Over the past few months, I’ve been in England, China, Denmark, New Zealand and Canada. Each of them is rethinking their health care IT strategy and is not entirely satisfied with past progress. I’m often asked by senior government officials to help harmonize IT strategy at the country level. That — I can do. I frequently say that health care IT issues are the same all over the world. Here are a few ...

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Many organizations have asked me to comment on the impact of the Trump presidency on health care and health care IT.    I served the Bush administration for four years and the Obama administration for six years.   I know that change in Washington happens incrementally.   There is always an evolution, not a revolution, regardless of speechmaking hyperbole. What am I doing in Massachusetts?   I’m staying the course, continuing ...

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Recently, the American Medical Association CEO called digital health care products modern day "snake oil." As a provider and a technologist, I think we need a deeper dive to understand the issues, avoiding the kind of hyperbole that’s so common in politics today. Paul B. Batalden, MD, Senior Fellow, Institute for Healthcare Improvement (IHI), once said "Every system is perfectly designed to get the results it gets." Let’s take ...

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When my father died three years ago,  my comments at his funeral noted that the greatest aspiration any of us can have is to make a difference in the world.  My father’s life made a difference. I’m always self-critical and analyzing my own life.  I moved to Boston 20 years ago this month.   In those 20 years of service to Beth Israel Deaconess Medical Center (BIDMC), Harvard, numerous federal organizations, ...

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Over the past several years I’ve written about the inadequate state of clinical documentation, which is largely unchanged since the days of Osler, (except for a bit more structure introduced by Larry Weed in the 1970s) and was created for billing/legal purposes not for care coordination. One of the most frequent complaints in my email box these days is a sense that the current record is filled with data, but little knowledge and ...

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Over the past few months, Beth Israel Deaconess Medical Center (BIDMC) has been exploring the use of wearable computing. In the emergency department we’ve been evaluating an early unit of Google Glass, a high tech pair of glasses that includes a video camera, video screen, speaker, microphone, touch pad, and motion sensor. We have been able to access our internal web-based ED dashboard on Glass, in a secure manner that ensures all ...

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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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Now that Labor Day has come and gone,  I’ve thought about the months ahead and the major challenges I’ll face. 1. Mergers and acquisitions. Health care in the US is not a system of care, it’s a disconnected collection of hospitals, clinics, pharmacies, labs, and imaging centers.  As the Affordable Care Act rolls out, many accountable care organizations are realizing that the only way to survive is to create “systemness” through mergers, ...

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breakthrough-prize-sergey-brin-google-glass I recently had the opportunity to test Google Glass. It’s basically an Android smartphone (without the cellular transmitter) capable of running Android apps, built into a pair of glasses.  The small prism “screen” displays video at half HD resolution.  The sound features use bone conduction, so only the wearer can hear audio output.   It has a motion sensitive accelerometer for gestural commands.   ...

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In the Boston marketplace, Partners Healthcare is is replacing 30 years of self developed software with Epic.   Boston Medical Center is replacing Eclipsys (Allscripts) with Epic.   Lahey Clinic is replacing Meditech/Allscripts with Epic.  Cambridge Health Alliance and Atrius already run Epic.   Rumors abound that others are in Eastern Massachusetts are considering Epic.  Why has Epic gained such momentum over the past few years? Watching the implementations around me, ...

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