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EHR
The Big Idea in Understanding “Accountable Care Organizations”
Here’s the big idea: accountable care organizations (ACOs) are about creating accountability.
ACOs of various types are being proposed in national health reform legislation. For all you ever wanted to know about ACOs, read How to Create Accountable Care Organizations from the Center for Healthcare Quality and Payment Reform.   I spent an hour and a half poring over the details of this excellent report written by Harold Miller.
My mistaken impression has been to focus on the organizational form of ACOs, rather than their objectives. Organizational form is relevant […]
Meeting Announcement: “Introduction to the Clinical Groupware Collaborative”
by Steve Adams, CEO, RMD Networks and Acting President, Clinical Groupware Collaborative Â
I’m writing to extend a warm personal invitation to learn more about the Clinical Groupware Collaborative (CGC). To-date, purely through word-of-mouth over 40 companies have expressed interest in the CGC, and we expect that you’ll be hearing a lot more about us over the coming months.
Our meeting will take place next Tuesday, September 22, 6 PM in conjunction with The Forum 09, the annual meeting of DMAA: […]
The Third Rail in HITECH Implementation: “Please Don’t Make Us All Speak Latin”
By Vince Kuraitis and Steven Waldren MD, MS. Dr Waldren is Director of the Center for Health Information Technology at the American Academy of Family Practice (AAFP).
Two issues have rightfully surfaced front and center in the public’s understanding of HITECH Act implementation:
” definition of “Meaningful Use” of EHRs, and
” definition of “certification” process for EHRs
…and we applaud the progress of the workgroups and the HIT Policy Committee in addressing these issues constructively.
However…a THIRD issue lurks – “Data harmonization at the […]
CCHIT’s Latest Gambit
by Glen Laffel MD, PhD
Many of us have enjoyed a few good minutes of fun having our fortunes told by soothsayers who claim they can predict our future based on patterns of tea leaves in a cup or the playing cards we’ve pulled from a deck.
We pay a few dollars for the entertainment and if the fortune teller is skilled, we are temporarily impressed by his “insight.” But once we leave the carnival, we come back […]
PR Blunder of the Year: Federation of American Hospitals Says Meaningful Use Should Not Tie to Quality Improvement
These guys really don’t get it, and they need to be called on the carpet, taken to the woodshed, or pick your own favorite cliche.
The Federation of American Hospitals (FAH) sent a letter to Dr. David Blumenthal (National Coordinator for Health IT) arguing that “Meaningful Use” funding should not be tied to achievement of quality measures. The FAH is the trade association for for-profit hospitals; the letter is dated August 26 and a copy is available on […]
What’s a Network Industry? Is Healthcare One?
This post is a foundational overview of characteristics of network industries. Much of the terminology will deserve deeper discussion, but we have to start somewhere.
In his book The Economics of Network Industries, Professor Oz Shy lists four characteristics of network industries.
The main characteristics of these markets which distinguish them from the market for grain, dairy products, apples, and treasury bonds are:
Complementarity, compatibility and standards
Consumption externalities [network effects]
Switching costs and lock-in
Significant economies of scale in production
In this essay, I’ll quote from Dr. Shy in explaining each […]
Intro to a New Series
  “We need to make care linkages a core competency of American health care.”Â
George Halvorson, Chairman and CEO, Kaiser Foundation Health Plan, Kaiser Foundation Hospital
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There’s a double meaning to the title of this new series: Healthcare Crosses the Chasm to the Network Economy
At the level of technology, it’s a reference to Geoffrey Moore’s bestselling business/technology book — “Crossing the Chasm”. The Chasm here is the huge gap between early adopters of technology and mainstream users. The book describes the process of bringing […]
HIT Policy Committee Recommends “Minimum” Certification of EHRs
At last Friday’s meeting, the HIT Policy Committee adopted the recommendations of the Certification and Adoption Workgroup.
Between the initial recommendations in July and the adopted recommendations in August, one critical word was added to the definition of “certification”. That one word is “minimum” — and this one word expresses the correct approach and philosophy for the government’s role in the certification process for EHRs.
In this post I’ll address why a “minimum” approach toward certification makes […]
“Meaningful Use” Criteria as a Unifying Force
by Vince Kuraitis, Steve Adams, and David C. Kibbe MD, MBA
Over the past several years, many diverse initiatives have arisen offering partial solutions to systemic problems in the U.S. health care non-system.Â
We see Meaningful Use Criteria recommended by the HIT Policy Committee as a unifying force for these previously disparate initiatives. These initiatives have included:
Patient Centered Medical Homes (PCMHs)
Regional Health Information Organizations (RHIOs)/Health Information Exchanges (HIEs)
Payer Disease/Care Management Programs
Personal Health Record Platforms — Google Health, Microsoft HealthVault, Dossia, health banks, more to come
State/Regional […]
Overcoming The Penguin Problem: Setting Expectations for EHR Adoption
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Economists call it “The Penguin Problem” — No one moves unless everyone moves, so no one moves.Â
The role of user expectations is crucial in getting penguins to move off of ice floes and in the successful adoption of new network technologies. I’ll cover two main points in today’s essay:
How “The Penguin Problem” Helps Explain Low EHR (electronic health record) Adoption To-Date
How Recent Federal Actions Are Setting Higher Expectations for EHR Adoption
The Penguin Problem and Low EHR Adoption To-Date
While not the only factor, […]