by Robert B. Teague, M.D.

As we progress through yet another cycle of sound and fury of EMR hype--not to mention billions of dollars of public largesse--the question remains: Why doesn't anyone use these things?

For those of you with a dim view of human nature, pure petulance and willful obstruction seem to be the easy answer. I don't think so, though. The truth is, for clinical purposes, they don't work.

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by Maria K. Todd, MHA, PhD

It's been said that "no good deed goes unpunished." This is certainly true when it comes to negotiating with managed care companies, as I've learned the hard way. Little did I know; a contract that is never signed can still become binding if one party can prove that what actually happens in the relationship between the two parties demonstrates a meeting of the minds.

Many payer agreements have passed my desk during my career in managed care and healthcare administration. As a beginner, I thought that if we didn't sign the contract, we weren't bound by its terms. In one case, more than 15 years ago, a physician with whom I worked decided that he would refuse to sign the contract draft agreement.

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by Pam McNutt

Healthcare CIOs are understandably concerned about the scope of the work they'll be facing in implementing electronic health records. The promise of stimulus funding for healthcare organizations that "meaningfully use" electronic health records has definitely raised the profile of these clinical systems.

My peers' concern was apparent in a recently completed survey by the College of Healthcare Information Management Executives (CHIME), which showed that CIOs are concerned about their ability to implement applications that are based on standards under consideration by the Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services.

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by Nancy Cawley Jean

A crisis. Most hospitals have one at some point. If your organization hasn't faced one yet, it will. Whether a local disaster fills your ED to overflowing or a sentinel event occurs and makes the headlines, your staff and your board will need to know what happened, and the media will probably be camped outside your front door. For the communications team, it's all hands on deck.

While every situation is unique, when it comes to communication surrounding a crisis, there are general rules that apply to all. I believe that being visible, honest and timely are the most important.

In a crisis, the last thing you should do is assume it will all blow over, or that word will not get out. Definitely not true, particularly in the age of Twitter, Facebook and other forms of social media. Playing possum will not make the situation go away. To use an old advertising tagline, "inquiring minds want to know."

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by Dr. Kenneth H. Cohn

I enjoyed reading Anthony Cirillo's post last week about how his views of healthcare changed once his mother became a patient--so much so that it inspired me to share my own experience.

Like the people whose sudden illness he describes in his post, I was cruising along in life until my third year of surgical residency, when I noticed a lump in my neck. It was later was diagnosed Stage 1A non-Hodgkin lymphoma. I received eight courses of chemotherapy, complicated by a Vincristine-related seizure that caused three compression fractures of my thoracic spine.

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by John Cunningham

Group purchasing in healthcare continues to be under scrutiny from lawmakers in Washington, but as a senior supply chain officer, I don't understand what the noise is all about.

Lawmakers have become convinced that GPOs restrict the provider's choice and ultimately dictate what providers can select and use. This could not be further from the truth.

Yes, GPO members are encouraged to purchase on the GPOs contracts in order to get the best value. But providers will still make choices outside of the GPO contract portfolio when it is in the provider's best interest to do so.

If anything, the value that GPOs provide to their members has been diluted over the past decade, due to pressures from manufacturers, suppliers, and their related industry associations.

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by Anthony Cirillo

Until you experience the healthcare system as a patient or a caregiver, you will truly never know how to fix it. A few cases in point: A year ago on Christmas Eve my mother took a tumble that fractured her neck. She ended up in the hospital for a week as a result.

Experiencing the hospital up close and personal as a concerned son, I came to realize that I could serve a much bigger role as an outsider talking about healthcare issues than as a chief marketing officer in a hospital--a position I spent many years at and would probably never do again.

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by Jeff Brown, MD

Health care is in great ferment. The organizational side is particularly not much fun right now, but upheaval is too often the only way that we can get to a future of better possibilities. Congress' current meddling is rattling everyone's cage to get used to the idea of change in our business-as-usual thinking, which might in the end be the most lasting benefit of it. Just like the shift to managed care did.

And the key to that change is that we have to rethink how physicians and hospitals work together to manage what we do to help people. To do this, we need to realize that hiding behind the burgeoning problems of spiraling cost and inefficiency and blocking optimum solutions to those problems are the differing basic assumptions from our training that physicians and administrators bring to the table.

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