One of my interns was “running the list” with me last week (giving me a thumbnail update on the plans for each of our inpatients). It was standard stuff until he got to Ms. X, a 80ish-year-old woman admitted with urosepsis who was now ready for discharge. “I stopped her antibiotics, advanced her diet, called her daughter, and YoJo’ed her.”
Say whaa?
I’m pretty sure that the most valuable thing I’ve done in my 15 years running UCSF’s inpatient service has been to convince the hospital to hire a discharge scheduler, Yolanda Jones, a delightful woman with a big smile and the world’s most thankless job. When a patient is ready for discharge, the interns send Yolanda a note with a list of follow-up appointments, radiology studies, and other outpatient tests that need to be scheduled. She makes all the appointments, then calls the patient and intern with the info. Our hospital would cease to function if not for Yolanda; she is the unsung hero of the medical service.
Allscirpts' CEO Glen Tullman has had a good year. Allscripts' stock is up four-fold, sales are going well and some people think that ARRA/HITECH's fillup to the healthcare IT industry is mostly his doing--he was an early fundraiser for Obama. Any clouds on the horizon? You'll have to watch the interview I did with him at HIMSS to find out.
I saw a patient today and looked back at a previous note, which said the following: “stressed out due to insurance.” It didn’t surprise me, and I didn’t find it funny; I see a lot of this. Too much. This kind of thing could be written on a lot of patients’ charts. I suspect the percentage of patients who are “stressed out due to insurance” is fairly high.
My very next patient started was a gentleman who has fairly good insurance who I had not seen for a long time. He was not taking his medications as directed, and when asked why he had not come in recently he replied, “I can’t afford to see you, doc. You’re expensive.”
Just when we thought things were calming down in the world of Health 2.0, it’s kicking off. WebMD has been watching Everyday Health take over its spot as top Health site ranking in the ComScore rankings (cue angry diatribe from those who don’t believe Comscore, and explanations from those who think they understand what Comscore is up to). They’ve also presumably been watching as MedHelp.org went from nowhere to close to 10m visits a month (WebMD claims 60m users but Comscore says closer to 24M).
A surprise move by ONC/HHS indicates the wheels may be falling off health IT reform at about the same rate they've fallen off Democrats' broader health reforms.
David Blumenthal and his staff have unveiled two separate plans to test and certify EHR technology products and services. We don't think this is a good idea. We've supported the purpose and spirit of the ARRA/HITECH incentive programs, and believe ONC's/HHS' re-definition of EHR technology puts it on a trajectory to improve the quality and efficiency of health care in the U.S. But this recently-announced two-stage EHR technology certification plan bears all the marks of a hastily drawn up blueprint that, if rushed into production, could easily collapse of its own bureaucratic weight.
After days of technical gremlins holding me back, I'm getting my HIMSS interviews up online. I’ll start with one from two of my favorites. This is Daniel Palestrant of Sermo and Jonathan Bush of athenahealth, who are starting to work together in a potentially interesting way (if you’ve been following my mantra of Health 2.0 Tools and Communities merging). And both of them are pretty riotous to interview, so enjoy!
As I noted in another post, the media seems to be turning “reconciliation” into an ugly word.
But “filibuster” is the word with a more unsavory history. (Thanks to HeathBeat reader Barry Carroll who sent me a link to the history of the word.)
“Filibuster” finds its root in the Spanish word “filibustero,” which means “pirate.” The filibuster was originally seen as an opportunity to “pirate” or “hijack” a debate. (more...)
Today till WedsI'll be at HIMSS in Atlanta. You can see me at the Bloggers panel at 3pmMonday, or more importantly at the talk Jane Sarasohn-Kahn & I are giving on Health 2.0 & Participatory Medicine at 1pm on Tuesday in Georgia Ballroom 1.
I’ll also be wondering around with the trusty flipcam, so expect to see a few schedules and not so scheduled interviews up on THCB too. And you can always follow my twitter feed http://twitter.com/boltyboyIf you want to meet me, best bet is to DM or follow my social schedule herealthough with Jetlag waking me up at 4am not sure how long I’ll last tonight!
For those of you just getting up on Friday, here's a little taste of the atmosphere we're drinking in for the upcoming Health 2.0 Europe conference. And yes, we have been working hard here too!
This is not a fun day for athenahealth, and frankly with HIMSS coming up, not a fun time to have such a day. None of this has anything to do with their products or their client services, but late last night the company announced that it’s going to be restating its earnings. You can see a longer discussion on The Street.combut essentially it appears that athenahealth has been amortizing its installation costs over one year whereas they ought to have been doing it over more years. The net result is that they’ll have to restate some earnings and are going to miss the next earnings reporting deadline. The stock is off roughly 12% today.