Harvard Business School

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Few U.S. Hospitals Can Fully Share Electronic Medical Records

Lisa Rapaport | Reuters | October 2, 2017

Less than one in three U.S. hospitals can find, send, and receive electronic medical records for patients who receive care somewhere else, a new study suggests. Just 30 percent of hospitals had achieved so-called interoperability as of 2015, the study found. While that’s slight improvement over the previous year, when 25 percent met this goal, it shows hospitals still have a long way to go, researchers report in Health Affairs...

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Halamka's Cautionary Tale for Healthcare

During my CIO career, I’ve worked on a few Harvard Business School case studies and I’ve had the “joy” of presenting my failures to Harvard Business school students for over a decade. I enjoy telling stories and inevitably the cases I teach are about turning lemons into lemonade. In this post, I’d like to tell a story about a recent experience with Marvin Windows and lessons learned that apply to healthcare...

Hard to Communicate with Other Teams? Check Out These Tips

When teams in the same organization—or even across organizational boundaries—start to collaborate, they will most likely realize that not all of their goals align. The IT team, for instance, might not have the same criteria for success as the sales team. Different teams have different benchmarks, even if the teams are part of a larger organization (as in the case of relationships between a developer team and an operations team). But the teams all strive towards the same goal, which is to make the organization successful. And they rely on each other to accomplish that goal. For this reason, learning more about why a team is working on a specific project, not just focusing on how they're involved and what the project is about, can help you foster better relationships across your organization...

It’s About Time: Open APIs Finally Burst Onto Healthcare’s Sluggish Scene

Sue Montgomery | Nuviun | June 9, 2014

In the midst of the struggles that we face with interoperability, efforts that support open API use may well hold the keys to the HIT Kingdom...

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On The Positive Effect of Collaboration and Information Sharing Among Physicians

For better and for worse, our healthcare system is built around physicians. For the most part, they’re the ones we rely on for diagnoses, for prescribing medications, and for delivering care.  And, often, simply for being a comfort. Unfortunately, in 2023, they’re still “only” human, and they’re not perfect. Despite best intentions, they sometimes miss things, make mistakes, or order ineffective or outdated care. The order of magnitude for these mistakes is not clear; one recent study estimated 800,000 Americans suffering permanent disability or death annually.  Whatever the real number, we’d all agree it is too high.  Many, myself included, have high hopes that appropriate use of artificial intelligence (AI) might be able to help with this problem.  Two new studies offer some considerations for what it might take.

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OpenNotes Introduces Advisory Board

Press Release | OpenNotes, Beth Israel Deaconess Medical Center | September 12, 2016

OpenNotes is pleased to announce that ten extraordinary advocates for health care quality and improvement are the founding members of the OpenNotes Advisory Board. OpenNotes is a national movement that urges doctors, nurses and other health care providers to share the notes they write with the patients they care for...

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Samuel Shem Calls for Using VistA and the VA Model of Care to Solve the Physician Burnout Crisis

On November 1st Newsweek published an extraordinary Op-Ed by Samuel Shem titled Why Computerized Medical Records Are Bad for Both You and Your Doctor. In the article, Shem, pen name for the American psychiatrist and well-known author Stephen Joseph Bergman, presents evidence that poorly designed electronic medical records (EMRs) and over-regulation are to blame for the growing crisis of physician burnout and suicide. The rate of suicides among physicians has risen to a staggering number--three per day. Shem argues that there is a "better way," and that is shown by the electronic health record (EHR) system used by the U.S. Department of Veterans Affairs (VA). The VA's EHR is called VistA. Shem's view is supported by a large and increasing number of physicians and nurses. Read More »

The Joy of Mentoring

Since 2016 is the 20th year I’ve served as CIO, I’ve given a great deal of thought to the various careers I’ve had and the roadmap for the 20 next years of my working life. In my late teens and 20s I was an entreprenuer running a 35 person software company while doing my medical and graduate school training. I was also a winemaker, home builder and engineer. In my early 30’s I was an Emergency physician, software coder, and data analyst. In my mid 30’s as a CIO, I focused on architecture, high reliability computing, and centralization of IT service delivery. In my early 40’s, I focused on disaster recovery, interoperability, and educational technologies..

The Wrong Legacies of Health Information Technology

I read two articles this week that got me thinking, Robert Charette's "Inside the Hidden World of Legacy IT Systems" (IEEE Spectrum) and Douglas Holt's "Cultural Innovation" (Harvard Business Review). Both deal with what I'll call legacy thinking. It's a particular problem for healthcare...If you are in healthcare and rely on legacy systems, you're in trouble. If you are in healthcare and are not acutely aware of what your Achilles heel is, someone else is going to exploit it. Even if you are a new healthcare entrant with more modern technologies but still based on the current ideology, your impact is going to be limited.

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Why Computerized Medical Records Are Bad for Both You and Your Doctor

Samuel Shem | Newsweek | November 1, 2019

We should not click for cash, but for care. We can use the data to benefit the patient-and the medical professionals...The EMR could have been a lifesaver. It still can be. If we get rid of on-screen, for-profit billing, and use electronic screens exclusively for care, we solve a lot of problems. We could create a true national health care system, modeled after our existing two national systems-Medicare/Medicaid and the VA. As in all other national systems, each procedure would cost about the same all over the country. On longitudinal charts showing the health of Americans as they age, a sharp rise in good health suddenly increases at age 65, when Medicare kicks in. Read More »