Tag: "health IT"

More Bad News for Health IT

Despite high marginal products, the potential benefits from expanded IT adoption are modest. Over the span of our data, health IT inputs increased by more than 210% and contributed about 6% to the increase in value-added. Virtually all the increase in value-added is attributable to the increased use of inputs – there was little change in hospital multi-factor productivity. Not-for-profits invested more heavily and differently in IT than for-profit hospitals. Finally, we find no evidence of labor complementarities or network externalities from health IT.

Full NBER study by Jinhyung Lee, Jeffery S. McCullough and Robert J. Town.

May 04, 2012 | 3 comments | by

Can Computers Replace Doctors?

They are already reading Pap smears:

Pap-screening computer, the BD FocalPoint GS Imaging System, is a marvel of medical engineering. The machine’s image-searching software rapidly scans slides in search of more than 100 visual signs of abnormal cells. It then ranks the slides according to the likelihood they contain disease, and it identifies 10 areas on each slide for a human to scrutinize…. In one study, doctors and technicians working without the robot detected 79.2 percent of abnormal slides; with the robot, 85.8 percent of abnormal slides were found…  Working manually, a cytotechnologist can analyze about 80 to 90 slides a day (regulations set the maximum at 100 per day). Using the FocalPoint, a human examiner can go through 170 slides per day.

And there is more:

In addition to Pap tests, computers are now routinely used by radiologists to analyze mammograms, and a range of similar technologies could upend the way pathologists and radiologists screen for many other ailments. So far, machines have proved useful in detecting abnormalities on images of the colon, the chest, and coronary arteries, and they may soon help doctors analyze prostate and breast biopsies.

Full Slate article here. HT: Ezra

Oct 05, 2011 | 8 comments | by

British EMR Experiment Ends in Failure

While the Obama administration is in the process of spending billions on developing electronic medical records, the British government has concluded that its £12.7 billion national electronic medical records system is a failure and that “there can be no confidence that the programme has delivered or can be delivered as originally conceived.” The Telegraph reports that Andrew Lansley, the Health Secretary, said “Labour’s NHS IT Programme let down the NHS and wasted taxpayers’ money by imposing a top-down IT system on the local NHS, which didn’t fit their needs.”

The two parts that have worked and will be retained have been a part of the U.S. health care landscape for some years. The first is a nationwide NHS email system. The second is Choose and Book. Choose and Book lets patients who have been given a password and a reference number by their primary care physician “choose where [one] goes for your first consultation by comparing the hospitals [one has] been shortlisted at” and book, cancel, or change one’s appointment online as well as by phone.

Sep 30, 2011 | 5 comments | by

Therapists Online

The event reminder on Melissa Weinblatt’s iPhone buzzed: 15 minutes till her shrink appointment.

She mixed herself a mojito, added a sprig of mint, put on her sunglasses and headed outside to her friend’s pool. Settling into a lounge chair, she tapped the Skype app on her phone. Hundreds of miles away, her face popped up on her therapist’s computer monitor; he smiled back on her phone’s screen.

She took a sip of her cocktail. The session began.

Full story here.

Sep 29, 2011 | 5 comments | by

Quote of the Day

Fantasy baseball managers have far more data to evaluate players for their teams than patients and referring doctors have in matter affecting life, death and disability.

George Shultz, Arnold Milstein, and Robert Krughoff, Wall Street Journal.

Sep 27, 2011 | 5 comments | by

Government to Add 122,000 Additional Medical Billing Codes

Medicare has about 7,500 different tasks for which physicians can get reimbursed. If you add in regional adjustments, there are potentially 6 billion different prices. If this isn’t complicated enough, doctors and hospital currently have about 18,000 different billing codes they can use when sending bills to insurers. However, the federal government doesn’t believe 18,000 codes allows for enough detail. According to the Wall Street Journal:

A new federally mandated version will expand the number to around 140,000—adding codes that describe precisely what bone was broken, or which artery is receiving a stent.

It will also have a code for recording that a patient’s injury occurred in a chicken coop. (See code.)

Indeed, health plans may never again wonder where a patient got hurt. There are codes for injuries in opera houses (see code), art galleries (see code), squash courts (see code) and nine locations in and around a mobile home (see codes), from the bathroom to the bedroom.

The level of detail is astounding. For example, there are three different codes for getting bitten by a squirrel. See for yourself.

Sep 15, 2011 | 7 comments | by

You’ve Got Mail… But It’s Not From Your Doctor

 A new report from the Center for Studying Health System Change finds that only 6.7% of doctors routinely email their patients; despite the fact that more than one-third (34.5%) of physicians have access to the technology at work.  In fact, email is the least-used information technology in physicians’ offices. Nearly one-third prescribe electronically. About half of physicians routinely access patient notes and medication lists electronically.More than three-quarter of physicians can view lab results, diagnostic tests and radiology reports electronically; and six-in-ten do so routinely. 

Here’s why so few doctor communicate with their patients by email… “Physician concerns about increased workload without reimbursement, uncertainty about impacts on quality of care, and challenges related to data privacy and security and medical liability have hindered adoption and use of e-mail to communicate with patients.”

Oct 19, 2010 | 5 comments | by

Smartphones as Mental Health Tools

Despite warning patients to stay away from bars where they used to drink and neighborhoods where they used to buy drugs, eventually they’d end up there… So [Patrick] Dulin designed an app. Whenever a patient gets near a risky area, a message pops up on her phone with coping strategies or the app fires off requests for support to family, friends or sponsors…

At the University of Massachusetts, Edward W. Boyer takes it a step further. He hooks up a wireless pulse and skin-conductance anklet to his patient’s mobiles, and his app intervenes whenever it detects that its user is anxious or craving.

Full article on cellphone “therapy apps.”

Oct 01, 2010 | 7 comments | by

Assault on Medical Privacy

Current indications suggest that the health IT requirements in the new federal health law will be combined with state initiatives to make medical privacy a quaint historical notion. Which raises an essential question—at what point does lying to your doctor make sense given that your medical history and your identity are an open book?

The Commonwealth Fund, AcademyHealth, and the Robert Wood Johnson Foundation are funneling money to efforts to convince state governments to pass laws requiring that all health care providers provide data to state run databases on every health care transaction. The goal is the creation of electronic records that can be used to track the type of medical care provided to each patient and the health behaviors of those judged to need oversight. These state efforts will be the building blocks for the ObamaCare electronic medical records system.

Apr 14, 2010 | 3 comments | by

From the Horse’s Mouth

On the Goal of Health Care Reform

Dr. David Blumenthal, a Harvard professor and key health advisor to President Obama: "The more people have, the more of it they tend to spend on healthcare." But as a nation's wealth increases and standards of medical care become higher and more costly, the lowest income groups get priced out. Government controls are needed to push down healthcare costs (and by inference, standard of care) to a level that everyone, including the poor, can afford, or to what government can afford to provide to everyone equally. The goal is not only universal coverage but also a similar healthcare experience for everyone, regardless of ability to pay (New England Journal of Medicine, March 8, 2001).

On the Rhetoric vs. the Reality of Reform

Dr. Ezekiel Emanuel, a health policy advisor in the Office of Management and Budget and brother of Rahm Emanuel, the president's chief of staff: "Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records, and improving quality are merely 'lipstick' cost control, more for show and public relations than for true change." (Health Affairs, February 27, 2008.) True change must include reassessing the promise doctors make when they enter the profession. The Hippocratic Oath is partly to blame for the "overuse" of medical care: Physicians take the "Hippocratic Oath's admonition to 'use my power to help the sick to the best of my ability and judgment' as an imperative to do everything for the patient regardless of the cost or effects on others." (Journal of the American Medical Association, June 18, 2008.)

Jul 02, 2009 | 10 comments | by
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