Saturday, May 11, 2013

Book Review: Innovation with Information Technologies in Health Care, Lyle Berkowitz and  Chris McCarthy, editors, Springer Verla, London, 303 pages, Indexed, $61.49
Physician attitudes towards electronic health records vary.   Two basic schools of thought exist- true believers  and rueful skeptics.
True believers tend to say, “Look , this thing call health information is the wave of the future. Get with the program.  Install EHRs.  Live with them. It’s the law of the land.”
Rueful skeptics are more prone to say,” Tell me when we get to the future.  Tell me when EHRs are useful, don’t cut my productivity,  get between me and my patient, and  someone else will pay for them.”
This book documents the health information technology innovation  case for believers  and seeks to encourage the skeptics.  
The book’s  two editors, Lyle Berkowitz and Chris McCarthy work for large health innovative health care organizations, Northwestern Memorial Hospital in Chicago and Kaiser Permanente in Oakland, California.   They have led the innovation movement at  the national level – Berkowitz at the Szollosi Healthcare Innovation Program at Northwestern School of Medicine and McCarthy at the Innovation Learning Network//Innovation Consultancy at Kaiser.
Their book features 43 authors at large health care organizations telling their stories of innovation from conception to execution.  The stories focus mainly on how EHRs and their various iterations have bettered and transformed health care in their institutions.
Berkowitz and McCarthy give three reasons why their book should be read.
·         Information technology is an increasingly important part of everyday life in health care, but a large gap exists between reality and potential.

·         Healthcare innovation is HOT, Everybody is talking about and scrambling to lower costs and improve quality.

·         The delivery and reimbursement of healthcare is in the midst of major changes.

This book is not a book about a solitary innovator or great guru, like Steve Jobs, working out of a garage.  It is about teamwork in large organizations.  It is not about a single transformation idea. It is about multiple ways EHRs are incrementally transforming care .  It is not about how Obamacare is  driving innovation or how innovators are using EHRs to help implementation or minimize its consequences.   The health law is not even mentioned.
Instead the book is about how to structure innovative systems  and the process of innovation as practiced in large institutions by  innovative teams.
In the book’s first two chapters, the two editors, in breezy colloquial language, couched in HIT management terms, use stories as told by authors in 20 large health organizations to make their points.   The stories relate the Whats, the Whys, the Whens, the Wheres, and the Hows of the reasons why  innovations came about, the pitfalls and pratfalls and the successes and where they are headed.
The larger story is how EHRs , serve as the basis and inspiration of organizations’ “healing edge,”  i.e. as tools to provide the right care , for the right reasons, in the right sequences, in the right places, at the right times, performed by the right people.
The literary mechanism gluing these stories together is a fictional Martinez family – Barbara, the mom, Ray, the dad, Cindy, the daughter, and her younger brother, Mike.  At the start of each chapter,  a family member presents with a health problem.   The EHR innovation addresses the problem, alleviates it,  or resolves in an efficient, effective manner.
The various storytellers share their tales in this sequence:  opening problem, background of the organization, what is the innovation, why they created the innovation,  how it succeeded, what were the results, what lessons did they learn, what do they conclude, and what do they see in the future.

Tweet:  The book, “Innovation with Information Technology in Healthcare,” describes how health firms use electronic health records to improve care.

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