HEALTHY ONLINE

Somewhere between the 20th century Bank ATM and the 25th century Tricorder, lays the EMR that we should have today. Somewhere between the government-designed Meaningful Use EMR and the Holographic doctor in Star Trek, there should be a long stretch of disposable trial-and-error cycles of technology, changing and morphing from good to better to magical. For this to happen, we must release the EMR from its balls and chains. We must release the EMR from its life sentence in the salt mines of reimbursement, and understand that EMRs cannot, and will not, and should not, be held responsible for fixing the financial and physical health of the entire nation. In other words, lighten up folks….. A patient’s medical record contains all sorts of things, most of which diminish in importance as time goes by. Roughly speaking, a medical record contains quantifiable data (numbers), Boolean data (positive/negative), images (sometimes), and lots of plain, and not so plain, English (in the US). The proli...

“Better Care for Individuals, Better Health for Populations, and Lower Per Capita Costs” [ ihi.org ] If you stop to think about the holy grail of health care reform, also known as the Triple Aim, it sounds like a grand challenge involving wizardry or wishful thinking or worse, propaganda for the masses, particularly the last part. It’s like attempting to build a better driving machine, with better fuel efficiency at lower cost. Or maybe it’s like trying to make a chocolate cake that is most scrumptious, quicker to prepare and has very few calories. Yeah, right…. You can have one of the three, and maybe two, but certainly not all three. Not that there is anything wrong with trying…. And when it comes to health care it is actually imperative that we try, and failing will have dire consequences for all but the very few who are always shielded from consequences. The Institute for Health Improvement (IHI) who introduced the Triple Aim philosophy, now adopted by the government, is also pro...