Waiting doom, good business move, or “agitprop” are begging the question whose stable is fuller? Reality checks:
- EDs are
overcrowded used to board inpatients.
- Hospitals must be fiscally responsible, run like businesses.
- Hospital either have no physical inpatient beds or have no staffed inpatient beds.
- Where inpatient beds are not staffed, boarding in the ER is a more favorable economic decision.
- Where there are no physical beds, because beds are “being held” for elective admissions or transfers, boarding in the ER is a more favorable economic decision.
- Where inpatients are boarded in the ER, because inpatient areas will exceed nursing-ratios, boarding in the ER is a more favorable economic decision.
11 months ago
MedicalQuack raise the issues of competing strategies and philosophies for health information exchange. One end of the spectrum is the
PHR-movement, with
Google Health and Microsoft’s
HealthVault the front-runners. On the other end of the spectrum is the
RHIO-movement, lead by insurers and governmental and non-governmental third-party providers. A fundamental question at play here is what should constitutes the individual’s health information silo? Should it reside in multiple entities relying on yet-to-be-build exchanges? Or should it reside in the individual’s silo where access is granted on a “need-to-know” basis? Aggregation and exchange versus distributed access, this will be an interesting and important contest to watch.
11 months ago
Interesting two announcements today:
MedPedia and
Knol. MedPedia is reminiscent of the start of
eMedicine several years ago, an invaluable resource and a commercial property. eMedicine had its academic beginnings as well. Contrast that with Knol, which appears to be a director competitor or heir to
Wikipedia. What I would want from both: authoritative content with an
API that allows for
mashups and
device independence.
11 months ago
DB’s rant:
[T]hose who champion P4P make an unfortunate assumption. They believe that you can push one button, and only impact the desired outcome. They are obsessed with measurement, and believe that measurement will improve health care. They are so dangerous.”
Brings to mind a phrase from the “Satisfaction Cult:”
they don’t care how much you know, until they know how much you care
Complicit with this assertion is the measuring and elevation of subjective reporting to objective fact. What is missed, is an appreciation for the limitations of the english language — where “you” is both the second-person singular and plural pronoun. The “Satisfaction Cult” (and the strong P4P-adherents) see “you” as singular and all statistical scores and variances are singular in origin and causality. Wonder if “you” is plural? Then scores and variances are matters of plurality and causality is never found. Which “you” smacks of reality?
1 year ago
