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An Uber for Doctor Housecalls

NY Times, May 5, 2015

BEI Commentary: HEAL is a smartphone app that delivers a doctor (primary care or pediatrician) to your doorstep in 20 to 60 minutes for a flat fee of $99. It will be very interesting to see how this goes.

New smartphone apps can deliver doctors to your doorstep. Heal is a smartphone app similar to the on-demand car service Uber, but instead of a car, a doctor shows up at your door. Users download the app and then type in a few details such as address and the reason for the visit. After adding a credit card and a request for a family doctor or a pediatrician, the physician arrives in 20 to 60 minutes for a flat fee of $99. Heal began in Los Angeles in February, recently expanded to San Francisco and is set to roll out in another 15 major cities this year. Heal doctors are on call from 8 a.m. to 8 p.m., seven days a week, said Dr. Renee Dua, a founder and the chief medical officer of Heal. Heal doctors arrive with a medical assistant and a kit stocked with the latest high-tech health gadgets, including tools needed to take your vitals or shoot high-definition video of your eardrum. Heal has a roster of doctors who have affiliations with respected hospitals and programs such as the University of California, Los Angeles; Columbia; and Stanford. Read More

A Busy Doctor’s Right Hand, Ever Ready to Type

NY Times, January 12, 2014

BEI Commentary:  Scribes have entered the scene in clinics and operating rooms, liberating physicians from the constant note-taking that modern electronic health records systems demand.

Amid the controlled chaos that defines an average afternoon in an urban emergency department, Dr. Marian Bednar, an emergency room physician in Dallas, entered the exam room of an older woman who had fallen while walking her dog. Like any doctor, she asked questions, conducted an exam and gave a diagnosis — in this case, a fractured hand — while also doing something many physicians in today’s computerized world are no longer free to do: She gave the patient her full attention.

Standing a few feet away, tapping quickly and quietly at a laptop computer cradled in the crook of her left arm, was Amanda Nieto, 27, Dr. Bednar’s scribe and constant shadow. While Ms. Nieto updated the patient’s electronic chart, Dr. Bednar spoke to the woman, losing eye contact only to focus on the injured hand. Read More

Texting the Teenage Patient

New York Times, Octobe 8, 2012

BEI Commentary: A very interesting article about how some physicians are using social media. Obviously there are a lot of issues to work out, but it looks like these technologies can be put to good use in working with patients.

The teenager’s cellphone buzzes. Her doctor, Natasha Burgert, is texting her: “Better morning with this medication?”

Another teenager opens his phone. “Everything is great,” reads Dr. Burgert’s discreet text. “Go ahead with the plan we discussed. Please reply so I know you received.”

And on the morning of college entrance exams, a teenager who suffers from a roiling stomach reads Dr. Burgert’s texted greeting: “Prepared. Focused. Calm. Your body is healthy and well. Good luck today.” Read More

Abuse of Electronic Health Records

New York Times, September 25, 2012

BEI Commentary: Please make sure you are billing the correct amount – not too much and not too little.

The Obama administration has issued a strong and much-needed warning to hospitals and doctors about the fraudulent use of electronic medical records to illegally inflate their billings to Medicare. Attorney General Eric Holder Jr. and the health and human services secretary, Kathleen Sebelius, cited “troubling indications” that some providers are billing for services never provided and vowed to prosecute. They sent a letter to five major hospital trade associations on Monday, two days after an article in The Times described in detail how greater use of electronic records might be making it easier for hospitals and doctors to submit erroneous payment claims. Read more

Medicare Bills Rise as Records Turn Electronic

New York Times, September 21, 2012

BEI Commentary: Please make sure you are not using your EHR to overbill.  It looks like some hospitals, in search of additional revenue, are doing just that. I’m sure that CmS and payers will be looking for this in the data analytical tools that are coming online, and some people will have fines and fraud charges to deal with.

When the federal government began providing billions of dollars in incentives to push hospitals and physicians to use electronic medical and billing records, the goal was not only to improve efficiency and patient safety, but also to reduce health care costs.

But, in reality, the move to electronic health records may be contributing to billions of dollars in higher costs for Medicare, private insurers and patients by making it easier for hospitals and physicians to bill more for their services, whether or not they provide additional care. Read More

Vital Signs by Phone, Then, With a Click, a Doctor’s Appointment

New York Times, April 11, 2012

BEI Commentary: This represents just a smattering of what is going on in the HIT arena.  There are hundreds of companies like these out there.  Expect to see all kinds of changes in healthcare of the next several years.

If ever an industry were ready for disruption, it is the American health care industry. Americans spend about $7,600 a year per person on health care, one in two adults lives with a chronic disease and the average wait time to see a doctor in a metropolitan area is 20 days. Entrepreneurs have responded by starting health care technology companies that are changing the way we interact with the entire system.

They are also responding to an evolving model of health care, which will ultimately be focused more on outcomes than on services, and to the Medicare and Medicaid Electronic Health Records Incentive Program, which, in an effort to improve the coordination of care, gives providers financial incentives to adopt electronic health records and report how they use them. “We are about to see a fundamental transformation in the way care is delivered and the way patients are engaged with that care,” said Frank Moss, head of the New Media Medicine Group at the M.I.T. Media Lab. Here is a sampling of the innovative companies pushing that transformation: Read More

Panel Emphasizes Safety in Digitization of Health Records

New York Times, November 8, 2011

BEI Commentary: EHRs need to be designed to insure the safety of patients.  That is not a given, and resources need to be devoted to insure that these issues are kept to a minimum.  The Institute of Medicine has recommended that there be oversight of EHRs to assist in this situation.

Poorly designed, hard-to-use computerized health records are a threat to patient safety, and an independent agency should be set up to investigate injuries and deaths linked to health information technology, according to a federal study released Tuesday.

The report by the Institute of Medicine comes as the government is spending billions of dollars in incentive payments to encourage doctors and hospitals to adopt electronic health records. The Department of Health and Human Services requested the study, in response to concerns from some doctors and public health experts that the drive for digital records might bring a wave of technology-induced medical errors. Read More

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