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by Lynn McVey
Mother Jones magazine recently published a critical piece about EHR vendor Epic. It reported: 1) "There is no interoperability." What does this mean? It means the information remains in silos. 2) "Epic focuses on Epic-to-Epic data exchanges." What does this mean? No interoperability and more silos. 3) "Is the government fed up with Epic?" What does this mean? I'll bet they wish they would have selected only one EHR vendor for all 5,000 hospitals. Sure, I understand free market and capitalism, but healthcare doesn't have the time it takes for mergers and acquisitions to end up with only a few solutions. It's ironic that we currently have hundreds of technology solutions in an industry that doesn't have technology skills.
My email's auto-signature is a quote from my healthcare hero, Dr. Atul Gawande. Dr. Gawande says "We have one opportunity to leverage technology to improve care. That opportunity is data." Fortunately, the hundreds of technology solutions that foster non-productive "silos" are not our savior. So now what?
by Lynn McVey
"This data isn't accurate!" If I had a nickel for every time a manager, physician or employee told me that, I’d have a dime. It didn’t take me long to not only deliver the data source, but also the details behind the data in preparation for this cry-baby retort.
"This data isn't accurate!" is the monster we created ourselves by refusing to learn how to perform data analytics. This was created when we added a layer of “decision-support IT staffers” to do our work. Data analytics, predictive analytics or business intelligence are big, scary words that most times mean simple sorting of spreadsheet columns. I’m not a very trusting person, so I have issues with relying on data manipulated by someone else. Plus, every intervention by someone else reduces the integrity of the data one level.
I insist on using the database myself, selecting the criteria I need and creating my own reports. Unfortunately, I seem to be in the minority. Most of the C-level executives in my space do not know how to use Excel, even some CFOs I’ve met. I wish I had that level of trust, but alas, if I had a nickel for every translation error I’ve found in an IT-generated report, I could retire.
by Lynn McVey
When it comes to patient safety, we are still practicing “disease”-care instead of “health”-care. One of my favorite times of year is when new annual healthcare data is released. If you’re a data junkie like me, you’ve probably already read Measuring the Quality of Healthcare in the U.S., which the Kaiser Family Foundation produces each year. This year, Kaiser celebrates that the quality of the U.S. health system is improving in many areas. However, when data junkies like me review data, my spider senses start tingling and my skepticism forces me to drill deeper.
At the top of the data pile is overall mortality rate. In 1990, 1,075 patients died per 100,000. In 2013, only 835 patients died per 100,000, which appears to be an improvement. Unfortunately, if we drill deeper, we see self-reported health status data. In 1996, 15 percent of patients report fair/poor health status, whereas in 2013, that increased to 18 percent. Before we celebrate that we keep patients alive longer, we need to ask if a longer life with poor health should be a celebration.
by Lynn McVey
It was 2:38 a.m.; the phone call I was waiting for. My Dad was 92 and lived a full life of family, fun, faith, purpose and service. He was healthy up until the day he went into heart failure. With his 30-page, attorney-prepared, Advance Directive in hand, he announced to his family and cardiologist that he planned to follow his instructions under the sub-chapter "heart failure." My 92-year-old Dad refused to have a pacemaker inserted.
For four days, we gathered family and friends to say goodbye to the man who had no enemies. Many times, there were 10 or more in his room, listening to him tell stories about each of us, as he held our hands and hugged us. It was obvious he was prepared for this moment. It was actually very beautiful to watch him acknowledge everyone individually, say an emotional goodbye, and leave each of us with some gift of advice for our future happiness.
On the fifth day, his heart rate was dipping into the 30s, which would have been his final day with us. In a surprise last-minute call, he agreed to have a pacemaker. He lived another six months at my home. I was fortunate enough to live the last chapter with my Dad. We shared meals, American Idol ("That Jennifer is one pretty girl," he'd say both Mondays and Tuesdays), my porch swing, his granddaughter, root beer floats, tennis matches, career talk and stories I had never heard before. For me, that was a priceless six months.
by Lynn McVey
While having a casual conversation with my buddy who is a salesperson, she told me she "doesn't believe there is such a thing as a selfless act." I disagreed, although I didn't argue. It's my personal opinion that my opinion isn't powerful enough to change anyone's thinking.
Unfortunately, my salesperson buddy was scheduled for major surgery thousands of miles away from me and my hospital. Since I couldn't convince her to travel cross country to my facility, I reached out to connect to folks in the facility she was using. I've helped navigate healthcare events for many non-healthcare folks in my career. As an insider, I know how frightening hospitals are. We know the system is too complex and complicated and in dire need of a major repair, so I'm always happy to do my part as an insider.
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