by Nick Jacobs
April 20, 2007 at 9:53 am
· Filed under Health IT
Numerous journals cross my desk each week. Everything from Forbes to The Pediatric Surgery Digest, but this week the introductory letter in Government HealthIT caught my eye. Paul McCloskey, Editor, discusses the content of that journal.
This paragraph was the grabber for me: “For example, without some agreement on a national health care identification number, we may be simply too large a nation of health care consumers to expect total machine accuracy in health record matching. According to our article in this issue by senior editor, Nancy Ferris, the best we can expect from the National Health Information Network is about 98 percent accuracy, and that doesn’t account for garbage-in. An error rate of more than two percent in a country of 301.5 million people will create no end of headaches.”
Mr. McCloskey goes on to describe articles about the impact of wikis, blogs and other social medical technologies on the health care community with this sneak preview: A recent British study conclued that in difficult cases, “it’s often better for doctors to google for a diagnosis.” He, as do I, wonders how the AMA would react to that study?
So, as we move more completely into a new world order of more open communication, we will continue to see the morphing of our previous rules, perceptions, and realities. As we embrace the almost incomprehensible power of our international connectivity and communication capabilities, we begin to realize that the impact of this new unification technology is that our world will never be the same. Maybe, instead of concentrating on creating peace through war, we could provide everyone with a Treo or Blackberry across the world and let them Google democracy, or capitalism, or freedom.
Openness causes accountability. I’ll never forget the first time I heard that hosptials are killing hundreds of thousands of people each year through medical errors. It was a chilling reality that clearly demonstrated that every hospital should publish its mortality rates, infection rates and readmission rates. It was a telling story of the power of secrecy and conversely of the power of transparency.
So, the national electronic medical record is already predictably doomed to a loss of 6,020,000 human souls as we simply calculate the 2 percent miss rate. The equivalent to 40,000 757 airplanes dropping out of the air each year, fully loaded.
Let’s force transparency in health care, and insurance, and the building industry and the investment industry and law. Well, you probably see where I’m coming from on this one.
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I couldn’t agree with you more.
We are on the same page here. See my
http://ajfortin.com/2007/03/01/health-care-more-translucent-than-transparent/
It may amuse you.
Google is a lot less impressive for diagnosis than this post and the Government Health IT article imply (as I’ve written in Stupid pet tricks, aka Google diagnosing http://www.healthbusinessblog.com/?p=975)
Clinical decision support tools can be useful, especially for diagnosing rare diseases. The best tools prompt the user for useful findings they might not otherwise have considered. Typing symptoms into Google is a cute trick but not a serious way to practice medicine.
Actually, David, this POST didn’t endorse, we just reported on the Goverment Health IT article that quoted a British study that said, “Docs should use Google.” I’m SURE there are better ways to do it . . . Nick
[…] Jacobs provided an interesting blog post recently on Wikis, Blogs and Transparency as it relates to healthcare. Nick argues that hospitals should disclose more information such as […]
Back in the year 2000, it was brought to my attention that approximately 1,600,000 Americans die in American hospitals each year from malnutrition. The older the patient is, the greater their risk factors. This is only the tip of the iceberg, because it does not touch on the figures of people that die from medical malpractice.
In fact, there are so many risk factors from using the American hospital system, it is actually difficult to figure out what really kills patients. In many cases, it is a compounding of malnutrition, malpractice, and institutional infections.
These figures are all buried in anecdotal experience. They are not systematically gathered, because the potential for legal liability is so horrendous. To compound the problem, over the past seven years, we have been increasingly overwhelmed by Fundamentalist Truthiness: the reinvention of what is possible, using wild guesses, instead of scientifically converging on the most likely possiblilities. Jesus rode a dinosaur? It could have happened, because the earth is only 6,000 years old? With the blurring of the lines of truth and science, then anything becomes possible, and the truth becomes the first casualty.
There is talk of HIPAA, and patient rights. This is just talk. Increasingly, we have law-makers who do not understand the legal and socio-technical environment in which they are passing laws, and the result becomes the kind of grand-motherly admonition to a michievous boy: “You be careful out there, now!” If you look at the HIPAA laws, you will see that there are no standards, just vague admonitions by inexpert grandmothers. There have been no prosecutions under HIPAA: the law is so vague, prosecution is not possible.
Now compound this with a judiciary that is increasingly at sea in a technological world. Judges and lawyers have little background in technology, and even less in the truth, which means that the rate of invention in American Fundamentalist courts (”It could have happened”) lead to utterly meaningless decisions, leaving those with the deepest pockets at profound risk.
In turn, those with deep pockets move to protect themselves. That means further restriction on information, to ensure that it cannot be given as evidence in America’s courts. The Government likes this outcome, because it absolves them of any responsibility for action.
This merry-go-round of inaction and incompetence is totally aceptable to the mass of Americans, now distracted from their daily lives by Iraqi atrocities. It seems that the searchlight shining on Iraq, and the 3,000 or so American casualties there, have somehow obscured the millions of deaths that have meanwhile happened in America’s hospitals during the past four years.
This is compounded by the news media’s lack of investigative reporting, which leaves a spoon-fed population the Fox alternative to news.
So the answer, as always, is take responsibility for yourself. While mass murder and mayhem continue their way of life in American hospitals, protect yourself by watching your own life, and surrounding yourself with knowledgeable people who will take action to protect you, and commit in turn to take action to protect them if they finish up in an American hospital.
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