In a sidebar to the September cover story I did for Healthcare IT News, I reviewed some of the work of Scot Silverstein, M.D., who has long been chronicling problems with EHRs and other health IT systems. Unfortunately, he wasn’t available for an interview in time for that report, but he was last week, so I got him for a new podcast.
Silverstein, a professor of health informatics at Drexel University in Philadelphia, considers EHRs to be experimental and, sometimes, less safe than paper records and would like to see health IT subjected to the same kind of quality controls as aerospace software or medical devices. “Suboptimal system design could lead even careful users to make mistakes,” Silverstein said in this interview.
During this podcast, we refer to a couple of pages that I promise links to, so here they are. Silverstein writes regularly for the Health Care Renewal blog, a site founded by Roy Poses, M.D., a Brown University internist who runs the Foundation for Integrity and Responsibility in Medicine. His definitions of good health IT and bad health IT appear on his Drexel Web page.
Podcast details: Scot Silverstein, M.D., on health IT safety risks. MP3, mono, 128 kbps, 33.8 MB. running time 36:59.
1:10 How this interest came about
3:05 His blogging
3:45 His 11 points demonstrating why he believes the FDA should be concerned about health IT risks
5:00 IOM, FDA and ECRI Institute statements on health IT safety
5:50 Comparing EHRs to medical devices and pharmaceuticals
8:35 Lack of safety testing in health IT
9:25 Issues with EHR certification
10:00 Safety validation of software
10:35 EHR’s role in Texas Health Presbyterian Hospital’s initial discharge of Ebola patient
11:50 EHR failure causing medical harm to a close relative
13:10 Poor design vs. poor implementation
14:35 Who should regulate?
15:55 Billions already spent on EHRs
16:45 Threat of litigation
17:40 “Postmarket surveillance” of “medical meta-devices”
18:50 EHRs now more like “command and control” systems
19:30 Movement to slow down Meaningful Use
20:17 Safety issues with interoperability
21:40 Importance of usability
22:30 His role at Drexel
24:18 “Critical thinking always, or your patient’s dead”
25:05 Lack of health/medical experience among “disruptors”
29:30 Training informatics professionals and leaders
31:15 Concept vs. reality of “experimental” technology
32:50 Advice for evaluating health IT
33:55 Guardians of the status quo
35:10 Health IT “bubble”
36:10 Good health IT vs. bad health IT
Judy Murphy, R.N., Director of the Office of Clinical Quality and Safety in the Office of the National Coordinator for Health Information Technology, and the ONC’s chief nursing officer, is stepping down Oct. 17 to become CNO of IBM Healthcare Global Business Services.
Murphy has been with the ONC since December 2011 after 25 years as a nursing and informatics expert at Aurora Health Care in Wisconsin; she had led Aurora’s EHR program since 1995. Most importantly to those of us in the media, she has never been afraid to speak her mind and provide good quotes. Now that she’s moving back to the private sector, she won’t be hamstrung by political and considerations when she gives public presentations.
According to National Coordinator Karen DeSalvo, M.D., health IT specialist Jon White, M.D., will be on part-time detail from the Agency for Healthcare Research and Quality to serve as interim head of the Office of Clinical Quality and Safety and acting ONC chief medical officer until those positions get permanent replacements. (Former ONC CMO Jacob Reider, MD, is now deputy national coordinator.) Andy Gettinger, M.D., of Dartmouth Hitchcock Medical Center, will head up patient safety efforts at the ONC on an interim basis.
“Judy’s CNO responsibilities will be entrusted to the other nurses at ONC until a replacement CNO can be named,” DeSalvo said in a memo to ONC staff.
PALO ALTO, Calif. — I’m out here in the Bay Area, in part because Intel-GE Care Innovations invited me to be one of six judges of its first-ever “hackathon” this past weekend. (Full disclosure: Care Innovations paid my travel expenses, but placed no editorial demands on me.)
On Saturday, I sat down with CI CEO Sean Slovenski to discuss a number of issues in digital health and health reform, but I found myself most curious about CI’s new Validation Institute, launched in late June, which looks to bring some truth to some outrageous claims made by entrepreneurs in the untamed world of digital health, telehealth and population health management. I turned on the voice recorder, and this short podcast is the result.
(Sorry for the bit of background noise. We both live in the Midwest, and just had to do this outside on a gorgeous California morning.)
Podcast details: Interview with Sean Slovenski, CEO of Intel-GE Care Innovations, on the company’s new Validation Institute. MP3, stereo, 192 kbps, 9.2 MB. Running time 6:38
It’s infographic time! In fact, it’s time for two infographics.
The first is from HIMSS, celebrating 25 years of the organization’s annual health IT leadership survey. Some interesting findings, as pointed out by a HIMSS publicist:
The second infographic comes from HealthITJobs.com. Not surprisingly, the most lucrative jobs are in consulting, and those with experience get paid significantly more than newbies.
I often share jokes and humorous videos here, sometimes because a product is worthy of ridicule, but also to illustrate how some health IT is going mainstream. I’m going to do it again today because two things happened in the last week that I had not seen before.
First, though Stephen Colbert has made fun of digital health and fitness products before, last week he took it upon himself to do so on consecutive nights.
On Sept. 8, he took down the forthcoming Pavlok fitness bracelet, a product that sends an electrical jolt to the wearer’s arm as a reminder to exercise. It also debits the user’s bank account and posts an embarrassing message on Facebook. No, really. “When you’re in a dark place, alone at home, out of shape and too tired, overweight or depressed to work out, it’s probably because you weren’t getting enough public humiliation,” Colbert said.
A night later, Colbert, like the rest of the world, was talking about the Apple Watch. After cheering wildly about the announcement, Colbert asked, “What does it do?” He then showed a picture of himself from high school and said it was finally cool to wear a calculator watch.
Then, on Friday, no less than America’s Finest News Source, The Onion, got into the act with its “American Voices” feature, in which common people (actually, the same five or six headshots recycled for years with different names and occupations) give their fake opinions on a newsworthy topic. That day, the subject was, “Patients Making Record Number Of Telehealth ‘E-Visits’ With Doctors,” with a reference to an actual Deloitte study on that very topic.
As one “commenter” said, “Until doctors can email me painkillers, I don’t see the point.”