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Friday, August 4, 2017

KHIT topics


Mostly in no particular order above (and relatively limited sub-topical granularity), other than to note that this blog began with gumshoeing "EHRs" as "The REC Blog" shortly after I was re-hired by HealthInsight in 2010 to resume EHR support work (that I'd begun in 2005 under the precursor federal QIO "DOQ-IT" initiative (before getting laid off in 2007 as a result of 8SOW budget mismanagement above me). See also here, from another of my blogs at the time.
I can only legitimately lay claim to relative "SME" status (Subject Matter Expert) to a few of the foregoing areas: e.g., EHRs (outpatient), Workflow, Process QI, Analytics, HIPAA, and, of course, Patient. For the remainder, I am simply a fairly well-read, endlessly curious student (ongoing) and activist citizen/reporter, and I take care here to cite (typically at some length) the best thinkers I encounter. I should be getting residuals from Amazon for all of the books I've touted and linked.
This blog started principally as an online "diary" of my experience of the Meaningful Use initiative within which I served as a workflow and HIPAA security consultant to small to medium primary care practices ("Project Coordinater" was my official title).

My incoming hope (naive, as it would turn out) was that we might leverage the REC opportunity to help practices materially improve their operations broadly (with perhaps collaborative involvement from my ASQ Health Care Division), with InfoTech at the center of that effort (after all, Medicare "QIOs" had been re-named to be "Quality Improvement Organizations," succeeding their prior designation as "PROs" -- Peer Review Organizations).

My REC, like all of them, quickly became simply "body count" focused -- getting MU client practices from EHR adoption to Stage I MU "attestation." We got paid incrementally through ONC via "milestone" achievements, and, being significantly understaffed to meet our practice recruitment and MU progress targets, "milestone compliance" it would be. Noble devotion to process QI would be seriously backburnered. Early on, I took some annoying crap from one of my Utah HQ Sups for even pushing the idea ("...exceeding your scope").

Whatever. I didn't make any secret of my reaction to that.

Given that the blog was my nights and weekends personal sidebar project, I began to broaden my scope to whatever I thought relevant to health care QI, always episodically rotating back around to Health IT. Hence the roaming span now comprising the effort. I've never entertained the idea of trying to "monetize" it. Now nominally "retired," I continue to write here simply because it's important, and maybe my little ankle-biting, no-ulterior-motives solo effort will add a bit of signal to the noise. I am grateful for all of you who stop by and read this stuff. I will try to keep showing up at the major Health IT and QI conferences.

Given my younger daughter's grave illness, it's been difficult to keep up with focus and pace lately. But, I will try to soldier on. As I post this today, she completes round 7 of her indeterminate length course of chemo. New CT and MRI scans on tap for next week. Imagine our anxiety.

FALL 2019 UPDATE

My younger daughter Danielle died on April 27th 2018, I had open-heart aortic valve replacement surgery on August 23rd 2018, and we moved to Baltimore on April 15h 2019. My blog focus is shifting more and more to topics such as Global Warming, socioeconomic justice, and "Deliberation Science"--and science more broadly.

While my continuing interest in all things healthcare space remains, there are larger, significantly more pressing matters at hand. Thanks for continuing to read these rants. I will do my best to try to add value.
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INTERESTING STAT ARTICLE
Armed with science (and snark), a gynecologist takes on Trump, Goop, and all manner of bizarre health trends'

he tweets while she’s walking Luna, her nearly blind cat. (Yes, walking her. On a leash.) And while she’s at home, waiting for the sourdough to rise. She blogs while she’s directing her two teenage sons to fold the laundry.

In posts that careen between empathy, outrage, and snark, Dr. Jennifer Gunter presses a provocative crusade to protect women’s health, preserve reproductive freedoms — and, while she’s at it, dismantle all the dubious, dangerous medical advice she comes across in the wilds of the internet…
ONE OF MY LATEST READS


Stay tuned. See their antecedent paper "Why do humans reason?" (pdf) apropos of topics in cognitive neuroscience as they go to AI/NLP.

JUNE 2021 UPDATE
 
What a difference eight years out of the clinical trenches, a cross-country relocation, a Parkinson's dx, and a pandemic make. My views on Health IT are increasingly abstract and academic, my on-the-ground HIT observations relegated principally to those of a Medicare patient (though, the SOAP Note workflow process has not changed materially in the past decade). 

There are numerous more pressing concerns to be addressed, many of which involve information technologies. I try to stay on top of many of them and post constructively about them.

FALL 2021


No shortage of pressing work to do.
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More to come...

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