Is an electronic health record (EHR) a good business decision for a physician practice ?
(This is cross-posted from iMedicalApps.com .)
As many readers are aware, the 2008 HITECH act included a $44,000 incentive for any qualifying physician who implements an approved EHR and puts it to “meaningful use”. The tenets of meaningful use are mostly known* but the final list is not due to be published until this Summer. Our senior editor, Iltifat Hussein is working on more detailed analysis as part of his MPH program but two published analyses shed a little light, or at least numbers, on this question.
What many people, myself included, wondered is where did this $44,000 number come from ? It turns out that it came out of a single published paper which surveyed the implementation costs of an EHR, averaged across fourteen family practice groups [Miller, et al, Health Affairs, 2005] and arrived at an average cost of $44k.
Aside from the marvel of setting far-reaching national legislation on such a small sample size, the next question is what is the financial benefit of implementing an EHR and is there a business argument in favor of it ?
Apple’s iPhone & iPad and the end of the hacker
I was talking to a friend the other day who shares a common love for gadgets, especially the electronic kind. He told me that he had “jumped ship” from the iPhone to Android and bought a Nexus One. That seemed a little odd but not terribly striking. What really caught my attention is what he said next, which is that he spent most of one night “rooting” (i.e. jailbreaking) his Android phone to allow him to tether its cellular data to his computer.
Now, I know this guy has a demanding job and probably does not have a lot of spare time. What I realized from my reaction though, is that this type of computer hobbyist is now almost a dinosaur.
Why not just use the internet to transmit health information ? The transformative potential of NHIN Direct
David Kibbe, MD recently penned a detailed post on the basics of the NHIN Direct project titled “Getting to the Health Internet” . It is great reading and I highly recommend it. Below are a few of the points I found the most interesting.
EHR stimulus is not about technology adoption, it is about changing health care delivery: Dr. Blumenthal, ONC Director
The NY Times recently reported on a Health IT conference attended by many technology leaders.
The story emphasized the tug of war between older, large EHR vendors with major investments in “client-server” technology and newer, web-based vendors who provide EHRs as “software-as-a-service” (SaaS).
New host (WordPress)
Dear reader,
As of May 9, I have switched blog hosting provider from Tumblr to WordPress. The reasons are several, but the decision is not without drawbacks. One of them is breaking links to old posts. Therefore, my apologies iif you arrive at an error message following a link. Please use the search feature to find the post of interest.
MGMA Confirms Productivity Loss with Government’s EMR Program
From Evan Steele’s SRSoft blog (worth checking out):
“What struck me at last week’s annual meeting of HIMSS (Health Information and Management Systems Society) was the conspicuous absence of conversation about the effect of the ARRA legislation on physician productivity—there was hardly a mention of the subject throughout the conference. Jeffrey Belden, M.D., of the HIMSS Usability Taskforce, did point out that documenting patient exams in an EMR takes 10 times as long as documenting by dictation, but offered no solution to that problem. Admittedly, the audience contained few, if any, physicians. However, once again, it struck me that physician productivity was the elephant in the room—the topic that no one was discussing, even though physicians are the very people upon whom the success of the program is so dependent.”
…. Continued
The Blio Reader Could Launch a New Digital Era of Medical Textbook Publishing
The medical textbook has long been a ripe target for digital enhancement. In the 1990s the paragon of digital publishing was the CD ROM. At that time, publishers produced premium versions of their leading texts which included a CD ROM with additional images, search capability and even videos.
As the internet became a viable distribution model, publishers moved the supplementary content to the web and started offering paid subscriptions. Of course, the internet also encourages free distribution, and thus arose comprehensive medical ad-supported websites aimed at consumers and physicians, e.g. WebMD and Medscape, respectively. One national society, the American Academy of Orthopedic Surgeons, launched a large, curated site of surgical and non-surgical treatment techniques for its members (“orthopedic knowledge online”) which includes videos of surgical procedures and offers continuing medical education (CME) credits.
My Search for an iPad stand – the device that does not tell you how to hold it
The rising popularity of laptops has encountered only a few small obstacles along its way. Until recent increases in battery life, scanning for hidden electrical outlets was a required skill for the itinerant worker. Sore shoulders were a the bane of the laptop bag pack rat and going through airline security was always a nuisance. One thing one did not have to contend with is the question of how to hold a laptop: the answer is in the name. Since the keyboard is horizontal, the screen vertical and the two are connected, there was not much ergonomic mystery.
The iPad is a little more confusing. Reading a book in bed and reading an eBook – the same. Reading a magazine sitting on the sofa with the copy on the sofa arm and surfing the web on the sofa – the same. But what do you do when you want to type on the iPad ?
Bluetooth is admitted to the hospital – the potential of Bluetooth 4.0 to revolutionize medical device communication
This article stems from a conversation between Mike Foley, executive director of the Bluetooth Special Interest Group (SIG), Iltifat Hussain, editor of iMedicalApps.com and myself April 2010.
Background
The Bluetooth standard has been around since 1999 when first Ericsson and then, quickly, other manufacturers of mobile devices and cell phones came together to specify a standard for near-distance wireless connectivity.
The Main Features of Bluetooth (from thewirelessdirectory.com):
- Operates in the 2.4GHz frequency band without a license for wireless communication.
- Real-time data transfer usually possible between 10-100 meters
- Close proximity not required as with infrared data (IrDA) communication devices as Bluetooth doesn’t suffer from interference from obstacles such as walls.
- Supports both point-to-point wireless connections without cables between mobile phones and personal computers, as well as point-to-multipoint connections to anable ad hoc local wireless networks.
Good-enough and plenty: the future of Android
While I did not follow the events of the recent Google developer conference (“Google I/O”), apparently, a good part of the fireworks consisted of loud, public taunting of Apple and the iPhone.
Since much of this taunting came out of the mouths of Google senior executives, it was covered in the tech press and predictably stirred up comment threads all over the blogosphere. In truth, the schoolyard level of the rhetoric (see Kara Swisher) probably will not serve Google well in the long run. This is because Google needs its partners’ trust in order for them to continue as enablers, via their devices and services, in Google’s primary business of amassing massive stores of data against which to sell advertising.
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May 23, 2010 at 11:40 am Leave a comment