Watch users stumble with Healthcare Technology

I saw this video on HIS Talk, so you may have seen it already, but it is worth sharing.

It's too easy to forget the end-user experience. If what we do doesn't make that experience work for the clinicians, we can't get the data we need.

Making Health Care Better

This article in the New York Times earlier this month is long, but worth reading. If the ads are distracting, try Readability.

David Leonhardt writes about Dr. Brent James of Intermountain Heathcare and how he is using data to improve the practice of medicine. A number of things have to be done to make this useful. And meaningful.

1) You have to have good data which shows concrete improvement in outcomes based on specific changes in health practices.
2) You have to give the practitioners that data as part of their regular workflow, making the preferred action easy to accomplish.
3) You still have to allow doctors to do what they feel is best for a specific patient. Meaning #2 above is not required, but suggested.
4) You have to measure which clinicians are following the suggestions and what the outcomes are in a continuous feedback loop.

It's a lot of work and it's complicated, which is why most medicine is not done this way.

Unfortunately, we also still have a system that doesn't reward some of the quality improvements that can be achieved using data like this; that's a subject for another post. It is easy to see how health care costs keep rising when preventing exacerbations and adverse events can cost a health system money, however.

Forget all the hype about healthcare IT and read this article. The potential we have for improving patient care is tremendous.

Speech by Dr. Robert Kolodner

The recent National Coordinator for Health Information Technology gave an interesting talk at Georgia Tech last Wednesday, 11/4/09. You can watch all 80 minutes here. Thanks to GA Tech and Emory and their Health Systems Institute for sponsoring the discussion.

A lot of the talk was about health as opposed to health care. We tend to forget the accomplishments of public health in the last decade.

Dr. Kolodner spent several years at the VA before his time with the feds. As such, he understands what a good EMR can do for data collection and analysis. Late in the talk, he showed a graph of hypertensives and how well controlled their blood pressure was. With the VA patient population, there were several hundred thousand data points. The fascinating part was the discovery that BPs were better controlled in the fall than in the spring. What you can learn when you have the data...

Dr. K. quotes Peter Drucker as describing health systems. Drucker says they are "very complex". Dr K's un-named mentor always told him that "Beginning are messy". We need to at least be at the messy beginning of beginning to use the data we gather about this complex system which is US healthcare.