Open Source, White Plains, Healthcare

Spent yesterday on the 8th floor at 123 Main Street for meetings with Bob Barthelmes - Red Sox fanBob's team.    He's got a great bunch of people together – and it is inspiring to be part of a team that's doing important work in a meaningful way.   Working with a team of smart people who "get it"  and are intrinsically motivated is always good to re-charge the batteries – much like I feel when I go to STFM meetings.  That's saying  a lot, I suppose, since I remain such an "I."

Olivier was among the participants – though  he didn't speak up as much as I would have liked.  Perhaps He's an "I" too.  🙂

He did show me his Smartcard.  Every French Citizen has one – French Health Access Cardand they have had them for TEN YEARS.  One wonders why we can't get even the easy parts right in the US.  The reimbursement structure for health care here is so broken – and – like a virus – this permeates all of how we attempt to deliver health care.  Our IT systems – from the EMRs to the practice management systems – need to be far more complex so that the even more complex billing proclivities can be managed by herds of people on both sides of the money:  people I pay to GET it – and people the payers pay to DENY it.  How dumb.    When my office overhead is ~ 60% .. (this is typical in primary care) .. it means that more than half of the money we collect doesn't go to health care.  Makes one think about other crazy paradigms of care delivery – eh?   Maybe not so crazy.

The French Smart card is just an example of how a system just works as it should.  Sure – Michael Moore's movie is a bit over the top – but he's right. 
Of course he's right.  I've been a member of PNHP for nearly two decades now (I hosted the website in my attic for its first few years of existence) and though I've been less involved in the organization lately – I remain convinced that we need to fix this problem with a single-payer solution.   Intelligent use of technology – with patients at the center – will also help us to spend less time on the administrative chores – and more time on the important work of making thoughtful, evidence-based decisions with our patients. 

Yes – WITH our patients – not for them:

In the 1970s … studies began to show that patients with chronic conditions who are active in their own care have much better health outcomes. And yet … doctors and patients are still stuck in … "Marcus Welby mode" — with the omniscient, paternalistic doctor ministering to the passive, nodding patient.
(From this Washington Post article)

In Health IT – we need to practice precisely the same way:  Understand best practice, educate our customer, and develop our skills, tools and partnerships in a manner that will help support them to the best of our ability.  This is too important to treat it like a business.  This is a profession – guided by important principles of equity, fairness, and benevolence.  

Tags: HealthIT Open Source