symtym

What's in your Augean Stable?

Fri, 25 Jul 2008 12:37:00 -0700

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.

PHR v RHIO

Wed, 23 Jul 2008 17:11:31 -0700

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.

MedPedia and Knol

Wed, 23 Jul 2008 17:10:00 -0700

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.

Non-Profit Hospital, Non-Profit Medical Group, $5M Stark Settlement

Thu, 15 May 2008 11:14:33 -0700

Non-Profit Hospital, Non-Profit Medical Group, $5M Stark Settlement

Does Your Blog Have a Twitter Landing Page?

Tue, 13 May 2008 16:17:00 -0700

Does Your Blog Have a Twitter Landing Page?

Technorati Claim

Tue, 13 May 2008 12:54:44 -0700

Technorati Profile

They don’t care how much you know, until they know how much you care.

Tue, 13 May 2008 11:55:00 -0700

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?

The wreck of the good ship, EMTALA

Fri, 09 May 2008 19:12:52 -0700

The wreck of the good ship, EMTALA

EMTALA must always be viewed in light of its unintended consequences and unintended expectations — “just go to the ER” is not a national healthcare policy!

"How much will the experience with the social aspects of Web 2.0 leverage the enterprise?"

Mon, 21 Apr 2008 02:38:51 -0700

“How much will the experience with the social aspects of Web 2.0 leverage the enterprise?”

- Enterprise 2.0 To Become a $4.6 Billion Industry By 2013