Phillip Longman
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A 40-Year 'Conspiracy' at the VA
Four decades ago, in 1977, a conspiracy began bubbling up from the basements of the vast network of hospitals belonging to the Veterans Administration. Across the country, software geeks and doctors were puzzling out how they could make medical care better with these new devices called personal computers. Working sometimes at night or in their spare time, they started to cobble together a system that helped doctors organize their prescriptions, their CAT scans and patient notes, and to share their experiences electronically to help improve care for veterans...
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A paperless NHS? Swapping best practice and ideas with the US Veteran Health Administration to make it happen
If the NHS is serious about going digital it should continue to build on an existing partnership with the VHA and continue to revolutionise healthcare, says the report "Making connections - A transatlantic exchange to support the adoption of digital health between the US VHA and England’s NHS" developed jointly by the VHA, 3Millionlives and published by 2020health. Read More »
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Been there, Done that, Doesn’t Work: Veterans Health Administration IT goes back in time
If you have an interest in the worlds of economics, healthcare or technology, here’s a story that’s emerged this month that is worth noting for the record books. In the US, amidst the chaos of the Trump administration, yet another mistake has been made this month. For the record, it is worth noting that the US Department of Veterans Affairs (VA) Veterans Health Administration (VHA) ended up with a contract for a large IT solution for the next 10 years worth about $10 billion as of May 2018. On the face of it that may appear to be unremarkable news: just another big expensive contract for an IT system. Yet there is a part sad/part silly dimension to it that is well worth flagging up at this point.
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Beyond the theatrics of the VA wait-list scandal
The spin cycle of a Washington scandal, once set in motion, is more entertaining to watch than clothes washing at the local laundromat, even though the latter is better at cleaning up a mess. Read More »
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Big Tech Should Stay Out of Healthcare
...The use of digital technology in health care has enormous promise, to be sure. But, as the Wall Street Journal's coverage of Google's Project Nightingale revealed, there is also a potential dark side to these projects. Ascension, it noted, "also hopes to mine data to identify additional tests that could be necessary or other ways in which the system could generate more revenue from patients, documents show." That detail raises a key question that's largely overlooked in our health care debates: should the drive to maximize corporate revenues determine how health information technology develops and becomes integrated into medical practice, or should that be determined by medical science and the public?...An alternative path exists. In the 1970s, the Veterans Affairs Administration (VA) developed VistA, an open-source code system that was the country's first EHR system... Read More »
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Clueless or Craven? The White House Gets the VA Story Exactly Backwards
Sad to say, the Obama administration seems clueless about what might be broken at the VA and how to fix it. Either that, or it is just cravenly saying and doing whatever it thinks is necessary to make the story go away. Evidence for the clueless hypothesis came on Friday, when White House Deputy Chief of Staff Rob Nabors weighed in with his diagnosis (pdf) of what ails the VA. The document is extraordinary in its contradictions, sloppy formulations, and non-evidence-based conclusions.
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How VA Outsourcing Hurts Veterans
On Thursday, Sen. Bernie Sanders, chairman of the Senate Veterans Affairs Committee, announced that he had reached a compromise with John McCain and other Senate Republicans on how to fix whatever it is that needs fixing at the VA...the bill also contains one provision that is a significant concession to Republican enemies of government. If enacted, it would lower the quality of health care received by veterans while setting back the movement for health care delivery system reform generally.
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Is The 1.5+ Trillion Dollar HITECH Act a Failure?
Hopefully, the public statements made by President Obama and Vice President Biden will lead to a public debate over the monumental problems that the HITECH Act and proprietary EHR vendors have caused the American people. While the press continues to report the figure of $35 billion as the cost of implementing EHRs, that figure does not tell the entire story. Perhaps the next step is to provide accountability and transparency. That would start with firm numbers regarding the real costs of EHR implementations forced on an unprepared healthcare system by the HITECH Act.
- The Future Is Open
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Joe Conn-DoD Should Make Right Decision and Adopt VistA
I think what's needed now remains as obvious as it has for decades, which means Shinseki and Panetta got it only half right, because they were half wrong. There should be one EHR for the military and the VA, but it shouldn't be the just dispatched Frankenstein's EHR that was to be built out of custom-made and off-the-shelf parts. It should be VistA. The VA has a demonstrably superior EHR system, so the Defense Department brass should swallow their bureaucratic pride and adopt it. Read More »
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Just how long are those wait times at the VA really?
You probably saw headlines earlier this week like this one from CNN “Audit: More than 120,000 veterans waiting or never got care.” Sounds pretty bad, and so does the lede CNN used...Want to know what that audit actually shows? Click here (pdf), or trust me to give you the main findings and some context...
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NHS & VHA: Transatlantic Exchange of Ideas and 'Lessons Learned' on Adoption of Health IT Solutions
Britain's 2020Health.Org has just released a major report outlining how the United Kingdom can transform its healthcare system by enhancing its existing collaboration effort with the U.S. Veteran's Health Administration (VHA) and by sharing technology, knowledge and lessons learned on the effective use of Telehealth, PHR, and EHR systems. Entitled "Making connections - A transatlantic exchange to support the adoption of digital health between the US VHA and England’s NHS", the report lays out step by step how Britain's National Health Service (NHS) can create a digital revolution that can significantly enhance its ability to provide health care. Read More »
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Obama and Biden Blast EHR Vendors for Data Blocking
As they are winding their terms in office, President Barack Obama and Vice President Joe Biden dropped a stink bomb on the health IT industry. Speaking at different events on Friday, January 9th, the President and Vice President both criticized proprietary electronic health record (EHR) vendors as the primary obstacle to the success of their administration’s health care strategy. This is the highest level acknowledgment so far of the serious impact that “lock-in” EHR software vendors are having on America’s medical infrastructure and the ability of physicians to provide medical care.
The Association Of American Medical Colleges Responds To Phillip Longman’s “First Teach No Harm”
The AAMC is very disappointed that Mr. Longman did not contact the AAMC for information or comment when he was writing his article. We are writing to clarify a number of important points that his article fails to reflect. Read More »
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The Right Way to Modernize VA's VistA EHR: Shift Development to the Private Sector and the Cloud
While changes to VistA are warranted and necessary, trashing the entire system because one component may be flawed makes little sense from technological or financial perspectives. The VA scheduling scandal was the product of an agency overwhelmed by veterans returning from two theaters of war. In that scenario, the scheduling system became a scapegoat for organizational and human resources challenges that were bound to manifest in one way or another.The VA should not heed calls to replace VistA for these key reasons...
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The VA Waitlist Fiasco: VistA Should Not be Thrown Out With the Bathwater
Without a doubt, the death of American veterans as a result of the VA waitlist debacle is tragic and unacceptable. The Obama administration must move quickly and deliberately to fix the underlying problems and restore faith in the agency. If these issues were common throughout the VA network of hospitals and clinics, it might make sense to consider dramatic, earth-shaking alternatives like moving veterans to private providers and shuttering the VA. But they are not common. Indeed, as Washington Monthly reporter Phillip Longman has documented, the VA’s challenges are regional, not pervasive. Read More »
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