HEALTHY ONLINE

If this were a business concerned with bottom lines, cash flows and sustainability, this would be a good time to begin planning one of those posh executive retreats to evaluate current strategy. People would be feverishly working on pulling data for Power Point presentations, summarizing market research and deciding whether to select the vegetarian meal or not. If this were a better business, lots of little meetings would take place in preparation, and resolute department heads would be soliciting original thought from those not invited to the big executive retreat, but whose jobs are now on the line along with the department heads and maybe even the executive suite. But this is not a business and it is unclear who the executives are, or if there are any at all, so there will be no strategic retreat. There will be no retreat at all because we are witnessing the birth of a new religion, and the true faithful don’t ever retreat. Once upon a time, two three decades ago, health care busine...

While most folks are busy trying to keep up with Meaningful Use Stage 1, and Meaningful Use Stage 2 only recently emerged from the customary rulemaking process, those who plan for distant futures are providing us a glimpse of what is being considered for Meaningful Use Stage 3 and here and there a hint at the possibility of a never before mentioned Stage 4 and beyond. Since Stage 2 is still somewhat theoretical, there is little value to enumerating the proposed measures of Stage 3, which is not due to take effect until 2016, but it may prove instructive to take a general look at the overall direction that seems to be favored by policy makers for future design and use of EHR technologies. To that end, several new proposed measures seem most enlightening. The New US Census Bureau Stage 1 of Meaningful Use added language, race and ethnicity to the customary demographic information collected from patients, such as name, address, date of birth, gender, etc. Stage 2 proposes to add language...

I was headed to a meeting downtown yesterday, and finding a place to park in the city is always a challenge. Luckily, there is a little old lot right next to the office building, which is a bit more expensive and does not accept any ticket validation, but it’s very clean, well lit and convenient. Up until last year the lot was owned and operated by a “mom and pop” type of business. You pulled in, found a good spot and by the time you grabbed your stuff and stepped out of the car, an elderly gentleman was standing there writing your receipt. You gave him some cash, took the little pink receipt and went about your business. When you were done, you came back, got in your car and drove away. No automated barriers, no buttons, no credit cards and no hassles. Yesterday, my little parking lot was different. The first thing I noticed was that the parking spots were numbered, with big white digits imprinted on the freshly resurfaced asphalt. The second thing I noticed was that it was a bit hard...

Obamacare is here to stay, and with it a host of initiatives small and large, some intended and some not so much so, targeting massive transformation of the health care delivery system. One of those initiatives involves the adoption of the principles of a Patient Centered Medical Home (PCMH) for primary care as formulated by the primary care medical associations, and to a large extent, as translated into operational processes by the National Committee for Quality Assurance (NCQA). There are other implementations of the PCMH put forward by public and private organizations, but NCQA’s Medical Home recognition program is considered the gold standard for PCMH. The PCMH concept is also here to stay, and as is the case with Obamacare, the Medical Home model has its supporters, its detractors and all sorts of misconceptions and implementation missteps. If you randomly ask a primary care physician about his/her opinion on the Patient Centered Medical Home model of primary care, you will most...