Cutting and pasting in electronic health records as evidence of fraud and audits for Meaningful Use are hot topics in medical news these days. That prompted me to think about the move from volume to value in health care payment systems. When I started as a resident, we documented so those who read our notes…
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The Unintended Consequences of Today’s Health Delivery Model
Efforts in the name of efficiency and cost reduction have unintended consequences. When I was in practice, I admitted, or at least followed, all my patients in the hospital. There were no issues of aftercare, because I discharged them with appointments to see me within a day or two (rarely more). I knew what medications…
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Health Information Exchange-a 21st Century Upgrade Opinion
Not long ago, I injured my knee and discovered something else in the process: a severe sprain in the medical information system. Here’s the story: The emergency room took X-rays and an MRI and referred me to an orthopedist. He reviewed the tests and sent me to a specialist. But my specialist—an expert in his field—suddenly…
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Why the fuss over observation status? A typical conundrum
This post was originally published on 8/14/2013 This is an example of why observation status has caused such headaches for physicians and patients. You’re a hospitalist at Joe Smith County Health System. At 5 p.m. Monday, you hear this from an ER doc: “Hi, this is Gus in the ER. I’ve got a patient for…
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