MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'exuberance'. Sat, 03 Sep 2011 02:54:16 +0100 http://www.medworm.com/index.php?rid=5139650&cid=t_198903_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fwhy-bankers-need-to-stick-to-banking.html [Note: this post is very rich with hyperlinks. To fully understand the post, at least open the hyperlinks in a separate window and browse their material - ed.] In April 2011 I referenced a 2007 comment about health IT ROI, by then-Congressional Budget Office (CBO) head Peter Orszag, in a post entitled "Medicare/Medicaid Cuts? Spend Money on Patients - Not Computer Experiments": ... More on purported cost savings - Peter Orszag, former head of the Congressional Budget Office, said the use of electronic health records, without a major change in health care delivery, "would not significantly reduce overall health care costs" in the agency's 2007 report on long-term health care spending. He also said that according to data from the report, the return on investment for EHR's "is not going to ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5139650 Wed, 17 Aug 2011 20:27:00 +0100 5139650 http://www.medworm.com/index.php?rid=5069406&cid=t_198903_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F07%2Fon-ehr-warnings-sure-experts-think-you.html I frequently mention what I call an "irrational exuberance" about health IT affecting the judgment of otherwise intelligent people.Here's an example where an expert's prescient warning about HIT problems was ignored.This letter of April 21, 2010 was FAXed to the CEO and CC'd to the CMO of the hospital where my mother was injured due to a May 19, 2010 EHR-related error.Incidentally, they have, to my knowledge, no postdoctorally-trained Medical Informatics specialists on staff, and possibly nobody with substantive formal training in the domain.Names of people and places have been redacted. To the best of my knowledge, the letter's concerns were ignored:April 21, 2010CONFIDENTIAL[name redacted]President and CEO[name redacted] Hospital[address redacted]Re: Electronic medical records observatio... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5069406 Tue, 26 Jul 2011 14:39:00 +0100 5069406 http://www.medworm.com/index.php?rid=4893559&cid=t_198903_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F06%2F01%2Fabandoned-minds-social-justice-civil-rights-and-mental-health-part-2%2F The first duty of love is to listen. – Paul Tillich Love is no assignment for cowards. — Ovid In part 1 of this piece I described the atrocities at Willowbrook State School as the cause for changes in the delivery of mental health services in the U.S.  Elsewhere I have described some of the changes in state and federal law surrounding terminology used to describe disabled individuals, and a comparison between the U.S. and the delivery of mental health services in New Zealand. But these descriptions are only the macro version of the movement.  There is another side to this story, a personal side. In preparation for a forthcoming book I arranged to talk to a very unique couple. On December 15th, 2010 I got to meet two extraordinary people, Michael and Amy (not their real name... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4893559 Wed, 01 Jun 2011 18:50:34 +0100 4893559 http://www.medworm.com/index.php?rid=4592327&cid=t_198903_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fama-deluded-on-health-it-begs-for.html The American Medical Association (AMA) has become worse than useless:AMA urges issuance of EMR penalties be delayedCongressional Quarterly's CQ Weekly (3/14, Zeller) reports that "Congress strongly believes that electronic medical records will bring down the cost of healthcare, so much so that it has passed two laws providing incentives for doctors who upgrade their systems and levying penalties on those who don't."But, the American Medical Association is urging that the penalties be delayed. Notably, the association "says a Government Accountability Office study released in February bolsters its point that the two laws create competing incentives that contradict each other." [Just our sub-15% approval rating Congress at work - ed.] The article adds that the Department of Health and Human ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4592327 Mon, 14 Mar 2011 16:42:00 +0100 4592327 http://www.medworm.com/index.php?rid=3750013&cid=t_198903_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F07%2Fmeaningful-use-final-rule-have.html Meaningful use before meaningful usability?The Dept. of HHS today has released the final version of "Meaningful Use" rules on HIT, which can be seen here: Meaningful Use – Final Version Full Text.By what category of diligence were the rules for "meaningful use" finalized on the same date that a NIST conference is being held on health IT "usability" ("Usability in Health IT: Technical Strategy, Research, and Implementation", http://www.nist.gov/itl/usability_hit.cfm), implying there's a problem with usability of these experimental devices physicians are supposed to "meaningfully use?"Don't take my word on the issue of usability problems.The National Research Council's 2009 findings were that current HIT does not support clinicians' cognitive needs as here:CURRENT APPROACHES TO U.S. HEALTH... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3750013 Tue, 13 Jul 2010 18:49:00 +0100 3750013 http://www.medworm.com/index.php?rid=3718653&cid=t_198903_136_f&fid=39016&url=http%3A%2F%2Fturquoisegates.blogspot.com%2F2010%2F07%2Flisten-to-your-life.html Listen to your life. See it for the fathomless mystery that it is. In the boredom and pain of it no less than in the excitement and gladness: touch, taste, smell your way to the holy and hidden heart of it because in the last analysis, all moments are key moments, and life itself is grace.~ Frederick BuechnerI had a wonderful night.  I was awake for much of it, because of the random bouts of high heart rate.  I topped out at 172 last night.  But it didn't bother me much.  Without the sudden drop back down to 40 or 50 beats per minute, I did not suffer any chest pain or dizziness.  The only thing I felt was a sense of a my heart racing - as if I had jumped out of bed and run a lap around the unit.  This is due to my thyroid hormone levels being out of whack. Th... Turquoise Gates blogs http://www.medworm.com/rss/comments.php?id=3718653 Thu, 01 Jul 2010 15:23:00 +0100 3718653 http://www.medworm.com/index.php?rid=2916062&cid=t_198903_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F10%2Fnsw-nightmare-and-overuse-of-computers.html At "From Down Under: The Story of the Deployment of an ED Clinical Information System ‐ Systemic Failure or Bad Luck" I posted excerpts from an essay of the same name by an Australian medical informatics specialist about what appeared to be an Emergency Department (ED) nightmare.Those excerpts should be frightening to anyone who ever gets ill and might need to visit an ED (meaning, all of us).An ED electronic health record system (EHR) was to be installed in an entire Australian state, New South Wales (NSW), with 200+ hospitals that apparently presented a mission hostile user experience and great opposition by critical care physicians in a setting where death can occur - suddenly and irreversibly - in the flash of an eye. That Medical Informatics specialist's observations, analysis and q... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2916062 Thu, 22 Oct 2009 13:56:00 +0100 2916062 http://www.medworm.com/index.php?rid=2473251&cid=t_198903_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F06%2Fwharton-on-healthcare-it-can-i-go-home.html Professors at the Wharton School of the University of Pennsylvania (one of the most prestigious business colleges in the world) had some very interesting observations about healthcare IT yesterday in an article entitled:"Information Technology: Not a Cure for the High Cost of Health Care."I have been writing on these same themes - irrational exuberance, HIT not being a panacea or cybernetic miracle, HIT as a facilitating tool in medicine, not a revolutionary one (but only if "done right"), inadequate research to back up the often grandiose claims, and so forth for over a decade ("Contemporary Issues in Medical Informatics: Common Examples of Healthcare IT Failure", link). I penned such sacrilege, often at risk to my career due the unpopularity of these ideas, itself due to the irrational ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2473251 Fri, 12 Jun 2009 02:55:00 +0100 2473251 http://www.medworm.com/index.php?rid=2441282&cid=t_198903_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F05%2Fharvards-emr-justification-we-just-have_27.html I think what I termed "irrational exuberance" over health IT is now devolving into just simple irrationality.I am unfamiliar with the reasoning employed below (in boldface) by the Harvard researcher, Ashish Jha, MD, MPH (who authored the April 2009 EHR usage survey "Use of Electronic Health Records in U.S. Hospitals" in the NEJM).From "Cash for Computers", HealthLeaders Media, May 11, 2009. First, my opinions:... "This forced timeline [by 2014] is a very bad thing. I'm concerned it is going to take an experimental technology and turn it into a train wreck," Silverstein [me - ed.] says. "We need a more gradual process where we can learn from mistakes on a small scale to avoid reproducing them on a large scale ... So now, Silverstein says, healthcare providers are caught between their missio... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2441282 Wed, 27 May 2009 17:06:00 +0100 2441282 http://www.medworm.com/index.php?rid=1960597&cid=t_198903_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2008%2F11%2Fshould-us-call-moratorium-on-ambitious.html We are now engaged in a worldwide economic crisis, the likes of which have probably not been seen since the 1920's.In "Bank Bailout Puts £12.7bn NHS Electronic Medical Record Project In Jeopardy" I commented on how the world financial crisis of 2008 combined with chronic project difficulties and mismanagement was creating such high levels of doubt about the UK's Connecting for Health (CfH) national program for electronic health records (EHR's), that the program was under consideration for cancellation.From that post:Christine Connelly, the Department of Health's recently appointed head of informatics, is understood to be reviewing whether the programme is a cost-effective way of improving the quality and safety of patient care.She will have to find compelling arguments to stop the Treasur... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=1960597 Fri, 14 Nov 2008 04:43:00 +0100 1960597 http://www.medworm.com/index.php?rid=1723431&cid=t_198903_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F08%2F22%2Fexuberant-videos%2F Kay Redfield Jamison is a great speaker and a recent lecture video captures her mix of expertise and enthusiasm. Exuberance: The Passion for Life is about positive emotions often overlooked by psychology and psychiatry, while asking when does passion turn pathological? Jamison talks about how exuberance changes all of us by creating leaders adept at risk-taking, resilience, achievement, creativity, and teaching. This video’s an hour long, but you won’t notice the time. Randy Pausch, RIP, is the perfect example of an exuberant, inspiring speaker in the famous Last Lecture, Really Achieving Your Childhood Dreams. His enthusiasm was viral to millions of viewers, and worth viewing the hour-long lecture format. I’ve featured another Kay Red Field Jamison video here before, b... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1723431 Fri, 22 Aug 2008 06:30:54 +0100 1723431 http://www.medworm.com/index.php?rid=1231811&cid=t_198903_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2008%2F02%2Fblue-cross-of-california-wellpoint-to.html I commented on the "irrational exuberance" over healthcare IT here. Health IT is a double-edged sword. It can be used, and it can be misused. In the hands of the wrong people, it will "revolutionize healthcare" all right ... but not in the direction health informaticists and clinicians would desire.The title of this post seems the logical outcome based on the self-initiated debacle of Blue Cross of California, as posted at Wellpoint Halts Attempts to Have Doctors "Rat Out Patients":Blue Cross of California is sending physicians copies of health insurance applications filled out by new patients, along with a letter advising them that the company has a right to drop members who fail to disclose 'material medical history,' including 'pre-existing pregnancies.''Any condition not listed on the ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=1231811 Thu, 14 Feb 2008 15:35:00 +0100 1231811