NY Times/Steve Lohr asks " Why the Economic Payoff From Technology Is So Elusive. " The answer in medicine is obvious.
In a June 5, 2016 article, New York Times reporter Steve Lohr ( http://topics.nytimes.com/top/reference/timestopics/people/l/steve_lohr/index.html ), who reports on technology, business and economics, asked the following question: Why the Economic Payoff From Technology Is So Elusive New York Times, Business Day By STEVE LOHR JUNE 5, 2016 http://www.nytimes.com/2016/06/06/business/why-the-economic-payoff-from-technology-is-so-elusive.htm l Your smartphone allows you to get almost instantaneous answers to the most obscure questions. It also allows you to waste hours scrolling through Facebook or looking for the latest ...
Source: Health Care Renewal - June 7, 2016 Category: Health Management Tags: healthcare IT benefits healthcare IT difficulties healthcare IT dissatisfaction healthcare IT risk New York Times Steve Lohr Source Type: blogs

NY Times/Steve Lohr asks "Why the Economic Payoff From Technology Is So Elusive." The answer in medicine is obvious.
In a June 5, 2016 article, New York Times reporter Steve Lohr (http://topics.nytimes.com/top/reference/timestopics/people/l/steve_lohr/index.html), who reports on technology, business and economics, asked the following question:Why the Economic Payoff From Technology Is So ElusiveNew York Times, Business Day By STEVE LOHRJUNE 5, 2016http://www.nytimes.com/2016/06/06/business/why-the-economic-payoff-from-technology-is-so-elusive.html Your smartphone allows you to get almost instantaneous answers to the most obscure questions. It also allows you to waste hours scrolling through Facebook or looking for the latest deals on Ama...
Source: Health Care Renewal - June 7, 2016 Category: Health Management Tags: healthcare IT benefits healthcare IT difficulties healthcare IT dissatisfaction healthcare IT risk New York Times Steve Lohr Source Type: blogs

Clinical Practice Guidelines: Still Conflicted After All These Years
ConclusionFinancial relationships between organizations that produce clinical practice guidelines and the biomedical industry appear to be common. These relationships are important because they may influence, through guideline usage, the practice of large numbers of healthcare providers. We believe that to effectively manage conflicts of interest, organizations that produce clinical practice guidelines need to develop robust conflict of interest policies that include procedures for managing violations of the policy, make the policies publicly available, and disclose all financial relationships with biomedical companies.Edi...
Source: Health Care Renewal - June 3, 2016 Category: Health Management Tags: conflicts of interest guidelines Institute of Medicine institutional conflicts of interest Source Type: blogs

UK health IT'glitch': Hundreds of thousands of patients have potentially been given an incorrect cardiovascular risk estimation after a major IT system error
This in the UK. What is euphemistically referred to as an " IT system error " is, in reality, the mass delivery of a grossly defective medical device adversely affecting hundreds of thousands of patients.   I'm surprised not to see that other kindly euphemism, " glitch " ( http://hcrenewal.blogspot.com/search/label/glitch ): http://www.pulsetoday.co.uk/your-practice/practice-topics/it/gps-told-to-review-patients-at-risk-as-it-error-miscalculates-cv-score-in-thousands/20031807.article 11 May 2016   By Alex Matthews-King Hundreds of thousands of patients have potentially been g...
Source: Health Care Renewal - May 31, 2016 Category: Health Management Tags: Alex Matthews-King Clinical Safety Incident Dr Grant Ingrams glitch Harry Potter Patient care has not been compromised Source Type: blogs

UK health IT 'glitch': Hundreds of thousands of patients have potentially been given an incorrect cardiovascular risk estimation after a major IT system error
This in the UK.What is euphemistically referred to as an "IT system error" is, in reality, the mass delivery of a grossly defective medical device adversely affecting hundreds of thousands of patients.  I'm surprised not to see that other kindly euphemism, "glitch" (http://hcrenewal.blogspot.com/search/label/glitch):http://www.pulsetoday.co.uk/your-practice/practice-topics/it/gps-told-to-review-patients-at-risk-as-it-error-miscalculates-cv-score-in-thousands/20031807.article11 May 2016  By Alex Matthews-KingHundreds of thousands of patients have potentially been given an incorrect cardiovascul...
Source: Health Care Renewal - May 31, 2016 Category: Health Management Tags: Alex Matthews-King Clinical Safety Incident Dr Grant Ingrams glitch Harry Potter Patient care has not been compromised Source Type: blogs

HIT Mayhem, Canadian Style: Nanaimo doctors say electronic health record system unsafe, should be shut down, non-medical PR hacks say it's perfectly safe
Some candid honesty:To hell with doctors and nurses and their concerns about horrible health IT.   That seems the international standard in 2016 regarding their concerns.  There's just too much money to be made in this business to worry about such piddling annoyances as maimed and dead patients.Doctors, after all, don't know anything about computers, and cybernetic medical experiments on unconsenting human subjects are just good fun.This new example from Canada:http://www.theprovince.com/health/local-health/nanaimo+doctors+electronic+health+record+system/11947563/story.html Nanaimo doctors say electronic hea...
Source: Health Care Renewal - May 31, 2016 Category: Health Management Tags: Cindy E. Harnett healthcare IT difficulties healthcare IT risk Island Health Nanaimo Toni O ' Keeffe Victoria Times Colonist Source Type: blogs

Are You Ready for Some (Political) Football? - the NFL, Concussion Research, the NIH, and the Revolving Door
Probably because it involved the favorite American sport, the controversy about the risk of concussions to professional National Football League (NFL) players, and how the NFL has handled the issue is very well known.  A recent article in Stat, however, suggested that one less well known aspect of the story overlaps some issues to concern to Health Care Renewal.Allegations that a Prominent Physician and NFL Official Tried to Influence the NIH Grant Review Process The article began,Dr. Elizabeth Nabel, president of Boston’s Brigham and Women’s Hospital [BWH] and one of the nation’s most prominent medi...
Source: Health Care Renewal - May 26, 2016 Category: Health Management Tags: conflicts of interest NIH Partners Healthcare revolving doors Source Type: blogs

No Questions Asked - Journalist Parrots the Talking Points in Support of Hospital Executive Compensation
This article included no such attempts at balance.  So it ended up more like propaganda for managers' current privileged position in health care than journalistic inquiry.  It is sad to see reporting about important health policy issues devolve into propaganda to support the status quo, and those who personally profit the most from it.  But perhaps those who work at the Reading Eagle hesitate to offend those who are making the most from the current system.  It appears that the newspaer is owned by the Reading Eagle Company, and this, in turn is owned by the Barbey family, which according to Politico als...
Source: Health Care Renewal - May 20, 2016 Category: Health Management Tags: boards of trustees Catholic Health Initiatives executive compensation hospital systems hospitals Lancaster General Health perverse incentives Source Type: blogs

New Jersey Confidential: the Almost Secret Membership of the RWJ Barnabas Health Board
A Hospital System Tries to Hide its Board of Trustees The US Internal Revenue Service mandates disclosure of the membership of boards of trustees of non-profit corporations.  Nonetheless, as reported by New Brunswick (NJ) Today, the leadership of the newly formed RWJ Barnabas Health system has been doing their best to keep the membership of its board of trustees secret.The new organization created to function as the state's largest hospital chain is refusing to tell the public who serves on their Board of Trustees,...To elaborate,The two hospital networks officially combined to form a new conglomerate, the state's sec...
Source: Health Care Renewal - May 15, 2016 Category: Health Management Tags: anechoic effect boards of trustees conflicts of interest hospital systems RWJ Barnabas Health UMDNJ Source Type: blogs

Who Benefits? - Hospital Profits and Quality May Fall, But Hospital Executives' Compensation Keeps Rising
Conclusion - Change Will be Resisted So even when non-profit hospitals and hospital systems perform poorly, their executives continue to receive ever greater remuneration.   The executives, their public relations flacks, and their often compliant boards of trustees continue to cite the same stale talking points to justify their pay.   Yet these talking points are based on market fundamentalist theory and business school dogma whose credibility is increasingly challenged.   In the absence of anyone willing to confront them with these criticisms, the apologists for soaring health care executive pa...
Source: Health Care Renewal - May 2, 2016 Category: Health Management Tags: boards of trustees executive compensation hospital systems hospitals Lahey health market fundamentalism MetroHealth Medical Center pay for performance Source Type: blogs

Who Benefits? - Hospital Profits and Quality May Fall, But Hospital Executives' Compensation Keeps Rising
Conclusion - Change Will be ResistedSo even when non-profit hospitals and hospital systems perform poorly, their executives continue to receive ever greater remuneration.  The executives, their public relations flacks, and their often compliant boards of trustees continue to cite the same stale talking points to justify their pay.  Yet these talking points are based on market fundamentalist theory and business school dogma whose credibility is increasingly challenged.  In the absence of anyone willing to confront them with these criticisms, the apologists for soaring health care executive pay continue to pra...
Source: Health Care Renewal - May 2, 2016 Category: Health Management Tags: boards of trustees executive compensation hospital systems hospitals Lahey health market fundamentalism MetroHealth Medical Center pay for performance Source Type: blogs

Jama lays an egg
JAMA LAYS AN EGG Three months ago I took JAMA to task over a Viewpoint opinion piece about conflict of interest. The authors proposed dancing around the reality of financial conflict of interest in medicine by talking instead about confluence of interest. I countered with a proposal for the term competing interests, which would not paper over the problem. In that postI also included a letter I had sent to JAMA in response to the opinion piece, but which JAMA had declined to publish. I questioned whether JAMA had deep sixed all the critical replies it received.Now I can report that, in the April 26, 2016 print edition,...
Source: Health Care Renewal - May 1, 2016 Category: Health Management Tags: Anne Cappola Bernard Carroll competing interest conflict of interest Garret FitzGerald JAMA Source Type: blogs

Back to Paper After U.S. Coast Guard EHR Debacle: Proof of Hegel's Adage " We Learn From History That We Do Not Learn From History " ?
I have become blue in the face writing about healthcare information technology mismanagement over the years.   In fact, the original focus of my 1998 website on health IT (its descendant now at http://cci.drexel.edu/faculty/ssilverstein/cases ) was on HIT project mismanagement. If this industry actually had learned anything from history, I would not be reading nor writing about brutally mismanaged HIT endeavors in 2016.   Sadly, that is not the case. The Coast Guard, founded by Alexander Hamilton, has this as its motto and mission: http://www.gocoastguard.com/about-the-coast-guard Semper Paratus - &...
Source: Health Care Renewal - April 29, 2016 Category: Health Management Tags: Coast Guard EPIC Healthcare IT failure Leidos Lockheed Martin Politico Source Type: blogs

Back to Paper After U.S. Coast Guard EHR Debacle: Proof of Hegel's Adage "We Learn From History That We Do Not Learn From History"?
I have become blue in the face writing about healthcare information technology mismanagement over the years.  In fact, the original focus of my 1998 website on health IT (its descendant now at http://cci.drexel.edu/faculty/ssilverstein/cases) was on HIT project mismanagement.If this industry actually had learned anything from history, I would not be reading nor writing about brutally mismanaged HIT endeavors in 2016.  Sadly, that is not the case.The Coast Guard, founded by Alexander Hamilton, has this as its motto and mission:http://www.gocoastguard.com/about-the-coast-guardSemper Paratus - Always Ready.The ...
Source: Health Care Renewal - April 29, 2016 Category: Health Management Tags: Coast Guard EPIC Healthcare IT failure Leidos Lockheed Martin Politico Source Type: blogs

John Stossel Discovers Health Care Dysfunction, Blames it on " Socialists " - Like Maurice Greenberg (AIG), John Thain (Merrill Lynch), Sanford Weill (Citigroup), and David H Koch?
In conclusion, I am glad that some of the problems in the dysfunctional US health care system are getting more public attention.   However, now we need to calmly and rationally consider what is causing them and what to do about them without the blinders of ideology or vested interests.   IMHO, true US health care reform would put the operation of US health care organizations more in the hands of people who have knowledge and experience in health care, and are willing to be accountable to support health care professionals' values.   Furthermore, oversight and stewardship of these organizations sh...
Source: Health Care Renewal - April 24, 2016 Category: Health Management Tags: boards of trustees bureaucracy finance generic managers managerialism New York - Presbyterian Hospital Source Type: blogs

John Stossel Discovers Health Care Dysfunction, Blames it on "Socialists" - Like Maurice Greenberg (AIG), John Thain (Merrill Lynch), Sanford Weill (Citigroup), and David H Koch?
In conclusion, I am glad that some of the problems in the dysfunctional US health care system are getting more public attention.  However, now we need to calmly and rationally consider what is causing them and what to do about them without the blinders of ideology or vested interests.  IMHO, true US health care reform would put the operation of US health care organizations more in the hands of people who have knowledge and experience in health care, and are willing to be accountable to support health care professionals' values.  Furthermore, oversight and stewardship of these organizations should represent t...
Source: Health Care Renewal - April 24, 2016 Category: Health Management Tags: boards of trustees bureaucracy finance generic managers managerialism New York - Presbyterian Hospital Source Type: blogs

Lown Institute/ Right Care Alliance 2016 Conference
I am back from the annual Lown Institute/ Right Care Alliance meeting in Chicago.  A considerable part of the meeting was devoted to issues that may be familiar to readers of Health Care Renewal.Shannon Brownlee, in her keynote talk, "Introducing the Right Care Alliance," called our current US health care system "corrupt."  She noted how clinical research has been "hijacked," (see our posts on the suppression and manipulation of clinical research).  She noted how the multi-million dollar compensation of CEOs whose hospitals serve - not always well - primarily poor people (see ou...
Source: Health Care Renewal - April 22, 2016 Category: Health Management Tags: health care reform Source Type: blogs

The More Things Stay the Same - More Apparently Adulterated Heparin, This Time from Chinese Ruminants
The story of the contaminated heparin just will not go away.  We first wrote about it in 2008 (see first post here, most related posts here, and the longer summary at the end of this post.)Quick SummaryBaxter International imported the "active pharmaceutical ingredient" (API) of heparin, that is, in plainer language, the drug itself, from China. That API was then sold, with some minor processing, as a Baxter International product with a Baxter International label. The drug came from a sketchy supply chain that Baxter did not directly supervise, apparently originating in small "workshops" operating ...
Source: Health Care Renewal - April 13, 2016 Category: Health Management Tags: adulterated drugs Baxter China FDA heparin outsourcing Source Type: blogs

"Immersion Day" to Expose Hospital Board Members to Real Health Care for a Day - A Great Idea, but Why Should It Be News?
Last week, the New England Journal of Medicine published an article by Bock and Paulus describing an innovative program at Mission Health in Asheville, NC to expose health system board members to the real world of health care.(1)  The article was nice, but begged an important question: why was such a program news?The Immersion Day Program The article asserted:The U.S. health care industry has long been beset by seemingly intractable problems: incomplete and unequal access to care; perverse payment incentives; fragmented, uncoordinated care that threatens patient safety and wastes money; and much more.So the hypot...
Source: Health Care Renewal - April 7, 2016 Category: Health Management Tags: boards of trustees generic managers hospital systems hospitals managerialism Source Type: blogs

What is more important in healthcare, computers, or nurses and other human beings? Southcoast Health cutting dozens of jobs on heels of expensive IT upgrade
That I even have to ask the question on the title of this post is a tragedy and a scandal.I've written a number of posts on this blog about hospitals laying off staff and even put in financial jeopardy due to EHR implementation, e.g., my June 2, 2014 post "In Fixing Those 9,553 EHR "Issues", Southern Arizona’s Largest Health Network is $28.5 Million In The Red" at http://hcrenewal.blogspot.com/2014/06/in-fixing-those-9553-ehr-issues.html and numerous others indexed under "healthcare IT costs" at query link http://hcrenewal.blogspot.com/search/label/healthcare%20IT%20cost.  This ofte...
Source: Health Care Renewal - April 5, 2016 Category: Health Management Tags: EPIC healthcare IT cost Keith Hovan Southcoast Health Source Type: blogs

What You See Is Not What You Get - Purdue Pharma Executives Pleaded Guilty, but the Oxycontin Billionaires Went Unnoticed
What you see if often not what you get.   Nine years ago, three top executives of Purdue Pharma pleaded guilty to criminal charges of "misbranding" Oxycontin.  The case appeared to be a landmark.  In previous years, top executives of large health care corporations rarely faced legal consequences when their companies misbehaved.  Yet in the Purdue Pharma/ Oxycontin case, things were not what they seemed.  Maybe that is why this case never did yield a new era of accountability for top corporate health care leaders.Background - the Oxycontin Guilty PleasIn 2007, we posted about the executive...
Source: Health Care Renewal - March 31, 2016 Category: Health Management Tags: anechoic effect conflicts of interest deception health care corruption legal settlements marketing narcotics Oxycontin Purdue Pharma Source Type: blogs

Medstar Health CEO basically admits EHRs are unnecessary after hackers take out its HIT
It's corporate spin, of course, but that's the plain meaning of what he says:http://baltimore.cbslocal.com/2016/03/29/medstar-paralyzed-as-hackers-take-aim-at-another-us-hospital/For a second day, the region’s second-largest health care system deals with a crippling computer virus. MedStar Health says it is making progress, but WJZ is learning some patients are still feeling the effects.... Despite the challenges affecting MedStar Health’s IT systems, the quality and safety of our patients remains our highest priority, which has not waned throughout this experience. Fortunately, the core ways in which we delive...
Source: Health Care Renewal - March 30, 2016 Category: Health Management Tags: hacking MedStar Health Stephen R.T. Evans Source Type: blogs

Bad health IT at Medstar Health: FBI probing virus behind outage (And: ka-ching! ka-ching! EHR costs continue their upward spiral)
Once again, a definition of bad health IT:Bad Health IT ("BHIT") is defined 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, compromises patient privacy or evidentiary fitness, or otherwise demonstrates suboptimal design and/or ...
Source: Health Care Renewal - March 29, 2016 Category: Health Management Tags: computer security healthcare IT risk Hollywood Presbyterian Medical Center medical record confidentiality MedStar Health Patient care has not been compromised Source Type: blogs

Will There Ever Be Enough Straws to Break Corporate Health Care Managers' Impunity's Back? - Novartis Settles Yet Again, This Time for Bribing Doctors
Umpteenth verse, same as the first...As just reported by Bloomberg,Novartis AG said it agreed to pay $25 million to settle a U.S. Securities and Exchange Commission case that claimed the Swiss drugmaker paid bribes to health professionals in China to increase sales from 2009 to 2013.In particular,The SEC detailed a number of Foreign Corrupt Practices Act violations where Novartis employees provided items of value to health-care professionals in China, under the supervision of complicit managers. It also cited examples of how the company improperly recorded as legitimate expenses payments employees made for travel and enter...
Source: Health Care Renewal - March 25, 2016 Category: Health Management Tags: boards of directors bribery conflicts of interest deception executive compensation health care corruption impunity marketing Novartis Source Type: blogs

There They Go Again - the New England Medical Journal Publishes another Rant, this Time about Power Morcellation
In 2015, we noted (here and here) that the New England Journal of Medicine seemed to have been reduced to publishing rants about "pharmascolds" who are paranoid about conflicts of interest. Now there they go again.... BackgroundThe sad story about the risks of power morcellation for the treatment of fibroids has received considerable media attention.  The state of play through July, 2014 was described in a series of articles in the Cancer Letter of July 4, 2014. (Look here.) Uterine fibroids are a common affliction of women.  Their preferred surgical management had changed from open surgery to minimally...
Source: Health Care Renewal - March 20, 2016 Category: Health Management Tags: cancer FDA logical fallacies New England Journal of Medicine Partners Healthcare Source Type: blogs

Criminal matter for the Attorney General of NY? Hail the gods of medical computing, and the need for human sacrifice. NYC’s $764M medical records system will lead to ‘patient death’: insiders
I believe the suffering and death of my mother in 2010-2011 due to EHR flaws - including but not limited to lack of essential confirmation dialogs on medication deletion at triage, lack of notification messages informing down-line staff of such action by unqualified personnel (inadequate support of teamwork), and other issues - lends me some moral standing to comment on the following as a horrifying and potentially criminal matter.  (See http://khn.org/news/scot-silverstein-health-information-technology/).Two back-to-back articles appeared in the New York Post: NYC’s $764M medical records system will lead to &ls...
Source: Health Care Renewal - March 17, 2016 Category: Health Management Tags: Dr. Charles Perry Elmhurst Hospital Center EPIC healthcare IT risk Michael Gartland Mismanagement NY Post NYC Health and Hospitals politics Ramanathan Raju Source Type: blogs

"How Employed Physicians' Contracts May Threaten Their Patients and Professionalism" Authored by Health Care Renewal Bloggers Published in Annals of Internal Medicine
We have noted that increasing numbers of physicians provide patient care as employees of large organizations, often hospital systems, sometimes for-profit.  Since in these settings physicians must answer to generic management which may be more concerned with short-term revenues than patient care, these new arrangements are frought with hazards for physicians and patients. One set of hazards may be found in the contracts employed physicians must sign.   My fellow blogger, Dr Wally Smith, and I authored an article just published online "How Employed Physicians' Contracts May Threaten Their Patients and Profess...
Source: Health Care Renewal - March 9, 2016 Category: Health Management Tags: Annals of Internal Medicine contracts corporate physician generic managers hospital systems hospitals Source Type: blogs

Trumped Up "Nutritional" Products - A Cautionary Tale of Immediate Relevance
On Health Care Renewal, we frequently discuss deceptive marketing schemes designed to sell tests and treatments whose benefits for patients do not clearly outweigh their harms, and sometimes which are useless or dangerous.  In fact, we have to be selective about discussing such cases, because they are all too common.  Therefore, we tend to focus on cases involving the biggest and most powerful health care organizations, and/or the worst risks to patients.We have generally not discussed the myriad promotions of dubious "nutritional" tests and therapies, because there are just so many of them, the players...
Source: Health Care Renewal - March 4, 2016 Category: Health Management Tags: complementary/ alternative medicine deception Donald Trump marketing Source Type: blogs

It Has Come to This? - Donald Trump's "Truly Absurd," "Word Salad," "Gibberish" Health Care Policy
Health Care Renewal is officially non-partisan.  We do not endorse candidates for office, or political parties.  That does not prevent us from commenting on policy issues, and on pronouncements and actions by politicians and government officials when they relate to the issues that interest us.So, we have criticized excessive coziness among politicians and government officials on one hand, and big health care organizations and their leaders on the other.  We have noted conflicts of interest affecting politicians, particularly the revolving door, and other shadings towards corporatism.  We have noted how ...
Source: Health Care Renewal - February 27, 2016 Category: Health Management Tags: health care reform health policy politics ppaca Source Type: blogs

At least former ONC chair Blumenthal now says "health IT can [even] cause safety issues." Other than that, it's unicorns and fairies in the Harvard Business Review.
The truth about healthcare IT, that it is perilously insecure, and is causing clinician despair and patient harm, is increasingly becoming mainstream.  For example, seen at the eclectic, widely read, multi-author website of Beauchamp Brogan Distinguished Professor of Law at the University if Tennessee Glenn Reynolds, Instapundit (http://pjmedia.com/instapundit/):REMEMBER THE HEALTHCARE.GOV LAUNCH? Apparently so did some hackers:“To improve the quality of our health care while lowering its cost, we will make the immediate investments necessary to ensure that, within five years, all of America’s medical reco...
Source: Health Care Renewal - February 24, 2016 Category: Health Management Tags: David Blumenthal Glenn Reynolds Harvard Business Review healthcare IT dangers healthcare IT dissatisfaction healthcare IT utopianism Instapundit Source Type: blogs

Ho-hum, Another Month, Another Set of Multi-Million Dollar Settlements by Health Care Corporations Acting Badly
Amazingly, with a US presidential election looming, there is finally some public discussion here of the impunity of top corporate executives.  Columnist Gretcher Moregenson wrote on February 6, 2016 in the New York Times,Ho-hum, another week, another multimillion-dollar settlement between regulators and a behemoth bank acting badly.Then,As has become all too common in these cases, not one individual was identified as being responsible for the activities. Once again, shareholders are shouldering the costs of unethical behavior they had nothing to do with.It could not be clearer: Years of tighter rules from legislators ...
Source: Health Care Renewal - February 21, 2016 Category: Health Management Tags: adverse effects deception Fresenius health care prices impunity legal settlements Merck Pfizer Vioxx You heard it here first Source Type: blogs

Hollywood Presbyterian Medical Center: Negligent hospital IT leaders allow hacker invasion that cripples EHRs, disrupts clinicians ... but patient safety and confidentiality not compromised
To the cybernetic idealists out there who think computers are the greatest thing next to sliced bread in the healthcare environment, I say, pray you are not on the operating table when something like this happens:Hackers’ Ransom Attack On California Hospital More Proof Healthcare Cybersecurity Is FlounderingInternational Business TimesJeff Stone02/17/16 http://www.ibtimes.com/hackers-ransom-attack-california-hospital-more-proof-healthcare-cybersecurity-2309720Who would have thought that, for healthcare professionals, performing surgery, working long hours and navigating the dense world of U.S. health law would be&nbs...
Source: Health Care Renewal - February 18, 2016 Category: Health Management Tags: Allen Stefanek computer security Hollywood Presbyterian Medical Center medical record confidentiality medical record privacy Patient care has not been compromised Source Type: blogs

Bio-Tech U, Version 2 - Current Board Member of Four Biotechnology Companies, Fomer Pfizer Director, Former Genentech Executive to be President of Stanford
DiscussionTo summarize, the incoming president of Stanford, on of the most prestigious American universities, one of the foremost US sites for biomedical research, and home to an equally prestigious medical school and academic health center, spent most of the last 15 years heavily involved with the pharmaceutical and biotechnology industries.  He was a top Genentech executive for eight of those years, served as a director of the then biggest US pharmaceutical company, and currently is a member of the boards of directors of four biotechnology companies, and is chairman of one of them.  He earned nearly $2.5 millio...
Source: Health Care Renewal - February 11, 2016 Category: Health Management Tags: boards of directors conflicts of interest Genentech Stanford Source Type: blogs

The Rich (Hospital Managers) Get Richer - Carolinas Healthcare Raises Executive Compensation Once Again
This article lead with the failure of Carolinas Medical Center to report an infection apparently caused by the use of an endoscope that later was implicated in multiple infections at multiple hospitals.  The article noted thatFederal law requires hospitals to report deaths from a medical device to the FDA within 10 days. If the device seriously injures a patient, the hospital must notify the manufacturer within 10 days. Both notices require hospitals to fill out what the FDA calls Form 3500A."Notice: 360 to Lose Jobs at Health Care Facility" (WSOC-TV, January 26, 2016)The article noted layoffs at Carolinas M...
Source: Health Care Renewal - February 8, 2016 Category: Health Management Tags: Carolinas HealthCare Charlotte-Mecklenburg Hospital Authority executive compensation government public hospitals Source Type: blogs

HIMSS 2016 Presentation: Plaintiff's Lawyers Are The Cause of EHR Problems. They're Using Pristine, White-as-the-Blowing-Snow EHRs as "An Opportunity for Litigation"
In perhaps the most ill-informed, perverse rationalization/defense of bad health IT I've seen to date, the following appeared in an article about an upcoming HIMSS presentation (Healthcare Information and Management Systems Society's health IT mega-industry trade show, http://www.himssconference.org).I remind readers of the definition of bad health IT coined by myself and Australian polymath/informatics scientist Dr. Jon Patrick in 2012, as at my Drexel University College of Computing and Informatics website "Contemporary Issues in Medical Informatics: Good Health IT, Bad Health IT, and Common Examples of Healthcare I...
Source: Health Care Renewal - February 5, 2016 Category: Health Management Tags: evidence spoliation Greg Goth healthcare IT evidentiary issues Healthcare IT News healthcare IT risk Mary Re Knack Ogden Murphy Wallace Reed Gelzer Source Type: blogs

Whom Can You Trust? - FTC Charges DeVry University, Sister School of American University of the Caribbean and Ross University Medical Schools, with Deceptive Marketing
Now there is another reason for Americans who aspire to medical careers to be concerned about applying to offshore medical schools.IntroductionAdmission to US medical schools is increasingly difficult.  So many who seek medical careers may be tempted to apply to schools outside the US.  In the last 30 years, American entrepreneurs have opened offshore medical schools, mostly in the Caribbean, that cater to US students.  They teach in English, and do not require immersion in an unfamiliar culture, so may be more attractive than medical schools in other countries whose mission is to educate physicians to pract...
Source: Health Care Renewal - January 29, 2016 Category: Health Management Tags: deception DeVry Inc offshore medical schools Ross University Source Type: blogs

Jama jumps the shark
JAMA JUMPS THE SHARKMedical journals are supposed to promote professional values – scientific, social, and ethical. Quality matters, in each of these domains. Lately, however, highly ranked journals are failing in respect of ethics commentaries. Some editors seem happy to publicize or even to co-author commentaries that are dismissive of current ethics initiatives – like transparency of data reporting and disclosure of conflicts of interest (COI). That’s one way for journals to jump the shark in the race for ratings. They surely get attention and applause in some quarters – but those stunts are net ...
Source: Health Care Renewal - January 25, 2016 Category: Health Management Tags: Anne Cappola Bernard Carroll conflict of interest conflict of interest blog confluence of interest Garret FitzGerald JAMA Source Type: blogs

Health Care Managers as Ever More Effective Value Extractors - Following Up on Novant Health and Cape Cod Healthcare
The ever increasing compensation of top managers of health care organizations provides incentives to continue business as usual.  We have frequently discussed executive compensation for top health care leaders that seems wildly disproportionate to their contribution to their organizations' health care mission.Furthermore, not only does executive compensation seem to have anti-gravity properties, rising even at institutions facing financial challenges, or while other employees face salary cuts and job loss, but it continues even after the lack of justification for it has been called out. Herein we discuss two examples ...
Source: Health Care Renewal - January 21, 2016 Category: Health Management Tags: Cape Cod Healthcare executive compensation generic management generic managers Novant Health Source Type: blogs

Not Going to Take it Anymore - Doctors in the Pacific Northwest Unionize, Begin Collective Bargaining with Hospital Systems
We have posted about the plight of the corporate physician.  In the US, home of the most commercialized health care system among developed countries, physicians increasingly practice as employees of large organizations, usually hospitals and hospital systems, sometimes for-profit.  The leaders of such systems meanwhile are now often generic managers, people trained as managers without specific training or experience in medicine or health care, and "managerialists" who apply generic management theory and dogma to medicine and health care just as it might be applied to building widgets or selling soap.We ...
Source: Health Care Renewal - January 18, 2016 Category: Health Management Tags: concentration of power corporate physician generic management generic managers labor unions managerialism PeaceHealth University of Washington Source Type: blogs

Death of EHR "Meaningul Use" imminent. (Hopefully the death of the 'National Programme for Health IT in the HHS' is imminent, too.)
I've written a number of posts on the Orwellian-named "Meaningful Use" experiment with electronic health records systems, imposed upon United States physicians by the Department of Health and Human Services through its Office of the National Coordinator for Health Information Technology (ONC).See these posts and others retrieved by query link http://hcrenewal.blogspot.com/search/label/meaningful%20use:Meaningful Use Final Rule: Have the Administration and ONC Put the Cart Before the Horse on Health IT?Meaningfully Experimental Protocols and Interfaces to Nowhere? Nagging Questions On Healthcare IT RemainScience o...
Source: Health Care Renewal - January 13, 2016 Category: Health Management Tags: AMA Andy Slavitt CMS James Madara meaningful use NPfIT ONC Source Type: blogs

Health Care Corruption Workshop Slides Now Online
Slides from the workshop entitled Defense Against the Dark Arts - Understanding and Challenging Health Care Corruption given by Dr Roy Poses and Dr Wally Smith at the Physicians for a National Health Plan (PNHP) meeting, October, 2015, in Chicago, IL, US, are now online here. There also is a link to the slides on our Past Meetings and Events page. (Source: Health Care Renewal)
Source: Health Care Renewal - January 9, 2016 Category: Health Management Tags: health care corruption Source Type: blogs

Yet another observation that known health IT-caused injuries and deaths are "the tip of the iceberg"
Conclusions: Adverse events associated with health IT vulnerabilities can cause extensive harm and are encountered across the continuum of health care settings and sociotechnical factors. The recurring patterns provide valuable lessons that both practicing clinicians and health IT developers could use to reduce the risk of harm in the future.Note the statement at pg. 5:... The actual incidence of harm cannot be reliably estimated from this data; nonetheless, it is generally agreed that safety events represented in malpractice claims are the ‘tip of the iceberg', insofar as the vast majority of cases, even cases that ...
Source: Health Care Renewal - January 8, 2016 Category: Health Management Tags: CRICO healthcare IT harms healthcare IT risk ICD-10 Journal of Patient Safety tip of the iceberg Source Type: blogs

Repeated crushing by alligators and crocodiles: ICD-10 has you covered. Harmed by bad health IT? No codes for that.
Your government at work, spending your tax dollars and making your doctors want to retire early due to increasing bureaucratic busywork. The new ICD-10 coding system they must now use has codes like these, in case you get attacked by a crocodile or alligator.It even has codes for repeat crushing by the critters...Notably missing: there are no codes for harms caused by defective, mis-designed or badly implemented electronic medical records/ordering/lab review systems, which are occurring as documented in numerous posts on this blog.  (My mother would comment, but she is deceased from ICD-10 code ...uh, oh wait, no cod...
Source: Health Care Renewal - January 8, 2016 Category: Health Management Tags: AMA American Medical Association bureaucracy healthcare IT dangers ICD-10 Source Type: blogs

Generic Management of Health Care Non-Profits, Brought to You by Leaders of (Sometimes Failed, or Bailed Out) Finance on the Board?
Introduction - Managerialism  We have frequently posted about what we have called generic management, the manager's coup d'etat, and mission-hostile management. Managerialism wraps these concepts up into a single package.  The idea is that all organizations, including health care organizations, ought to be run people with generic management training and background, not necessarily by people with specific backgrounds or training in the organizations' areas of operation.  Thus, for example, hospitals ought to be run by MBAs, not doctors, nurses, or public health experts.  Furthermore, all organizations ou...
Source: Health Care Renewal - January 7, 2016 Category: Health Management Tags: boards of trustees finance generic management generic managers managerialism Source Type: blogs

Stealth Public Relations and Health Advocacy, Special Pleadings and the Opposition to Guidelines Discouraging Overuse of Narcotics
As I have written before as a physician who saw too many dire results of intravenous drug abuse, I was amazed how narcotics were pushed as the treatment of choice for chronic pain in the 1990s, with the result that the US was once again engulfed in an epidemic of narcotic abuse and its effects.  In mid-December, 2015, as reported in the Washington Post,The nation continues to suffer through a widespread epidemic to prescription opioids and their illegal cousin, heroin. The CDC estimated that 20 percent of patients who complain about acute or chronic pain that is not from cancer are prescribed opioids. Health-care prov...
Source: Health Care Renewal - January 4, 2016 Category: Health Management Tags: CDC Cephalon conflicts of interest deception Endo Health Solutions Johnson and Johnson narcotics public relations Purdue Pharma stealth health policy advocacy Source Type: blogs

How Managerialists Turned Housestaff Training into a Zero-Sum Game: the Continuing Saga of the FIRST and iCompare Studies
Conclusion: the Problem is Managerialism    While the ongoing trials of housestaff sleep deprivation have been largely anechoic, the recent Washington Post commentary by Clark and Harari make questions about why in the world medical academics would have set up such trials and continue to defend them even more stark.But it seems that medical academics are boxed in, playing a zero-sum game.  They may know that there housestaff are overworked and sleep deprived, a situation that endangers the housestaff and their patients.  Yet every reasonable way one could imagined improving the situation would require s...
Source: Health Care Renewal - December 22, 2015 Category: Health Management Tags: academic medical centers amphetamines clinical trials generic managers managerialism medical ethics post-graduate medical education resident sleep deprivation Source Type: blogs

How Managerialsm/ Generic Management Damaged the American Red Cross
The American Red Cross is a storied non-profit organization.  It provides disaster relief, provides a major part of the US blood supply, and has important public health teaching functions, such as teaching cardio-pulmonary resuscitation (look here).  Nonetheless, its operations have become increasingly controversial.  ProPublica has been investigating them for years.  The latest ProPublica report, entitled "The Corporate Takeover of the Red Cross," showed how this renowned organization has suffered under generic management/ managerialism, providing another case study showing how bad generic ma...
Source: Health Care Renewal - December 16, 2015 Category: Health Management Tags: executive compensation generic management generic managers managerialism ' coup d etat marketing Red Cross Source Type: blogs

A Small Challenge to Impunity - Lawsuit Against Former Synthes CEO Proceeds
ConclusionsThe just revealed story of the lawsuit against the extremely rich former CEO of Synthes does suggest that perhaps individuals injured by our curent dysfunctional health care system could use the legal system to try to challenge those who get rich from enabling such injuries.  Or not, because the outcome of this lawsuit is uncertain.Furthermore, the initiation of this lawsuit again reminds us that those who lead large health care organizations, and may profit mightily from them, regardless of the effects on patients' and the public's health, remain beyond the law.  It is not clear why the US Department ...
Source: Health Care Renewal - December 10, 2015 Category: Health Management Tags: anechoic effect impunity Johnson and Johnson legal settlements Synthes Source Type: blogs

Drinking the Managerialists' Kool-Aid? - Why Did Medical Educators Launch Trials of Increased Sleep Deprivation of Physician Trainees Apparently in Violation of the Nuremberg Code?
It all seemed so bizarre.  In 2014, with little fanfare, two large trials that imposed longer work hours and sleep deprivation on physician-trainees (interns and residents), ostensibly to combat the problem of excess hand-offs of patients among physicians.  Both trials involved multiple academic medical centers, including some of the most prestigious in the US.  Within a year, the American Medical Student Association (AMSA) and Public Citizen called for a federal investigation of the trials, calling them "highly unethical."This unprecented conflict between prestigious academic medical institutions ...
Source: Health Care Renewal - December 3, 2015 Category: Health Management Tags: clinical trials informed consent logical fallacies managerialism medical ethics nuremberg code resident sleep deprivation Source Type: blogs

Ross Koppel challenges feckless academics on poor health IT design
The academic health IT community has spent the past decade (at least) burying their collective ostrich heads in the sand about the crappy software that is called health IT.A few, though, have taken on the health IT industry at the heart of bad health IT design (including yours truly, which sadly was not enough to save my own mother from health IT design defects).Probably the bravest soul on these issues, however, is Penn sociologist Ross Koppel.  In a critique of the latest from the medical informatics academic community on reigning in the hazards of this technology, an article by Sittig and Singh at U. Texas, he wrot...
Source: Health Care Renewal - November 27, 2015 Category: Health Management Tags: dean sittig healthcare it design defects healthcare IT risk ross koppel Source Type: blogs