Comments on: Monday Morning Update 12/7/09

By: Todd Johnson

Todd Johnson — Wed, 09 Dec 2009 18:00:41 +0000

re: Beth Friedman:

Good point. I agree that natural language processing coupled with transcription/voice recognition is a powerful tool for harnessing structured information. It also promises to be an easily adopted solution. One downside, however, is availability. With EMR products, the note begins to take shape (and be available to other providers) as information is documented throughout the day/event. For acute care, this can be a nice side effect of EMR’s (particularly during the transfer from one service tot he next).

By: S Silverstein

S Silverstein — Tue, 08 Dec 2009 16:34:54 +0000

“Big government IT projects (including here) usually flop, which is why the VA’s VistA is even more remarkable (although the fat cat contractors weren’t involved early enough to mess it up – that came later).”

They do when run primarily by apparatchiks and not insiders.

The reasons why VistA has been as successful as it has are easy to understand. See the book “Medical Informatics 20/20: Quality And Electronic Health Records Through Collaboration, Open Solutions, And Innovation” written by some of those insiders, http://www.amazon.com/Medical-Informatics-Electronic-Collaboration-Innovation/dp/0763739251 .

They also really “get it” about the issues causing IT to fail. See p. 18-20 , available via Amazon in book preview mode if you have an account.

By: VERY Anon

VERY Anon — Mon, 07 Dec 2009 16:14:04 +0000

rxpete: “Being required to pay for and use a proprietary coding system (CPT) to process claims seems absurd. Shouldn’t the coding system be placed in the public domain?”

You’d think so, wouldn’t you? Especially with a federal law (HIPAA) requiring their use and their publication in the Federal Register.

But, no. The AMA employs full time lawyers who stamp out any Fair Use vision of CPT codes. They make over $70 million a year in CTP copyrights and are not willing to give it up easily. I love how the AMA works against it’s own members!

Note that this problem doesn’t exist with ICD-9/10 codes.

I know this, and a lot more, because I received a cease-and-desist letter (25 pages long!) from the AMA a few years ago as the result of a popular FREE on-line CPT tool I made. It exists no more. Thanks AMA! If you want a Dan Brown-esque conspiracy story, dig around and learn about the source of the CPT codes…they didn’t all come from one place and they weren’t all seamless integrated. Many people had similar ideas at the same time, but you don’t hear about them any more…the AMA snookered a few of them.

By: Beth Friedman

Beth Friedman — Mon, 07 Dec 2009 15:36:36 +0000

Re: Electronic physician documentation and 100% physician adoption. Todd, what if the fastest physician documentation method – dictation and transcription – could also exhange and analyze structured information? Wouldn’t that solve the physician adoption probelm while enabliing the physician’s natural workflow? Some transcription vendors are already doing this (Webmedx,MModal, Stentel). Mark Anderson calls it “Discrete Reportable Transcription”. Could at least answer #1 on your wish list in the near future. Beth Friedman, RHIT

By: Noah Praetor, MD

Noah Praetor, MD — Mon, 07 Dec 2009 14:27:02 +0000

Luis G is correct in playing the blame game.
Why do you suppose the Brits are planning to stop the river of green into the pockets of the HIT companies? Are CPOEs the zhu zhu pets of health care? The Brits may think so.