From The Editor | August 4, 2011

A Trip Down Health IT Memory Lane

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By Ken Congdon, editor in chief, Health IT Outcomes

Believe it or not, this article marks the 100th editorial opinion column I've written for Health IT Outcomes. To commemorate this milestone, I planned to take a page out of television sitcoms. What I mean by this is many sitcoms treat their 100th episode as a "clip show" where they edit together the most memorable scenes from the past seasons into one cohesive program. However, it proved difficult to string together bits and pieces of each of the articles I've written over the past 2+ years into one cohesive article. Therefore, what I decided to do instead was highlight some of the pieces I've written that generated the most reader reaction (both good and bad) and share some of this feedback with you. The reader feedback generated by each of these pieces demonstrated that the subject matter struck a chord with our audience. Eliciting this type of response from readers drives interaction, which, in my opinion, is what it's all about.

U.S. Healthcare By the Numbers — 11/12/2009

By far, the most controversial article I've written to date. In this column, I reference some unflattering U.S. healthcare statistics in regards to life expectancy and infant mortality. I also make some opinionated statements that suggest that maybe (just maybe) the U.S. healthcare system isn't the superior model in every regard and that perhaps we could learn a thing or two from the way healthcare is handled in other countries. Needless to say, these remarks were met with vehement opposition from some members of our audience, the most passionate comments coming from the following reader:

"I cannot stand these articles that continue to lay out bogus statistics that have no real meaning when it comes right down to it. There are so many factors that come into play when it comes to life expectancy and the overall health of a nation's population that are too many to mention in this email — the least of which is how the statistics are manipulated by those who want to prove their agenda. It's all politics and power. Period.

I tell you what, Ken. I would love for you to go and live in Finland, or even easier, Canada, for about five years and see how you like it. Better yet, go move there when you are about 60, 65, or 70, and then write about how great their system is when you have to wait 6 months for your MRI. I hope you are still alive when you finally get it done."

Just to clarify, my article was never intended to say that the healthcare delivered by other countries is "great" or better than the U.S. healthcare system. I was trying to illustrate that that there might be some "pieces" or "components" from foreign healthcare practices that we can leverage to further improve upon our own healthcare system. Maybe I should have chosen my words a bit more carefully.

The Apple iPad's Impact On Healthcare — 2/18/2010

Oftentimes readers will call out important considerations I didn't fully explore in an article I write, and I appreciate this added information. As a journalist, I don't always know the full breadth of the challenges associated with incorporating technology into a healthcare facility, and getting added insight from our readers in the trenches is always a plus. For example, in this article I wrote about the Apple iPad, I focused on a lot of the positives the platform could potentially bring to the healthcare market, but failed to adequately address the security issues involved with the platform. The following reader helped set me straight:

"I read your February article on the iPad. One item that was not mentioned was security, especially as to how it relates to HIPAA/HITECH compliance. Both the iPhone and iPad suffer from vulnerabilities, which even iOS does not fully mitigate. Given the jailbreak and Safari vulnerabilities, a healthcare institution may be required to report to regulators or a state attorney general that patient information potentially could be exposed. I don't think a healthcare institution could, in good conscience, consider patient information secure given these vulnerabilities. It would help if iPhones and iPads were FIPS-certified, but it doesn't seem that Apple is willing to go that route. Although I think these devices offer operational benefits, they don't outweigh the regulatory, statutory, financial, or reputational risks an institution assumes with their deployment. Unfortunately, what I see currently in the industry is a love affair with the devices, but an almost casual concern with security."

Quality Care Begins With Proper Credentialing — 4/15/2010

In this article, I outline the importance of proper credentialing in patient care, and how many healthcare facilities still employ manual procedures to manage their physician credentialing activities. This column stresses the potential benefits of automated credentialing systems in streamlining these processes. This article generated a lot of support from members of our audience, including the following response:

"Do you think any type of law will ever be put in place to help medical staff professionals do their jobs more effectively? I've been in credentialing for more than 15 years and I have not seen a lot of progress toward mandating electronic credentialing systems, even though these solutions would clearly improve the quality of care for patients. When money is tight, the credentialing office is usually one of the first places that experiences budget cuts. Most medical staff offices are overworked, under staffed, and use homegrown credentialing programs that just don't work for larger systems anymore. I am hopeful that one day, before I retire, I'll see mandated improvements to the credentialing process. It is way past time to move physician credentialing into the 21st century and get us out of the basement!"

The Impact Of EHRs On Patient Care — 1/28/2011

In this article, I offer evidence against a study by Stanford University School of Medicine that suggests that EHRs do little to improve the quality of patient care. In this piece, I provide several case examples that prove the positive affect EHRs are having on patient care throughout the country. The following reader comment simply added to my list of evidence:

"I appreciate the insight you shared in your article about EHRs/Patient Care. One other item that is often overlooked is if the provider is actually using the EHR system to retrieve information more quickly electronically, or is he or she just asking an office worker to print the health data out for them? When the focus is on Meaningful Use as opposed to simply installing the EHR technology, the efficiency of the system (and the quality of patient care) will be greatly enhanced."

Google Health Flatlines — 6/30/2011

In this article, I editorialize on the reasons behind Google Health's demise and the future of the PHR. My viewpoints provoked a reader to share some of his own:

"The Google brand itself may have hurt Google Health in the long run. Google built its business around free-flowing information. If you are logged into Google, they will collect data and store your queries. Knowing the brand and the company history, perhaps people just didn't feel comfortable storing their private health data on the Google Health platform. We as an American society are very much "hung up on" privacy. I think we need to take a completely different approach to the PHR in the U.S. than Google Health did."

Re-reading these select articles of mine and the reader feedback they generated was definitely a learning experience for me. I hope you got some value out of the information presented as well — whether it was the first time or second time you've read the columns. Going forward, I will strive to provide you with even more original Health IT content on a weekly basis that will provoke ideas and interaction.

Have a comment or feedback for Ken on this article? He can be reached directly at ken.congdon@jamesonpublishing.com.