I was invited to attend a private breakfast with book author, surgeon, and New Yorker contributor Dr. Atul Gawande shortly before Dr. Gawande’s talk at The New Yorker Festival. Over breakfast, Dr. Gawande spoke with IBM executive Dr. Paul Grundy on the future of health care. The event was sponsored by IBM so there was plenty of talk about how technology can and will influence the practice of medicine -- ...

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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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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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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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In July, I began an exciting role at Einstein: assistant dean for educational informatics. One of my main objectives is to optimize the use of technology to advance and deepen learning. But as much as I welcome it, technology alone will not achieve our educational goals. Recently, David J. Hefland, the president and vice chancellor of Canada’s Quest University, characterized the model of ...

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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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The discourse on the problems of the modern healthcare system contains much vitriol and blame. There is a distinct flavor of adversarial combat in the discussion; pitting physicians, those in the trenches, with those politicians and lawmakers on the other side. With estimates of healthcare costs exceeding 15% of the gross domestic product of the United States, it is easy to understand the passion that the topic evokes. The complexity ...

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