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Wednesday, October 24, 2012

REC Blog post number 1100111

In binary, that is.

Or, "CIII" in Roman (interesting that there's no provision for "zero" per se in the Roman enumeration system).

Post no. 103.

Number bases are arbitrary. If we had three fingers on each hand, we'd have a base 6 numbering system, in which case this would be post number "251."

Hope everyone is having a good day. Lots more upon which to reflect write.

I spent several hours logged into the live Intel "Online Innovation Summit 2012" yesterday.

Pretty nice (these will all be available in podcast format).

The Race to Reinventing Health—National Challenges to Innovation
October 23, 9:00 a.m. to 10:30 a.m. PDT

Join global thought leaders on healthcare innovation as they discuss challenges and strategies to address market forces shaping healthcare delivery in the 21st century, including a rapidly aging population, unsustainable healthcare costs, and a shortage of primary care workforce.

Big Data and Analytics in Healthcare and Life Sciences
October 23, 10:30 a.m. to 12:00 p.m. PDT

With the explosive growth of data output in healthcare, new challenges arise: downstream analytics with rapidly evolving parameters, data sources, and formats; storage, movement, and management of massive datasets and workloads; and the challenge of expressing the results and translating the latest findings directly into improving patient outcomes.

Collaborative Care: How Mobile Tools Help You Thrive in Healthcare Reform
October 23, 12:00 p.m. to 1:30 p.m. PDT

One dramatic way to transform care delivery and control costs is to look at the systemic effect of collaborative-care workflows on the system, which can dramatically lower admission and readmission, and allow patients to be treated in a variety of settings other than the hospital. How must IT systems adjust to allow for this real-time collaboration?
This tiresome Pedant heard the phrase "the data is" so many times my synapses ached.

Then I downloaded the latest ONC data on Meaningful Use attestations by EP/hospital and Vendor/Product. While sorting the data in Excel prior to running some pivot tables, I noticed something I'd never paid attention to before.

"My data has headers"
Lordy. "Resistance are futile..."


This is pretty cool.

Just a screen cap. The entire image is quite long. Linked here.


Still searching for the succinct, pithy "workflow" allusion.

Tried to find a good overhead / "birds' eye" photo of an interstate highway traffic jam. But, you get the idea. This is my Primary's office at 8:03 a.m., lol.


There is a new television show on Fox this fall called "The Mob Doctor." Its heroine, Dr. Grace Devlin, is a surgeon who, in order to help settle her brother's gambling debt, agrees to serve as a one-woman HMO for Chicago's underworld. This would include everything from tending to the wounds of the nearly-whacked to treating the strep throats of gangsters' children.

While this professional track would have its unique occupational hazards, one appealing advantage makes up for the downsides: You can bet that no one is making Dr. Devlin use an electronic medical-record system...
The full article is firewalled at The Wall Street Journal, but, you can read the comments. A quick sample:
The lifetime goal of every bureaucrat is to create the "perfect form." That is, a form that anticipates and covers every possible question or scenario. Never mind whether the form has any practical use. The job of every other bureaucrat who follows is to make sure that perfect form is filled out correctly and completely.

Then, the "perfect form" has to be completely redesigned after ICD-10 comes out. How long and complicated can a form get? We haven't seen it yet. Simplification? What simplification?

Headline I have NOT yet seen in Healthcare IT News or "Paper Charts Hacked, 500,000 Patient Records compromised."

Just wait for the arrival of the new ICD codes! They went from about 12,000 to 20 times the number of codes to improve quality. (eg things like cut on finger becomes cut on right index finger on the palm side between the 2nd and 3dr knuckle ...)

Don't forget the difference between being bit by a parrot and bit by a macaw .

I personally like "burn while water skiing".

And don't forget the important "injury due to fall out of space craft" - I've been waiting for that specific code for 30 yrs.
Some funny pushback stuff. Grossly overstated on the number of pending ICD-10 codes, but, point taken.

Dan Diamond, California Healthline Contributing Editor

The world may not be ready for a Romney presidency.

Or more specifically: world leaders may not have done enough homework.
An interesting Washington Post story this week suggested that because the foreign polls have been so bullish on President Obama -- 82% of Germans in one survey expected Obama to be re-elected -- lawmakers around the world may be scrambling to adjust to a new team of U.S. diplomats and set of policies.

Is the health sector better prepared?

Given the close race -- as of press time on Wednesday, most polls had the presidential race neck and neck -- there's been growing scrutiny of Republican health proposals. For example, the Kaiser Family Foundation and the Urban Institute on Tuesday released another report on the GOP House Budget Committee's Medicaid plan.

But there's been much less examination of the people who would steer Romney's Department of Health and Human Services and the policies they'd carry out...
Click the byline. Read all of it. Buku timely links citing the breath of interests.

We'll perhaps -- perhaps -- have a bit of clarity in less than two weeks. I've already voted. Wish that would stop the ad nauseum TV commercials and the tree-killing crap wedged in my front screen door.


Indeed. Nice post. I was there at Health 2.0 SF as well (still trying to catch up with my observations). Took particular interest in the Health Law 2.0 pre-conference track.

Federal Register/Vol. 77, No. 203/Friday, October 19
Abstract: ONC seeks approval to collect key data from a relatively small sample of clinical laboratories nationwide for the Evaluation of the State Health Information Exchange Cooperative Agreement Program. The National Survey on Health Information Exchange in Clinical Laboratories will assess and evaluate the electronic transfer of health information from clinical laboratories to ordering physicians. It will focus on two key measures: (1) Percentage of laboratory facilities that are able to send structured lab results electronically to ordering physicians and (2) percentage of lab results that are currently being sent electronically in coded format to ordering physicians.
Sounds simple enough.

"1,489 burden hours. Estimated, annualized"

My question to the email contacts in the FR announcement: "Shouldn't this have been a responsibility of the state HIE Cooperative Grant Awardees? What are they doing with all that money?"

FierceEMR article here.

Patient I.T. Engagement in Stage 2 is Policy Gone Awry
By Robert DeFazio, OCT 24, 2012

During a presentation at the MGMA Conference, Travis Broome, a health insurance specialist at the Centers for Medicare and Medicaid Services, responded to the worries of practice administrators who insisted their patients are not interested in using patient portals necessary to meet Stage 2 meaningful use patient access measures. Broome said practices would have to push the use of portals.

I ask Mr. Broome, is this meaningful use or meaningful coercion? ...

...This is medical policy gone terribly awry. The HHS Secretary and her policy advisors should change the requirement such that it lays out what should constitute the minimum expected functionality of a patient portal without at the same time prescribing any specific percentage of users.

Demanding patients, whom neither HHS regulates nor physicians control, to use portals and simultaneously holding the threat of failing meaningful use tests over the heads of physicians for not succeeding as social networkers is not only bad policy; it is also amazingly unintelligent and high-handed.
Ouch. What do you think?


In the Mail section:
[Nicholas] Lemann’s article includes a quotation from Clayton Christensen, a professor at Harvard Business School, that speaks volumes about the Republican Party’s and Romney’s failure to connect with the working poor: “People who run against him [Romney] are liberal in the sense that they vote for legislation that takes money out of one person’s pocket and puts it in another person’s. . . . They don’t get it. They don’t have any idea of what life is like at the bottom of the pyramid.” As a doctor who cares for many indigent children, I believe that I “get it” as well as Romney, Christensen, and President Obama do. I support legislation that “takes money out of one person’s pocket” so that a profoundly disabled child on a home ventilator can have the equipment and care she needs to survive. I am in awe of the unbelievable dedication of the parents and families of sick kids, and the continual grinding exhaustion and frustration they experience. I see how close to the edge our system forces them to live, and I can’t imagine what they will do if the Romney-Ryan team eviscerates Medicaid. The idea that these families are “takers” offends me; they give far more to the world than I do, and, with all due respect, I suspect that they give more than most private-equity executives or business-school professors. What is most telling about the quotation, however, is the hidden assumption that decisions about how best to help those at “the bottom of the pyramid” should be settled among policy Ă©lites. Surely, those who live at the bottom of the pyramid “get it” better than anyone else.

David W. Roberson, M.D.
West Roxbury, Mass.
"...takes money out of one person’s pocket and puts it in another person’s"

Otherwise Socialistically known as "insurance."

Google "RomneyCare."

It's a red flag that this "Clayton Christensen, a professor at Harvard Business School" was not readily emailable (hedged behind a form). As Forbes put it, "[T]he great discoverer of the disease of disruptive innovation."


More to come...

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