With the Department of Justice announcement of the $155 million dollar eClinicalWorks settlement (including personal liability for the CEO, CMO and COO), many stakeholders are wondering what’s next for EHRs. Clearly, the industry is in a state of transition. eCW will be distracted by its 5-year corporate integrity agreement.    AthenaHealth will have to focus on the activist investors at Elliott ...

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At HIMSS, I listened carefully to payers, providers, patients, developers and researchers. Below is a distillation of what I heard from thousands of stakeholders. It is not partisan and does not criticize the work of any person in industry, government or academia. It reflects the lessons learned from the past 20 years of health care IT implementation and policy making. Knowing where we are now and where we want to be, ...

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As I've listened to the confirmation hearings for cabinet nominees, I’ve realized that no one with health care IT expertise has been identified by the transition team. I continue to ask all my colleagues about any contact they’ve had with anyone advising the new administration. So far, no one has been asked anything by anyone related to health care IT. At this early time in the administration, it’s important to offer ...

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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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