Diet and Nutrition. Natural Health, and Healthy Living

Let’s Reboot America’s Health IT Conversation Part 2: Beyond EHRs

Dan Axel — Wed, 07 Jan 2009 01:01:06 +0000

Yesterday we tried to put EHRs into perspective. They're important, and we can't effectively move health care forward without them. But they're only one of many important health IT functions. EHRs and health IT alone won't fix health care. So developing a comprehensive but effective national health IT plan is a huge undertaking that requires broad, non-ideological thinking.

As we've learned so painfully elsewhere in the economy, the danger we face now in developing health care solutions is throwing good money after bad. We don't merely need a readjustment of how health IT dollars are spent. We need to reboot the entire conversation about how health IT relates to health, health care, and health care reform. To get there, we need to take a deep breath and start from well-established and agreed-upon principles.

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Beverly Hills Plastic Surgeon uses his patients liposuction fat to fuel his girlfriends SUV.

Dan Axel — Tue, 06 Jan 2009 06:01:07 +0000

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Call for Safe Medicine at the State Capitol

Dan Axel — Tue, 06 Jan 2009 00:01:54 +0000

Call for Safe Medicine at the State Capitol - CALPIRG

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On “A New Chapter in Medical History”

Dan Axel — Mon, 05 Jan 2009 22:01:57 +0000

In the winter 2009 issue of the Journal of Interdisciplinary History,a review essayappearsby Anne Hardy, one of the preeminent historians of medicine in the world, entitled "A New Chapter in Medical History." Here is the Abstract:

Once the domain of physicians intent on recording and memorializing professional achievements, the history of medicine has become fully interdisciplinary, encompassing myriad topics. Oddly, however, the problems that actually generate medicine, the diseases themselves, have—with such notable exceptions as plague, cholera, smallpox, tuberculosis, and hiv/aids—attracted relatively little attention until recently. Disease history now appears ready to enter a new phase.

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Let’s Reboot America’s HIT Conversation Part 1: Putting EHRs in Context

Dan Axel — Mon, 05 Jan 2009 16:01:20 +0000

Kibbe & Klepper are back with an update to their pre-Christmas piece on EHRs and the forthcoming Obama Administration's investment policy towards them. Lest you think that this is just a small group here on THCB and fellow traveler blogs shouting to each other, I'd point you towards the Boston Globe article about their previous "Open Letter," which shows that this discussion (and a similar piece on THCB from Rick Peters) appears to be being taken very seriously. As it should--Matthew Holt

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Not exactly health care, but follow the money…

Dan Axel — Mon, 05 Jan 2009 15:01:40 +0000

Michael Lewis has returned from writing about Jim Clark, technology, baseball and football to his first topic; finance. (Liars Poker is still the best book about Wall Street ever) His two part piece with hedge fund manager David Einhorn this weekend in the NY Times is one of the best things I’ve seen on the current financial crisis and what to do about it.

It’s called The End of the Financial World as We Know It and How to Repair a Broken Financial World. (I recommend reading them both straight through). And yes, Lewis wants more transparency and more regulation.

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A me-too strategy for me-too drugs

Dan Axel — Mon, 05 Jan 2009 06:01:24 +0000

AstraZeneca appears set to follow Merck into the market for “bio-similars.” (See AstraZeneca may join generic rush.) Congress and the media tend to portray biosimilars are analogous to generic chemistry-based pharmaceuticals, and therefore believe that they will lead to much lower prices as a result of the commoditization of these products. If all goes according to plan, that should cut the price of biologics by 50 to 95 percent as has been the case for generic versions of traditional pharmaceuticals.

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A new year’s resolution for greater hospital transparency

Dan Axel — Sat, 03 Jan 2009 23:01:51 +0000

Just thinking, along the lines of a New Year's resolution. What if all of the hospitals in the Boston metropolitan area -- academic medical centers and community hospitals -- decided as a group to eliminate certain kinds of hospital-acquired infections and other kinds of preventable harm? And what if they all committed to share their best practices with one another and to engage in joint training and case reviews in these arena? And what if they all agreed to publicly post their progress on a single website for the world to see?

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Can the physical examination save us from the dehumanization of medicine?

Dan Axel — Sat, 03 Jan 2009 00:01:44 +0000

In last week’s NEJM, physician-author Abraham Verghese paints a disturbing picture of a medical world in which technology has morphed from tool to object, the patient relegated to a supporting role. To me, Abraham has nailed the diagnosis but not the treatment.

I had the distinct pleasure of getting to know Abraham when we both served on the board of the ABIM (actually I came to know his work 15 years earlier, when I reviewed his bestselling book, My Own Country, for the NEJM). Abraham is a romantic and a traditionalist, and in last week’s New England Journal piece he poignantly lays out a problem he has fretted about for years: namely, that information technology is dehumanizing the practice of medicine. Describing rounds with his ward team at Stanford, his new academic home (he was recently recruited there from the UT-San Antonio), he recalls:

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The Downfall of AIG

Dan Axel — Fri, 02 Jan 2009 23:01:08 +0000

Those of you outside of Washington, DC likely missed the Washington Post's three-part investigation of the events leading to the downfall of AIG.

It makes for good holiday reading. I highly recommend the series to you.

Knowing the culture at AIG from many years of activity with the company and its leadership, I can tell you the story certainly has the culture right.

While this is not a health care story per se, it is a story about risk taking and understanding, and never getting cocky about, risk. AIG execs argued for years they really had no risk in their credit default swap business. My experience is that when someone is willing to pay you lots of money to lay a risk off on you--in this case a whopping $80 billion of exposure--there is risk.

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