PGY 39, Day 103
Should we call it the HIT Parade?
Easy now, don't jump on the bandwagon. Think first; jump later? Think and walk? Better yet, StepWisely(R)
This is my latest comment with regard to Health Information Technology flaws and fixes.
Happy Monday! I will try to post on your blog (DONE http://biomedres.blogspot.com/2011/10/more-on-hits-impact-on-dr-patient.html?showComment=1318263890772#c2930562617135789482) and will go to my blog as well.
Thanks again for including me in your conversion(s). It is good to know that some are thinking (actually thinking) about doing the right thing in regard to HIT.
BUSINESS OF MEDICINE vs PROFESSION OF MEDICINE vs HEALTHCARE
Regrettably, as with all things medical over the last couple of decades, there are many (THIRD PARTIES) out there who would be happy to take some $$$ out of this pot ... without regard to impact on patients and patient care. In other words, most (if not all) of these systems are a great source of income for the vendor and I venture that ALL would FAIL the scrutiny of cost benefit analysis, if they were in the mix of new products and services being examined. DON'T give them the money! Make them prove that it is worth it!
But, everyone has (without good reason) jumped on the HIT train ... and it is being pushed full speed ahead ... before the tracks are laid. Sure, I like the data to play with, but is it worth compromising patient care to get it? And, the prices you are paying are a RIP OFF!
My advice? If you don't want to waste money on HIT, 1. Don't buy anything before you test it! 2. Better yet, make it yourself and run pilots before you spread it around like fertilizer ... cough ... cough ... sputter. 3. Don't waste your time negotiating with 3rd party HIT vendors. Make them prove their systems by loaning trial hardware and software for testing on site!
Seems as if Governments are in a good position to help develop a SECURE INTERNET that runs parallel to, but separate from the existing hardware and software. Over this INTERNATIONAL HEALTH NET, Personal Health Information could be shared (Standardized Data on OPEN SOURCE SOFTWARE that each patient and provider has) between providers and patients anywhere in the world. Open source, Non Profit COOPERATIVE makes the most sense, because NOBODY should profit (over and above a reasonable wage) from Healthcare. Like ($$$) banks, the information would be held by each patient and provider, but not in central data banks.
Just my opinion:)
To be continued ...
Dr. Mike
Michael F. Mascia, MD, MPH
dr.mike@ihealsolutions.com"
T
Tuesday, October 11, 2011
Sunday, October 9, 2011
Mission: Healing October 9, 2011
PGY 39, Day 101
Thinking about Steve Jobs, and my brother Peter. Good men, lost to the world, but lives lived well.
V2
Sunny Day
Silent ...
Sunbeams Spotlight Shimmering
Leaves
Flutter ... dance in gentle breeze ...
soon to be naked trees.
Some, radiant dressed, scream for attention ...
about to drop their cover.
Reflecting ...
rhythm, autumn's amber glow ...
crystal blue skies ...
eternity.
Seasons ... men ... women ... come and go,
cricket, squawking bird, rustling squirrel,
each endless solo
squall and swan song sung ...
to no avail,
sensing ... warm, sweet, calm ...
days savoring seasons' fruit ...
moments pale.
Watching, wondering how can it be?
The inchworm ... tiny thing,
efortlessly dangling ... floating ...
up ... down ... side to side ...
on a sparkling string ...
nearly invisible.
But, that is just a distraction.
Have a Happy Sunday and Do The Right Thing!
Dr. Mike
Thinking about Steve Jobs, and my brother Peter. Good men, lost to the world, but lives lived well.
V2
Sunny Day
Silent ...
Sunbeams Spotlight Shimmering
Leaves
Flutter ... dance in gentle breeze ...
soon to be naked trees.
Some, radiant dressed, scream for attention ...
about to drop their cover.
Reflecting ...
rhythm, autumn's amber glow ...
crystal blue skies ...
eternity.
Seasons ... men ... women ... come and go,
cricket, squawking bird, rustling squirrel,
each endless solo
squall and swan song sung ...
to no avail,
sensing ... warm, sweet, calm ...
days savoring seasons' fruit ...
moments pale.
Watching, wondering how can it be?
The inchworm ... tiny thing,
efortlessly dangling ... floating ...
up ... down ... side to side ...
on a sparkling string ...
nearly invisible.
But, that is just a distraction.
Have a Happy Sunday and Do The Right Thing!
Dr. Mike
Saturday, October 8, 2011
Healing: Saturday, October 8, 2011
PGY 39, Day 100
This morning, I wrote these words and sent them out on twitter, as I was enjoying my morning coffee. Just a few moments on a Saturday morning ... awake moments of meditation. Try it. You might like it.
10/8/11 10:47 AM
BEING ... Warm sun, hot coffee, birdsong, blue skies, sweet air ... leaves sparkle ... glow ... dancing in the gentle breeze ... is.
Dr.Mike
This morning, I wrote these words and sent them out on twitter, as I was enjoying my morning coffee. Just a few moments on a Saturday morning ... awake moments of meditation. Try it. You might like it.
10/8/11 10:47 AM
BEING ... Warm sun, hot coffee, birdsong, blue skies, sweet air ... leaves sparkle ... glow ... dancing in the gentle breeze ... is.
Dr.Mike
Friday, October 7, 2011
Mission: Healing October 7, 2011
PGY 39, Day 99
Fall Rhythm ...
Hushhhhh ... the only sound in this sweet air ...
and a few notes ... birdsong ... chipmunk rustling ...
gently drifting through trees ...
green leaves flutter and dance ...
Submission.
Sunbeams,
burning through flesh, take the chill out of bones,
and spotlight the brilliant ones screaming for attention ...
standing out among the forest's green, gray and brown.
Ahhhhhh ... being ... this is ... an intermission.
Summer's swan song over,
sweet day's calm,
silent blue skies give a hint of what was
and
what is to come.
Happy Friday!
Dr. Mike
Fall Rhythm ...
Hushhhhh ... the only sound in this sweet air ...
and a few notes ... birdsong ... chipmunk rustling ...
gently drifting through trees ...
green leaves flutter and dance ...
Submission.
Sunbeams,
burning through flesh, take the chill out of bones,
and spotlight the brilliant ones screaming for attention ...
standing out among the forest's green, gray and brown.
Ahhhhhh ... being ... this is ... an intermission.
Summer's swan song over,
sweet day's calm,
silent blue skies give a hint of what was
and
what is to come.
Happy Friday!
Dr. Mike
Mission: Healing October 7, 2011
PGY 39, Day #99
Business of Medicine: More on Problems With Health Information Technology ...
These are comments on a HIT bloggers reflections regarding my Top Ten HIT Problems Post from a few weeks ago ...
Some day I will figure out how to link all this together, so that it can be followed.
Thanks for including me in your conversation. I take it that in the UK your HIT is non proprietary and Government property?
As a front line provider & proponent who has dabbled in EMR creation and relational data bases for ... how long have they been available? ... I am continually struck by the inadequacy of proprietary EMR products available in the US. And, I can only conclude that the proprietary model is the major barrier to eliminating the flaws ... or is it Ego? Money/Ego? Money vs Ego? Money & Ego ...
Anyway, no matter what the causes, I strive to set up a Non-Profit Doctor-Patient Health Care Cooperative, and think that the HIT problems can be resolved as a part of the Mission. The objective would be to find a group of IT people who will work together with me to create the ultimate open source HIT platform. I can do it on paper ... I just can't do it electronically.
It is interesting to note that the HIT people look at me as if I have two heads when I tell them that their product is not good enough, because it gets between us ... between the Doctor and the Patient ... and takes time away from my patient care time. They just don't get it. I should not be surprised, right? HIT people think that interacting with a computer is natural, right? Prove me wrong.
Well, like it or not, I have watched technology chip away at the Doctor Patient Relationship and nursing time ... bit by bit over the years. Now, it is simply madness ... And, while it may not make a difference ... in certain scenarios where care is irrelevant and people will get better anyway (most clinic patients), it is a serious problem in the ICU, or in the OR to have 25 - 50% of physician time spent on computers. This is foolishness! Especially today ... in an era with availability of such sophisticated technology. Doctors and nurses spending precious patient care time on computers? This is CRAZY, not NORMAL! NOT RIGHT and NOT ACCEPTABLE. If I only had a chance to talk with Steve Jobs ... I am sure he would have seen the value of fixing this problem. Ah, well ... it is what it is.
Right now, as it stands, we could instantly solve the HIT interphase problem and help reduce unemployment by hiring scribes to serve as the interphase between Doctor and Patient ... one for each patient in the ICU and one for each patient in the OR. (Do what you like in the clinic.) This would work as an instant stop gap measure while we push to bring this monster around to a technology that is friendly to the Doctor - Patient relationship and Nursing care of the patient.
To be continued ...
Dr. Mike
dr.mike@ihealsolutions.com
Business of Medicine: More on Problems With Health Information Technology ...
These are comments on a HIT bloggers reflections regarding my Top Ten HIT Problems Post from a few weeks ago ...
Some day I will figure out how to link all this together, so that it can be followed.
Thanks for including me in your conversation. I take it that in the UK your HIT is non proprietary and Government property?
As a front line provider & proponent who has dabbled in EMR creation and relational data bases for ... how long have they been available? ... I am continually struck by the inadequacy of proprietary EMR products available in the US. And, I can only conclude that the proprietary model is the major barrier to eliminating the flaws ... or is it Ego? Money/Ego? Money vs Ego? Money & Ego ...
Anyway, no matter what the causes, I strive to set up a Non-Profit Doctor-Patient Health Care Cooperative, and think that the HIT problems can be resolved as a part of the Mission. The objective would be to find a group of IT people who will work together with me to create the ultimate open source HIT platform. I can do it on paper ... I just can't do it electronically.
It is interesting to note that the HIT people look at me as if I have two heads when I tell them that their product is not good enough, because it gets between us ... between the Doctor and the Patient ... and takes time away from my patient care time. They just don't get it. I should not be surprised, right? HIT people think that interacting with a computer is natural, right? Prove me wrong.
Well, like it or not, I have watched technology chip away at the Doctor Patient Relationship and nursing time ... bit by bit over the years. Now, it is simply madness ... And, while it may not make a difference ... in certain scenarios where care is irrelevant and people will get better anyway (most clinic patients), it is a serious problem in the ICU, or in the OR to have 25 - 50% of physician time spent on computers. This is foolishness! Especially today ... in an era with availability of such sophisticated technology. Doctors and nurses spending precious patient care time on computers? This is CRAZY, not NORMAL! NOT RIGHT and NOT ACCEPTABLE. If I only had a chance to talk with Steve Jobs ... I am sure he would have seen the value of fixing this problem. Ah, well ... it is what it is.
Right now, as it stands, we could instantly solve the HIT interphase problem and help reduce unemployment by hiring scribes to serve as the interphase between Doctor and Patient ... one for each patient in the ICU and one for each patient in the OR. (Do what you like in the clinic.) This would work as an instant stop gap measure while we push to bring this monster around to a technology that is friendly to the Doctor - Patient relationship and Nursing care of the patient.
To be continued ...
Dr. Mike
dr.mike@ihealsolutions.com
Mission: Healing October 7, 2011
PGY 39, Day #99
As usual, I am thinking ... always thinking more as I recover from my week of patient care and sleep deprivation. Delayed processing of the events of the week and examination of my emotions ... a trick I have learned over the years to keep emotions out of my interactions with patients. This works for patient care, but I am sure it drives everyone else in my life crazy.
Anyway, lately I have been thinking that I need to start posting some of my Stress Management strategies & some pages from the "Stress Management Workbook: An Action Plan for Taking Control of Your Life and Health". I wrote it with a Psychologist friend & co-worker (Stephen Aronson, PhD) to help worried well patients get healthy and stay healthy. More than half of my Family Practice patients (I did Family Medicine for 14 years before Anesthesiology & Critical Care) were suffering from stress related disorders, and, even though less than 10% of the folks were motivated to "take control" of their own health, I thought it was a worthy endeavor. The book was written in 1979, and published by Appleton Century Crofts in 1981, and ... low and behold, it is still sound and relevant. I have threatened to publish an electronic version and to write a new edition for years, and, maybe I will just have to start posting the updates in the blog.
The fact is, that little has changed with regard to the fundamentals of Stress & Stress Management, but I can update the book with new and emerging problems since the original publication. Not much needs to be added, but there are some issues that deserve special attention for the New Millennium. Specifically, I will update the immunization section, add a sections on AIDS, and bits for some of the newer global issues and worries such as terrorism, financial instability and disaster preparedness. Also, an electronic version should enable strategically placed live links for references and easy user updates.
Hopefully, I can get some feedback and interaction from my Twitter Followers, Facebook Friends and Blog Readers, so that I can fine tune the New Edition to make it particularly relevant and helpful. What do you think?
Dr. Mike
As usual, I am thinking ... always thinking more as I recover from my week of patient care and sleep deprivation. Delayed processing of the events of the week and examination of my emotions ... a trick I have learned over the years to keep emotions out of my interactions with patients. This works for patient care, but I am sure it drives everyone else in my life crazy.
Anyway, lately I have been thinking that I need to start posting some of my Stress Management strategies & some pages from the "Stress Management Workbook: An Action Plan for Taking Control of Your Life and Health". I wrote it with a Psychologist friend & co-worker (Stephen Aronson, PhD) to help worried well patients get healthy and stay healthy. More than half of my Family Practice patients (I did Family Medicine for 14 years before Anesthesiology & Critical Care) were suffering from stress related disorders, and, even though less than 10% of the folks were motivated to "take control" of their own health, I thought it was a worthy endeavor. The book was written in 1979, and published by Appleton Century Crofts in 1981, and ... low and behold, it is still sound and relevant. I have threatened to publish an electronic version and to write a new edition for years, and, maybe I will just have to start posting the updates in the blog.
The fact is, that little has changed with regard to the fundamentals of Stress & Stress Management, but I can update the book with new and emerging problems since the original publication. Not much needs to be added, but there are some issues that deserve special attention for the New Millennium. Specifically, I will update the immunization section, add a sections on AIDS, and bits for some of the newer global issues and worries such as terrorism, financial instability and disaster preparedness. Also, an electronic version should enable strategically placed live links for references and easy user updates.
Hopefully, I can get some feedback and interaction from my Twitter Followers, Facebook Friends and Blog Readers, so that I can fine tune the New Edition to make it particularly relevant and helpful. What do you think?
Dr. Mike
Monday, October 3, 2011
Mission: Healing October 3, 2011
PGY 39, Day 95
Recovering from another week in the ICU. This was a moderate week, in the sense that we had a strong care team and a patient population that did not exceed our capacity. In other words, we did not have to stretch beyond capacity at any time during the week and all patient care, teaching, research and administrative objectives were met. it is not uncommon that some unimportant things have to be put off, so that patients can get the care that they need.
For obvious reasons, patient care details can't go in here, but I can and do talk about my goals, objectives and methods ... patient care, teaching, research and administration. Patients and Patient Safety always come first in my book. Toward that end, I have developed some tools that are designed to keep inexperienced Doctors and Nurses on target with our Mission: optimal patient care. These are all part of the StepWisely(R) System that I have been using over the last few years.
Previously, I have given you bits and pieces in this blog and through twitter. Here is a bit more ... will expand on it over time.
STOMPP(TM)IT = Strategic Targeted Operations Management for Patient Protection & Preservation Integration Tool: A tool to keep the team on Target with the Optimal Patient Care Mission. This team development tool is a series of check lists that helps the members of the team to stay FOCUSED on the CRITICAL GOALS AND OBJECTIVES that are most likely to result in a good outcome. They include General Patient Goals and TOPS(TM) (Targeted Organ Protection Strategies) that are patient & organ specific. In other words, they are designed for the management of each patient on the basis of each patient's specific needs. While I can't be specific about any real patients, over time, I will give theoretical examples of how these are used in the care of each critically ill patient.
That's all for now ...
If you have specific questions, you can contact me by email @ dr.mike.ihealsolutions
Ciao for now,
Dr. Mike
Recovering from another week in the ICU. This was a moderate week, in the sense that we had a strong care team and a patient population that did not exceed our capacity. In other words, we did not have to stretch beyond capacity at any time during the week and all patient care, teaching, research and administrative objectives were met. it is not uncommon that some unimportant things have to be put off, so that patients can get the care that they need.
For obvious reasons, patient care details can't go in here, but I can and do talk about my goals, objectives and methods ... patient care, teaching, research and administration. Patients and Patient Safety always come first in my book. Toward that end, I have developed some tools that are designed to keep inexperienced Doctors and Nurses on target with our Mission: optimal patient care. These are all part of the StepWisely(R) System that I have been using over the last few years.
Previously, I have given you bits and pieces in this blog and through twitter. Here is a bit more ... will expand on it over time.
STOMPP(TM)IT = Strategic Targeted Operations Management for Patient Protection & Preservation Integration Tool: A tool to keep the team on Target with the Optimal Patient Care Mission. This team development tool is a series of check lists that helps the members of the team to stay FOCUSED on the CRITICAL GOALS AND OBJECTIVES that are most likely to result in a good outcome. They include General Patient Goals and TOPS(TM) (Targeted Organ Protection Strategies) that are patient & organ specific. In other words, they are designed for the management of each patient on the basis of each patient's specific needs. While I can't be specific about any real patients, over time, I will give theoretical examples of how these are used in the care of each critically ill patient.
That's all for now ...
If you have specific questions, you can contact me by email @ dr.mike.ihealsolutions
Ciao for now,
Dr. Mike
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