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Posts Tagged EHR

Health 2.0 Show: Joshua Seidman, ONC on “Meaningful Use”

Earlier this week, 51 healthcare groups wrote to the Centers for Medicare and Medicaid Services asking for the current federal EHR adoption goals to be done “in a manner that will remove barriers to and promote the widespread adoption of health information technology.” This letter, sent on May 3, is an interesting backdrop for Wil Yu and Joshua Seidman’s participation in the Health 2.0 Show’s webinar on meaningful use today. It appears from the letter to CMS that the concern is not simply the adoption rules for EHRs but how these groups’ advanced HIT systems might or might not meet those requirements by 2011 and most importantly whether hospitals are eligible for the associated incentives.  (The debate over ‘pushing’ adoption through institutions, as opposed to ‘pulling’ adoption through patient-centered approaches will be taken up in another post.)

Dr. Seidman started his Health 2.0 Show webinar with a similar comment to his other addresses to eHealth groups, “it is not about technology but about transforming healthcare.”  He is right, and this is the heart of the meaningful use discussion.  It is also a perspective that should inform our reaction to the letter to CMS from earlier this week.  Slowing things down until 2017 or speeding them up will not matter unless we are approaching the problem in the right way.  With over $200M in beacon grants announced this week, we must ask ourselves:

Are EHRs a data-source or a presentation layer? If we are simply replicating paper-based medical documents in electronic form, are we really advancing the state of the art?  What parts of these data challenges should be handled in federal rules and which parts should be tackled by new open standards to re-architect the very plumbing of the Internet?

CLOUD is a non-profit technology standards consortia advocating, promoting and developing a language for people on the Internet.  This language, like HTML, is not focused on any particular domain, health or otherwise.  As a result, we are not advocating a specific approach to EHRs or final rules from ONC at HHS.   Read the rest of this entry »

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Digital Debacle for EHRs in Britain: The Challenge of Using 19th Century Thinking to Solve 21st Century Problems

Last week’s Daily Telegraph in the UK reveals the challenges we will face with EHRs in the United States if we do not change our perspective on the solution before cementing 19th century approaches into rules at HHS. “Patient’s Medical Records Go Online Without Consent,” by Kate Develin does an excellent job of looking at the implications of seeing this as a records problem rather than a patients problem.  EHRs divorced from the patients to whom they belong is at the heart of the digital debacle in Britain.

The following quote is at the very heart of the privacy issue:

The “summary” records contain basic medical information including illnesses, vaccination history, and could include medication patients have been given. Ages and addresses are also included. (emphasis added)

The issue with privacy on the Internet today is that the data silos into which our records are poured not only include What I Am™ but Who I Am™.  The combination of critical health information Read the rest of this entry »

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Tim Brown, CEO of IDEO, Speaks on “Change By Design” on NPR

NPR’s Rene Montagne interviewed Tim Brown this morning on the issue of healthcare and design.  Tim said that he would love to create “the electronic medical record of the future” and that many new solutions have to be designed around people.  Interview is here.

CLOUD could not agree more with Tim and were thrilled to take part in a dialogue on this topic with frog design yesterday in a Twitter forum on #futureofhealthcare.  Transcript will be posted here soon.  The frog design sponsored forum was on their recent article, “Is the Future of Healthcare Social?” in Fast Company.

Not only is Tim right that the EMR of the future must be controlled by people Read the rest of this entry »

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