Driving In Traffic

In an earlier post, I mentioned that my local member of the House of Representatives in DC has put forth some legislation (H.R. 4641, otherwise known as ADOPT HIT act) to encourage physician’s to adopt electronic medical records into their practice.

On Rep. Gingrey’s site, he is once again stumping for increasing the tax breaks for physicians who implement electronic medical records. Backing him up on this is is a new Commonwealth Fund study on physician investment in health IT that was published April 10th in the Archives of Internal Medicine.

The data for the Commonwealth Study was collected in 2003— 3 years ago. Most will agree that probably since then there has been significant changes in physician’s use of the internet. Despite that, I think there are some very interesting findings from this research.

In 2003:

It would appear that Rep. Gingrey’s ADOPT HIT is directly trying to off- set some of the costs associated with the basic investment in the infrastructure (equipment and software) for Health IT systems. Notably, I did not see any allowance for training in the summaries of the ADOPT HIT act that I’ve run across.

While I think the tax breaks are wonderful, it is important to note, that physicians will not be getting the items for free. They will still have to invest quite a good sum out of their pockets.

I’m wondering if there will be enough left over for training the staff to use it properly? Now don’t get me wrong, I’m not advocating for a handout. However, I think a plan needs to be made. Training in a small to mid-size office often is a triple cost endeavor. You have to pay the person for the time they are in training. You have to pay for the the time of the person who will cover their job while they are training. Then you have to pay the trainer.

I would surely hate for people to sink large sums of money into a technology that they do not use because they cannot afford to train the staff.

Technorati tags: Phil Gingrey, Commonwealth Fund, ADOPT HIT, Electronic medical record

The search for innovation needs to be organized separately and outside of the ongoing managerial business. Innovative organizations realize that one cannot simultaneously create the new and take care of what one already has. They realize that maintenance of the present business is far too big a task for the people in it to have much time for creating the new, the different business for tomorrow. They also realize that taking care of tomorrow is far too big and difficult a task to be diluted with concern for today. Both tasks have to be done. But they are different. Innovative organizations, therefore, put the new into separate organizational components concerned with the creation of the new.

Drucker P.F. (1974). Management: Tasks, responsibilities and practices. New York: Harper & Row.

We know that we need some changes in the delivery of health care services. More efficient, more consumer-driven, more cost-effective. Is there room for innovation in the delivery of healthcare services? Dare we dream of making it better?!?!?! If so, are we willing and able to commit the resources needed to change our systems?

Technorati tags: healthcare, innovation, Peter Drucker

Last night the Hubby and I had dinner with old friends we had not seen in a while at Ichiban Japanese Steakhouse. You know those hibachi places– they don’t foster quiet table conversation. Instead, the conversation tends to be located at whatever end of the table you are at.

I was sitting next to my old friend, Joe, who is a minister who has accepted the charge of starting a new church (Church Planting) for a local conference of a major Christian denomination. He clearly loves his job. However, he readily admits that due to a number of circumstances the task is harder than he expected. Careful not to be seen as complaining, he embarked on a brief conversation of the obstacles that he was facing.

Immediately, it was clear that one of the first steps to solving his problems was to establish some sort of web presence. I was immediately reminded of Toby’s post over at The Medical Blog Network where she discusses the plight of a new neighbor seeking a dentist. In her story, gone are the days of the Yellow Pages, now folks are using the internet to locate businesses and learn more about them. She goes on to conclude that blogs are a good part of a marketing strategy. Previously on her blog, she discusses the role of blogs in a not-for-profit marketing plan.

I have been thinking about not-for-profit blogs because of my work with the animal rescue. However, my conversation with Joe last night has gotten me off of my duff to investigate a little further.

What are the benefits of a blog to a not-for-profit?

Tom Murphy over at PR Opinions discusses the benefits of “Charitable blogs”. He says:

Why should charities be interested in blogs? Well there’s loads of reasons:

Advocacy: Blogs are the perfect medium for creating platforms where passionate and articulate individuals and organizations can clearly communicate their views on issues and drive the debate.

Accountability: When people give to charity, often the most powerful means of keeping them involved is to show them how their donation is being used. Blogs provide the perfect platform for demonstrating the results of fundraising.

Show and Tell: Can you think of a more powerful tool for charities that using blogs to showcase the issues they’re facing or trying to solve on a daily basis? Whether it’s aid workers blogging in a foreign country or homeless people sharing accounts of their lives.

Every other benefit of blogs: Blogs promise organizations many benefits, and alongside the first three points, they offer charities exactly the same benefits. Whether it’s about conversations, knowledge sharing, search engine optimization etc. blogs can help

Wayne Hurlbert at Blog Business World recently posted that not-for-profit blogs can help SEO efforts but encourages organizations to blog on issues that are pertinent to their area of service. Here the idea is that blogging provides a good avenue for people to find you and if you blog about things that are important to your organization that translates into people having a better idea of who you are and what you are about.

More questions…

Now, I have a good idea of some benefits. Unfortunately, I have more questions. Big Surprise…

I suppose I best sign off with a To Be Continued……

Technorati tags: not-for-profit, blogs,

Two posts ago, I was just talking about electronic medical records. So it is interesting, that today Dr. David Brailer resigned as the National Coordinator of Health Information Technology. Thanks to KaiserNetwork for the info… Click here to read more.

Dr. Brailer will continue to consult with the government on this but his commute from San Francisco to DC has proved quite stressful according to the story.

I’m going to keep an eye on this and see how this evolves. Very interesting….

Technorati tags: David Brailer, Health IT, Electronic Medical Records

The US health care system is massive, primarily because the United States’ market-oriented economy has allowed it to evolve without a concise plan. Rather ironically, the US Healthcare system does not operate under traditional “free market” rules. Instead it operates under imperfect market conditions.

Now for folks that are familiar with healthcare economics and policy, this certainly is not news. Our healthcare economic structure is indeed part of the problem!

However for individuals in the general public, they are typically unaware of how this creates and atmosphere of unlimited demand for healthcare services in our country. To date, there has always been someone (insurance company, charity, organizational bad debt write off, Medicaid, Medicare) to pay for these services. However with the emergence of the boomer generation and increased number of uninsured in the US, the gravy train is breaking down from the load. If these forces are not corrected, our healthcare system will implode.

What to do?

I know this is going to sound very “pie-in-the-sky,” but I think as we move toward a more consumer-driven healthcare system that we need to take the time to educate and emphasize the role of stewardship of healthcare resources. Use what you need, but understand that if you consume services and resources simply because you can that it places undue stress on the system. For example, don’t use the emergency room to get a prescription for an antibiotic to treat a sinus infection.

Admittedly as a society, we are horrible about stewardship toward Mother Earth. So why should we expect people to be good stewards about the healthcare services they utilize?

Admittedly, I never thought we would ever see the emergence of hybrid cars or the government funding of research to look into alternative fuels. However, taking a page from the global warming and gasoline/oil pinch we in the US find ourselves in, I think the world around us is giving us clues in the healthcare realm upon which we can capitalize and begin to educate consumers. First from my own personal experience, this year I have seen a big increase in my contribution to my insurance premiums and medication co-pays. I read the paper, so I know I am not alone in this. Second, companies are feeling the pinch. I have friends who work for companies who have had to reduce their health care benefits in order to not let their premium contributions eat away at the stability of their companies. Third, every week a national news outlet publishes something about the skyrocketing costs of healthcare. I see it on the nightly news and I think others see it too. Lastly, our government is always screaming about the cost of medicare and medicaid benefits. Geez…. when is the last time we actually heard about them increasing the benefits? More often than not, we hear about medicaid programs running out of money and the possiblity of increasing taxes to be able to cover the huge costs of medicare and medicaid programs.

OK– hitting everyone in their pocketbooks is the best way to grab someone’s attention. And you’ve got mine! The next step is begin to educate people on what they can do to help the situation. Right now, every person who receives health services should be asking

How much is this costing? Total costs, not just my co-pay.

Are there other cheaper and equally effective treatments for my medical condition?

Doc’s, healthcare providers, and healthcare organizations aren’t gonna like this, but consumer-driven healthcare is here. We need to be planning on how we are going to grow this movement in a healthy direction.

Technorati tags: health economics, Health Insurance, Health policy, consumer-driven healthcare

Having always been a person with opinions on how things can and should be done, I love to harrass my state representatives and congress people. Just last week, I cruised on over to my local representative’s, Phil Gingrey, webpage to make sure he was working (rather than eating free lunches off of lobbists).

I was delighted to see that he recently appeared (April 6th) before the House Committee on Small Business, Subcommitte on Regulatory Reform and Oversight to talk about the implementation of electronic medical records (EMR) and other Health IT in small to medium size medical practices. Click here to see a transcript of his remarks.

Rep. Gingrey’s address was to introduce his new legislation, H.R. 4641 or the ADOPT HIT Act, that seeks to help physicians implement health information technologies into their practice by offering tax incentives. Those tax incentives include:

Now, I’ve been reading a bit on RHIO’s and how the Department of Health and Human Services is awarding contracts to set up Nationwide Health Information Network. Additionally, I remember that a couple of years ago, President Bush mentioned that he was going to push the implementation of EMRs as a part of a whole plan to help control the rising costs of healthcare. He reasserted this again in the latest State of the Union Address. The Executive Summary of the plan emphasizes a vision for “Consumer-centric and Information-rich care.” So now with Rep. Gingrey’s ADOPT HIT initiative, it would seem as if we are well on our way to moving toward the goals set forth by President Bush in 2004.

Now, I’m not arguing the value of this endeavor. As an administrator, I wholeheartedly agree that this is all good in theory and given the data to date that it has a real chance of improving the delivery of healthcare. However, I believe that the average doctor with a small to medium practice feels somewhat immune to this intiative for developing a nationwide network of health information. I wonder if many health service providers are aware of how their lives are going to dramatically change if Rep. Gingrey’s ADOPT HIT legislation passes and actually manages to encourage the adoption of EMRs. At the very least for the average physician/provider, that change means making friends with Mr. Computer or hiring someone to do it.

Now I admit, there are some physicians that are quick adopters. However, I just don’t see the average physician or small to medium practice relishing the idea of spending money on EMRs, learning how to use them and changing the operation of his practice. We all are creatures of habit and it is a difficult sell unless you can really spell out personally relevant ways that it will improve the care of a person’s specific caseload.

Things may go well as long as this is voluntary for the practitioners. However, given the ever-expanding role of the government in the delivery of healthcare, renewed rumblings for a universal healthcare model in the US and my read of the plan, this is setting up to be mandatory in the future. So really, in essense these are just the first steps toward being a full-blown government regulation– complete with its own regulatory office at USDHHS.

While I don’t really want to sound like I’m playing the role of a canary in the coal mine, but Rep. Gingrey’s legislation may be a first step toward “Borg-like” assimilation where “resistance is futile”. My fear is, like many providers were dragged “kicking and screaming” into managed care era, that providers will dig in their heels at the 11th hour on this too. I may be wrong, but I just hate to see a fight brewing when there is time to build a consensus.

Update (April 20,2006): Mike Ryan has written an article over at the Medical Blog Network that is worth taking a look at that reports that consumers and now Dr. David Brailer are having second thoughts about this.

Technorati tags: Health IT, Phil Gingrey, Electronic Medical Records, Electronic Health Records

The Wind-up:
For those of you who have a laptop, you know that not every place has a wifi set up for you to use. Many that do are not to generous and will charge you an arm and a leg for it’s use.

I found this really cool site, Plazes, that is sort of an underground attempt to log all the places, you can access the internet from your laptop (wireless and lan based). Given how hinkey my Hubby is about our wireless network security, I was delighted that I did not see my address on there, but I did find a few places that I knew nothing about. In fact, I think the next time I’m out and about I might just drop by a few of the places listed by me and see if it works.

The Pitch:

Plazes is a downloadable program that logs all of the places that a user accesses the internet while rambling about with his or her laptop.

The Plazer looks for the hardware ID of your local network (MAC ID) and checks whether it is already in the database with an address, so we can place you at that location. That is all it does. The Plazer is NOT Spy/Mal/Adware. The Plazer does not make your network or your PC vulnerable to any attacks. Your MAC ID is not publicly accessible and is only used for identifying your network.

Coordinates for these hot spots gets loaded into the Plazes program and you are allowed to add pictures and comments. It also integrates with Flickr.

Plazes users are given Karma Points for finding new Plazes.

Every time you discover a new Plaze, you get karma points. Top discoverers show up in a special list so you can compete with others and map your favorite Plazes. If you are the discoverer of a Plaze you will be presented a button to edit your special description. You get karma points for every Plaze you discover and for every successful invitation you sent out. Your Karma points are reflected in the discoverer list.

The Swing:

Since I haven’t used this, I don’t know if it is a “Home Run,” “Base Hit”, “Pop Fly” or a “Strike-out”. I’d be interested in hearing people’s take on this. At the very least, it sounds like it could be a little fun.

Technorati tags: Plazes, Wireless, WiFi

When I first was thinking about starting my business blog, one of my main concerns was which platform or service to use. Thankfully, I was lucky enough to have a mentor (Teresa) who consulted with others to help me get information that could help me decide which service suited my immediate need of being affordable and easy to use, yet would allow me to grow should I love blogging.

Recently, USA Today (at least the Online Version) published an article that was picked up by Netscape on getting started in the blogosphere.
It provides a good overview of the various services available to begin blogging. While the advice is a little dated (in blogosphere terms), I think Josh Hallet’s words of wisdom still hold true— “Friends don’t let friends use bad blogging tools.”

Last month, he also posed 4 questions that every budding business blogger should consider before you start. In a nutshell, Josh suggests that:

I would also suggest that you approach this endeavor as a learning experience. If you are doing it right, your blog will evolve. Just as in real life, sometimes this comes by making mistakes. There is much advice out there in the blogosphere on how to deal with mistakes, but my advice here is to be prepared to make them yourself. Subsequently, at least have an idea of how you will handle it. In most cases, a sincere, humble apology and a detailed explanation of your benign intent will suffice.

Friendly readers, please expand on this topic. I know I have not covered everything.

Little League baseball is one of my simple joys of spring. I don’t have children so to get my “fix” I make the hubby take me out to the ball park to watch the local boys. It’s a pretty cheap date, so he doesn’t fuss much.

Last Thursday, while eating our favorite gelato, a series of interesting events caused me to begin thinking.

In a nutshell, one young boy who had missed an important play came in from the field. As soon as he stepped in the dugout, the child began to whine about how the error was not his fault and began to point fingers at other teammates. The coach turned around and sternly, but not rudely, asked the child to stop his tirade. The mother of the child quickly became enraged that the coach had structured her child. She ran up to the fence and began yelling at the coach and saying that she was going to sue the league to get her money back. After getting no attention from the coach, she sat back down on the bleechers and began to loudly rant to other parents around her. Basically, the joy left Mudville. I actually considered giving her the $30 dollar registration fee out of my pocket just to get her to hush. Instead, after enduring it for 20 minutes, we decided to leave and come back another day.

After getting over being annoyed that my good time had been spoiled and being appalled at how one woman could set such a poor example before 12 impressionable children, I began to think about what the scenario could teach me.

I’m an Atlanta native… born here and raised here. As with most children, I was taught to obey the rules of my parent’s house. When I was not at home, my parents said I had to obey the rules of their house and the house of my friends. I’ll readily admit, there were times that this was confusing and aggravating. Especially when you consider that in our small neighborhood, any parent could punish any child if the house rules were broken. This extended to the ballpark and coaches too. I know this notion may seem radical and perhaps cruel considering the social rules of today. However, please understand the priveledge was rarely exercised. I think it was actually used as more of a deterrent because the threat of “getting it” again when you got home was a horrifying thought in most cases.

This taught me the very realization that rules are different in different settings. I see this everyday in my adult life. It also taught me that in most cases, there is a really good reason why the rules are different in different setting. Subsequently, it can be a fruitless struggle to invoke your own outside rules onto inherently different settings.

I think as blogging evolves we are seeing a set of unwritten rules evolve with it. There has been much talk about blog manners, which like the rules about putting a napkin in your lap, are good in most every setting. However, there are also rules that are very specific to certain settings. For example, while it may be cool for a boy to spit on the ballfield, the same behavior would be met with shock, awe and disgust if he did that on the carpet at home. Such is the case for style and tone of certain blogs. It is simply inappropriate for personal blogs to develop a professional, aloof tone. Conversely, business blogs would not be taken seriously if they were extremely whiney or emotive. Healthcare blogs have it even harder, they must be personal enough while retaining their knowledgable credibility

As blogging begins to expand into other settings and be used in innovative ways, it is essential that we respect the rules of other’s houses. Subsequently, I find it helpful when bloggers post guidance on comments and posting. I think this helps me understand the boundaries and how to work and play appropriately without appalling the others around me.

My next task is to develop my own ground rules for this site. I’ve already done it for my business site.

If there are any physicians out there reading, what ground rules do you find important for your blogs? I think it will help me in my conversion process of my Non-blogging Doc. Did I mention that I am persistent?!?!?!

Technorati tags: medical blogs, blogging etiquette, comment rules, comment policy

There’s nothing like the feeling of being excited. The feelings of those little butterflies in your stomach, dancing happy feet and like you have the biggest grin over your face. While these subtle symptoms are most apparent to the you as you are experiencing it, usually one big question — “Guess What” — gives it away to those around you.

So….. Guess What?!?!?

I’m hanging out with a Diva!!!!

A couple of weeks ago Toby Bloomberg at Diva Marketing blog generously extended an offer for me to help her co-author a column on Medical/Healthcare marketing over at the Medical Blog Network. So I eagerly accepted. Every girl can learn a little bit about being a diva.

Our first column is up. We expect to post weekly. So drop by and leave us a comment.

Technorati tags: healthcare marketing, Toby Bloomberg, Medical Blog Network