August 11th was the 2nd anniversary of the epic implosion of George Allen's presidential campaign, the first defeat at the hands of YouTube. Two recent videos of unattended patients dying in ER waiting rooms leave me wondering whether healthcare has also entered the YouTube era.Remember the George Allen fiasco? A 20-year-old Indian-American named ...

Just returning from a work-acation, including a talk in Buenos Aires. Today I’ll briefly cover a few items: Medicare’s final “no pay” list; patient safety in Argentina; a great post on hospital finances; and one of the saddest things I’ve ever experienced.First, the final “no pay” list. I’m not sure if this was CMS’s intent, but their trial ...

Yesterday, Google launched Knol, immediately branded as Google’s answer to Wikipedia. As healthcare advisor to the project, I’ll say a few words about Knol, but focus on how it – and other forms of electronic self-publishing – may signal the end of medical publishing as we have known it.First, a word about Knol (the name is short for “a unit of ...

I recently heard from a UCSF physician who was flabbergasted when he sought an appointment in our general medicine practice and was told it was “closed.” Turns out we’re not alone: there are also no new PCP slots available at Mass General. The primary care crisis has truly arrived. I’ve written about the roots of the problem previously, and won’t ...

Yet another case of wrong-side surgery, this one at Boston’s Beth-Israel Deaconess Hospital. Though CEO Paul Levy does a nice job discussing the case on his blog, I’ll focus on two aspects Paul neglects: the role of production pressures in errors, and the tension between “no blame” and accountability.First, I hope you’ll read Paul’s piece (on his ...

I gave a keynote yesterday to the first-ever meeting on “Diagnostic Error in Medicine.” I hope the confab helps put diagnostic errors on the safety map. But, as Ricky Ricardo would say, the experts and advocates in the audience have some ‘splainin’ to do.I date the origin of the patient safety field to the publication of the IOM report on medical ...

There is nothing better than a good satire to capture certain (uncomfortable) truths – just ask any of the presidential candidates after an episode of Saturday Night Live. So check out this hilarious spoof on information technology interoperability.As Captain Kirk said to Bones, “have you lost your mind?” Hilarious? Interoperability? But really, ...

Google Health launched on Monday, which sent the world’s Google-watchers into a tizzy. I serve on Google Health's Advisory Council – which met all day Tuesday – and so here’s a bit of inside dish, along with my impressions of the site and the company.FYI, my work on the Council is covered by a Non-Disclosure Agreement, so I won’t reveal anything ...

Fresh on the heels of my recent bar coding epiphany comes another “unintended consequences” article. It turns out that the whipsawing that accompanies the adoption of new technologies is completely foreseeable, the “why doesn’t this thing work right?” phase as predictable as the seasons.Thanks to Dr. Mark Wheeler, Director of Clinical Informatics ...

Last week, Time Magazine named the 100 most influential people in the world. Among the luminaries was Dr. Peter Pronovost of Johns Hopkins. I thought it was an inspired choice.The modern patient safety field has been blessed with a number of important leaders and visionaries. A few examples: Lucian Leape, the Harvard surgeon who introduced the ...