I’m going to start with the last session I attended at HIMSS13, Farzad Mostashari‘s keynote presentation on Thursday morning. This year I attended quite a few ONC presentations. In the previous years I was too angry with the lack of progress to be able to listen, but this year I sense progress in the air with the push for having the patient more involved in their care, primarily by pushing to give patients their data.
Mostashari’s keynote was very thoughtful and interesting. It touched on a lot of thorny aspects of healthcare and demonstrated that the ONC is thinking about the real issues that confront clinicians and patients alike.
He started with an articulated reason of why we are pushing for better and more data in healthcare: because it would help us use that data to make better decisions beyond our intuitive and often wrong beliefs. He illustrated the point with a study in which male actors were interviewed on a breezy tall bridge by a female interviewer that gave them her number after the interview. Same experiment was repeated on a sturdy bridge. The people on the tall bridge called the interviewer more. Their brain interpreted the rapid heart beat with having feelings for the interviewer. It is difficult to judge the data in the middle of the fire…
He had calls for engaging the patient more often with one simple suggestion that I liked: ask your patients how are you doing. Doctors almost never hear from patients that left the practice. Did they leave because they are doing well or because they were unhappy or maybe they died?
The call for implementing health IT continued with a comparison between paper system and electronic systems. I thought this was a false problem especially for the HIT group: it’s not paper vs. electronic that is the problem, it’s bad (difficult to use, non-intuitive) electronic systems vs. good (helpful, easy to use, meaningful) electronic systems.
By the end of the talk he had great suggestions to make the right (and most common) thing to do easy and default, to create workflows that make sense and to MAKE PLANS WITH PATIENTS.
He talked about how standardization is needed and a necessary step before studying variations. The variations should be used to learn things, they should be documented and recorded. His observation that “The Problem is NOT too much standardization in Healthcare” was received with loud laughter. It does sound good… now how do we go about making this easy for providers. Here‘s how bad processes can hurt people and cost more money in the long run.