Saturday, August 7, 2010

Fix Health Care IT- Give it to Google

You may have noticed your health provider groaning behind a computer screen during a recent medical visit. No, the doctor did not have a toothache. Most likely, the doctor was being tortured by something called the electronic medical record, commonly called EMR.

This gauntlet, which cost a fortune and hours of sleepless nights, presents a multitude of problems to providers and patients alike. Suffice is to say, because there are so many software vendors, your medical data is fragmented in cyberspace. Contrary to popular belief, electronic records of different practices, hospitals and pharmacies are not connected. These expensive programs are difficult to learn and standardize. In fact there is a new government agency to facilitate our transition to an electronic medical nation.

Google please help.  Give me an EMR application that is intuitive, universal, ubiquitous, and most important open source (free). Oh and I want all those google "gadgets" to help improve the quality of care and keep me connected to my patients. The possibilities are endless. Imagine patient access with portals to medical history, appointment scheduling and lab results, email appointment reminders, electronic consultation online, telemedicine, tools to initiate and monitor lifestyle change; virtual "medical homes", doctor and patient education resources, web cam links to our patients in the ICU, online pharmacies with free generic drug offers, x-ray pics on google buzz or picasa, practice web pages / blogs, quality improvement measuring tools,  patient directed appointment scheduling, mobile device scalability, customizable interface and user preferences, embedded voice dictation and scanner services...even waiting room music, ...just to name a few.

Why Google? Why not! Google is halfway there (see Google Health). And I love those gadgets.

Wednesday, August 4, 2010

Nursing Home Care and the CNA

I have spent a large part of my professional life taking care nursing home patients. I have worked on management teams, and studied systemic approaches to improve care.  What I learned is the following. The direct care giver (CNA) is the key to the sucess or failure of a nursing home facility. So when a recent newspaper article about nursing home horrors was published, it stirred some emotions... enough to bring me our of my social media slump.

An online response to this article from a nurses aide demonstrated how unappreciated she felt.  Clearly, this response was from an individual who has the toughest job in the world.  Just think about what she must do to get through the day.  In some cases, aides are the only connection the patient has to the world. The dedication of some of these individuals is truely remarkable. I often wondered why anyone would do such a thankless job when they could earn more in Walmart and have a better quality of life.  The majority of aides care about their patients as if they were family. They infact do what most family members cannot or will not do. They get it from all ends; patients, family and management.  Ironically, they are the least paid and most undervalued members of the nursing home staff. This is evidenced by the tendency is to cut aide staffing during economic stress rather than management positions. This make no practical sense at all.  One middle management position would equal many CNA fte's.
If an investor approached me and said lets build a new nursing home, I would start with the aide. Focus your resources to ensure they are trained properly and have the proper temperment. I would pay them well and make sure they are part of key decision-making in they facility. They are an extension of the family and as such they should be involved in important aspects of the patients life. I would let them know they are enriching the lives of fellow human beings and intern enriching their own.