Journal of the American Medical Association (JAMA)
See the following -
On the Need to Improve User-Centered Design (i.e. Design Thinking) for Healthcare IT Usability
The lack of usability of electronic health records (EHRs) and healthcare IT applications, in general, has been in the news a lot again. This time it is a research report published in the Journal of the American Medical Association (JAMA) on March 27. The study analyzed voluntary error reports associated with EHR systems and found that problems with EHR usability may have directly resulted in patient harm. Unfortunately, this situation is all too common in the healthcare industry. Numerous health care systems are designed and created ad hoc, or with a very engineering-centric approach. End users are dissatisfied and often systems or workflows are abandoned and/or dangerous work-a-rounds created. A lot of people are saying Healthcare IT needs a disruption. What HealthIT needs is to begin to learn about and understand the needs, goals, and methods of the actual end-users, like doctors, nurses, medical assistants, etc.
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Reform Update: JAMA Study Suggests Money Alone May Not Be Enough To Improve Performance, Reduce Costs
One goal of health reform, among many, is to break the industry's dependence on incentives for hospitals and doctors to do a high volume of business. Incentives for volume invite wasteful spending, of course, and also can be harmful if patients receive unnecessary care as a result. Read More »
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Rethink Data, Transform Healthcare - Unlocking The Value Of Health Data
We are all consumers of healthcare and therefore have a vested interest in its future. As an observation, being an outsider to this sector, the healthcare global system looks increasingly broken as the rate of change and complexity increases. At the same time, my empathy is with those people working inside the profession that provide high quality, compassionate healthcare, and support. But maybe more help is needed to handle the relentless challenges and changes at the edge. Read More »
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Samuel Shem Calls for Using VistA and the VA Model of Care to Solve the Physician Burnout Crisis
On November 1st Newsweek published an extraordinary Op-Ed by Samuel Shem titled Why Computerized Medical Records Are Bad for Both You and Your Doctor. In the article, Shem, pen name for the American psychiatrist and well-known author Stephen Joseph Bergman, presents evidence that poorly designed electronic medical records (EMRs) and over-regulation are to blame for the growing crisis of physician burnout and suicide. The rate of suicides among physicians has risen to a staggering number--three per day. Shem argues that there is a "better way," and that is shown by the electronic health record (EHR) system used by the U.S. Department of Veterans Affairs (VA). The VA's EHR is called VistA. Shem's view is supported by a large and increasing number of physicians and nurses. Read More »
- The Future Is Open
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Study Highlights Rise In US Healthcare Costs Since 1980
A new study published in the Journal of the American Medical Association (JAMA) highlights important healthcare trends in the United States over the last three decades. The study, entitled “The anatomy of health care in the United States,” used publicly available data related to funding, patients, healthcare providers, and health outcomes. Read More »
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The Republican Case For Waste In Health Care
Conservatives love to apply “cost-benefit analysis” to government programs—except in health care. In fact, working with drug companies and warning of “death panels,” they slipped language into Obamacare banning cost-effectiveness research. Here’s how that happened, and why it can’t stand. Read More »
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Too little research backs high-risk medical devices
The U.S. Food and Drug Administration's Premarket Approval pathway allows high-risk medical devices on the market with only one study to prove their safety and effectiveness, and there are a limited number of studies done post-market, according to research published in Journal of the American Medical Association. Medical device regulation in the U.S. is more rigorous than in other parts of the world, but "the difference is, in many European countries they have much better capacity to follow devices once they are in practice," senior author Joseph S. Ross, M.D., of the Yale University School of Medicine, told Reuters.
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Wall Street Journal: "ObamaCare’s Electronic-Records Debacle"
This Wall Street Journal (WSJ) Op-Ed could have been entitled "President Sucker: Led Down the Garden Path by The Healthcare IT Industry." It is entitled "ObamaCare’s Electronic-Records Debacle", as below. First, though: On Feb. 18, 2009 the WSJ published the following Letter to the Editor authored by me...I have a different view on who is deceiving whom. In fact, it is the government that has been deceived by the HIT industry and its pundits. Stated directly, the administration is deluded about the true difficulty of making large-scale health IT work. The beneficiaries will largely be the IT industry and IT management consultants.
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What Doctors Really Think Of EHRs
We've seen the numbers: About 8 in 10 office-based physicians have adopted some type of electronic health record, and about half have an EHR with advanced functionality. But if we dig deeper, how do doctors really feel about these systems?...
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What The U.S. Can Learn From Brazil's Healthcare Mess
Here’s what it looks like when a sprawling, diverse nation tries to cover everybody....By a lot of measures, Brazil’s Sistema Único de Saúde—or SUS—has led to huge health gains.
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When It Comes to Pharmaceuticals and Medical Devices, We Should Ask More and Listen Better
A new study in JAMA suggests that nearly one-in-three drugs approved by the FDA between 2001 and 2010 had post-market safety issues, which caused safety communications to physicians and consumers, "black-box" warnings on labels, and drug withdrawals. It is not clear how many patients may have died or otherwise harmed by these issues...Lead author Joseph Ross, M.D., noted: "No drug is completely safe, and during premarket evaluation, we are not going to pick up all the safety signals," and urged "that we have a strong system in place to continually evaluate drugs and to communicate new safety concerns quickly and effectively."
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Why Computerized Medical Records Are Bad for Both You and Your Doctor
We should not click for cash, but for care. We can use the data to benefit the patient-and the medical professionals...The EMR could have been a lifesaver. It still can be. If we get rid of on-screen, for-profit billing, and use electronic screens exclusively for care, we solve a lot of problems. We could create a true national health care system, modeled after our existing two national systems-Medicare/Medicaid and the VA. As in all other national systems, each procedure would cost about the same all over the country. On longitudinal charts showing the health of Americans as they age, a sharp rise in good health suddenly increases at age 65, when Medicare kicks in. Read More »
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Young People Who Take High Doses Of Antidepressants Are Twice As Likely To Become Suicidal
Young adults taking high-dose antidepressants such as Prozac and Seroxat have double the risk of suicidal behaviour, warn researchers. A U.S. study of almost 162,000 found those aged 24 or younger were twice as likely to deliberately self-harm compared with youngsters taking standard doses of SSRI pills.
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Your Garbage Data Is A Gold Mine
One of the lesser understood aspects of what you can do with massive stockpiles of data is the ability to use data that would traditionally have been overlooked or in some cases even considered rubbish. This whole new category of data is known as "exhaust" data—data generated as a by-product of some other process...
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