HEALTHY ONLINE

It’s that time of year again when Meaningful Use conversations heat up because all sorts of deadlines are approaching, and as expected, nobody is ready. Meaningful Use was originally intended to have 3 stages, each lasting two years. At the end of 2011, Meaningful Use Stage 2, which should have started in 2013, was postponed by one year and reduced to 90 days to allow vendors and providers enough time to build, deploy and implement new functionality required for Stage 2. As 2013 is drawing to a close and Stage 2 is practically upon us, a flurry of organizations is petitioning the Secretary of Health and Human Services (HHS) to delay Stage 2 just a little bit longer. The College of Healthcare Information Management Executives (CHIME) fired the first shot back in May, asking for one more 12 months extension. Later in July, the American Medical Association (AMA) and the American Hospital Association (AHA) , combined forces and jointly requested additional flexibility to be built into Sta

(Source: forgotten-ny.com ) When a doctor, a lawyer, an accountant or any other professional graduated from University, or moved to a new town, he or she would most often locate a nice little office, prepare it for the big day and hang out a shingle to let the world know that new services are available. The world back then consisted of the immediate neighborhood in the big city or an entire small town out in the country.  While waiting for the new shingle to do its thing, the new doctor would most likely join the country club, attend the pee-wee league games of his/her children, patronize local eating establishments and slowly the word of mouth would help build a new practice that would become a fixture in the community for years to come. Fast forward to 2013 when nobody strolls leisurely where shingles are not hanging any more, and doctors rarely live and raise families within walking distance of their medical practice. Word of mouth has been largely replaced by text of iPhone and the

This is a warning shot across the bow of the mighty health care ship which seems to be changing course in search of calmer waters to carry the riches stowed deep in its rusty hull. I have no arsenal to fire anything more than sporadic warning shots through the descending darkness, but this ship is now on a collision course with the American people, the 47% that Gov. Romney scoffed at and an equal number that is yet to be awakened by the ringing disaster bells. The navigation chart used by the captains of this ship, mapping an America full of dumb and gullible people, too fat and too lazy to make any sudden movements as the corroding ship sails through their bodies, is woefully incorrect. Americans may be slower than most, more forgiving than others, but sooner or later, the health care ship will have to battle the people, and it will be sank, or emerge victorious at the conclusion of the American experiment. A couple of weeks ago I wrote about Dr. Ezekiel Emanuel’s thinly veiled fury

At some point it was decided that the exchange of clinical information between facilities of care is lacking in both quantity and quality, and it was further decided that a drastic increase in frequency of such exchange will improve the health of people and the quality of care they received, while reducing costs of health care. The idea, which is almost as old as medicine itself, has been perfected by physicians over centuries of evolving documentation standards and sharing of knowledge in general. As medicine became a service provided by a bewildering array of entities in parallel and/or in sequence over one lifetime, the need for clinical information exchange increased exponentially, making this particular activity a perfect candidate for computerization in the Internet age. Since all computerized functions are better and cheaper than their manual predecessors, it was decided that the Nation must engage in sophisticated exchange of health information to the point where one’s medical

A recent survey of physicians , conducted by Tilburt and colleagues and published in JAMA, finds that most doctors support measures to improve the quality of care, but are opposed to financial schemes aimed at reducing health care utilization across the board, and physicians do not believe that the responsibility for escalating health care costs lies solely with the medical profession, with 85% opposing the denial of “ beneficial but costly services to certain patients because resources should go to other patients that need them more ”. While over three quarters of respondents reported being aware of costs of care, and agreed that discouraging use of expensive treatments with limited benefits is a good idea, 78% believe that doctors “ should be solely devoted to [their] individual patients’ best interests, even if that is expensive ”.  The vast majority of the 2556 respondents to the survey place responsibility for escalating costs of care on multiple entities, such as insurers, hospit