I have been following  the news about the National Security Agency (NSA) access to our phone records with great interest.  If we as a society don’t sort some of this out, we’ll see a repeat in the health sector a few years from now. These discussions seem to pivot on issues of population-level safety vs. personal liberty, and on trust vs. suspicion re: how much of the process is driven by ...

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A recent article by Elizabeth Hipp decried the so-called hidden costs of free EMR systems. As a physician who uses a free EHR, I chuckle at stories trying to drum up fear and uncertainty about these systems. Though free EHRs have become mainstream, there still seems to be a clever news angle in highlighting their supposed pitfalls. We live in a time when Google offers all of its services ...

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About eight years ago I was desperate to improve my golf game. I just couldn’t straighten out my drives or hit my irons crisply. (Yes, I’m fully aware that this is a first world problem). I decided to try golf camp in Palm Springs for a few days. My sensei, a crusty ex-touring pro named Artie McNickle, watched me hit several dozen balls on the driving range, video recorder running. “So, ...

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Trust: A firm belief in the reliability, truth, ability, or strength of someone or something.
Technology, technology, technology. It is all we hear. Ugh. Let’s change the focus from “technology” to the useful and meaningful processes that technology enables:
  • knowledge
  • sharing
  • communication
  • trust
Technology is only an enabler, much like the social graph. They are tools, they are platforms, and if properly utilized, they may enable “disruption” or transformation. It is the few individuals, and I do mean a few, ...

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A recent experience with my father-in-law reminded me of something that has concerned me for some time. While EMRs have some benefits for older adults, on balance I believe that they portend more dangers. There are multiple reasons, but the biggest is that health care providers tend to believe everything they read in an EMR. Even if what they read is wrong! A wise computer programmer once told me that “computer’s ...

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The hype over mobile health is deafening on most days and downright annoying on some.  So it is with some reluctance that I admit that mobile has the potential to be a gamechanger in health.  I’ve professed enthusiasm before, but that was largely around the use of wireless sensors to measure physiologic signals and SMS text as a way to deliver messages to patients and consumers.  For several years, the ...

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Over the next few months, Jacob Reider will serve as the interim National Coordinator for Health Information Technology (ONC)  while the search continues for Farzad Mostashari’s permanent replacement. What advice would I give to the next national coordinator? David Blumenthal led the ONC during a period of remarkable regulatory change and expanding budgets. He was the right person for the “regulatory era.” Farzad Mostashari led ONC during a period of implementation when resources peaked, grants were ...

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I assume by now that you’ve heard the news: Google wants to tackle aging. Specifically, they announced the launch of Calico, “a new company that will focus on health and well-being, in particular the challenge of aging and associated diseases.” Because, says Larry Page, with some “moonshot thinking around healthcare and biotechnology, I believe we can improve millions of lives.” “Can Google Solve DEATH?” shrieks a TIME cover. Google’s goal, it seems ...

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Health IT is booming, or so they say. The hotly debated and highly politicized health care reform, a.k.a. Obamacare, has been shining bright lights on a segment of our economy that is quickly approaching $3 trillion per year, and is in dire need of improvement, or so they say. Depending on who you ask, some say that health care resources must be redistributed in a more equitable manner, while others ...

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What the unbundling of Craigslist has to do with todays EMRs Recently there’s been a lot of talk about the law of bundling and subsequent unbundling of web services. Many have used Andrew Parker’s brilliant image below to make the point. Craigslist came along and bundled everything into one place and, as a result, completely dominated. They destroyed multiple businesses in the process (including the rental and roommate web service I worked with ...

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