EHRs and their Impact on Quality of Care
Our findings indicate no consistent association between EHRs and CDS and better quality. These results raise concerns about the ability of health information technology to fundamentally alter outpatient care quality.
Like almost all science that gets reported in the general media, there is more to this study than what is described in the headlines and news reports. The study was published in a prestigious medical journal by two Stanford researchers. The implementation of the research methods they used appears to be sound.
- A frequent challenge – the study looks at correlation, which does not mean causality
- The quality measures used did not provide enough insight into actual quality improvement (process measures vs outcome measures)
- No detail of the EHR’s being used and if they had any decision support in place relative the the quality measures
- THe care assessed was individual episodes of care and improvements in actual quality occur over multiple episodes of care (the longitudinal medical record)
- Data analyzed was old (2005 – 2007) and in any field of technology including Healthcare Informatics this is old
- No indication of the training and skill set of the clinicians being assessed and success and failure fo EHR’s goes far beyond the technology and is closely tied to implementation and training
- The Electric light bulb
- Telephone
This ‘telephone’ has too many shortcomings to be seriously considered as a means of communication. The device is inherently of no value to us.
Western Union Internal Memo: 1876
- Automobile
- Microprocessor
- And even the internet and the world wide web
- First, and most important, the current article tells us nothing about which CDS guidelines were implemented in the systems that they studied. Practices and EHRs vary considerably in the number and type of CDS rules that they implement, and we do not know whether the CDS rules implemented by the practicesthat participated in the surveys addressed any of the 20 quality indicators evaluated by Romano and Stafford.
- Second, the current study and Garg and coauthors’ review considered very different categories of guidelines. Most of the guidelines (60%) in Romano and Stafford’s study concern medication use; none of them deals with immunizations or screening tests, which were the dominant subjects in the studies reviewed by Garg et al.3 Furthermore, in our experience, care providers are less willing to accept and act on automated reminders about initiating long-term drug therapy than about ordering a single test or an immunization.
- The third difference is that the current study examined the outcome of a single visit, while most of the trials reviewed by Garg and colleagues observed the cumulative effect of the CDS system on a patient over many visits.
- Finally, the data available from NAMCS/NHAMCS may be limited compared with what is contained in most of the EHRs used for Garg and coauthors’ trials. For example, the NAMCS/NHAMCS instruments have roomto record only 8 medications, even though at least 17% of individuals older than 65 years take 10 or more medications.
Snake Oil from Martha Stewarts Show – Detox Doc
it’s simply modern day snake oil salesman
THe myth that we have such a toxic environment we have to detoxify is preposterous. Not a shred of evidence supporting these claims:
There isn’t one scientific report validating any of these claims yet people continue to believe based on the power of personal persuasion. He (Mr Junger) exploits people’s ignorance with flim-flammery tricks and deceit. If detoxification was effective he wouldn’t need shady sales techniques. Instead, there would be scientific studies demonstrating its effectiveness. Mr. Junger should want these tests to validate his beliefs. He resists efforts to measure and verify his treatment because it would be revealed as the scam it is
You can see the marketing spin in this clip
Why is Martha Stewart allowign such tripe to be broadcast adding wieght to these claims. Don’t get fooled – our water, food and air is safe and you don’t need to pay any money to someone to detoxify or clean your Insert name of food, air or fluid>
Excellent Meaningful Use Qualification for Incentive Matrix
Nuance Self Service Mobile Developer Platform Announced Today
Additional Dangers of Vicodin
Toxic Waste Nuclear Sludge Candy Recalled for Lead
Adoption of EHR Likely to be Very High
- 80% of hospitals , AND
- 41% of Office based physicians
are intending to take advantage of the federal incentive payments for adoption and meaningful use of certified EHR’s
And Dr David Blumenthal posted a video comment on the registration for EHR Incentive programs
This is substantially higher than a recent set of stats that had the rates posted much lower. This is good news all round if the incentive program has stimulated that much interest and desire to move towards the digitization of the medical record which for Stage 7 has barely reached double digits according to the most recent HIMSS Analytics assessment of EHR implementations.
For those wanting more information
Information about the incentive payments program is available on the CMS website and the Regional Extension Centers (RECs) technical assistance is available at the HealthIT web site. So for those still pondering if this is worthwhile investment it seems that healthcare systems and your clinical peers see this as a valuable and positive move. Do you want to watch the train leave the station or be on it?
Docs struggling financially, but new tech makes job easier
http://www.healthcareitnews.com/news/survey-docs-struggling-financially-new-tech-makes-job-easier
Technology can actually make your life better…certainly according to doctors
A national license to practice medicine
This needs to be fixed if telemedicine is ever to take off
A national license to practice medicine
http://www.kevinmd.com/blog/2011/01/national-license-practice-medicine.html
A Contraceptive Culture
The US lags far behind Europe in contraceptive use with a corresponding higher rate of teen pregnancy and abortions….
A Contraceptive Culture
http://andrewsullivan.theatlantic.com/the_daily_dish/2011/01/contraceptive-culture.html Something wrong with this picture?
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