Monday, March 14, 2011

M.U. or A.C.O. Pick Your Poison

 

HIMSS 2011 has just adjourned, and the reviews are filled with prognosis and predictions.

by Neil Versel (Xerox)   Neil Versel

M.U.

The healthcare world is waiting nervously for HHS to release its proposed ACO regulations. HHS Secretary Kathleen Sebelius was on hand for a keynote address Wednesday morning, but gave no hint of when the regs might come. Instead, Sebelius and departing national health IT coordinator Dr. David Blumenthal mostly stuck to their general stump speeches, perhaps not wanting to stir up political controversy in this time of divided government.

In some ways, Blumenthal’s presence at HIMSS was notable for something he didn’t show up for. Deputy National Coordinator Dr. Farzad Mostashari, likely to be the interim coordinator when Blumenthal returns to Harvard in April, led the ONC town hall on Tuesday. Mostashari caused some seismic ripples through much of the vendor community on Monday by saying that ONC will be working with the National Institute for Standards and Technology and other organizations in the next six months to find ways to measure EHR usability, and that usability likely will be part of Stage 2 meaningful use, starting in 2013.

Farzad Mostashari, likely to be the interim coordinator when Blumenthal returns to Harvard in April, led the ONC town hall on Tuesday. Mostashari caused some seismic ripples through much of the vendor community on Monday by saying that ONC will be working with the National Institute for Standards and Technology and other organizations in the next six months to  find ways to measure EHR usability, and that usability likely will be part of Stage 2 meaningful use, starting in 2013. (Nothing like putting the cart before the horse)..Stage I was obviously designed for CMS and insurers, so those who wisely wait for a better standard, such as usabiity wil not receive a large incentive, and be penalized for caution. We must adopt inferior hardware and software platforms by such and such a date or suffer the consequences of a reduced reimbursement and/or reduced incentives. As usual our government would race to an implementation for it’s own self –centered purposes, since the funding actually comes from taxpayer pockets.

A.C.O.

HIMSS 2011 was not all about meaningful use. “Meaningful use in some ways fell off the radar,” another CMIO said on the same bus ride. The new buzz—and source of anxiety—is about Accountable Care Organizations.

An eponym ranked right up there and as controversial as the PACA law ACO is a new name looking for an organization upon which to plant it’s banner.

Hospitals and physicians alike are frantic to filter through the impending changes in billing and reimbursement model. Who will bill..  hospitals,.. physicians, or a third organism  which the hospital and physicians will create as a ‘holding entity?  This looks like another level of bureaucracy which will compromise whatever savings HHS is proposing by a huge re-organization of the industry. Efficiency in health care seems to be a moving target….a bit to the right, and then a bit to the left.

Just as some of the visionary ideas such as HIE and EMR are beginning implementation, the bureaucrats add more ingredients to the mix, further congealing real progress.

Sherry Turkle, the Director of MIT’s Initiative on Technology and Self, has become deeply pessimistic about our digital future. In her controversial new book, Alone Together,Turkle argues that the development of emotionally sympathetic robots like Tamagotchis and Furbies means that the “robotic moment” has arrived for the human race.She elaborates. In several interviews on TechCrunch

 

Turkle is not optimistic about social media, robotics, nor the development of emotionally sympathetic robots.  Please view the videos and read the TechCrunch interview then leave your comments here:

 

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