December 14, 2006

Not Xpensive

Filed under: — mlazoff

Thomson Clinical Xpert is available for free download to physicans, house staff, and medical students, among other healthcare practitioners. This is their new evidence-based, point-of-care PDA reference. (If you don’t see where to click on this page, try turning off your firewall or ad-blocking software.) 

It doesn’t hurt to ask…

Filed under: — mlazoff

Two recent surveys released earlier this month provide contradictory data regarding patients’ enthusiasm for electronic health records (EHRs). First, a PriceWaterhouseCoopers study, The Top Seven Health Industry Trends of ‘07 (free registration) found that only 34% of the 1,000 Americans surveyed last October are convinced that EHRs will improve the quality of healthcare. Then, several days later, the Markle Foundation released their survey of 1,000 (presumably different) Americans surveyed last November, 88% of whom believe online EHRs would be important in at least one component of quality care: reducing unnecessary and redundant tests.  EHR adoption has been slow in the US, and some predicted that patient interest would help spur growth in healthcare information technology.   

December 4, 2006

IT Phone Home

Filed under: — mlazoff

Use of Mobile and Wireless Technology Jumps in Hospitals, according to an article posted two weeks ago in Digital Healthcare and (the new name for Healthcare IT World News). “Even though adoption of electronic health records (EHR) and other clinical IT remains fairly anemic, at least one aspect of health-IT has taken giant steps forward in the last few years: the use of mobile and wireless technology where choices are proliferating.” Mobile technology here are essentially PDA smart phones with built-in Wi-Fi or Bluetooth wireless functionality. Technology has improved over just the past few years; according to the article, the time it takes to download images has decreased from 30 seconds to 3 seconds. Although screen size and resolution on these devices still do not allow for quality graphics, the article quotes several physicians who state that consulting on emergency conditions does not generally require subtle findings in CT scans or EKGs. The article goes on to describe upgrades in the major wireless networks, and how local area networks (LANs) such as Wi-Fi hot spots are bridging technology gaps. Specific LANs operating in hospital complexs are also described.

“And there’s another side benefit of the mobile devices. ‘Our kids, in particular, just love us carrying around our iPaqs,’ says [Julie] Massey, MD, a pediatrician.”

December 2, 2006

Wal-Mart Rollbacks EMR

Filed under: — mlazoff

A November 29th Wall Street Journal article (available to WSJ subscribers) reports on a plan by Wal-Mart, Intel and British Petroleum, among others, to develop a joint employee-owned digital medical records system that will link physicians, hospitals, and pharmacies. ”Their goal: to cut costs by having consumers coordinate their own health care among doctors and hospitals.” 

The initiative was suggested to Wal-Mart by the Centers for Disease Control and Prevention, who is active in several government HIT efforts. A 2005 CDC study posted on their site found less than 10% of office-based physicians use EMRs containing a minumum set of required features.

According to the WSJ, “At the heart of the Intel-Wal-Mart approach is the belief that if price and quality measures apply market pressures, technology can duplicate the integration that government-run health-care systems…achieve…The government posts pricing information using the fees charged to Medicaid. Groups including Hospital Quality Alliance, Ambulatory Quality Alliance and the Wisconsin Collaborative for Healthcare Quality rate hospitals and doctor groups on quality. ‘The evidence is beginning to show that what gets measured and reported publicly gets improved faster,’ says Christopher Queram, president of Wisconsin Collaborative for Healthcare Quality, which began rating southeast Wisconsin hospitals and doctors in 2003.”

Employee participation will be voluntary, but participants’ physicians must use electronic records and e-prescribing. As the nation’s largest employer, Wal-Mart has promoted its employee health plan as consumer-empowering, but others have criticized it as ”miserly.” Wal-Mart’s successful (if not profit-generating) $4 generic drug plan and their more controversial walk-in health clinics may be more marketing tools. 

Freely available commentaries on the article are available from the media company Red Herring, Intel, Wal-mart Plan Health Net, and in a post by Scot Silverstein, MD, from the thought-provoking Health Care Renewal, headed by Brown University’s Roy Poses, MD. [Added Dec 4: For background information, see Health-IT World News Intel, Wal-Mart Call For Employer Activism in Demanding Health IT. The reporter, Neil Versel, has posted a podcast of his interview with these companies’ executives.]

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