Tag: "health IT"

Electronic Health Records: Not Just An American Problem

A few years ago, this blog discussed the failure of government-dictated Electronic Health Records (EHRs) in the United Kingdom.

In Australia, the Liberal-National coalition government has decided to scrap the nation’s Electronic Health Record, blaming the previous Labour government for the current one’s failings. Unfortunately, the government plans to replace it with a new one, instead of leaving well enough alone:

The Abbott Government will deliver a rebooted personalised myHealth Record system for patients and doctors that will trial an opt-out, rather than opt-in, option as part of a $485 million budget rescue package to salvage Labor’s failed attempts to develop a national electronic medical records system.

Opt-out rather than opt-in? Doesn’t that sound kind of like a mandate? It’s an odd choice for a government that espouses free-market principles.

Malpractice By Electronic Health Record

Arthur Allen of Politico exposes yet another reason for doctors to fear Electronic Health Records: Their errors lead to lawsuits:

Medical errors that can be traced to the automation of the U.S. health care system are increasingly an issue in medical malpractice lawsuits.

Some of the doctors, attorneys and health IT experts involved in the litigation fear that safety and data integrity problems could undercut the benefits of electronic health records unless HHS and Congress address them aggressively.

“This is kind of like the car industry in Detroit in 1965,” says physician Michael Victoroff, a liability expert and a critic of the federal program encouraging providers to adopt EHRs. “We’re making gigantic, horrendous, unsafe machines with no seat belts, and they are selling like hot cakes.

Readers of this blog know why they are selling despite their serious flaws: The government has thrown almost $30 billion at hospitals and physicians to cause them to buy them.

Electronic Health Records Don’t Help Stroke Victims; And More Bad News

electronic-medical-recordNew research on over half a million stroke victims admitted to hospitals from 2007 to 2010 shows that there was no difference in quality of care for those admitted to hospitals with EHRs and those without:

The new study “is a wake-up call that we should heed,” writes Dr. John Windle, chief of cardiology at University of Nebraska Medical Center, in an accompanying commentary. Windle said electronic health records haven’t been proven to improve quality of health care, the health of large groups of people, or efficiency.

“An [electronic health record’s] first priority must be support of clinical care, not documentation for billing and reimbursement,” Windle said. (Randy Dotinga, HealthDay)

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Zenefits Raises $500 Million More To Reinvent Small-Biz Health Benefits

Most of us buy small-business health benefits the way our grandparents did when they ran the hardware store. It’s a business in dire need of reinventing. Zenefits looks like the company to do it. The company that was one of the top venture deals in health care last year is looking to repeat, raising $500 million at a $4.5 billion valuation:

This is Zenefits’ third funding round in less than a year and a half. The company raised $15 million in its Series A last January, then added $66 million in an June Series B round that valued it at more than $500 million.

Zenefits offers a cloud-based software-as-a-service human resources platform for small businesses that tries to be an all-in-one solution for compliance, onboarding, payroll, health insurance, and other employee benefits. The key is that the software is free to businesses; Zenefits makes its money as a broker of services, for example earning a fee from health insurers who register new businesses through Zenefits. (Brian Solomon, Forbes)

Top VC Backed-Health Tech Companies

PitchBook has compiled a roster of 2015’s top venture-capital financed health technology companies.

The three largest valuations are Modernizing Medicine, valued at $316 million, which provides an electronic medical assistant; WellTok, valued at $216 million, which provides personalized guidance on healthy behaviors; and Crosschx, valued at $64 million, which sans patients’ fingers to create a unique, secure identifier.

Pitchbook has also listed the three biggest deals so far this year:

Pitchbook2

Why Don’t You Own Your Own Health Data?

David Brailer, MD, was the first head of the Office of the National Coordinator of Health Information Technology (ONC), appointed by President George W. Bush. Today, he is a venture capitalist.

In today’s Wall Street Journal, Dr. Brailer notes that a law passed in 1996 governs our access to health information. Clearly, it needs updating:

This brave new digital world has one huge risk: You don’t own your health information. In 1996 the U.S. passed a law called HIPAA (Health Insurance Portability and Accountability Act) requiring hospitals, physicians, labs, pharmacies and other “covered entities” as well as the health plans and their “business associates” (for example, an information-technology vendor) to protect how your data is stored and released. But not without delays, often for months. You can’t force a covered entity to give your data to someone you choose, and you can’t stop them from giving it to someone they choose. Health apps? Most aren’t covered by HIPAA at all, and can do whatever they want with your information.

It is a fascinating indictment by someone with unique expertise in the field. Dr. Brailer is demanding a substantial rewrite to current law. He is also deflating ONC’s assertions that it is succeeding in granting patients ownership of our health data.

I participated in a meeting in September 2013, in which Dr. Brailer’s charismatic and enthusiastic successor, Dr. Farzad Mostashari, repeatedly announced that he and his colleagues had (gulp) “created” – not even “discovered” or “defined” – a “new right” for patients to access our data. The notion that government agencies “create” rights should obviously be anathema in the United States.

However, another major obstacle to solving the problem Dr. Brailer identifies is that health insurers control most of our health spending. They also want to control our data. As long as this is the case, we patients will struggle to own our health data in any meaningful senses.

Only when patients directly control payment to providers will providers respect patients’ ownership of our own health data.

Is Patient Scheduling Software Valuable to Doctors?

I am a huge fan of entrepreneurs who want to make medical care more productive and consumer friendly. I wish all of them the best of success. Unfortunately, I am concerned that one of the trends attracting venture capital is chasing a shrinking market. That trend is patient-scheduling software in physicians’ offices.

I was at an angel investor pitch off in Arlington, Virginia, yesterday where one such firm was seeking investors. Two great incubator/accelerators, StartUp Health in New York and Rock Health in San Francisco (and, now, New York) have invested in Arsenal Health, inventor of Smart Scheduling.

Firms like this promise algorithms that use data to predict cancellations and no-shows. I suppose this is the flipside of ZocDoc, the remarkably successful business that doctors use to find new patients to fill appointments that have been cancelled.

These are all great ideas. I am just not sure they make sense in the future environment, where there will be surplus of patients and a shortage of doctors. A few years from now, when the U.S. has Canadian-style waiting lists to see specialists, why would a physician invest in technology to manage cancellations and no-shows?

Such technology would be very valuable where there is a surplus of doctors competing for a limited number of patients. But I don’t think anyone anticipates that for U.S. health care. I hope I am wrong.

Health IT Juggernaut is Stumbling

The gold rush in Health Information Technology (HIT) appears to be winding down. Mercom Capital Group, LLC, reported that venture funding in HIT dropped 35 percent in the first quarter to just $785 million. Well, no trend lasts forever. Still, I have to wonder if investors aren’t getting a little concerned about putting so much capital into a space so dominated by government.

The Office of the National Coordinator of Health Information Technology (ONC), which has an overly ambitious 10-year strategic plan that needs to be rolled back, has pretty much confessed that the $30 billion taxpayers’ dollars spent on Electronic Health Records (EHRs) has been wasted.

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Unconnected Medical Devices Harm Patients

The federal government’s dominance of health information Technology (HIT) has been most apparent, and most harmful, in electronic health records (EHRs). However, the hand of government must lie heavily in other parts of health care, too.

An example is medical devices hooked up to patients at the hospital. Remarkably, these devices do not talk to each other, requiring nurses to waste time transcribing data from one device to another. This infographic summarizes a survey of 500 nurses commissioned by the West Health Institute:

Copyright: West Health Institute (2015)

Copyright: West Health Institute (2015)

 

These are appalling figures. I don’t know about you, but I figured out how to connect my VCR to my TV sometime during the 1980s. Medical devices are heavily regulated by the FDA. The fact that devices critical to hospital patients’ health are still not connected strikes me as a likely consequence of over-regulation.

Hits and Misses

Women jogging

Jogging may be good for your heart: But endurance runners are more likely to die from heat stroke than a heart attack.

Big shrink is listening: A smart phone app that monitors your voice for signs of manic/depression.

There’s little reliable evidence that fish oil helps prevent heart disease.

Ridiculous study or common sense? Eating fruit and vegetables is associated with greater flourishing in daily life.

Your dog wears a watch: Why your dog seems to know what time it is.