tag:blogger.com,1999:blog-32053362.post951912873855491068..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: Bigger is better? Not so fast!Paul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-32053362.post-36888029545894351322015-03-27T21:53:08.047-04:002015-03-27T21:53:08.047-04:00I’ve had a Medic Alert necklace for a number of ye...I’ve had a Medic Alert necklace for a number of years. When I landed in the ER last October, though, I later learned that I hadn’t renewed my membership for the past seven years! The information they had on file was likely out of date. I’ve since renewed my membership and updated the information.<br /><br />As it happens, I got a new iPhone yesterday and it came with a health app. Part of the app includes the opportunity to enter such health information as prescription drugs, allergies, diseases and conditions, surgical history, blood type, height and weight, date of birth and emergency contacts which I’ve done. I also have my wife carry a copy of my drug list in her purse. <br /><br />Every little bit helps but a more robust approach that would cover most of the population would be better and I think we should aggressively pursue the goal of electronic records interoperability so doctors and hospitals can easily access all relevant patient records when they need them.<br />Barry Carolnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-72934993448437255912015-03-27T19:00:43.517-04:002015-03-27T19:00:43.517-04:00Not quite equivalent, but signing up with MedicAle...Not quite equivalent, but signing up with MedicAlert, one can arrange to store all those items (tho only 2-3 MDs) plus emergency contacts, so any ER can request the info by phone/fax using your MedicAlert ID #. An abbreviated version is available on wallet card (which could raise privacy concerns) along with the noting the most crucial items (very compressed) on the medallion bracelet or necklace.Debbie Snoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-31404356192148928432015-03-27T16:00:26.401-04:002015-03-27T16:00:26.401-04:00One of Paul's former co-workers (John Halama) ...One of Paul's former co-workers (John Halama) at BID is a leader in the "Argonaut Project" <br /><br />Which is designed to improve interoperability between EHR's. <br /><br />WEDNESDAY, DECEMBER 17, 2014<br /><br />The Argonaut Project Charter<br /><br />http://geekdoctor.blogspot.com/search?updated-min=2014-01-01T00:00:00-08:00&updated-max=2015-01-01T00:00:00-08:00&max-results=50<br /><br />The following is the first paragraph in that blog. <br /><br />"Yesterday, a group of private sector stakeholders including athenahealth, Beth Israel Deaconess Medical Center, Cerner, Epic, Intermountain Health, Mayo Clinic, McKesson, MEDITECH, Partners Healthcare System, SMART at Boston Children’s Hospital Informatics Program, and The Advisory Board Company met with HL7 and FHIR leadership to accelerate query/response interoperability under the auspices of ANSI-certified HL7 standards development organization processes."<br /><br />Do a search on Argonaut Project and Halama for more details. <br /><br />But work is being done. <br /><br />Other things are also being done. eclinicalworks has agreements with EPIC to allow ECW to feed doctors data to Epic etc. <br /><br />It will take time. <br /><br />But if Halama, who is an acknowledged expert in the field believes progress is possible, I'd believe him. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-1396216792005375562015-03-27T12:43:57.736-04:002015-03-27T12:43:57.736-04:00I agree that a lot of possibilities for better med...I agree that a lot of possibilities for better medical management would open up if we had fully interoperable electronic records. Unfortunately, I don’t see a clear path for getting from here to there. It’s not like we patients could demand that doctors and hospitals adopt interoperability or we will go elsewhere for our care. Where would we go? At the same time, large hospital systems and IDN’s have an economic interest in making it difficult for patients to get some of their care outside of an enclosed system.<br /><br />I was intrigued after reading in Health Affairs magazine about the smart insurance cards that are used in Taiwan’s single payer system. The cards contain information such as allergies, prescriptions, current diseases and conditions, and whether the individual has a DNR or not among other things. <br /><br />A former colleague of mine is an EMT in his northern NJ town. He showed me a card that all of the EMT people carry that has a bar code on the back containing various medical information that they can choose to have included from a list of options. Why can’t that approach be made more widely available for a modest charge if necessary?<br /><br />When time is not critical, records from other providers can be faxed or delivered in other ways. I’ve been told by doctors that the information ER docs need most is any allergies the patient has, what drugs he takes, who his doctors are, any disease or conditions he currently has and whether or not he has a DNR.<br />Barry Carolnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-30524103606425449042015-03-27T10:10:49.416-04:002015-03-27T10:10:49.416-04:00You don't need to have common corporate owners...You don't need to have common corporate ownership to have care coordination among the various parts of the health care system. Clinical partnerships are possible without common ownership. It fact, if partnerships are based on true clinical coordination rather than center-driven business concerns, they are likely to be more effective.<br /><br />A key requirement, though, is to have truly interoperable electronic medical records systems to reduce the friction of patients being held within one system.<br /><br />FFS or capitation is not particularly relevant to the discussion, in my view. Clinical integration has occurred under both and has failed under both.Paul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-60764659439057038022015-03-27T08:35:25.151-04:002015-03-27T08:35:25.151-04:00I would love you read your view of the alternative...I would love you read your view of the alternative to IDNs. I expect that it is not a FFS cottage-industry medical system. Give us your view of where the middle ground is. Thanks.<br />Joanne.Joanne Roberts, MD, MHAhttps://www.blogger.com/profile/02647826357506847692noreply@blogger.com