Fish gotta fly, birds gotta swim: more on the opiate crisis
At so many levels, the current opiate crisis, and the way in which various actors are seeking to cope with it, proves rich in intriguing detail.For starters, it needs to be memorialized that there is a judge in Ohio--like Pennsylvania a fascinating political see-saw state--who ' s actually trying to do something about this crisis.Daniel Polster, a Clinton appointee and approaching two decades on the bench, hasconvenedall the parties caught up in the current crisis. Metaphorically locking them all in a room and saying " we ' ll solve this problem and maybe you get outa this room, " he included players not even directly invo...
Source: Health Care Renewal - February 2, 2018 Category: Health Management Source Type: blogs
Disastrously conceived, managed, and implemented U.S. Coast Guard EHR leaves our Coast Guard heroes safer ... after reversion to paper records
Sometimes, the typical EHR mismanagement debacles that I have been writing about since at least 1999 leave patientssafer. This is one such example.I note that the contents of this blog, as well as my still-extant Drexel website "Contemporary Issues in Medical Informatics: Good Health IT, Bad Health IT, and Common Examples of Healthcare IT Difficulties" (http://cci.drexel.edu/faculty/ssilverstein/cases/) and many other resources about healthcare IT mismanagement and failure, are available free of cost. They could have saved the Coast Guard many millions of dollars if their contents had been reviewed and taken se...
Source: Health Care Renewal - February 2, 2018 Category: Health Management Tags: Coast Guard EPIC Fedscoop News health IT failure IHiS Zaid Shorbajee Source Type: blogs
The inevitable downgrading of burdensome, destructive EHRs back to paper & document imaging
In recent days, I ' ve posted about current articles on the destructive nature of today ' s vastly over-complex, burdensome EHR technology. These posts included "Physicians Harassed by Overwhelming Levels of Messaging From Electronic Medical Records" athttp://hcrenewal.blogspot.com/2018/01/physicians-harassed-by-onerwhelming.htmland" Medical Economics: Highly experienced physicians lost to medicine over bad health IT " athttp://hcrenewal.blogspot.com/2018/01/medical-economics-highly-experienced.html.There are many other earlier articles of a similar nature discussed on this blog, e.g., the May 2017 post "Death ...
Source: Health Care Renewal - January 31, 2018 Category: Health Management Tags: Alexi Wright MD bad health IT burnout Christine A. Sinsky healthcare IT difficulties Healthcare IT failure Ingrid Katz MD NEJM Source Type: blogs
Burnout Returns to Center Stage
A recentMayo Clinic Proceedings guesteditorial, by Yale University physician Kristine Olson, asks the question--to some of us it ' s far from a rhetorical one--whether burnout among her fellow physicians is in fact " A Leading Indicator of Health System Performance? "Seems to me that her gist is: yes, it surely must be just such an indicator. If she ' s right, then our system ' s performance is in a heap of trouble.What is burnout? Our fearless editor, Dr. Poses, has addressed it repeatedly, including a few months agohere in these pages. But burnout is actually hard to delineate and hard to quantify. People quitting? ...
Source: Health Care Renewal - January 30, 2018 Category: Health Management Source Type: blogs
Physicians Harassed by Overwhelming Levels of Messaging From Electronic Medical Records
In yet another example of the clerical overload caused by bad health IT, physicians find themselves drinking from a fire hose through cybernetics. This, in the field of dermatology, let alone critical care specialties:Physicians Overwhelmed by Messaging From Electronic Medical RecordsMedicalResearch.com Interview with: Matilda W. Nicholas, MD, PhDDuke DermatologyJanuary 29, 2018https://medicalresearch.com/author-interviews/physicians-overwhelmed-by-messaging-from-electronic-medical-records/39671/MedicalResearch.com: What is the background for this study?Response: I have found many physicians overwhelmed by the e...
Source: Health Care Renewal - January 30, 2018 Category: Health Management Tags: bad health IT burnout healthcare IT dissatisfaction healthcare IT distraction healthcare IT harms medicalresearch.com Source Type: blogs
Medical Economics: Highly experienced physicians lost to medicine over bad health IT
The title of the article is actually "Physicians leaving profession over EHRs" , but that title omits the real impact of the phenomenon: seasoned physicians, along with their medical expertise, judgment and experience, are lost to the pool of people entrusted to provide care thanks to poorly designed and badly implemented IT:http://cci.drexel.edu/faculty/ssilverstein/cases/Bad Health IT is IT that is ill-suited to purpose, hard to use, unreliable, loses data or provides incorrect data, is difficult and/or prohibitively expensive to customize to the needs of different medical specialists and subspecialists, causes cognitive...
Source: Health Care Renewal - January 28, 2018 Category: Health Management Tags: bad health IT data trafficking Ddulite Medical Economics Munzoor Shaikh physicians leaving medicine Ramin Javahery MD Tom Davis MD FAAFP Source Type: blogs
More on the Opiate Abuse Epidemic: Where Again Does the Finger Point?
In arecentblog post we pointed to conservatives ' efforts to implicate Medicaid funding as somehow causative of, or at least promoting, the opiate " crisis. " After all, funding for medications means people will use, and sometimes abuse, those medications. Meds they might otherwise ill be able to afford. (Implied solution: cut Medicaid.)We also alluded to some of the logical fallacies in such thinking. Here, though, let ' s take it to another level: the blame game, where does it lead? Where does the finger point? Those who agree with Ronald Reagan that government is the problem, not the solution, fall into the trap of blam...
Source: Health Care Renewal - January 23, 2018 Category: Health Management Source Type: blogs
Not just bad health IT, but SPECTACULARLY bad health IT
I define bad healthcare IT as:... IT that is ill-suited to purpose, hard to use, unreliable, loses data or provides incorrect data, is difficult and/or prohibitively expensive to customize to the needs of different medical specialists and subspecialists, causes cognitive overload, slows rather than facilitates users, lacks appropriate alerts, creates the need for hypervigilance (i.e., towards avoiding IT-related mishaps) that increases stress, is lacking in security, lacks evidentiary soundness, compromises patient privacy or otherwise demonstrates suboptimal design and/or implementation. (http://cci.drexel.edu/faculty/ssi...
Source: Health Care Renewal - January 20, 2018 Category: Health Management Tags: bad health IT healthcare IT amateur KevinMD Niran S. Al-Agba Source Type: blogs
Will the New Conscience and Religious Freedom Division of the US Department of Health and Human Services Help Health Care Professionals Challenge Morally Objectionable Acts - Like Bribery, Fraud and Other Criminal or Corrupt Practices?
For a long time we have argued thathealth care corruption is a major cause of health care dysfunction. We have documented numerous cases in which health care professionals were exposed to or involved in actions, includingfraud,bribery (also known askickbacks), and othercorrupt orcriminalpractices, to which they likely had moral objections. We have also noted that in such situations, health care professionals often have little recourse, particularly in academic institutions.The New Conscience and Religious Freedom Division of the US Department of Health and Human ServicesSo perhaps a new initiative of the US Dep...
Source: Health Care Renewal - January 18, 2018 Category: Health Management Tags: bribery crime DHHS fraud health care corruption kickbacks revolving doors Source Type: blogs
Big Bang Theory of Health Care: Ever Since 1967
Hold on to your hat: it all comes together now. Looking at events in our nation ' s capital, in a strange fever dream, The Big Bang Theory just came to me. No, call it the Big Fecal-Bang Theory, as I read about how our national leadership proceeds from one inanity to the next.But when it comes to health care, and wiping out the safety net using false premises, inanity kills. So this is worth writing. But to see how it all ties together, we have to go back over half a century.Where else can you read about the hidden connections between Hollywood, health insurance in the US of A, Really Bad Tax Cuts, Wisconsin cheese-eaters,...
Source: Health Care Renewal - January 18, 2018 Category: Health Management Tags: logical fallacies Medicaid narcotics propaganda Source Type: blogs
The Big Bang Theory of Health Care Since 1967
Hold on to your hat: it all comes together now. Looking at events in our nation ' s capital, in a strange fever dream, The Big Bang Theory just came to me. No, call it the Big Fecal-Bang Theory, as I read about how our national leadership proceeds from one inanity to the next.But when it comes to health care, and wiping out the safety net using false premises, inanity kills. So this is worth writing. But to see how it all ties together, we have to go back over half a century.Where else can you read about the hidden connections between Hollywood, health insurance in the US of A, Really Bad Tax Cuts, Wisconsin cheese-eaters,...
Source: Health Care Renewal - January 18, 2018 Category: Health Management Tags: logical fallacies Medicaid narcotics propaganda Source Type: blogs
" Hot Spot For User Entry Error " : Hawaii missile alert: How one employee ‘pushed the wrong button’ and caused a wave of panic
A short post.I believe this WaPo story vividly demonstrates issues I ' ve seen in what Australian colleague Dr. Jon Patrick& I call " bad health IT. " We came up with the simple-to-comprehend terminology " Good health IT/Bad health IT " in his living room in Sydney after my presentation to the Health Informatics Society of Australia in 2012 on health IT trust (http://hcrenewal.blogspot.com/2012/08/my-presentation-to-health-informatics.html), to replace my earlier terms " health IT done well " vs. " done poorly. "It wasnot just " one employee who pushed the wrong button. " A team of apparently incompetent IT p...
Source: Health Care Renewal - January 15, 2018 Category: Health Management Tags: bad health IT core incompetence good IT/bad IT Hawaii missile alert technology risks use error Source Type: blogs
How To Challenge Health Care Corruption Under a Corrupt Regime?
Introduction: the Corruption of Health Care Leadership as a Major Cause of Health Care DysfunctionFor a long time we have argued thathealth care corruption is a major cause of health care dysfunction. As we wrote in August, 2017, Transparency International (TI) defines corruption asAbuse of entrusted power for private gainIn 2006,TI published a report on health care corruption, which asserted that corruption is widespread throughout the world, serious, and causes severe harm to patients and society.the scale of corruption is vast in both rich and poor countries.Also,Corruption might mean the difference between life a...
Source: Health Care Renewal - January 15, 2018 Category: Health Management Tags: anechoic effect conflicts of interest Donald Trump health care corruption mission-hostile management Source Type: blogs
Ill-Informed, Incompetent* Health Care Leadership: the Case of President Trump's Interview in the New York Times
ConclusionsWe have frequently criticized the leadership of big health care organizations as ill-informed, incompetent, ignorant of or even hostile to the values of health care professionals, deceptive, self-interested, conflicted or even corrupt. The President of the United States is the country ' s most important health care leader, since all government agencies that deal with health, health care, health care policy, etc report to him. Unfortunately, we have previously discussed examples of how the president appeared to be an ill-informed or incompetent health care leader, for examplehere. So it would be easy t...
Source: Health Care Renewal - January 5, 2018 Category: Health Management Tags: Donald Trump ill-informed management Source Type: blogs
A Remedy for Corruption
Do I really have a remedy for corruption? I wish I did. But, I have lately found an effective balm for the sickening discouragement that it is easy to feel when confronted day after day with another instance of the medical industry ’s price-gouging corruption, purposeful distortions, and callous disregard of patient welfare. That remedy is a new podcast from Australia:Ray Moynihan ’sThe Effective Dose. If you don ’t already recognize Moynihan’s name, he’s an author ofSelling Sickness and he ’s had a persistent interest in overdiagnosis and medicalization. He describes the podcast as “interviews...
Source: Health Care Renewal - January 1, 2018 Category: Health Management Source Type: blogs
