tag:blogger.com,1999:blog-9551150.post7779779460099582371..comments2024-03-28T01:27:23.408-04:00Comments on Health Care Renewal: Allscripts shares plunge on weak outlook, board changes, unhappy customers - but mostly unhappy customers, I surmiseRoy M. Poses MDhttp://www.blogger.com/profile/00497209843184497847noreply@blogger.comBlogger22125tag:blogger.com,1999:blog-9551150.post-51695590617824619642012-05-01T15:19:44.740-04:002012-05-01T15:19:44.740-04:00Anonymous April 29, 2012 4:11:00 PM EDT said:
The...Anonymous April 29, 2012 4:11:00 PM EDT said:<br /><br /><i>These are a good start for someone who is concerned but never used the systems.</i><br /><br />Recommendations I wrote in 1999 are still online <a href="http://www.ischool.drexel.edu/faculty/ssilverstein/informaticsmd/script1.htm" rel="nofollow">here</a>, and (tragically) are still relevant.<br /><br />-- SSInformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-88597444953045058392012-04-29T17:14:48.581-04:002012-04-29T17:14:48.581-04:00Oh, and Anonymous April 29, 2012 1:03:00 PM EDT, t...Oh, and Anonymous April 29, 2012 1:03:00 PM EDT, thanks for the compliment.<br /><br />-- SSInformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-32243245217679042422012-04-29T17:05:31.689-04:002012-04-29T17:05:31.689-04:00Anonymous April 29, 2012 1:03:00 PM EDT said...
H...Anonymous April 29, 2012 1:03:00 PM EDT said...<br /><br /><i>He simply does not have the experience or expertise for his comments to doctor users to be meaningful.</i><br /><br />I cannot comment regarding Mr. Holt specifically, but I do opine that I'm tired of being patronized on health IT by non-clinicians and those lacking formal graduate or post-doctoral education in the domain.<br /><brInformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-41258533595330688912012-04-29T16:11:03.572-04:002012-04-29T16:11:03.572-04:00Bullet points for Matthew to consider to improve t...Bullet points for Matthew to consider to improve the sad lot of today's HIT systems:<br /><br />Require IRB monitoring of the experiment.<br />Require informed consent, including risk of unexpected death.<br />Require informed consent for doctors who use the device and provide feedback to the vendors.<br />Require informed consent for nurses.<br />Publish a deinsentified list of all adverse Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-7137745390073072502012-04-29T13:03:48.203-04:002012-04-29T13:03:48.203-04:00I have used these devices of several main stream v...I have used these devices of several main stream vendors on real live (some are now dead) patients, including the vendor featured above. <br /><br />Dr. Silverstein is spot on in his comments and ideas. <br /><br />It is insanity that doctors are being directed by non doctors to use medical devices that do not have a proven safety record.<br /><br />M. Holt is an example of an industry pundit Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-74730103144101005422012-04-29T09:46:05.451-04:002012-04-29T09:46:05.451-04:00Re: "The gap between actual and mandated use...Re: "The gap between actual and mandated use of an electronic medication record three years after deployment" and http://www.wpi.edu/Pubs/E-project/Available/E-project-051010-054949/unrestricted/Danish_Health_IT_Project_Final_Report.pdf @ April 28, 2012 8:56:00 AM EDT:<br /><br />The situation with HIT in Denmark and other Scandinavian countries is far from utopian.<br /><br />In fact,InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-73451464311661228042012-04-28T17:47:47.152-04:002012-04-28T17:47:47.152-04:00Re: Anonymous April 28, 2012 3:41:00 PM EDT
1. ...Re: Anonymous April 28, 2012 3:41:00 PM EDT<br /><br />1. I agree with Roy Poses' comment above. let's leave out ad hominem (attacks against the person) and stick with ideas.<br /><br />2. Re: <i>"You should see Paul Levy's great article here as to why the EMR with all its flaws is better than that option."</i><br /><br />As I've repeatedly written, and as the IOM InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-11555771072592906982012-04-28T16:10:08.753-04:002012-04-28T16:10:08.753-04:00Good point, Dr. Poses. However, the point I raise...Good point, Dr. Poses. However, the point I raise in context to the comment relates to judgment, not correctness or applicability.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-34863816181274751792012-04-28T16:03:25.839-04:002012-04-28T16:03:25.839-04:00Anonymous of 28 April, 3:41 PM -
Your last senten...Anonymous of 28 April, 3:41 PM -<br /><br />Your last sentence implies an ad hominem fallacy. <br /><br />Whether or not he did have "probity problems," which I don't think is settled, they would not have had an effect on the correctness or applicability of his arguments.Roy M. Poses MDhttps://www.blogger.com/profile/00497209843184497847noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-37659761233210097162012-04-28T15:41:11.226-04:002012-04-28T15:41:11.226-04:00Holt said: "You should see Paul Levy's gr...Holt said: "You should see Paul Levy's great article here as to why the EMR with all its flaws is better than that option." <br /><br />Uhh, I do not think so. All I need are lab data, a user friendly MAR, and images at hand to write constructive progress notes and orders. The viewing of contemporaneous entries benefits of paper can not be equaled by EHR and CPOE devices.<br /><Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-76274367617656501812012-04-28T15:36:17.728-04:002012-04-28T15:36:17.728-04:00Anonymous April 28, 2012 9:40:00 AM EDT said...
&...Anonymous April 28, 2012 9:40:00 AM EDT said...<br /><br /><i>"How do you explain Epic's adding of new customers basically every week. ??" The users I know call it the cream of the crap.</i><br /><br />Again, under a cloak of secrecy that exists in this healthcare sector, it is uncertain what is really going on.<br /><br />Anyone who advocates health IT rollout nationally in the InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-35198138480195853842012-04-28T15:29:42.708-04:002012-04-28T15:29:42.708-04:00Anonymous April 27, 2012 9:37:00 PM EDT said...
I...Anonymous April 27, 2012 9:37:00 PM EDT said...<br /><br /><i>I am disappointed that someone of Holt's intellect is as naive and calloused as his statement demonstrates. The statement advocates an unregulated experiment using the patients, doctors and nurses as guinea pigs to "improve on it"</i><br /><br />You you must break a few eggs to make an omelet.<br /><br />Here's one InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-91380419797854367622012-04-28T15:14:32.515-04:002012-04-28T15:14:32.515-04:00Matthew Holt writes:
"So really this comes d...Matthew Holt writes:<br /><br /><i>"So really this comes down to marketing. If you dont think we should just go back to paper, you should create a little set of bullet points or paragraph of what we should do instead and run it in every article."</i><br /><br />Matthew,<br /><br />Thank you for the interesting suggestion. <br /><br />It shall receive all the consideration it is due.<InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-34901899223945719312012-04-28T11:15:42.332-04:002012-04-28T11:15:42.332-04:00Scott--
2 points. 1) you said it was Allscripts un...Scott--<br />2 points. 1) you said it was Allscripts unhappy customers proving that we should be throwing ARRA $$ at EMRs. You know and I know that Epic has just as many detractors and probably as many UI problems as the others, but it's been very successful and was before ARRA. (And yes I agree with you on the no-talk contracts and lack of open bug reporting)<br /><br />@) (and this is more Matthew HOlthttp://thehealthcareblog.comnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-81055064566178176142012-04-28T09:40:58.669-04:002012-04-28T09:40:58.669-04:00Matthew's question: "How do you explain E...Matthew's question: "How do you explain Epic's adding of new customers basically every week. ??"<br /><br />The users I know call it the cream of the crap. Care processes are disrupted, patients are neglected, but ther is a benefit: upcoding is easy with beautiful 6 page progress notes obfuscating the key points of care.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-21739683528934896112012-04-28T09:05:52.692-04:002012-04-28T09:05:52.692-04:00http://www.wpi.edu/Pubs/E-project/Available/E-proj...http://www.wpi.edu/Pubs/E-project/Available/E-project-051010-054949/unrestricted/Danish_Health_IT_Project_Final_Report.pdf<br /><br />Privacy of medical information is a low priority in Denmark due to the generally trusting mindset of Danish society. Most Danes trust that the government protects their privacy and are unaware of personal data collection and access. Danes can also find it difficultAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-13002060752627543252012-04-28T08:56:24.128-04:002012-04-28T08:56:24.128-04:00Title:
The gap between actual and mandated use o...Title:<br /> <br />The gap between actual and mandated use of an electronic medication record three years after deployment<br /><br />Author(s): Granlien, Maren Fich; Hertzum, Morten; Gudmundsen, Jette<br /><br />Proceedings/Book: eHealth Beyond the Horizon - Get IT There (2008)<br /><br />Pages:419-424<br /><br />PMID:18487767<br /><br />Abstract<br /><br />Three years after the hospitals in Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-25139257143950448032012-04-27T21:37:03.471-04:002012-04-27T21:37:03.471-04:00Holt states: "How is that going to happen unt...Holt states: "How is that going to happen until we get general EMR use and then improve on it?"<br /><br />I am disappointed that someone of Holt's intellect is as naive and calloused as his statement demonstrates. <br /><br />The statement advocates an unregulated experiment using the patients, doctors and nurses as guinea pigs to "improve on it" ultimately enriching the Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-78869594540941559822012-04-27T15:45:46.210-04:002012-04-27T15:45:46.210-04:00Note:
On the FD&C Act's passage:
http://...Note:<br /><br />On the FD&C Act's passage:<br /><br /><a href="http://en.wikipedia.org/wiki/Elixir_sulfanilamide" rel="nofollow">http://en.wikipedia.org/wiki/Elixir_sulfanilamide</a><br /><br />Elixir sulfanilamide was an improperly prepared sulfanilamide medicine that caused mass poisoning in the United States in 1937. It caused the deaths of more than 100 people. The public outcry InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-87080187890882648222012-04-27T15:38:14.670-04:002012-04-27T15:38:14.670-04:00(continued from above due to length)
How can mas...(continued from above due to length)<br /><br /><br />How can <a href="http://hcrenewal.blogspot.com/2012/01/2011-closes-on-note-of-electronic.html" rel="nofollow">massive security breaches</a>, made possible only by IT, be met with such indifferent "oh well, stuff happens" attitudes? <br /><br />Why does HIT receive such remarkable ethical special accommodation with respect to other InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-49443169854625264412012-04-27T15:34:23.606-04:002012-04-27T15:34:23.606-04:00Matthew Holt writes:
I have never seen you advoca...Matthew Holt writes:<br /><br /><i>I have never seen you advocate what the solution is--other than stop using what we have until something better magically comes along</i><br /><br />Matthew,<br /><br />Actually, I opine that you mistake the attitude of the industry for mine. An industry extant for decades that only now in 2011/2 starts to - and I emphasize starts to - get serious (under some InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-26503906129934822862012-04-27T10:50:06.191-04:002012-04-27T10:50:06.191-04:00So Scott. How do you explain Epic's adding of ...So Scott. How do you explain Epic's adding of new customers basically every week. Do you think their user interface modern and superb and easily accepted by all doctors? You are confusing one company's problems putting together the vendors it acquired with the overall logic of the ARRA stimulus. And if you dont think EMRs do any good here, try to explain why they work in Denmark?<br /><brMatthew HOlthttp://thehealthcareblog.comnoreply@blogger.com