Scot Silverstein's Good Health IT and Bad Health IT

If healthcare IT has a canary in the coal mine, it is Scot Silverstein, MD. But he characterizes himself as a pragmatist rather than anti-technology, saying, "The hospital or clinic is not a software beta-testing shop."

6 comments on "Scot Silverstein's Good Health IT and Bad Health IT"
Tim Cook (1/10/2013 at 5:34 AM)

You can find my comments in the Healthcare IT community on Google Plus at
Bob Coli, MD (1/9/2013 at 3:04 PM)

Dr. Donald Berwick's famous observation that in healthcare, "The excellence of the status quo is a sentimental illusion", accurately describes the chronic, dangerous and costly problem of poorly designed and implemented health IT systems. One of the most glaring examples of defective health IT design is the antiquated formats still being used to report the results of patients' diagnostic tests to physicians and patients. This is a user interface problem which has been overlooked or ignored since medical computing began in the 1960s with Homer Warner (1) and Octo Barnett. (2) The tsunami of test results data is important because it constitutes more than 80 percent of the objective data in an individual's medical record and it directly impacts at least 65 percent of all critical patient care decisions. (3) The basic "job" that American physicians and patients need to get done is efficiently viewing and sharing the billions of annual diagnostic test results. The basic problem confronting them is the user interfaces of EHR, PHR and HIE platforms are still using variable reporting formats to display results as incomplete and fragmented data. The adverse patient safety, workflow and redundant testing effects produced by this poor user interface design and unclear data display are very familiar to clinicians and nurses, but until recently, they have not yet been recognized by researchers, journalists, policy makers or the vendors of bad health IT systems. Fortunately, there is a relatively simple solution, which will require the development and adoption of an intuitive, easy-to-use, standard reporting format that can display the results of all 7,500 available tests as clinically integrated, actionable information. Accomplishing this may be finally becoming feasible because of unsustainable healthcare costs, disruption of "HIE 1.0" by ONC's emerging portfolio of open source interoperability standards, national expansion of consumer-centered, value-driven financing and delivery reforms and a recently more crowded and more competitive health IT system vendor marketplace. In addition to improving patient safety, by collaborating to overcome this major barrier to information visualization and full interoperability, government and the private sector can also support MU Stages 2 and 3 by helping physicians engage patients and their families, minimize unnecessary testing and improve physician workflow, practice efficiency and care coordination. (4) (1) (2) (3) (4)
canary keeper (1/8/2013 at 8:42 PM)

This comment system here is worse than the HIT computers managing the patients. Kudos to Dr. Silverstein for expposing the sham of HIT.
Canary Keeper (1/8/2013 at 8:36 PM)

Kudos to Dr. Silverstein and to you for featuring him. Finally, someone has the courage to stand up to the runaway steamroller aka health IT. The rush to digitize medical care has made a farce of medical care. This is such a sham.
Noah Zark (1/8/2013 at 7:13 PM)

There is little to zero GHIT out there. BHIT has toxic effects on the doctors and nurses forced to use it with resultant adversity to patients under their care. It is despicable that such a radical alteration in the administration of medical care has had little scrutiny but vast cheerleading. The fraud on the patients and taxpayers has got to stop.
Keith McITkin, PhD (1/8/2013 at 4:51 PM)

There is little HIT that I have seen that is not an impediment to safe and effective care. These systems of medical devices that control all care are inferior and insufficient for safety having never been evaluated by the FDA as would any medical other medical device. The Congress has been deceived by the vendors and their trade groups to waste $ billions as was done in the UK.


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