It’s Not About The Box Improving Care at Group Health with People, Process and Technology

July 27, 2010

Meaningful Use

Filed under: MyGroupHealth,Policy,Secure Messaging — Matt Handley @ 8:28 am

The Meaningful Use rules are now finalized – organizations can get past the lobbying and onto the work of making sure that their investments in technology make a difference for how we deliver healthcare.  It is a welcome change from resistance to action.  The final rules seem to most a pragmatic compromise, balancing engagement (not setting the bar too high) with achieving something that is – well – meaningful (not setting the bar too low).  It has something for most everyone, and is more like a fun run than a marathon.  Organizations that are committed to transformation on behalf of patients will find that while there is work to be done, it is do-able.

There are a host of summaries on the web – my two favorites:

David Blumenthal’s recent NEJM article

A summary from Robin Raiford

Pragmatism is a fine organizing principle, and might be just the right thing for the stage in development where our chaotic national health care “system” is – where most care is delivered through small offices and the hurdles to organizing care delivery are huge.  But in addition to pragmatism, we need a little inspiration – something to suggest that there is a rational future state that is more oriented towards what patients desire and benefit from than an incremental improvement in the chaos.  We argue for that in an April Health Affairs article about meaningful use .  The meaningful Use rules lack a patient voice, and are relatively timid about providing meaningful electronic access and access to their records and their doctors (and health care teams).   Our experience with patient centered HIT has demonstrated what is possible in the special setting of aligned financing and care delivery.  I am convinced that with strong leadership, and several of the provisions of health reform that allow experiments with payment reform, these things are possible to a far larger number of groups than was true in the past.

The blueprint isn’t that complicated, but getting there requires considerable changes in perspective for most groups.  Leveraging technology to improve outcomes for patients requires that we do two important things:

1. Keep the patient at the center
2. Think simultaneously about people, process and technology

Simple rules that allow innovations of all kinds.  We are looking forward to the challenge.

July 20, 2010

Open Notes – research gets underway

Filed under: Electronic Chart,MyGroupHealth,Open Sharing — Matt Handley @ 8:47 am

Today there is information about the Open Notes project in both one of my favorite journals (Annals of Internal Medicine) and my Dad’s (the Wall Street Journal).  They are interesting discussions about a long overdue change.

I have blogged about this before – Open Notes is an attempt to learn about the impact of allowing patients access to the doctor’s progress note.  100 Primary Care physicians have volunteered at three sites – Beth Israel Deaconess in Boston, Geisinger and Harborview.  The project will include about 25,000 patients who have access to their data online.

I look forward to seeing the impact – and the challenges of helping our group recognize that the content of a patient chart belongs to them, and engaging patients more directly is the rising tide that lifts all boats.

I welcome comments and concerns – this will be a great discussion in our communities

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