarily make life easier for...
October 6, 2008 in Electronic Medical Records, Physicians, Technology | Permalink | Comments (2)

Reader mail: EMR advice from an IT insider

By THCB Staff JD's comment on a recent post was so excellent it deserved re-running. Large medical systems generally have implemented EMRs while small, independent practices have not. It's not a government or socialism thing. That 13% EMR penetration statistic...
October 6, 2008 in Electronic Medical Records, Physicians, Technology | Permalink | Comments (5)

KevinMD turns into raving socialist...

By Matthew Holt Well not quite, but in his op-ed at USA Today Kevin talks about why it’s a problem for the US not to have wide deployment of EMRs, and notes that it’s the wrong incentives that are to...
October 1, 2008 in Electronic Medical Records, Physicians, Policy | Permalink | Comments (6)

Do gamers make better surgeons?

By Sean Neill Something I had not seen before coming to the U.S. was robotic surgery, even though some UK centres do offer it. Leonardo da Vinci has had many attributes associated with his name, but what would he think...
October 1, 2008 in Physicians, Technology | Permalink | Comments (1)

Busines ties and MRIs -- it's not rocket science

By Sarah Arnquist The Health and Human Secretary Inspector General's office concluded last week that doctors are likely to order more MRIs if they have business ties with the imaging provider. Shocking, isn't it? Modern Healthcare reports that inspector general's...
October 1, 2008 in Economics, Physicians, Policy | Permalink | Comments (2)

Wonder if your doctor is laughing at you?

By Sarah Arnquist That CNN headline grabbed my attention and got me to read a column that basically chastises the 17 percent of internal medicine residents who reported they had laughed at patient in a survey published in JAMA. The...
September 12, 2008 in Hospitals, Physicians, Quality, Sarah Arnquist | Permalink | Comments (3)

The never ending stent-bypass debate

By Charlie Baker A new study - a big one ($50 MM) - was recently released that compared the short and long term effects of drug eluding stents to bypass surgery for patients with serious heart disease. The headlines --...
September 10, 2008 in Charlie Baker, evidenced-based medicine, Physicians | Permalink | Comments (2)

Making medical school more affordable

By Maggie Mahar Maggie Mahar is an award winning journalist and author. A frequent contributor to THCB, her work has appeared in the New York Times, Barron's and Institutional Investor. She is the author of Money-Driven medicine: The Real Reason...
September 10, 2008 in Maggie Mahar, Physicians | Permalink | Comments (4)

Do membership practices offer privileges or just reserved for the privileged?

By Scott Shreeve I have watched the meteoric rise of popular term “Medical Home.” While I personally dislike this phrase, it has caught on in the popular vernacular and looks like it is here to stay. In conjunction with the...
September 2, 2008 in Consumers, Physicians, Scott Shreeve, The Industry | Permalink | Comments (3)

Keep tabs on your digital footprint

By Susannah Fox Is it "disordered" behavior to Google your doctor? An article in JAMA suggests that doctors should be on their guard. The Journal of the American Medical Association recently published an article about how doctors should be aware...
September 1, 2008 in Consumers, e-patients, Physicians, Susannah Fox, Web/Tech | Permalink | Comments (0)

Hello Health open for business

By Matthew Holt Hello Health, the clinic that Jay Parkinson has been promoting for a while, is open for business. If all the patients are as happy as the first patient, success is assured! The deal is that they’ve gone...
August 25, 2008 in Concierge medicine, e-patients, Electronic Medical Records, Health 2.0, Physicians, primary care, Technology | Permalink | Comments (13)

A few socialist musings for Monday

By Matthew Holt I just watched the closing ceremony of the Olympics, and the word is that state sponsorship of little known or cared about sports like swimming, gymnastics and cycling gets more medals and so should be encouraged. Bob...
August 25, 2008 in Economics, Matthew Holt, Physicians, Policy, Policy/Politics | Permalink | Comments (1)

On Rural Doctoring: The Landscape

By Theresa Chan This is the first part of a series that first appeared on the blog Rural Doctoring, where Theresa Chan writes about her experience working as a family physician and hospitalist in a rural Northern California community. I've...
August 20, 2008 in Physicians, primary care | Permalink | Comments (2)