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Showing posts with label faith-based informatics beliefs. Show all posts
Showing posts with label faith-based informatics beliefs. Show all posts

At Risk in the Computerized Hospital: The HITECH Act as Social Policy Malpractice, and Passivity of Medical Professionals

I am revisiting the issue of HITECH in light of recent reports on health IT drawbacks and/or failure to achieve long-claimed advantages.

The HITECH Act, a multi-billion dollar EHR incentive/penalty measure inserted into the 2009 American Recovery and Reinvestment Act legislation (ARRA or 'economic recovery' act), is proving to be an example of what should be called "Social Policy Malpractice."

The HITECH Act was largely a consequence of intense industry lobbying on behalf of the IT industry (as in the Washington Post at "The Machinery Behind Health-Care Reform: How an Industry Lobby Scored a Swift, Unexpected Victory by Channeling Billions to Electronic Records", May 16, 2009).

It is in fact not based on science or reliable evidence, and has led to increased patient endangerment and a worsening national debt picture.

The recent revelations of reports from diverse sources including but not by any means limited to the following indicate that HITECH and its expenditures of billions of dollars on experimental, unregulated, unproven technology represents social policy malpractice:
 
  • Budget reports - in view of the deficit spending reported by OMB and others that is causing national debt to spiral out of control, jeopardizing the economic well being of the United States, and with upcoding as a side-effect and no cost savings, HITECH is an unaffordable extravagance. 

Of course, I'd already cited these reports in past posts but they bear repeating:

      • FDA (known injuries and deaths are likely the "tip of the iceberg" because of the impediments, and EHRs are medical devices that should fall under the FD&C Act, but FDA has largely refrained from enforcing our regulatory requirements with respect to HIT devices because they're a political hot potato - Jeff Shuren MD JD, CDRH), http://hcrenewal.blogspot.com/2011/04/fda-decides-regulating-implantable.html;

      I'd called for a moratorium on ambitious EHR plans for similar reasons as far back as 2008, at posts here and here.
       
      The path that ethical medical centers and clinicians should take is to delay computerization in 2012 and push for slowdown or retraction of HITECH and its penalties for non-adopters. 

      Yet instead, what is usually seen is excuses and cheerleading by healthcare organization leaders, and passive physician and nurse acceptance of deficient information technology.  

      This stunning passivity and acceptance by physicians and nurses of a deeply flawed technology of unknown risk seems largely due to physician learned helplessness and the Stockholm Syndrome.  See the posts on "physician learned helplessness" at http://hcrenewal.blogspot.com/2007/10/physicians-learned-helplessness.html (commenting on observations in MedScape written by a lawyer), as well as on the "Stckholm Syndrome"  at http://en.wikipedia.org/wiki/Stockholm_syndrome. 

      Per a psychiatrist/informatics specialist Dr. Scott Monteith who has commented on this blog, the compliance of clinicians may also be a manifestation of the inherent human psychopathology reflected in the Milgram Experiment (and elsewhere):

      The Milgram experiment on obedience to authority figures was a series of notable social psychology experiments conducted by Yale University psychologist Stanley Milgram, which measured the willingness of study participants to obey an authority figure who instructed them to perform acts that conflicted with their personal conscience. Milgram first described his research in 1963 in an article published in the Journal of Abnormal and Social Psychology, and later discussed his findings in greater depth in his 1974 book, Obedience to Authority: An Experimental View.


      As to the consequences of physician "acceptance" of this technology in 2012 in its present condition, physicians are:

      • Acting, in effect, 'in loco parentis' for their patients, not in the latter's best interests, who are not even afforded opportunity for informed consent.  This is in violation of long-accepted norms of human subjects experimentation and research such as the Belmont Report, Nuremberg Code and HHS human subject protection regulations at 45 CFR part 46 themselves;
      • Giving free provision of their expertise and labor at improvisation and workarounds, in effect providing free alpha and beta testing to an entirely unregulated IT sector;

      National health IT leaders have proven to be hyperenthusiasts about health IT benefits as well:

      ... This from Robert Kolodner, former head of the Office of the National Coordinator for Health IT (ONC) at HHS:

      Dr. Robert Kolodner, a physician who headed the federal push for electronic medical records in 2007, acknowledged that billing abuse took a backseat to steps likely to entice the medical community to embrace the new technology.

      Kolodner said officials were certain the savings achieved by computerizing medicine would be so great that billing abuse, “while needing to be monitored, was not something that should be put as the primary issue at that time.”

      In other words, sideline (ignore) health IT-based billing abuse (and safety risks to the live patients subjected to this experimental technology without informed consent) because "we believe" the savings will be greater based on "our faith in the technology."
       
      Such individuals contributed materially to the social policy malpractice represented by the HITECH ACT.

      Considering all of the above, I call once again for a moratorium on further economic incentives for EHR adoption, and investment in the very measures recommended by the National Research Council in its Jan. 2009 report "Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions" that:

      In the long term, success will depend upon accelerating interdisciplinary research in biomedical informatics, computer science, social science, and health care engineering.

      This research must be conducted, of course, with full human subjects protections in place.

      -- SS
      8:32 AM

      Lake County Health Department: The extremes to which faith-based informatics beliefs can drive healthcare facilities - Depression era soup lines at the clinic?

      Here is a story exemplifying the extremes to which faith-based informatics beliefs can drive healthcare facilities, to the benefit of IT companies and at the expense of patients.  This is occurring a bit north of the Chicago area:

      County Health Department clinics moving to electronic records

      By Judy Masterson

      Last Modified: Sep 11, 2012 02:43AM

      People who rely on Lake County Health Department clinics for their health care have found cuts in service during walk-in hours as the department began implementing a new electronic medical record.

       That, as is explained further in the story, is an understatement.

      The massive shift to electronic storage of medical data by the department has been underway for about two years, at a cost through April 2012 of $3.8 million, according to department spokeswoman Leslie Piotrowski.

      During the first phase, appointment-taking, laboratory, financial and demographic information and billing were transferred from paper records to electronic storage. Under the newest phase of the project, physicians and staff are being trained to use new computer software to electronically gather health histories and record information on tests, treatments and prescriptions.

      Are they using the software to record health histories, or to gather them?  There is a difference, and I believe this passage exemplifies that these "EHRs" are no longer innocuous filing systems, but are interfering in and regulating the information gathering process from patients itself (i.e., the physician-patient relationship) itself.  More on that issue below.

      Denise Koppit, Health Department associate director of primary care services, acknowledged the training has temporarily cut by half the number of walk-in patients seen at the department’s clinics in Waukegan, Zion, North Chicago, Highland Park and Round Lake Beach.

      Cut by 50%?  That is remarkable.  That an electronic record system could be so hard to learn and use that patient count has to be halved is stunning - and outrageous.

      It suggests a fiasco in the making in terms of care quality when the clinicians are asked (and probably forced) to get back to more traditional volumes.

      Similar situations are noted here:  

      "Avatar fails - No, not the Cameron movie, but yet another lousy EMR system implemented by amateurs." http://hcrenewal.blogspot.com/2010/11/avatar-fails-no-not-cameron-movie-but.html

      and here:

      "Contra Costa's $45 million computer health care system endangering lives, nurses say." http://hcrenewal.blogspot.com/2012/08/contra-costas-45-million-computer.html

      “We’re learning new systems which totally change the way we gather information about patients,” Koppit said, noting “it was a little bumpy” the first day, Sept. 5, but Sept. 6 “it was a little better.”

      "Totally change the way we gather information about patients?"  (As opposed to "the way we record information?")

      This is concerning to me, as it suggests interference (ill-conceived and deleterious interference is probably more accurate) in medical processes by technology.  To my knowledge, there's been no revolution in clinician history taking and performance of physical exams.  The state government needs to examine exactly what is being referred to.

      Also - add "a little bumpy" to the list of banal excuses for toxic software such as - it's a rare event, it's just a 'glitch',  it's teething problems, it's a learning experience, we have to work the 'kinks' out, it's growing pains, etc.

      I'm actually surprised not to see the usual refrain in this article, that "patient care was not compromised."

      ... “We want to improve quality of care and increase efficiency so patients don’t go through multiple tests and so everyone can see medications,” Koppit said. “This will allow ready access to patient information. Patients will receive a printout of their diagnoses, medications and lab work.”

      As described in other posts (query link here), these are "faith-based informatics beliefs" (i.e., enthusiasm and technology-deterministic statements of fait accompli not driven by robust evidence, especially considering the state of health IT in 2012).

      Patients who transfer to different providers, will receive their medical history and information in a paper file or on a flash drive.

      Paper file?

      The reductions in number of walk-in patients accepted hit the Zion clinic especially hard. One user, who contacted the Lake County News-Sun, said patients waiting outside the clinic “on any given day” look like “a Depression-era soup line” that snakes around the corner of 27th Street.

      Koppit said that the Zion clinic, which also serves patients from Winthrop Harbor, Beach Park and Wadsworth, relies on just two physicians who typically treat between 12 and 15 walk-ins per day.

      Health IT project managers whose plans caused “a Depression-era soup line” of sick patients should be sanctioned, in my opinion. 



      When an EMR implementation causes "Depression-era soup lines" at the clinic, one can reasonably conclude project mismanagement is occurring.

      This is entirely unnecessary, and endangers patients dependent on the care provided in these clinics.  This project as structured, in fact, violates patient's rights in my opinion.


      She admitted that regular appointments can take two months to schedule. “If somebody comes in very sick, we’re trying to get them squeezed in,” she said.

      We're "trying to get them squeezed in"?  And, if they are harmed or die because they can't be "squeezed in", or because the clinicians are up to their necks in cybernetic frenzy, who's liable?

      I suggest the implementation leadership team should, in that case, find themselves as defendants.

      -- SS
      10:55 AM

      The Scientific Justification for Meaningul Use, Stage 2: The NWB Methodology

      The Final Rule for Meaningful Use Stage 2 has been released.  It is at this link (PDF).  It is a mere 672 pages in length, a quick read during one's evenings of leisure.

      Here is, from page 18 verbatim, the scientific justification for the program.  The finest scientific methods were used to achieve these criteria in justification of spending of $15 billion of taxpayer money in "incentives" (probably a low estimate), not counting the additional hundreds of billions the buyers themselves will spend that is diverted from your healthcare to the IT sector:

      3. Summary of Costs and Benefits

      This final rule is anticipated to have an annual effect on the economy of $100 million or more, making it an economically significant rule under the Executive Order and a major rule under the Congressional Review Act.

      Accordingly, we have prepared a Regulatory Impact Analysis that to the best of our ability presents the costs and benefits of the final rule. The total Federal cost of the Medicare and Medicaid EHR Incentive Programs between 2014 and 2019 is estimated to be $15.4 billion (these estimates include net payment adjustments for Medicare providers who do not achieve meaningful use in 2015 and subsequent years in the amount of $2.1 billion).

      In this final rule we have not quantified the overall benefits to the industry, nor to EPs, eligible hospitals, or CAHs participating in the Medicare and Medicaid EHR Incentive Programs. Information on the costs and benefits of adopting systems specifically meeting the requirements for the EHR Incentive Programs has not yet been collected and information on costs and benefits overall is limited. 

      Nonetheless, we believe there are substantial benefits that can be obtained by eligible hospitals and EPs, including reductions in medical recordkeeping costs, reductions in repeat tests, decreases in length of stay, increased patient safety, and reduced medical errors. There is evidence to support the cost-saving benefits anticipated from wider adoption of EHRs.

      There's no truly robust evidence of generalizable benefit, no randomized trials, there's significant evidence to the contrary (that, incidentally, is deliberately being ignored), there's risk to safety that this disruptive technology causes in its present state (but the magnitude is unknown, see quotes from 2012 IOM study here) that MU and "certification" do not address, there's a plethora of hair-raising defect reports from the only seller that reports such things, but CMS justifies the program with the line:

      "Evidence [on benefits] is limited ... Nonetheless, we believe there are substantial benefits that can be obtained by eligible hospitals and EPs ... There is evidence to support the cost-saving benefits anticipated from wider adoption of EHRs."

      I am deeply impressed by the level of rigorous science here.  We are truly in a golden age of science.

      I recommend NIH, NSF, FDA and all other research and regulatory agencies immediately adopt this rigorous HHS methodology (called the "NWB" methodology for "nonetheless we believe") in their professional pursuits and research grant approval processes.

      -- SS
      6:53 PM

      Health IT difficulties and controversial excuses from health IT hyperenthusiasts and extremists

      As I observed at my Aug. 15, 2012 post "Contra Costa's $45 million computer health care system endangering lives, nurses say" and other posts, common in case reports of health IT difficulties is the refrain (usually from a seller, healthcare executive or health IT pundit) that:

      • It's a rare event, it's just a 'glitch',  it's teething problems, it's a learning experience, we have to work the 'kinks' out, it's growing pains, etc.

      Or perhaps worse:
      • Patient safety was not compromised (stated long before the speaker or writer could possibly know that).

      What these statements translate to:  any patient harm that may have resulted is for the "greater good" in perfecting the technology.

      Here is the problem with that:

      These statements, while seemingly banal, are actually highly controversial and amoral. and reflect what can be called "faith-based informatics beliefs" (i.e., enthusiasm not driven by evidence).

      They are amoral because they significantly deviate from accepted medical ethics and patient rights, especially regarding experimentation or research such as the plain language of the Nuremberg code, the Belmont Report, World Medical Association Declaration of Helsinki, Guidelines for Conduct of Research Involving Human Subjects at NIH, and other documents that originated out of medical abuses of the past.

      Semantic or legal arguments on the term "research", "experimentation" etc. are, at best, misdirection away the substantive issues.  Indeed, for all practical purposes the use of unfinished software (or software with newly-minted modifications) that has not been extensively tested and validated and that is suspected to or known to cause harm, without explicit informed consent, is contrary to the spirit of the aforementioned patients' rights documents.

      They are excuses from health IT hyper-enthusiasts ("Ddulites"), who in fact have become so hyper-enthusiastic as to ignore the ethical issues and downsides.  The attitude gives more rights to the cybernetic device and its creators than to the patients who are subject to the device's effects.

      These excuses are, in effect, from people who it would not be unreasonable to refer to as technophile extremists.

      -- SS

      Addendum:

      The Belmont Report of the mid to late 1970's, long before health IT became at all common, actually starts out with a section discussing "BOUNDARIES BETWEEN PRACTICE AND RESEARCH."  I have updated one of the observations in that section to modern times:

       ... It is important to distinguish between biomedical and behavioral research, on the one hand, and the practice of accepted therapy on the other, in order to know what activities ought to undergo review for the protection of human subjects of research.

      ... When a clinician [or entire healthcare delivery system - ed.] departs in a significant way from standard or accepted practice, the innovation does not, in and of itself, constitute research. The fact that a procedure is "experimental," in the sense of new, untested or different, does not automatically place it in the category of research.

      Radically new procedures of this description [such as use of cybernetic intermediaries to regulate and govern care - ed.] should, however, be made the object of formal research at an early stage in order to determine whether they are safe and effective. Thus, it is the responsibility of medical practice committees, for example, to insist that a major innovation [such as health IT - ed.] be incorporated into a formal research project.

      Health IT appears to have been "graduated" from experimental to tried-and-true without the formal safety research called for in the Belmont report.

      The Belmont report continues:

      Research and practice may be carried on together when research is designed to evaluate the safety and efficacy of a therapy. This need not cause any confusion regarding whether or not the activity requires review; the general rule is that if there is any element of research in an activity, that activity should undergo review for the protection of human subjects.

      Instead, what we have for the most part are excuses and special accommodations for health IT, on which the literature is conflicting regarding safety and efficacy, all the way up to the Institute of Medicine.

      -- SS
      8:30 AM

      Cart Before the Horse, Part 3: AHRQ's "Health IT Hazard Manager"

      (Addendum: the AHRQ hazards manager taxonomy report can see seen at http://healthit.ahrq.gov/sites/default/files/docs/citation/HealthITHazardManagerFinalReport.pdf.)

      In a July 2010 post "Meaningful Use Final Rule: Have the Administration and ONC Put the Cart Before the Horse on Health IT?" and an Oct . 2010 post "Cart before the horse, again: IOM to study HIT patient safety for ONC; should HITECH be repealed?" I wrote about the postmodern "ready, fire, aim" approach to health IT:

      In the first post, I wrote:

      ... These "usability" problems require long term solutions. There are no quick fix, plug and play solutions. Years of research are needed, and years of system migrations as well for existing installations.

      Yet we now have an HHS Final Rule on "meaningful use" regarding experimental, unregulated medical devices the industry itself admits have major usability problems, along with a growing body of literature on the risks entailed.
      For crying out loud, talk about putting the cart before the horse...

      Something's very wrong here...

      However, this situation is anything but humorous.

      How more "cart before the horse" can government get?

      In the second post, I wrote:

      ... So, in the midst of a National Program for Health IT in the United States (NPfIT in the U.S.), with tens of billions of dollars earmarked for health IT already (money we don't really have, but it can be printed quickly, or borrowed from China) the IOM is going to study health IT safety, prevention of health IT-related errors, etc. ... only now?

      Here we go yet again.

      The problem with the AHRQ (Agency for Healthcare Research and Quality, a division of HHS) announcement below of a webinar about a new tool for identifying, categorizing, and resolving health IT hazards, as I have written before, is putting the "cart before the horse" and throwing medical ethics to the wind.

      If we've just developed a tool "for identifying, categorizing, and resolving health IT hazards", the magnitude of which others such as IOM admit are unknown to our detriment (e.g., Health IT and Patient Safety: Building Safer Systems for Better Care, pg. S-2), then health IT is, it follows, an experimental technology.

      If it is an experimental technology, AHRQ and others in HHS should probably be raising the issue of a slow down or moratorium on widespread rollout under HITECH until risk management and remediation is better understood.  At the very least they should be calling for patient informed consent that a device that will largely regulate their care is experimental, that a competency "gap" exists among healthcare practitioners within the "health IT environment" (meaning patients are at risk), and that patients should be offered the opportunity for informed consent with opt-out provisions.  The principals should not just be announcing a webinar:

      Sent: Tuesday, June 05, 2012 12:23 PM
      To: OHITQUSERS@LIST.NIH.GOV
      Subject: Register Now! AHRQ Health IT Webinar "Purpose and Demonstration of the Health IT Hazard Manager and Next Steps" June 11, 2:30 PM ET

      Agency for Healthcare Research and Quality

      Purpose and Demonstration of the Health IT Hazard Manager and Next Steps

      June 11, 2012 — 2:30-4 p.m., EST

      The Agency for Healthcare Research and Quality (AHRQ) has identified a gap in a health care/public health practitioner’s competency within the health IT environment. This webinar is designed to increase practitioners’ competencies in several areas: improving health care decision making; supporting patient-centered care; and enhancing the quality and safety of medication management by improving the ability to identify, categorize, and resolve health IT hazards.

      The Webinar will explore the Health IT Hazard Manager—a tool for identifying, categorizing, and resolving health IT hazards. When implemented, the tool allows health care organizations and software vendors alike to learn about potential hazards and work to resolve them, including the use of data to communicate potential and actual adverse effects. The session will discuss how the Health IT Hazard Manager was tested and refined as well as strategies and implications for deploying it. The target audience includes AHRQ grantees/researchers; health care providers, including physicians and nurses; consumers/patients; and health care policymakers.

      ... Webinar learning objectives include:

      1. Describe the rationale for developing the Health IT Hazard Manager and how it evolved through alpha and beta testing.
      2. Explain the process for identifying and categorizing health IT-related hazards.
      3. Demonstrate how the Health IT Hazard Manager would be used [i.e., it's not yet in use, despite mandates for HIT rollout with penalties for non-adopters - ed.] within and across care delivery organizations and health IT software vendors.
      4. Discuss policy and process implications for deploying the Health IT Hazard Manager via different organizations (i.e., AHRQ; Office of the National Coordinator for Health IT; Patient Safety Organization(s); Accrediting bodies; IT entities).

      In effect, HHS seems to be saying "we're working on the HIT risk problem, but roll it out anyway; if you get harmed or killed, tough luck."  This seems a form of negligence.

      Have we thrown out all we know about medical research and human subjects protections in face of the magical powers and profits of computers in medicine?

      -- SS
      1:11 PM

      ONC's "Health Data Palooza" - A Title of Exceptionally Bad Taste, For a "See No Evil" Meeting

      The Office of the National Coordinator of Health IT has sent out this announcement:

      Subject: HEALTH DATA PALOOZA III: Unleashing the Power of Data to Improve Health
      From:    ONC Health IT
      Date:    Thu, May 10, 2012 10:36 am

      HEALTH DATA PALOOZA III: Unleashing the Power of Data to Improve Health

      June 5-6th, Washington DC
      Health Data and Innovation Week
      www.hdiforum.org | #healthdata

      CONFIRMED SPEAKERS
      Kathleen Sebelius, Secretary of Health and Human Services
      Marc Bertolini, CEO Aetna
      Thomas Goetz, Execuitve Editor of WIRED
      Atul Gawande, surgeon and author
      Bill Frist, former Republican Majority Leader
      Dominique Dawes, two time gold medal winner
      Todd Park, US Chief Technology Officer


      Hear from Farzad Mostashari, National Coordinator for Health IT on data liberation
      ONC will host breakout sessions on Consumer e-Health, HealthData.gov,
      and Uses of Data by ACOs
      ONC will release nine challenges during this year’s event! 


      This title for a government-sponsored meeting is bizarre and tasteless in my opinion.  What is deemed by ONC to be the major source of this data?  Health IT.

      "Palooza?"

      From Urban Dictionary:

      An all-out crazy party; partying at one place with a ton of people like there's no tomorrow; The art of throwing a very drunken extravagant party with a plethora of friends

      "Data Liberation?"    

      What about "patient liberation" -- from risk?

      Considering it unlikely that issues in the bulleted points below, commented on in detail in past posts on this blog, will be discussed at this meeting, the title of the meeting is especially tasteless:
      • There is a markedly unscientific "irrational exuberance" pushing clinical IT into wide use at a dangerously rapid pace. This exuberance is contradicted by a growing body of literature that shows the benefits are likely far less than stated, e.g., by way of example, the ad-hoc set at http://www.ischool.drexel.edu/faculty/ssilverstein/cases/?loc=cases&sloc=readinglist 
      • The technology remains experimental, its rollout is a human subjects experiment on a massive scale lacking nearly all the protections of other human subjects experimentation and for IT in mission critical settings (e.g., informed consent, formal quality control/validation/regulation, formal postmarket surveillance and reporting) due to extraordinary legal and regulatory special accommodations afforded the technology and its purveyors;
      • Defects of in-use systems are rampant, inappropriately turning patients and clinicians into software alpha and beta testers (e.g., as in the voluntary FDA MAUDE database, http://hcrenewal.blogspot.com/2011/01/maude-and-hit-risk-mother-mary-what-in.html which contains information for just one HIT vendor, Cerner, who voluntarily reports such issues);
      • The technology is unsupportive of clinician cognitive needs (2009 National Research Council study, which also stated that accelerating interdisciplinary research in biomedical informatics, computer science, social science, and health care engineering will be essential to perfect this technology);
      • The roles of scientific discovery and anecdote have been turned on their heads. RCT's of clinical IT are nearly non-existent and lower-level evidence (e.g., weak observational, pre-post, qualitative, and other study types) are cited as "scientific proof" of efficacy and safety justifying hundreds of billions of dollars of taxpayer (or is it Chinese loan?) expenditures.  Yet, risk management-relevant case reports of harmful events and near misses, crucial to help organizations and regulatory agencies understand risks are dismissed as "anecdotal" (e.g., Blumenthal: "The [ONC] committee [investigating FDA reports of HIT endangement] said that nothing it had found would give them any pause that a policy of introducing EMR's could impede patient safety," he said, while ONC issued an article based on questionable research methods entitled "The Benefits Of Health Information Technology: A Review Of The Recent Literature Shows Predominantly Positive Results" extolling the virtues of HIT, written about at http://hcrenewal.blogspot.com/2011/03/benefits-of-health-information.html).
      • Risks are definite, with known patient injury and death, but the magnitude is admittedly unknown by JC (2008 Sentinel Event Alert), FDA (2010 Internal memo on HIT risks and statements of Jeffrey Shuren MD JD about known harms likely being "the tip of the iceberg"), IOM (2011 report on HIT risk), ECRI Institute (Top ten healthcare technology hazards for 2011 and 2012), NORCAL Mutual Insurance Company 2009 report on EHR risks, others;
      • Existence of severe impediments to information diffusion about risks explicitly admitted by FDA (2010 memo), IOM (2011 report), others;
      • Usability of commercial products in real world settings is often poor (e.g., NIST 2011 study on usability), promoting "use error" (user interface designs that engender users to make errors of commission or omission, where many errors are due not to user error per se but due to designs that are flawed, e.g., poorly written messaging, misuse of color-coding conventions, omission of information, etc.)
      • These systems promote capture and display of clinically irrelevant information in the interest of charge capture, and result in reams of "legible gibberish" with many negative characteristics that make it difficult for other clinicians and reviewers to establish a cohesive, definitive narrative of clinical events and timelines.

      Health IT and health data issues are not 'partying' affairs. An un-seriousness about anything related to health IT seems in vogue of late.

      Finally, I ask:  does this "Health Data Palooza" bring my Ddulite term to life?

      Ddulite: Hyper-enthusiastic technophiles who either deliberately ignore or are blinded to technology's downsides, ethical issues, and repeated local and mass failures.

      A Ddulite Palooza.  How charming.

      Like the recent extravagances of other government agencies such as GSA in Las Vegas and the Secret Service in Colombia, let's hope this Data Palooza is a Palooza in name only.

      In light of those recent scandals, calling a government sponsored meeting a "Palooza" seems inappropriate on that basis as well.

      -- SS

      5/13/12  Addendum:

      A commenter pointed this flyer out:


      (click to enlarge)

      I post it here with no additional comments.

      -- SS
      10:21 AM