As the year winds down, I like to look back through the news stories and blog items I’ve written over the past year and pull out a few favorite quotes that seemed provocative or thought-provoking. For me, this process serves as a reminder of how quickly the health IT landscape is changing. I hope that reading through them does the same for you. Without further ado, then, and in no particular order, here are my favorite quotes from the stories I wrote in 2013:
“The biggest waste in the healthcare system is not unnecessary treatment or duplicated test results; it is that we collect data and never use it again.” -- Chris Lehmann, M.D., Vanderbilt University professor of pediatrics and biomedical informatics
“It’s a travesty. It is time to open the kimono. It may require some extra security work, but it is time for them to get it going for patients.”— Judy Murphy, R.N., deputy national coordinator for programs and policy at the Office of the National Coordinator for Health IT, in noting that there are now online immunization registries in 48 states, and only three allow access by patients.
“It’s becoming clear that done right, big data can support meaningful observational analyses about patient safety, and done right, that will be true of comparative effectiveness research, but it will be harder.” -- Richard Platt, M.D., M.S., professor and chair of the Harvard Medical School Department of Population Medicine at the Harvard Pilgrim Health Care Institute in Boston
“We are investing money we don't have to implement this in areas where it doesn’t make sense. The conversations we are having are just bizarre. Do you know whether, in the trenches, we are creating unanticipated problems? Do you have a way of systematically tracking where those are and can we mitigate them in Stage 3?” -- Question for ONC executives from anonymous audience member at AMIA conference in Washington, D.C., in November
“Any hospital that buys health IT has a dickens of a time with decision support to transform healthcare because the tools are so difficult to use, and informatics expertise is in short supply. It’s like buying Excel with no macros or function keys.” -- Blackford Middleton, M.D., Assistant Vice Chancellor for Health Affairs and Chief Informatics Officer at Vanderbilt University
“Unfortunately, just as in Stage 1, we will see some people focusing on checking the box, rather than what will actually improve healthcare.” -- Brian Dixon, a research scientist at the Regenstrief Institute in Indiana, talking about the challenges of meeting clinical decision support requirements of Stage 2.
“People say that releasing the data may make us look bad. But that is the point. We have to be willing to fix things where the data shows deficiencies. That is a conscious choice you have to make.”— Nirav Shah, M.D., M.P.H., New York State Commissioner of Health.
“OpenNotes isn’t a project anymore; it has grown into a movement.” --Tom Delbanco, M.D., founding chief of the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center in Boston
“Our longer term vision is that every healthcare interaction benefits from all the world’s knowledge. Every encounter that generates knowledge should add to the world’s knowledge. If we aren’t accomplishing that in the next seven years, we won’t have met the challenges in time.” -- Farzad Mostashari, M.D., National Coordinator for Health IT
“We knew this was a big risk. One board member said it could be a career-ender. But we had developed good rapport with them and had delivered on promises so far. Because we had developed that degree of respect, they trusted us on this decision.”-- Rob Hack, executive director of the HealtheConnections regional health information organization in central New York State, speaking about swapping the health information exchange platform from Axolotl it had been using for three years for a new one provided by Mirth Corp.
“The reality is that most independent physicians have traditionally operated in a data-poor environment. They couldn’t tell you how many of their hypertensive patients have their blood pressure under control. They would have no easy way of finding that out if you asked them.” --Carl Couch, M.D., president of the Baylor Quality Alliance in Texas
Stage 2 of meaningful use “is going to take the same amount of education that we did in stage 1, using specialist societies to show people how it can be done in a smooth way without taking them out of their work flow. Fear of the unknown rather than not wanting to do it is the roadblock.”— Cathy Costello, regional extension center project manager for Ohio Health Information Partnership
“We are not the quality police. We are trying to improve the functionality of systems by driving new requirements and capabilities of systems. I don’t see us as the quality police. I don’t think that is the right objective for us.” -- Neil Calman, M.D., president and CEO of the Institute for Family Health, during a Health IT Policy Committee meeting on whether ONC should be in the job of measuring quality at all.
“As I think of what we have put in place, it is absolutely going in the right direction. We still have a long way to go. It is still too hard to use the certified EHR in the way providers want to. It is still too hard to get information out of the system into third-party applications should they chose to use them. So we have to keep pushing, and dig deeper to get to a common floor of capabilities across the country. We need to have common assumptions about what systems can do. We are on the right track.” -- Farzad Mostashari, M.D., at his last Health IT Policy Committee meeting as ONC’s leader