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Who Should Head the VA?

...last Saturday, Cosgrove suddenly withdrew his name from consideration, stating that he still had work that needed doing at the Cleveland Clinic. What might that work be? Just hours before Cosgrove made his announcement, the intrepid trade magazine Modern Healthcare published a little noticed article that revealed a long pattern of safety problems at the Cleveland Clinic—problems that were so serious that the federal government repeatedly threatened to shut off the $1 billion a year the clinic collects from Medicare.

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The ONC 10 Year Vision

On June 5th 2014, ONC released  “Connecting Health and Care for the Nation: a 10-Year Vision to Achieve an Interoperable Health IT Infrastructure." The plan is divided in 3 year goals, 6 year goals, and 10 year goals. Five specific tactics support the strategies. Below is a summary of the report and a few comments from my Massachusetts experience that support the reasonableness of the ONC goals.

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VistA and Epic: A Tale of Two Systems

Over the last few weeks, access to VA health care for veterans has been all over the news.  At the same time, the DoD is moving to procure a replacement EHR system.  So it seems there is no time like the present to review a recent RAND case studies report entitled “Redirecting Innovation in U.S. Health Care: Options to Decrease Spending and Increase Value.” The case studies include a chapter comparing America’s two most broadly deployed EHRs: The VA’s VistA and Epic.

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How VA Outsourcing Hurts Veterans

On Thursday, Sen. Bernie Sanders, chairman of the Senate Veterans Affairs Committee, announced that he had reached a compromise with John McCain and other Senate Republicans on how to fix whatever it is that needs fixing at the VA...the bill also contains one provision that is a significant concession to Republican enemies of government. If enacted, it would lower the quality of health care received by veterans while setting back the movement for health care delivery system reform generally.

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VA Care: Still The Best Care Anywhere?

...[A]s the author of the title Best Care Anywhere, Why VA Health Care would be Better for Everyone, it’s been dispiriting to have it confirmed by a preliminary inspector general’s report that some frontline VA employees in Phoenix and elsewhere have been gaming a key performance metric regarding wait times. But what’s really has me enervated is how the dominant media narrative of the VA “scandal” has become so essentially misleading and damaging to the cause of health care delivery system reform...

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The ONC Reorganization

Many people have asked me to explain the recent reorganization at ONC, reducing 17 different offices to 10...Simply, the era of stimulus has ended and ONC no longer has the operating budget to do as many projects as fast as during the era of ARRA... Read More »

Why Open Source Is the Future of Clinical Trials

Clinovo is a Clinical Research Organization (CRO) that partners with life science companies to streamline their clinical trials. Their CTO Marc Desgrousilliers is managing the development of ClinCapture, their open source Electronic Data Capture (EDC) system. In this interview, he tells us more about why healthcare needs open source and why it is the future of clinical trials... Read More »

FDA Antimicrobial Resistance Guidelines Fail to Address Root Causes

Last December, the Food and Drug Administration (FDA) published two controversial documents on its website: Guidance 213 and the Veterinary Feed Directive (VFD). The guidelines stirred a firestorm of protests from public health offiicials who argue that the guidelines are too weak to prevent the continuing growth of antibiotic resistant germs...the crisis, as outlined by Dr. Joseph Mercola, is that we are now "facing the perfect storm to take us back to the pre-antibiotic age, when some of the most important advances in modern medicine – intensive care, organ transplants, care for premature babies, surgeries and even treatment for many common bacterial infections – will no longer be possible." Read More »

29th VistA Community Meeting: Details of Upcoming Technical Conference

The upcoming 29th VistA Community Meeting (VCM), to take place June 2-4 at George Mason University in Fairfax, Virginia, is shaping up as a breakthrough gathering of technical experts on VistA and community members. The conference is bringing senior leaders from several US Federal Government agencies, including the US Department of Veterans Affairs (VA) and the Indian Health Service (IHS) together with technical leaders of the VistA community to collaborate on improving the VistA and RPMS EHRs.

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Sequencing, cloud computing, and analytics meet around genetics and pharma Bio-IT World Shows What is Possible and What Is Being Accomplished

Bio-IT World shows what is possible and what is being accomplished...last week I took the subway downtown and crossed the two wind- and rain-whipped bridges that the city of Boston built to connect to the World Trade Center. I mingled for a day with attendees and exhibitors to find what data-related challenges they’re facing and what the latest solutions are. Here are some of the major themes I turned up...

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