New York Times: "In Second Look, Few Savings From Digital Health Records", and AMA Med News on EHR Harms
This post should perhaps be entitled "I told you so."A letter I wrote in response to the Wall Street Journal's "A Health-Tech Monopoly", Feb. 11, 2009 was published Feb. 18, 2009 under the header Digitizing Medical Records May Help, but It's Complex.I wrote:Dear Wall Street Journal,You observe that the true political goal is socialized medicine facilitated by health care information technology. You note that the public is being deceived, as the rules behind this takeover were stealthily inserted in the stimulus bill.I have a different view on who is deceiving whom. In fact, it is the government that has...
Source: Health Care Renewal - January 15, 2013 Category: Health Medicine and Bioethics Commentators Tags: New York Times Julie Creswell healthcare IT risk Reed Abelson American Medical News healthcare IT safety healthcare IT risks David Brailer Pennsylvania Patient Safety Authority Source Type: blogs

Pfizer's Pfourteenth Settlement - a Small Reminder of Continuing Impunity
Well, that did not take long.  Less than a month after its last legal settlements were announced, Pfizer had to settle again. The Details of the Settlement This case, involving charges filed by the Texas Attorney General, was only reported locally, e.g., here in the Houston Business Journal:The state of Texas will receive more than $36 million from two civil Medicaid fraud settlements with Pfizer Inc and Endo Pharmaceuticals,  Attorney General Greg Abbott said Friday. Both companies will pay $18.17 million to the state, plus attorney fees and relator shares. The federal government is also entitled to a share...
Source: Health Care Renewal - January 11, 2013 Category: Health Medicine and Bioethics Commentators Tags: executive compensation deception boards of directors impunity Pfizer legal settlements governance Source Type: blogs

At University of Miami, Faculty Without Confidence in their Hired Managers Afraid to Identify Themselves
The University of Miami has provided some vivid examples of the contrast between the power and privileges of the leaders of large health care organizations and the subservient role of faculty and staff. Background Back in 2006, we noted that while the University of Miami was paying its janitorial support staff less than seven dollars an hour, and supplying them with no health insurance, its President, Donna Shalala, was living in a 9000 square foot official mansion, with staff hired to make her bed.  While Ms Shalala did not seem very perturbed about the living conditions of the lowliest University staffers, as a...
Source: Health Care Renewal - January 9, 2013 Category: Health Medicine and Bioethics Commentators Tags: executive life style mission-hostile management medical schools Donna Shalala free speech University of Miami anechoic effect Source Type: blogs

Some Real-World Lessons for the Health IT Hyper-Enthusiasts
An article was published in Health Leaders Media yesterday by Scott Mace, senior technology editor entitled "Scot Silverstein's Good Health IT and Bad Health IT" at this link.(Actually, the terms "good health IT" and "bad health IT" themselves came as a result of my discussions in Australia with Prof. Jon Patrick of my conviction, presented to the Health Informatics Society of Australia in my Aug. 2012 talk "Critical Thinking on Building Trusted, Transformative Medical Information:  Improving Health IT as the First Step", that to be trusted and do no harm, health IT must be &ldq...
Source: Health Care Renewal - January 9, 2013 Category: Health Medicine and Bioethics Commentators Tags: healthcare IT unintended consequences healthcare IT difficulties Ddulite Kiran Raj Pandey healthcare IT toxicity Wes Fisher MD Source Type: blogs

Why Did the "Dean of Health Care Economics" Urge Reforms that "Appeal to Some Special Interests?"
We have often discussed, some would say belabored, the importance of the "anechoic effect" in health care.  Particular issues which would make those who benefit the most from our current dysfunctional health care system uncomfortable are often considered not to appropriate for polite conversation.  A prominent recent article in JAMA provided a great example of  how there are certain topics that health care, services, and policy experts avoid discussing.Summary of the Article The article was by Victor R Fuchs, who has been called the" dean of health care economics."  His topic was why...
Source: Health Care Renewal - January 7, 2013 Category: Health Medicine and Bioethics Commentators Tags: health care reform health services research anechoic effect Source Type: blogs

ONC and "Health IT Patient Safety Action & Surveillance Plan": When Sociologists Uphold the Hippocratic Oath While Physicians Pay Respect to the Lords of Kobol, We Are in a Dark Place, Ethically
[Note: this essay contains many hyperlinks. They can be right-clicked and opened in a separate tab or window.]I've been meaning to write more on the just-before-Christmas, Friday afternoon, minimal-visibility release of the ONC report I'd written about in my Dec. 23, 2012 post "ONC's Christmas Confessional on Health IT Safety: HIT Patient Safety Action & Surveillance Plan for Public Comment."   (The ONC report itself is available at this link in PDF.)The Boston Globe and Globe staff writer Chelsea Conaboy, however, have beaten me to the punch in the Jan. 3, 2013 article "Federal government rele...
Source: Health Care Renewal - January 5, 2013 Category: Health Medicine and Bioethics Commentators Tags: Cliff Rieders Chelsea Conaboy ross koppel Cybernetik Über Alles HIT Patient Safety Action and Surveillance Plan healthcare IT safety Boston Globe Ashish Jha ONC John Halamka Source Type: blogs

BLOGSCAN - When Private Equity Owns Hospitals
On his Not Running a Hospital blog, Paul Levy discussed reasons for concern when private equity firms purchase and operate hospitals.  He used the example of Steward Health Care, now a for-profit hospital system (which also employs physicians to provide direct patient care), which in turn is owned by Cerberus Capital Management.   The issue is pertinent due to recent discussion in the media about Cerberus' newly stated intention to sell the large firearms and ammunition business it assembled, Freedom Group.  This intention was only stated after the tragic multiple murders of children and teachers by gun...
Source: Health Care Renewal - January 4, 2013 Category: Health Medicine and Bioethics Commentators Tags: Cerberus Steward Health Care private equity Source Type: blogs

Oh, the Prices we Pay ... for Questionable Drug Marketing to Enrich Corporate Insiders - the Case of Questcor's H P Acthar Revisited
In 2007, we first discussed the case of the amazing pricing of H P Acthar, a very old drug of questionable usefulness, as an example of the irrationality of health care prices in the US, and of the failure of the organizations that ought to resist outrageous pricing in our mixed, pseudo-market based health care system to do so.  A recent New York Times article has updated this case.BackgroundAs we wrote in 2007, ACTH (adrenocorticotrophic hormone) is a naturally occurring hormone that stimulates the activity of the adrenal gland, which produces cortisol and other glucocorticoid and mineralocorticoid hormones. &nb...
Source: Health Care Renewal - January 3, 2013 Category: Health Medicine and Bioethics Commentators Tags: executive compensation deception institutional conflicts of interest key opinion leaders Questcor marketing health care prices manipulating clinical research ACTH suppression of medical research Source Type: blogs

Question for the New Year: Why is There Next to No Reaction to the Gilded Age of Health Care?
For the New Year, it is time to ponder- why is there still no organized outrage over the ongoing incompetent, uncaring, self-interested, conflicted, and often outright corrupt leadership of health care organizations we have documented incessantly on Health Care Renewal?For example, just a few days ago, we documented a series of cases in which large US and multinational health care organizations settled cases alleging they deceptively marketed drugs so as to exaggerate their benefits and conceal their harms, bribed doctors and officials  outside of the US, gave kickbacks to US doctors, defrauded the US government, and ...
Source: Health Care Renewal - December 31, 2012 Category: Health Medicine and Bioethics Commentators Tags: propaganda governance finance leadership Source Type: blogs