Best Care Anywhere
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Aspect of Health Law Has Been Helping Veterans for Years
As Supreme Court arguments for and against the Affordable Care Act began Monday, the retiring director of the country's biggest Veterans Health System district said one element of the law transformed health care for veterans long ago. Read More »
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Been there, Done that, Doesn’t Work: Veterans Health Administration IT goes back in time
If you have an interest in the worlds of economics, healthcare or technology, here’s a story that’s emerged this month that is worth noting for the record books. In the US, amidst the chaos of the Trump administration, yet another mistake has been made this month. For the record, it is worth noting that the US Department of Veterans Affairs (VA) Veterans Health Administration (VHA) ended up with a contract for a large IT solution for the next 10 years worth about $10 billion as of May 2018. On the face of it that may appear to be unremarkable news: just another big expensive contract for an IT system. Yet there is a part sad/part silly dimension to it that is well worth flagging up at this point.
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Beyond the theatrics of the VA wait-list scandal
The spin cycle of a Washington scandal, once set in motion, is more entertaining to watch than clothes washing at the local laundromat, even though the latter is better at cleaning up a mess. Read More »
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Big Tech Should Stay Out of Healthcare
...The use of digital technology in health care has enormous promise, to be sure. But, as the Wall Street Journal's coverage of Google's Project Nightingale revealed, there is also a potential dark side to these projects. Ascension, it noted, "also hopes to mine data to identify additional tests that could be necessary or other ways in which the system could generate more revenue from patients, documents show." That detail raises a key question that's largely overlooked in our health care debates: should the drive to maximize corporate revenues determine how health information technology develops and becomes integrated into medical practice, or should that be determined by medical science and the public?...An alternative path exists. In the 1970s, the Veterans Affairs Administration (VA) developed VistA, an open-source code system that was the country's first EHR system... Read More »
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How VA Outsourcing Hurts Veterans
On Thursday, Sen. Bernie Sanders, chairman of the Senate Veterans Affairs Committee, announced that he had reached a compromise with John McCain and other Senate Republicans on how to fix whatever it is that needs fixing at the VA...the bill also contains one provision that is a significant concession to Republican enemies of government. If enacted, it would lower the quality of health care received by veterans while setting back the movement for health care delivery system reform generally.
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Is The 1.5+ Trillion Dollar HITECH Act a Failure?
Hopefully, the public statements made by President Obama and Vice President Biden will lead to a public debate over the monumental problems that the HITECH Act and proprietary EHR vendors have caused the American people. While the press continues to report the figure of $35 billion as the cost of implementing EHRs, that figure does not tell the entire story. Perhaps the next step is to provide accountability and transparency. That would start with firm numbers regarding the real costs of EHR implementations forced on an unprepared healthcare system by the HITECH Act.
- The Future Is Open
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Obama and Biden Blast EHR Vendors for Data Blocking
As they are winding their terms in office, President Barack Obama and Vice President Joe Biden dropped a stink bomb on the health IT industry. Speaking at different events on Friday, January 9th, the President and Vice President both criticized proprietary electronic health record (EHR) vendors as the primary obstacle to the success of their administration’s health care strategy. This is the highest level acknowledgment so far of the serious impact that “lock-in” EHR software vendors are having on America’s medical infrastructure and the ability of physicians to provide medical care.
Phillip Longman's Senate Testimony Before the The State of VA Health Care Hearings
We need to open up the VA and grow it, extending no-questions-asked eligibility not only to all vets but to their family members as well. This not only makes clinical sense, it also makes economic sense. So long as the VA remains one of, if not the most, cost- effective, scientifically driven, integrated health care delivery systems in the country, the more patients it treats, the better for everyone.
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VA Care: Still The Best Care Anywhere?
...[A]s the author of the title Best Care Anywhere, Why VA Health Care would be Better for Everyone, it’s been dispiriting to have it confirmed by a preliminary inspector general’s report that some frontline VA employees in Phoenix and elsewhere have been gaming a key performance metric regarding wait times. But what’s really has me enervated is how the dominant media narrative of the VA “scandal” has become so essentially misleading and damaging to the cause of health care delivery system reform...
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Veterans aren’t the only ones waiting for health care
But the big question with these stories about the VA is, "compared to what?" This scandal wouldn't exist if the VA didn't have performance metrics on its employees. If it didn't measure or care whether veterans get prompt appointments it could just do what the rest of the health-care system has done and not hold people responsible for these metrics. Read More »
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VistA is Going Places, and Also Staying Put
The Veterans Health Administration's hospital software, VistA, is a computing legend. Few pieces of software have become the subject of a popular book (Best Care Anywhere), won repeated awards for their usability, or been credited with a 180-degree turn-around in an organization's quality. But VistA is getting long in the tooth, and many--including now the VA itself--are questioning whether it's time for something new.The speculations aren't just about VistA. They extend to all health care software of that generation, including the industry's leading electroinc health record (EHR) system--Epic--and the venerable Intermountain Healthcare.
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