Healthplans and Libraries; HIT Adoption Low

Bookmarks, September 23rd through October 1st:

State of the Union: AHRQ HIT Conference

As part of my arrival, I attended the annual Agency for Healthcare Research and Quality’s annual Health Information Technology Conference. As of this writing, the materials from the conference are being posted, so more should be available soon.

I read a review of this conference that characterized it as “interesting, yet confusing.” What I saw was continued nascency of this field. There are unfortunately many incentives that do not support the ideals that we have for health care information technology; much of the work done in that light shows progress.

Of course, I immediately drifted to one of the sessions discussing the use of LEAN (Toyota Management System) in healthcare. This was headlined by very well known organizations in the field, including Intermountain Healthcare, University of Pittsburgh, and Denver Health. I was interested in both the presentations and the people giving them as well as the audience. When I sit in a room like this, I always ask, “Is Art Byrne in here?” because he/she may very well be, given the right fuel and environmen. This is why I appreciate that AHRQ is funding work across a diverse group of health systems. One thing I noticed, though, was that there were people who knew six sigma really well, there were people who knew LEAN really well, there were people who knew the Chronic Care Model really well, but I was unsure that anyone knew all three together. There is so much passion for quality improvement – is there a standard method to do it?

A Birthday Present; Joining the Underinsured

Now that I am relocated in a different city, I don’t have access to routine healthcare, just for urgencies, based on a cooperative arrangement with a sister organization here. This is appropriate and actually generous considering the type of coverage offered at home. At the same time, though, I will carry the feeling of needing to take extra care of myself. My personal physician doesn’t live here anymore.

Before I left, I did take a look at my preventive care schedule, and it so happens that it was time for a cholesterol check. I’ve achieved a “new level of adulthood,” and the guideline has shifted the screening age downward, so we’ve met in the middle. When I told my boss it was time, he asked me if I would be willing to take a statin if it turned out I was high risk (I haven’t been checked in a really long time). This isn’t something I was really prepared to think about. Even the most basic preventive test causes anxiety.
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New Badge, Last Day

Yesterday was my last full day in the office before starting my sabbatical. Since the organization recently replaced employee badges as part of a move to a new headquarters, it was also the day I picked up mine. Due to an error in printing though, it listed my department as HUMAN RESOURCES, instead of QUALITY & INFORMATICS. I showed it to one of my colleagues who said, “That’s what you do, anyway.” I think they’re right, and in a very complimentary way to the people that I get to serve. These are the most accomplished professionals around, who ultimately will do whatever it takes to help patients, and Informatics is one of the things that helps them get there, as a means, rather than as and end in itself. I always say that Informatics is about people, not about technology. After reflecting on this happy accident, I wore my badge with pride all day, pleased with the affirmation of what I really do.

And with that fond memory, along with many others, the journey now begins….

Bookmarks for September 21st through September 22nd

September 21st through September 22nd:

Information Therapy on the Go

“Oh, you’re a doctor.”

That’s a statement that can cause a jolt of fear, depending on the situation, and typically when a family member, friend, or stranger continues with a request for medical advice. And so it came, from a person driving the coach ferrying me during a conference I am attending.

“Maybe you can look at this thing on my skin and tell me what you think of it.”

Jokingly, I said, “So, instead of a tip, you’d like some professional services?”

What I’ve been taught is that this is among the riskiest situations – offering a diagnosis outside of the exam room, outside of the physician-patient relationship. Why can’t patients just go to their own doctor to ask these kinds of questions? I knew the answer to this one already, as we had been talking about the skyrocketing cost of health care in the community I am staying in.
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A Dialogue at the Public Library about Internet enabled care

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I have been working steadily with the excellent Seattle Public Library system to expand our health information offerings into the community. This has included some training on our health information resources, and last week, the first presentation I gave to patrons at my local library, the Montlake Branch, in Seattle, WA.

This branch is brand new, and just added Wi-Fi access. The week I presented, there was a traveling computer lab in the facility, complete with laptops, projector, and wireless network. I went with the ideas I had about what patients might be interested in from a topic of “Leveraging the Internet to Navigate the Health Care System,” based on what I refer to as our “50,000 patient-years” of experience interacting with patients online. The assumptions I made in preparing my presentation were proven wonderfully incorrect from this session. I can’t wait to do more.

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