RHetoric

An NPR photographer snapped some photos of the attendees at a Senate hearing on health reform, then posted them online with an invitation to viewers to identify the lobbyists in the audience.  The result is here.  Brilliant!

As one who suffered through many a Senate hearing in DC (without a Blackberry), I can attest that the audience is mostly made up of congressional interns (in the summer) and junior lobbyists who have not quite made a name for themselves.  That's evident on the faces in this set of photos. Nonetheless, readers have identified a couple of whales.

My favorite though, is the ID of "Tom Gilligan, Self Employed Consultant" - his mug is completely blocked by people sitting in front of him, which means only he knows that's him sitting there.  So he ID'd himself on the NPR site.  And why not?  When you're a self employed consultant you need all the free PR you can get.

The message is simple: you would ask your waiter a few questions about the menu; so why wouldn’t you ask your doctor a few questions about your care?

I was talking health reform with my primary care physician last week, and she made an interesting comment:  “One of my biggest frustrations with healthcare is that most of my patients just expect me to tell them what to do.”

Whoa - this was not a criticism of Medicare, or Obama, or insurers, or anyone else in the supply chain - it was directed at the patients themselves!

As patients, we tend to think of our primary care physicians as the managers of our care.  But in truth, they are simply contributors.  Our insurance companies, specialists, and even friends and family are all contributors.  This can be frustrating and even vexing, but it is a golden opportunity for health reformers, and for IT.

If IT can make medical information more accessible, portable, and personalized, perhaps we patients can be empowered to ask informed questions and contribute to decision-making about our care.  We have a long way to go.  But some of the emerging tools within Google Health and HealthVault are encouraging.

Even if a patient never maintains a personal health record, asking a few questions at the doctor’s office could vastly improve the quality of one’s care.

With all the stimulus money lining up to flow into healthcare to spur the adoption of electronic health records, people are starting to ask exactly what the Obama Administration means by “meaningful use” of EHR’s.

It’s an excellent question, because it gets to the heart of the real public policy challenge.  What is the point of spending all this money if it doesn’t improve quality?  We cannot measure success by counting the number of PC’s in a hospital; we have to measure it by the number of errors eliminated; the improvements in care, and the elmination of inefficiencies.

Dr. David Blumenthal, a health advisor to the Obama team and now the president’s lead on health IT, does an excellent job of setting this stage in the New England Journal of Medicine.  One item he vaguely touches on but is sure to be the next wave of health IT advocacy and lobbying in DC is the pressure to change the law.  I don’t think that’s such a bad idea - there is far too much focus on EHR technology and not enough on all the other IT innovations that are already radically improving healthcare.  With or without changes, it is good to know that people have their eye on the real prize:  improving the quality of care.