At the intersection between Web 2.0, social media, Health IT and healthcare reform lies the tools of the new economy. Aside from the blogosphere, a whole host of social media tools can be useful to provide real time information, networking possibilities and develop grassroots efforts for reform. As Cascadia has said we now have a consumer voice in the ongoing Health Informatics conversation using the new social networking tools.
Tim O'Reilly, Founder and CEO of O'Reilly Media, was interviewed by Blaise Zerega of Flora.tv at Web 2.0 2009. In the clip below he argues that microblogging service Twitter is changing real-time information search and describes how Twitter is going to be such a powerful tool in the new digital economy.
Forrester Research CEO George Colony calls the current economic trouble the Gateway Recession, and end of the Gateway Recession will usher in a new technology era. In discussing the importance of social media in this new economy Rob Preston, Editor-in-Chief of Information Week makes a compelling argument that one "gateway realization is the need to give customers, partners, and employees freer access to one another via social media, Web 2.0 collaboration tools, consumer devices, and other contraband systems."
The discussion of hugging data and the video of Tim Berners-Lee's Ted Talks where he envisioned a "Semantic Web" - an evolved version of the same system that recognizes the meaning of the information it carries. As I said, we need to consider how we can best securely share data and develop open standards that work. Social media provides a wonderful framework for collaboration.
The conversation continues and you can jump in any time...
Alphabet Soup
There are many commonly used abbreviations in discussing Health IT. I thought it might be helpful to list some here:
AHIC American Health Information Community
AHIMA American Health Information Management Association
AHRQ Agency for Healthcare Research and Quality
ANSI American National Standards Institute
CCHIT Certification Commission for Healthcare Information Technology
CDS Clinical Decision Support
CHC Community Health Centers
CMS Centers for Medicare and Medicaid Services
CONNECT NHIN gateway
CPOE Computerized Physician Order Entry
EHR Electronic Health Record
EMR Electronic Medical Record
FHA Federal Health Architecture
HHS Department of Health & Human Services
HIE Health Information Exchange
HIMSS Healthcare Information Management Systems Society
HIPAA Health Insurance Portability and Accountability Act
HIT Health Information Technology
HITSP Health Information Technology Standards Panel
HL7 Health Level 7
HRSA Health Resources and Services Administration
ICD International Statistical Classification of Diseases and Related Health Problems
JCAHO Joint Commission on Accreditation of Healthcare Organizations
NCVHS National Committee on Vital and Health Statistics
NHIN Nationwide Health Information Network
NIH National Institutes of Health
NLM National Library of Medicine
ONC Office of the National Coordinator (usual abbreviation for ONCHIT)
ONCHIT Office of the National Coordinator for Health Information Technology
PHR Personal Health Record
PQRI Physican Quality Reporting Initiative
RHIO Regional Health Information Network
SLHIE State Level Health Information Exchange Consensus Project
SNOMED Systematized Nomenclature of Medicine
VHA Veterans Health Administration
VistA Veterans Health Information Systems and Technology Architecture
I particularly would like to point out the differences between EMR, EHR and PHR. These terms tend to be used interchangeably, but they actually refer to different things. In fact the definition of EHR depends a lot on what the definiton of "meaningful use" is. You could define an EMR as just the physician interface and EHR including both a physician and patient interface (with some interoperability between systems). PHR is still an ill-defined concept that has been slowly developing over many years. Certainly PHR is a computerized application that stores an individual's personal health information. The key difference being that a PHR is typically a health record that is created, controlled and maintained by an individual patient, while the EMR is created, controlled and maintained by the provider. Hopefully one day we will have an intersection at truly meaningful EHR.
AHIC American Health Information Community
AHIMA American Health Information Management Association
AHRQ Agency for Healthcare Research and Quality
ANSI American National Standards Institute
CCHIT Certification Commission for Healthcare Information Technology
CDS Clinical Decision Support
CHC Community Health Centers
CMS Centers for Medicare and Medicaid Services
CONNECT NHIN gateway
CPOE Computerized Physician Order Entry
EHR Electronic Health Record
EMR Electronic Medical Record
FHA Federal Health Architecture
HHS Department of Health & Human Services
HIE Health Information Exchange
HIMSS Healthcare Information Management Systems Society
HIPAA Health Insurance Portability and Accountability Act
HIT Health Information Technology
HITSP Health Information Technology Standards Panel
HL7 Health Level 7
HRSA Health Resources and Services Administration
ICD International Statistical Classification of Diseases and Related Health Problems
JCAHO Joint Commission on Accreditation of Healthcare Organizations
NCVHS National Committee on Vital and Health Statistics
NHIN Nationwide Health Information Network
NIH National Institutes of Health
NLM National Library of Medicine
ONC Office of the National Coordinator (usual abbreviation for ONCHIT)
ONCHIT Office of the National Coordinator for Health Information Technology
PHR Personal Health Record
PQRI Physican Quality Reporting Initiative
RHIO Regional Health Information Network
SLHIE State Level Health Information Exchange Consensus Project
SNOMED Systematized Nomenclature of Medicine
VHA Veterans Health Administration
VistA Veterans Health Information Systems and Technology Architecture
I particularly would like to point out the differences between EMR, EHR and PHR. These terms tend to be used interchangeably, but they actually refer to different things. In fact the definition of EHR depends a lot on what the definiton of "meaningful use" is. You could define an EMR as just the physician interface and EHR including both a physician and patient interface (with some interoperability between systems). PHR is still an ill-defined concept that has been slowly developing over many years. Certainly PHR is a computerized application that stores an individual's personal health information. The key difference being that a PHR is typically a health record that is created, controlled and maintained by an individual patient, while the EMR is created, controlled and maintained by the provider. Hopefully one day we will have an intersection at truly meaningful EHR.
Affordable Health Choices Act
The Senate Committee on Health, Education, Labor and Pensions (HELP) has announced the Affordable Health Choices Act.
“Our health care system is a crisis for American families and President Obama and members of Congress of both parties recognize the urgency of the problem. Our goal is to strengthen what works and fix what doesn’t. Over the next few days, we will continue working with our Republican colleagues on common sense solutions that reduce skyrocketing health care costs, assure quality care for all and provide affordable health insurance choices. Much work remains, and the coming days and weeks won’t be easy. But we have a unique opportunity to give the American people, at long last, the health care they need and deserve,” said Senator Kennedy, Chariman of HELP.
Earlier this year, Kennedy and Senator Max Baucus, Chairman of the Finance Committee, which shares jurisdiction of health care reform with HELP, established a joint process that will lead to complementary legislation being marked-up next week. The full text of the bill is available here.
The bill is silent on the crucial questions of the employer mandate and a public health insurance option. The HELP bill proposes broader reform measure than expected in the Finance Committee's bill, expected to be released over the next few weeks. This summer is going to be an exciting time for healthcare reform!
Daschle and Gingrich discuss healthcare
Former Senate Majority Leader Tom Daschle and former House Speaker Newt Gingrich discussed healthcare reform during a panel discussion at the National Press Club sponsored by Volunteers of America. A video from an interview with the two men is below. It is nice to see both sides willing to have a reasonable discussion.
If President Barack Obama wants healthcare reform this year, he’s going to have to be flexible and accept “half a loaf” on certain issues Newt Gingrich, founder of the for-profit consultancy Center for Health Transformation, said. Congress and the administration “will get nothing” if they approach reform with an all-or-nothing attitude, he added. Gingrich acknowledged that the reform effort could get “locked up” by various demands, and possible push back from hospitals and doctors. Any healthcare-reform effort should emphasize wellness and best practices to eliminate waste from the system, Gingrich said, adding that he was in favor of 100% coverage—but not a single-payer system.
Tom Daschle, who had been nominated for HHS secretary, was not as optimistic about the chances of getting a bill through Congress. Cost, quality and access issues remain, “and so little attention has been given to long-term care” in this debate, said Daschle, who gave legislation a 50-50 chance of getting approved. He stressed the need for a priority for Health IT and stated that we need to "change the paradigm from illness to wellness" by addressing chronic care management.
Neither man thought Medicare was doomed, however, even though the trust fund is predicted to dry up in 2017. Congress will find a way to fix the problem, Gingrich said. “I don’t think it will run out of money.”
Tom Daschle, who had been nominated for HHS secretary, was not as optimistic about the chances of getting a bill through Congress. Cost, quality and access issues remain, “and so little attention has been given to long-term care” in this debate, said Daschle, who gave legislation a 50-50 chance of getting approved. He stressed the need for a priority for Health IT and stated that we need to "change the paradigm from illness to wellness" by addressing chronic care management.
Neither man thought Medicare was doomed, however, even though the trust fund is predicted to dry up in 2017. Congress will find a way to fix the problem, Gingrich said. “I don’t think it will run out of money.”
Hospitals cutting off social media access
A disturbing trend in healthcare facilities is blocking social media sites for staff. I would be very interested in knowing how you are all dealing with this and what methods work best for allwoing access, yet controlling it so that it is appropriate and effective.
Some helpful resources are:
Faith and Healthcare
Many people claim that spirituality within the context of healthcare is mumbo jumbo and does not deserve to be part of the conversation. I think it is arrogant to assume that we have enough knowledge to discount the obvious benefits of including faith and spirituality in the healthcare dialogue. Reading through American Family Physician a peer reviewed journal of the American Academy of Family Physicians, along with other journals and research results, can give some insight into this thorny issue.
Attending to the spiritual dimension of the patient provides the physician with a deeper understanding of the patient and his or her needs. The provider might use a variety of spiritually informed therapeutic tools that could greatly facilitate the patient's coping ability, thus enhancing well being. A spiritual assessment as part of a medical encounter is a practical first step in incorporating consideration of a patient's spirituality into medical practice. The HOPE questions provide a formal tool that may be used in this process.
Barbara Apgar, M.D., M.S. in an article in American Family Physician discusses research on the significance of intercessory prayer for the sick, referencing the study by Harris WS, Gowda M, Kolb JW, Strychacz CP, Vacek JL, Jones PG, et al. A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted to the coronary care unit. The authors conclude that supplementary, remote, blinded, intercessory prayer produced a measurable improvement in the medical outcomes of critically ill patients in the CCU. Clinical trials on the Effects of Meditation on Mechanism of Coronary Heart Disease seem to bear out the same conclusion. Prayer and meditation are very effective tools in the fight against disease and valuable to promote healing and wellness.
Walter L. Larimore, M.D., reports that 99% of surveyed family physicians believe that religious beliefs can heal, 75% believe other people’s prayers (i.e., intercessory prayer) can promote healing. Based on his own clinical practice and dialogue with other family physicians Larimore suggests that “infrequent religious attendance or “poverty of personal faith” should be regarded as a risk factor that is nearly equivalent to tobacco and alcohol abuse.
The impact of spiritual practices and disciplines such as prayer are obvious. While issues of faith and beliefs and how to implement those in medical care, such as through prayer, are controversial they should not be ignored. In light of some of the research on spirituality in healthcare we can not dismiss prayer as a possible viable intervention. And since the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), requires the administration of a spiritual assessment then it will be good to include standard templates for these assessments in an Electronic Health Record to be used for quality reporting. A good template for spiritual assessment and review of the JCAHO requirements and guidelines for implementation by Hodge can help social workers being called on to conduct spiritual assessments.
I am firm believer in technology enabled healthcare - but I also am absolutely certain that we should not try to push God out of the healthcare arena.
Courage to be first
Since the early 90s, numerous newspapers, magazines and radio and TV broadcasts have told the story of
MCMC appeared in a Bill Moyer’s PBS series called “Healing and the Mind” and was even featured in a book highlighting American companies noted for their outstanding customer service.
But now the hospital that many say has written the book on how to create a true patient-centered healing environment has had an entire book written about it. Courage to be First: The Journey of Mid-Columbia Medical Center Becoming the First Planetree Hospital in America was released in March by Second River Healthcare Press.
The book tells the story of MCMC’s dramatic transformation over the last two decades, beginning with the hospital’s implementation of the Planetree model of care in the early 90s. MCMC’s story was written by Dick Baltus, as told by former CEO Mark Scott, current CEO Duane Francis and many hospital employees, with Leland Kaiser, Ph.D., offering commentary after each chapter.
Baltus is a consultant and writer, who served as the MCMC’s part-time public relations director during the Planetree implementation and continues to work with the hospital today. Kaiser is a renowned healthcare futurist, motivational speaker and authority on
Kaiser visited the hospital several times and, when Scott retired from MCMC in 2002, Kaiser proposed they collaborate on a book about the process of changing so profoundly their manner in which hospitals treated their patients.
Courage to be First is targeted at readers in the healthcare management industry, as well as any business committed to improving customer service. Like the hospital itself, the book has received enthusiastic reviews.
B. Joseph Pine, co-author of The Experience Economy (named one of The Best 100 Business Books of All Time) wrote: “There is not a hospital in the world – or any company in the healthcare field, for that matter – that could not benefit from this enlightening book. Read how
And from John Nance, the author of Why Hospitals Should Fly: “The very concept of a true patient-centered hospital – the vision of patients actually being partners in their own care – should have never been a radical idea. But somehow along the evolution of healthcare, it became just that. ‘Courage to be First’ is the story of how a visionary hospital CEO made it live again in the form of a
President/CEO Francis says the book will serve as a lasting tribute to Scott, the hospital board and management team, and all the physicians, nurses and employees who over the years have remained committed to a vision that began as a bold experiment and has turned into a way of life at MCMC.
“It took a lot of vision, and frankly a lot of guts, to attempt something that was considered so revolutionary at the time,” Francis says. “This was an industry that was not very comfortable with change in the early 90s, and to attempt to change the status quo, at least in this small corner of the world, really required a leap of faith.
“I think it’s very appropriate that the story of how that happened successfully at MCMC be chronicled. Courage to be First will serve as a lasting tribute to all the people who ensured this hospital became a true place of healing that was worth writing, and reading, about.”Courage to be First is available for purchase on-line at www.couragetobefirst.com.
Subscribe to:
Posts (Atom)