March 18, 2007

Not every snowflake is unique*, but…

Filed under: — mlazoff

The strongly pro-electronic health record (EHR) American Academy of Family Physicians just published a sobering article in their Family Practice Management, EHRs Fix Everything—and Nine Other Myths. Authored by David Trachtenbarg, MD, a family physician who disclosed a financial relationship with one EHR vendor, the take-home message of this readable essay begins the final paragraph: “Every EHR implementation is unique.” 

*According to wikipedia’s entry on Snow

March 11, 2007

EMIssion highly improbable

Filed under: — mlazoff

The March issue of Mayo Clinic Proceedings published a trio of studies looking into potential electromagnetic interference (EMI) of mobile devices in health care. They found rare instances of interference from mobile devices involving implantable cardioverter defibrillators and electrocardiograms outside the hospital setting. Importantly, they found no interference using mobile devices within hospitals, although only a handful of mobile and medical devices were tested. The hospital tests were conducted by the same group who found in 2005 that older analog cell telephones produced the most interference when placed within 3 feet of (also generally older) medical devices. 

The issue’s editorial closes with a summary of current standards and suggestions for the future: “On its Web site (, the FDA’s recommendations are more or less generic statements that medical facilities should check their equipment, identify locations where EMI could be problematic (eg, operating rooms and intensive care units), and educate staff. On the basis of the results of the 3 reports in the current issue of Mayo Clinic Proceedings it would be appropriate for the FDA to take a more explicit stand that EMI is unlikely to occur in a hospital setting and that internal regulations in health care facilities should reflect that fact. Recommendations should also reiterate that the risk is not zero and that medical personnel should remain vigilant in order to detect and mitigate the uncommon occurrence of clinically relevant EMI of medical devices.”

March 8, 2007

A mixed performance

Filed under: — mlazoff

Based on General Internists’ Views on Pay-For-Performance and Public Reporting of Quality Scores: A National Survey published in the March/April issue of Health Affairs and reported yesterday in iHealthbeat and GovernmentHealthIT articles, over 75% of randomly selected general internists surveyed support financial incentives from government and/or health payers to improve care. According to these articles, for Lawrence Casalino, MD, PhD, the lead investigator and an assistant professor of health studies at the University of Chicago, the strong support for pay-for-perfomance was a surprise, and a positive sign for health IT adoption. Yet less than half of physicians surveyed support public disclosure of quality scores from medical groups, and even fewer support public reporting of scores from individual physicians, even if the results reflect quality care accurately—which most believe will not be the case anyway. 

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