Information Technology

My Interview with Health IT Leader John Halamka

Of the nearly 100 people I interviewed for my upcoming book, John Halmaka was one of the most fascinating. Halamka is CIO of Beth Israel Deaconess Medical Center and a national leader in health IT policy. He also runs a family farm, on which he raises ducks, alpacas and llamas. His penchant for black mock turtlenecks, along with his brilliance and quirkiness, raise inevitable comparisons to Steve Jobs. I interviewed him in Boston on August 12, 2014. Our conversation was very wide ranging, but I was particularly struck by what Halamka had to say about federal privacy regulations and HIPAA, and their impact on his job as CIO. Let’s start with that. Halamka: Not long ago, one of our physicians went into an Apple store and bought a laptop. He returned to his office, plugged it in, and synched his e-mail. He then left for a meeting. When he came…

2014 Gift Guide: What’s the Hottest Tech to Get Your Hospitalist?

HOSPITALIST TOP TECH GIFT GUIDE 2014 It is that special gift giving time of year. What to get that favorite hospitalist of yours? Don’t fret. I’ve compiled a short list of the hottest trending #hospitalistgifts. I may walk around the hospital with a pager like a 1980s drug dealer. But you can have the latest technology in Hospital Medicine. Instant Replay Package In 2014, MLB added replay review for those close calls. Equip your emergency room with the same technology the major sports carry with upgrades that allow for admission call reversals. “Hey Dr. Hospitalist, I have a chest pain in bed 5. Seems labs and ECG are ok, but 3 days of continuous chest pain, need to bring him in.” “Do you mind if we check out the instant replay?” “Alright, let’s go to the monitors. Hmmm. Looks like he’s been here 5 times for the same chest pain the…

Meaningful Use. Born, 2009, Died, 2014?

The policy known as Meaningful Use was designed to ensure that clinicians and hospitals actually used the computers they bought with the help of government subsidies. In the last few months, though, it has become clear that the policy is failing. Moreover, the federal office that administers it is losing leaders faster than American Idol is losing viewers. Because I believe that Meaningful Use is now doing more harm than good, I see these events as positive developments. To understand why, we need to review the history of federal health IT policy, including the historical accident that gave birth to Meaningful Use. I date the start of the modern era of health IT to January 20, 2004 when, in his State of the Union address, President George W. Bush made it a national goal to wire the U.S. healthcare system. A few months later, he created the Office of the…

The Medical Consumer, the “Priceline-ing” of Health Care, and Your Hospitalist Subsidy

by Dr. Brian Harte, MD, FACP, SFHM The increasing prevalence of “consumer-directed health plans,” AKA High-Deductible Health Plans (HDHP), as well as the insurance exchanges, public reporting and technology, has opened up the floodgates of health care consumerism. Can we imagine a day when the internet and price transparency permit comparison shopping, and perhaps even consumer-driven price negotiation with health care providers? Twenty years ago, most of us arranged and purchased our vacation travel arrangements using a “travel agent.” The internet brought a wave of accountability and transparency of information (i.e. customer reviews, pricing, etc.) to the travel consumer’s fingertips, Ultimately sites such as Priceline which allow consumers a weightier hand in the purchasing process, upending both the travel industry and the travel agent profession. We aren’t all the way to a “pricemedline.com” in healthcare, although there are many examples of companies pushing the industry in that direction. What we…

Who is the most productive hospitalist in the country? Guess what. It’s not you.

  Some of you might know CMS released our Part B productivity data earlier in 2014.  We have discussed on the policy side of SHM how we might use the data to learn about our field.  Unlike other specialties, we do not have a unique billing identifier.  Without the information, we cannot easily interrogate the database and view the patterns of the more than 40,000 hospital-based practitioners within our healthcare system.  The absence of such a feature creates gaps in our learning.  And as they say, you can't manage what you can't measure. We will acquire a unique code at some point, my conjecture, but until we do, we use inpatient-billing figures to assist in tagging physicians who practice hospital medicine. Most guess ambulatory docs do not bill greater than 25% of their codes on the hospital side, and as the hospitalist majority have their boards in IM or FP…
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