healthy4u

Rerun: Health Information Technology Basics From Calif. Nurses Association and National Nurses Organizing Committee

I think this post <a href="http://hcrenewal.blogspot.com/2010/04/health-information-technology-basics.html">from two years ago</a> on IT realities in healthcare merits a repeat appearance. --------------------------- I have never before seen a document like the one entitled "Health Information Technology Basics", by the Institute for Health & Socio-Economic Policy, California Nurses Association and the National Nurses Organizing Committee. It is available <a href="http://www.calnurses.org/research/pdfs/ihsp_tech_basics_sept_2009.pdf">at this link</a> (PDF). [Note- now at archive.org <a href="http://web.archive.org/web/20100202074048/http://www.calnurses.org/research/pdfs/ihsp_tech_basics_sept_2009.pdf">here</a> - ed.] It is long but contains rather interesting views on the issue of health IT, management and clinicians (nurses). <div style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj2kPMNq2zuprs2la92q9jJFG3VU5EB9TYmXG1TJUCE-fc6BX0hfDmvzTnZayFxED27w7lFQkE3rmvehts9-hBnHn3bOjPJoYZMF219p7p1rvHUXdvEiAsYfy9u7pgPuYWp6sSY0MH5dgrE/s1600/whereispatient.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5715319571018970930" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj2kPMNq2zuprs2la92q9jJFG3VU5EB9TYmXG1TJUCE-fc6BX0hfDmvzTnZayFxED27w7lFQkE3rmvehts9-hBnHn3bOjPJoYZMF219p7p1rvHUXdvEiAsYfy9u7pgPuYWp6sSY0MH5dgrE/s320/whereispatient.jpg" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 233px;" /></a>From the PDF, this cartoon is satirical but touches on a most serious issue - distraction due to technology. Click to enlarge. </div> I find the following passages of particular interest as they reflect views we express on this blog, and attack the notion of cybernetic miracles being wrought: <blockquote>Skill is the ability, drawn from education and experience, to do something expertly. It can also be defined as the effective exercise of professional judgment in non-routine situations. Following prescribed rules, as a machine would, makes an employee competent to perform tasks, but it doesn’t make the employee skilled. They can do their job as long as there are no surprises. But when something unexpected happens, the rules break down, and caring for patients means facing the unexpected every day. Only skilled health professionals can cope with the unexpected. To know what to do, they have to rely on their own judgment. The exercise of judgment is the essence of skill. ... Much health information technology is skill-degrading. As the work of health professionals becomes increasingly automated, they lose the ability to do their jobs without HIT. To make matters worse, they’re expected to keep pace with machines. They serve the machines rather than doing the more gratifying work of patient care, and ultimately they’re compensated less well. </blockquote> And this: <blockquote>Displacement [of people by machines] is hard to spot because it’s unlikely to appear as a one-to one correspondence; that is, you probably won’t find a robot sitting in your colleague’s chair tomorrow. It’s more likely to happen piecemeal, over an extended period, and through attrition. <ul><li>The job of patient care will be redefined, privileging technical over clinical skills.</li><li>The hospital will begin to hire more HIT specialists and fewer RNs.</li><li>Functions performed in the past by health professionals will be fragmented and reallocated between machines and less-skilled employees.</li><li>Increased technical efficiency will enable the hospital or HMO to expand without expanding its workforce.</li></ul></blockquote> And this: <blockquote>Use of any hospital technology must be consistent with safe, therapeutic, and effective patient care. Health information technology is a complete unknown in this regard. It’s an enormous social experiment designed by computer scientists and implemented by hospital administrators. HIT hasn’t grown organically from the needs of patients but has been imported from other industries. Known as enterprise resource planning, it’s adapted from similar technology designed to manage business operations on a massive scale and already being used to run the world’s largest corporations. Caring for patients isn’t business. It requires compassion, judgment, and advocacy. Because RNs have the moral right and legal duty to advocate for patients, they have to be able to override the automated decision-making of HIT designed to serve business interests. RNs have to work collectively to control health information technology rather than trying to fix it. It’s important to recognize that tinkering can’t fix HIT because its primary purpose is to mechanize, or routinize, patient care. It’s designed to quantify the unquantifiable, to replace the patient with an imaginary statistical norm. High-quality healthcare can’t be mechanized because it depends on people—on patients and caregivers—and people are infinitely more complex and capable than computers can ever be.</blockquote> Amen to that. Read the entire document for a union-oriented view of health IT. It contains many truisms regarding HIT irrational exuberance and the control issues of the healthcare management class. -- SS

Rerun: Health Information Technology Basics From Calif. Nurses Association and National Nurses Organizing Committee

I think this post from two years ago on IT realities in healthcare merits a repeat appearance. --------------------------- I have never bef...

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The Golden Calf Explains How Economism Lead to the Divine Right of CEOs

Our fellow blogger (on <a href="http://brodyhooked.blogspot.com/">Hooked: Ethics, Medicine and Pharma</a>), family physician and bioethicist Dr Howard Brody, has written a book on economic ideology that helps explain some of the issues we frequently discuss. Dr Brody's book, <a href="http://www.amazon.com/Golden-Calf-Economism-American-Policy/dp/1463762755">The Golden Calf</a>, is about how the social science of economics has been taken over by an ideology he and others call "economism."  Economism Economism consists of these major ideas: <ul><li>"'The economy' is a separate and distinct sphere of society."  This means that economic planning can be independent of consideration of the rest of society.</li><li>"Even if only a part of society, the economy is the primary part."  Thus economic planning, thinking, policies etc take precedence over other planning, thinking, policies, etc.</li><li>"People are, at core, economic beings.  The laws of the marketplace describe virtually asll of their behavior and the reasons for it.  People are beings of economic exchange, driven first to make money and then to spend on the goods obtainable in the marketplace."  So all other human thought, values, emotions, etc are less important.  The answer to the question, "what does love have to do with it?" is nothing.  Neither does honesty, morality, or ethics have to do with it.</li><li>"Economic calculation is the best way to understand, value, and manage human life.  It is appropriate that every aspect of our lives be thought of and analyzed in terms of economic calculations."  This essentially asserts that economists, economic thinking, and the marketplace should rule the world.  </li><li>"The economy, above all else, must be managed solely with an eye towards its own technical requirements - that is, what economists study.  There ought to be no interference from politicians, or policymakers, or moralists, or anyone else."  Thus, not only should greed be considered good, but greed ought to be enacted into law.  </li></ul>Economism's Prescription for Health Care Stated so baldly, economism may seem absurd.  However, it is easy to see its influence.  For example, Dr Brody explained how economism would state: <blockquote>what sort of health system the U.S. ought to have. It would be one that is governed by the laws of the market, and that treats all aspects of health care as consumer goods. How much any person 'needs' health care would be determined by one thing only - what that person is willing to pay on the open market. Anything else would be denounced as illegitimate interference with the market by politicians, policymakers, and other do-gooders.</blockquote> This, of course, corresponds very well with a lot that is said about health care by its current leaders. How often have we heard about the health care market, and how the only way to improve health care is market-based reforms? (Look <a href="http://hcrenewal.blogspot.com/2010/08/how-fallacy-of-perfect-health-care.html">here</a>).  How often have we heard leaders of hospitals refer to their "industry?" How often have we heard of patients as consumers, and doctors as providers? The list can go on. The problems are that economism does not provide good tools for prediction or management of the economy. Worse, <blockquote>If we want to live in a society that reflects basic human values, including acceptable moral rules, economism is a very poor guide. Yet economism is blind to its own deficiencies. it claims to be able to tell us the definitive answer to any problem in any aspect of human life, and accuse us of being irrational if we disagree with its proposals. If a powerful elite takes over control of a society, wedded to economism as their belief system, then the results for that society could be disastrous.</blockquote>The origins of economism provide an explanation for a phenomenon we have often seen in health care, the lack of <a href="http://hcrenewal.blogspot.com/search/label/accountability">accountability</a> of health care leaders, which we sometimes have described as CEO exceptionalism. We have noted how health care leaders almost never seem to need to take responsibility for their organizations' misbehavior and its outcomes, (look <a href="http://hcrenewal.blogspot.com/search/label/legal%20settlements">here</a>) and in fact can command ever increasing <a href="http://hcrenewal.blogspot.com/search/label/executive%20compensation">compensation</a>, no matter how badly they or their organizations do. The Religious Origins of Economism To understand this explanation, first note that Dr Brody suggested that economism is not a science. It did not arise out of an effort to use logic and reason to explain evidence. Instead, it seems to have come from two strains of religious thought that got translated into economic terms.  Dr Brody suggest that while it may make sense to think of economism as an ideology, it functions more like a religion, so that viewing economics ruled by economism as a social science would be a very big mistake. The first strain was the Protestant evangelism found in England in the 18th century. Evangelicals of that time <blockquote>regarded poverty as part of a divine program. Evangelicals interpreted the mental anguish of poverty and debt, and the physical agony of hunger or cold, as natural spurs to prick the conscience of sinners. They believed that the suffering of the poor would provoke remorse, reflection, and ultimately the conversion that would change their fate [in the afterlife]. In other words, poor people were poor for a reason, and helping them out of poverty would endanger their mortal souls.</blockquote>Thus, people who fail in the marketplace of life are sinners. Markets should not be regulated to prevent such failure, because doing so would prevent their still possible salvation. On the other hand, the Puritanism of the 17th and 18th centuries, and its 19th century evolution in the US <blockquote>was creeping up on the idea, not only that material wealth and worldly success was a good thing in the eyes of God, but that seeing oneself become successful and wealthy was the strongest possible sign of God's grace and one's status among the Elect.</blockquote> Things then got more extreme. <blockquote>The moderate idea that those who enjoy material wealth in the earthly life may have been especially favored by God seems gradually to have morphed into the extreme idea that God wishes us to bestow on the super-rich our adulation and unquestioning allegiance.</blockquote> So, <blockquote>For example, Reverend Russell Cornwell's lecture called 'Acres of Diamonds' proved so popular after he first wrote it in 1870 that he was called upon to give it six thousand times over the next quarter century. He preached: 'I say you ought to get rich, and it is your duty to get rich.'</blockquote> Thus, <blockquote>We have been conditioned to believe that wealth is an infallible sign of God's favor.</blockquote> Here is the religion behind CEO exceptionalism, lack of CEO accountability, outrageous CEO compensation, the imperial CEO. CEOs can become extremely wealthy, and "wealth is an infallible sign of God's favor," generating the notion of the divine right of CEOs. Summary No wonder that we have yet to see any logic or evidence to support CEO exceptionalism. Instead, we have seen logical fallacies used to support <a href="http://hcrenewal.blogspot.com/2011/05/logical-fallacies-to-defend-ceos-from.html">lack of CEO accountability</a> and <a href="http://hcrenewal.blogspot.com/2010/09/logical-fallacies-in-defense-of-million.html">immense CEO compensation</a>. The wealth of our leaders cannot be addressed with logic and evidence if it is a sign of God's favor. Thus, anyone whose religious beliefs are perfectly compatible with 18th century English evangelism and 17th through 19th century British and American Puritanism and its aftermath might be happy with the divine right of CEOs, and with economism in general. However, Dr Brody makes the powerful point that economism functions like a religion, and at best is an ideology, not scientific paradigm. Anyone who is uncomfortable with the religious beliefs that underlie it ought to be very uncomfortable with its precepts, as should anyone who believes that economics or health care should be based on evidence and logic. Specifically, in health care and in the larger economy, anyone who does not believe that rich CEOs are especially favored by God should question why they should be so rich, and why they should be so unaccountable. Dr Brody has written a powerful and important book which goes a long way to explain the irrationality that has infected health care. People of all, or of no religious beliefs should pay attention.

The Golden Calf Explains How Economism Lead to the Divine Right of CEOs

Our fellow blogger (on Hooked: Ethics, Medicine and Pharma ), family physician and bioethicist Dr Howard Brody, has written a book on econom...

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A distasteful result of data mining, "artifical intelligence" and hospital advertising

A distasteful result of data mining, "artificial intelligence" and hospital advertising: Last night in some ad-hoc Internet wanderings I ended up at a YouTube video of the touching ending of the movie "<a href="http://en.wikipedia.org/wiki/Ghost_%281990_film%29">Ghost</a>" with Demi Moore and the late <a href="http://en.wikipedia.org/wiki/Patrick_Swayze">Patrick Swayze</a>. A computer-generated ad popped up, advertising the prowess of a local big-name hospital in treating pancreatic cancer. <div style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZXcRX3YyW0N5JhN_O5LPliIqy9XI5yrZSDvJ14-5OrAhp_scfPbeaDb7Gv_zjZIE8sa1x0AeHJodHpXUQron-KKqeUTcylzKOYVJJLQMJZlKh9ypoWydAxYNSK06FLAaWxD7sDZbb7EEg/s1600/ghost.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5714943348416696978" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZXcRX3YyW0N5JhN_O5LPliIqy9XI5yrZSDvJ14-5OrAhp_scfPbeaDb7Gv_zjZIE8sa1x0AeHJodHpXUQron-KKqeUTcylzKOYVJJLQMJZlKh9ypoWydAxYNSK06FLAaWxD7sDZbb7EEg/s320/ghost.jpg" style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 276px; height: 194px;" /></a>I really don't want to see medical ads about cancer when watching this... </div> Considering the context: how gross. So much for cybernetic "artificial intelligence" <a href="http://hcrenewal.blogspot.com/2011/01/ibms-watson-jeopardy-and-revolutioning.html">replacing the human mind</a>. -- SS

A distasteful result of data mining, "artifical intelligence" and hospital advertising

A distasteful result of data mining, "artificial intelligence" and hospital advertising: Last night in some ad-hoc Internet wander...

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Infanticide As A Right: Killing Babies No Different From Abortion, "Experts" Say?

Holy Hippocrates... This is nihilism at its finest. This is what happens when "education" turns into madness. Infanticide of newborns becomes a right: <blockquote>The Telegraph Feb. 29, 2012 <a href="http://www.telegraph.co.uk/health/healthnews/9113394/Killing-babies-no-different-from-abortion-experts-say.html">http://www.telegraph.co.uk/health/healthnews/9113394/Killing-babies-no-different-from-abortion-experts-say.html</a> Parents should be allowed to have their newborn babies killed because they are “morally irrelevant” and ending their lives is no different to abortion, a group of medical ethicists linked to Oxford University has argued. The article, published in the Journal of Medical Ethics, says newborn babies are not “actual persons” and do not have a “moral right to life”. The academics also argue that parents should be able to have their baby killed if it turns out to be disabled when it is born. The journal’s editor, Prof Julian Savulescu, director of the Oxford Uehiro Centre for Practical Ethics, said the article's authors had received death threats since publishing the article. He said those who made abusive and threatening posts about the study were “fanatics opposed to the very values of a liberal society”. The article, entitled “After-birth abortion: Why should the baby live?”, was written by two of Prof Savulescu’s former associates, Alberto Giubilini and Francesca Minerva. They argued: “The moral status of an infant is equivalent to that of a fetus in the sense that both lack those properties that justify the attribution of a right to life to an individual.” Rather than being “actual persons”, newborns were “potential persons”. They explained: “Both a fetus and a newborn certainly are human beings and potential persons, but neither is a ‘person’ in the sense of ‘subject of a moral right to life’. </blockquote><div class="fifthPar"></div> My observations: 1. These medical ethicists should keep their "ethics" within their own families. 2. One wonders if the current non-consensual human subjects experimentation known as "health IT" is justified by the same "ethicists." -- SS Addendum March 1, 2012: We've been here before. From another blog: Tacitus, a.k.a Publius (or Gaius) Cornelius Tacitus (AD 56 – AD 117) was a senator and a historian of the Roman Empire. Tacitus criticized the "rebels" of the time for, among other things, their refusal to kill newly born babies: <a href="http://en.wikisource.org/wiki/The_Histories_%28Tacitus%29/Book_5" rel="nofollow nofollow" target="_blank">http://en.wikisource.org/wiki/The_Histories_%28Tacitus%29/Book_5</a> . See section 5. Such a practice was apparently <a href="http://en.wikipedia.org/wiki/Infanticide#Pagan_European_tribes">no big deal</a> then. This "ethics" proposed at Oxford represents a return to uncivilizedness. -- SS

Infanticide As A Right: Killing Babies No Different From Abortion, "Experts" Say?

Holy Hippocrates... This is nihilism at its finest. This is what happens when "education" turns into madness. Infanticide of new...

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Semi-Retirement of a Salesman - Weldon to Retire as Johnson and Johnson CEO

The extremely well compensated CEO and Chairman of Johnson and Johnson, the huge and recently hugely troubled US based pharmaceutical and device company, is going to retire, at least as CEO.  Reporting on this event may shed a little more light on the sorts of leadership problems that now commonly afflict health care organizations. The Credo Johnson and Johnson was once one of the US' most respected companies.  Its <a href="http://www.jnj.com/wps/wcm/connect/c7933f004f5563df9e22be1bb31559c7/jnj_ourcredo_english_us_8.5x11_cmyk.pdf?MOD=AJPERES">credo</a>, written in 1943 by Robert Wood Johnson, bravely begins: <blockquote>We believe our first responsibility is to doctors, nurses and patients, to mothers and fathers, and all others who use our products and services. In meeting their needs, everything we do must be of high quality. </blockquote>Dishonoring the Credo Yet in the last few years the company has not honored this credo. It seems to have lost the ability to manufacture high quality products. It has had to make 30 separate product recalls since 2009. The latest was Liquid Infant Tylenol. (The current WSJ Health Blog list of recalls can be found <a href="http://blogs.wsj.com/health/2012/02/17/jj-recall-watch-mcneil-pulls-liquid-infant-tylenol-on-dosing-system-concerns">here</a>.) Johnson and Johnson also has an amazing recent record of ethical lapses and guilty pleas, including: - Convictions in two different states in 2010 for misleading marketing of Risperdal - A guilty plea for misbranding Topamax in 2010 - Guilty pleas to bribery in Europe in 2011 by J+J's DePuy subsidiary - A guilty plea for marketing Risperdal for unapproved uses in 2011 (see <a href="http://hcrenewal.blogspot.com/2011/08/why-cultivate-weldons-confidence-ceo.html">this link</a> for all of the above) - Accusations that the company, which makes smoking cessation products, participated along with tobacco companies in efforts to lobby state legislators (see post <a href="http://hcrenewal.blogspot.com/2011/09/smart-alecs-strange-bedfellows.html">here</a>) - A guilty plea to misbranding Natrecor by J+J subsidiary Scios (see post <a href="http://hcrenewal.blogspot.com/2011/09/johnson-and-johnson-pleads-guilty.html">here</a>) -  Most recently, in 2012, testimony in a trial of allegations of unethical marketing of the drug Respirdal (risperidone) by the Janssen subsidiary revealed a systemic, deceptive stealth marketing campaign that fostered suppression of research whose results were unfavorable to the company, ghostwriting, the use of key opinion leaders as marketers in the guise of academics and professionals, and intimidation of whistleblowers.  After these revelations, the company abruptly settled the case (see post <a href="http://hcrenewal.blogspot.com/2012/02/texas-tmap-trials-as-illustration-of.html">here</a>). Disconnect Between Leadership Performance and Rewards Nonetheless, until very recently, the top leadership of the company continued to collect outrageous compensation, and to be regarded as a font of health care wisdom, even by the current US administration. In 2010, the company gave CEO and Chairman William Weldon over $29 million in compensation, saying he "met expectations," (see <a href="http://hcrenewal.blogspot.com/2011/03/despite-recalls-legal-settlements.html">this post</a>). In 2011, just days after the company pleaded guilty in the Risperdal marketing case (above), CEO and Chairman Weldon was invited to the White House to discuss health care (see <a href="http://hcrenewal.blogspot.com/2011/08/why-cultivate-weldons-confidence-ceo.html">this post</a>.) Just after his resignation was announced a few days ago, the Wall Street Journal <a href="http://online.wsj.com/article/SB10001424052970203918304577243542528572590.html">reported</a> that Weldon would get an increased bonus for 2011 ($3.1 million, up from $1.98 million in 2010), and an increased base salary ($1.97 million up from $1.92 million.)  His total compensation for 2011 was not yet revealed.  Swapping One Salesman for Another A single New York Times <a href="http://www.nytimes.com/2012/02/24/business/alex-gorsky-of-jj-emerged-from-its-sales-culture.html">article</a> suggested one reason why Weldon's reign was ultimately so unsuccessful, and perhaps why his successor may not do better. <blockquote>Alex Gorsky, the newly named chief executive of Johnson & Johnson, shares a crucial biographical detail with William C. Weldon, the man he is succeeding. Both got their starts as pharmaceutical sales representatives, a notoriously grueling job that — because it demands stamina, charisma and a near devotion to making the sale — has become a crucible for future drug company executives in recent years.</blockquote> Indeed, Mr Weldon's <a href="http://www.investor.jnj.com/governance/biodetail.cfm?bioid=3197">official biography </a>indicates he "served in several sales, marketing and international management positions." The <a href="http://www.investor.jnj.com/governance/managementdetail.cfm?bioid=23627">official biography </a>of CEO-to-be, Alex Gorsky, stated he "began his Johnson & Johnson career as a sales representative with Janssen Pharmaceutica in 1988. Over the next 15 years, he advanced through positions of increasing responsibility in sales, marketing, and management." Previously, he earned "a Bachelor of Science degree from the U.S. Military Academy at West Point, N.Y., and spent six years in the U.S. Army, finishing his military career with the rank of Captain. Alex earned a Master of Business Administration degree from The Wharton School of the University of Pennsylvania in 1996." Apparently neither current nor nominated CEO had any direct experience in patient care, nor in biomedical or clinical science, nor in chemistry, engineering or manufacturing. So both are generic managers, that is, health care leaders without any direct experience in health care, or in the science and technology underlying it. "Making the Numbers" Versus the Credo Moreover, they are both a particular type of generic manager, salespeople. As the Times reported: <blockquote>Mr. Gorsky, who is 51, fits the mold of someone who once 'carried the bag' — industry slang for working as a sales representative. He is known as a polished speaker and an intense yet likable manager who is a quick study when it comes to learning new topics.</blockquote> However, while sales people may be personable, they often have goals that have nothing to do with responsibilities "to doctors, nurses and patients, to mothers and fathers,...." As the Times article also noted, <blockquote>But the ethos of the sales representative may not be what Johnson & Johnson needs right now, said Erik Gordon, who teaches business at the University of Michigan. 'That culture was very much the Weldon culture writ large — we will make our numbers for the analysts, period,' he said. 'And if that means we have to cut costs on things that affect quality, then by God, we’re going to make those numbers.'</blockquote> So while Johnson and Johnson for years prided itself as a company that put the needs of patients and health professionals first, it hired leaders from the culture of sales where the impetus is to "make the numbers," to fulfill short term revenue goals, no matter what. This illustrates how generic management given perverse incentives in an era that honors greed and puts short-term economic goals ahead of all others had hollowed out health care. We wish Mr Gorsky well, but worry that if he too focuses just on making the numbers, the result will be only mischief. The Moral of the Story Health care organizations need leaders that uphold the core values of health care, and focus on and are accountable for the mission, not on secondary responsibilities that conflict with these values and their mission, and not on self-enrichment. Leaders ought to be rewarded reasonably, but not lavishly, for doing what ultimately improves patient care, or when applicable, good education and good research. On the other hand, those who authorize, direct and implement bad behavior ought to suffer negative consequences sufficient to deter future bad behavior. If we do not fix the severe problems affecting the leadership and governance of health care, and do not increase accountability, integrity and transparency of health care leadership and governance, we will be as much to blame as the leaders when the system collapses.

Semi-Retirement of a Salesman - Weldon to Retire as Johnson and Johnson CEO

The extremely well compensated CEO and Chairman of Johnson and Johnson, the huge and recently hugely troubled US based pharmaceutical and de...

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BLOGSCAN - Keeping the Echoes Alive

We frequently discuss the <a href="http://hcrenewal.blogspot.com/search/label/anechoic%20effect">anechoic effect</a>, how many of the cases and issues of interest to <a href="http://hcrenewal.blogspot.com/">Health Care Renewal,</a> which conversely may be troubling to the powers that be in health care, often fail to inspire as much discussion, or the echoes that they deserve, either in the "main-stream media," or in the medical and health care literature.  A <a href="http://1boringoldman.com/index.php/2012/02/27/more-on-echo-echo-echo-echo-echo-echo-echo">new post</a> on the 1BoringOldMan blog likened the anechoic effect to the "flooding" phenomenon seen in psychotherapy, basically how patients seek to change the subject when a particularly troubling issue comes up.  Furthermore, the semi-anonymous blogger, "Mickey," is hopping on our tiny bandwagon for those dedicated to keep these troubling topics from completely fading from public view.

BLOGSCAN - Keeping the Echoes Alive

We frequently discuss the anechoic effect , how many of the cases and issues of interest to Health Care Renewal, which conversely may be tr...

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True or Not? Death By Deletion, Adventist Health System IT Whistleblower Patricia Moleski Speaks Out

Not sure what to make of this yet: <div style="text-align: center;"><a href="http://workmancompensationlawyers.net/12/23/death-by-deletion-adventist-health-system-it-whistleblower-patricia-moleski-speaks-out/"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5714029864071150194" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjlHdzwxZwvVcxZUB0fkLhI1MY8nXfdxFdIjjuBc56E72oN5YBlT5GoMyAubm_fK9QYC-tWvL1LaEu6HTSGjLZEw-grfGGaprfwkdHRgGgJOtFluHvWylSud8uEHR8EQiig-vsqw1HY3Bz5/s320/moleski.jpg" style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 311px; height: 258px;" /></a>Whistleblower Patricia Moleski speaks out about health IT abuses - play at <a href="http://workmancompensationlawyers.net/12/23/death-by-deletion-adventist-health-system-it-whistleblower-patricia-moleski-speaks-out/">http://workmancompensationlawyers.net/12/23/death-by-deletion-adventist-health-system-it-whistleblower-patricia-moleski-speaks-out/</a> </div> A former hospital IT worker claims very deliberate mass spoliation (e.g., deletion) of electronic medical record evidence to limit her (ex)-employer's liability for EHR-related medical malpractice on patients and injured workers who were entitled to workers compensation, as well as EHR defects. She alleges that IT personnel are used as naïve accomplices to perform the spoliation acts. She grew suspicious when she was asked to delete nursing information about a patient who committed suicide by jumping out a hospital window after an EHR-related drug overdose. The video is over an hour long and is worth listening to. She made these claims to the FBI and alleged to have suffered retaliation including firing, and possible terroristic activities directed against her. <a href="http://www.barbclark.org/e_mail_to_governor_christ.pdf">A Feb. 2010 letter to Gov. Crist, Sen. Grassley</a> and many other government officials, a <a href="http://www.barbclark.org/counter_claim_petition_against_adventist_health_system_sunbelt_healthcare_corporation.pdf">9th Judicial Circuit court document</a> for Orange County, FL (PDF), and other details - some scary - can be found via a google search on this person's name: <a href="https://www.google.com/search?q=Patricia%20Moleski">https://www.google.com/search?q=Patricia%20Moleski</a> . <div style="text-align: center;"><a href="http://www.barbclark.org/e_mail_to_governor_christ.pdf"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5714192301488956402" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3r5LNUCzUdeRm_RB7sSNhCtI1DOljSSvPRHqzXTI4QQD4SHy3BHvRLtzutycP2ewk0HYO5UoQ0cggetV0XsV4u5ckhXdWgOmJYTJR-G0wmIg4UjxAb2x6e3_eXqQi0mHHiUHN8n4WIgko/s320/moleski_letter.jpg" style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 324px; height: 392px;" /></a>A Feb. 2010 letter to Sen. Grassley, former Fla. Governor Crist, various other senators, news media, etc. alleging serious, systematic, purposeful HIT evidence tampering and erasure. Click to bring up full letter. </div> This could be the "Libby Zion" (or Bernard Madoff?) case of the health IT world if these allegations are true. -- SS

True or Not? Death By Deletion, Adventist Health System IT Whistleblower Patricia Moleski Speaks Out

Not sure what to make of this yet: Whistleblower Patricia Moleski speaks out about health IT abuses - play at http://workmancompensationlawy...

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