So This is Healthcare?


I don’t even know what I am reading any more.  In the article Challenges posed by accountable care drive new data uses I was stumped to even recognize this as even healthcare.  Here are some samples:

  • In many cases, ACOs are finding they need to incorporate data from a variety of sources, placing new importance on activities such as master data management, analytics and population health management applications.
  • According to Hess, one of the keys for ACO success is the ability to gather the data and combine it into a data warehouse that can direct overall efforts. “Master data management (MDM) tools are critical to the success of these efforts.”
  • “Some MDM tool providers focus on patient identity resolution—the classic (enterprise master patient identifier) problem space—while others focus exclusively on reference data, which is the space of terminology management tools,” Hess says.
  • Doctors are gaining interest in all this added data. “Some doctors are secretly data junkies,” Pomeroy says. “Some are curious, but have never had access to high fidelity data. The new level of transparency is pulling them in.” Value-based care is creating a tipping point in physician interest, he says. “It’s the new way they do business.”
  • Aside from data helping ACOs to accomplish their mission, data can also be used to help providers get a vision of their potential future in an ACO. John Kelly, principal business advisor for Edifecs, says data can be used to see where their risks would lie, if a provider organization joined an ACO. Organizations are having to sign on to an ACO “with a blindfold on,” he says, and “that’s why there are a lot of horror stories going on.
  • This requires the ability to test and manage thousands of data-sharing relationships. The data is likened to a supply chain, Kelly says. “The irony is: every other industry has been doing this. It’s about supply chain integration–all those things that other industries have already nailed.”

To be fair, I lifted this all from the Health Data Management site so I know this is their line of work and these techies are getting psyched out of their mind to play with all this health data. The problem is that patients are human and not numbers.   They are not part of a “supply chain”.  This pendulum has swung too fair in the direction of industrialized medicine and now needs to swing back some.  How?  There needs to be more effort into low tech, individualized medicine. Call it face time with your doctor. Or, how about lets start using the metric TWP or Time With Patient?  Yeah, that would slow things time and put a wrench in the system but isn’t that what patients want?

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  9 comments for “So This is Healthcare?

  1. Mary Carney
    August 24, 2016 at 10:49 pm

    The concept of population medicine really escapes me. I see one patient at a time. I do not go to the patient ‘s home to monitor whether or not the patient takes the prescribed meds. I do not go shopping for groceries with my patients.
    My responsibility is to advise. The patients have a choice I am not responsible what they do with the advice.
    I do not practice population medicine.

    • rsw
      August 25, 2016 at 9:45 am

      You don’t understand.

      Population medicine is all about punishing doctors for events over which they have no control.

  2. Kurt
    August 24, 2016 at 8:50 pm

    Doctors becoming data junkies?????? Nothing is going to change in this country until people
    who know better are held accountable for their lousy health behaviors. All this data collecting
    is like shredding cash. It will make no difference as to where the overall health of this country is heading. Get into a cash DPC like Doug, retire ASAP or feasible or don’t go into primary care in the first place.
    Oh. What’s that you say? It’s “politically INCORRECT” to hold people accountable for their lousy behaviors? Hmmmm, maybe that’s why I’m avoiding taking on new patients who have the potential of being high maintanence or are on pre-existing narcotics that I can’t figure out why from the data presented. I don’t want to be blamed for their lousy outcomes I have no control over.

  3. Seneca
    August 24, 2016 at 7:04 am

    With a minimal understanding of all this gibberish, it seems obvious what all this data massaging is ultimately designed to do: cherry pick the healthiest patients so that Corp Med can make more money by not taking care of the sick ones.

    • Bridget Reidy
      August 25, 2016 at 12:08 am


  4. DrWally
    August 23, 2016 at 11:31 am

    I think the real “tools” are the ones that are spouting this gibberish.

  5. Perry
    August 23, 2016 at 10:09 am

    Yes, this is healthcare, according to this quote from Medical Economics:

    “Whenever I talk to small practices, I start by letting them know their ability to be successful in a value-based world will hinge on their ability to collect and measure data,” says Daphne Saneholtz, JD, head of the healthcare practice for the Columbus, Ohio-based law firm Brennan, Manna & Diamond.

    Patient care? What’s that?

  6. Steve O'
    August 23, 2016 at 8:55 am

    One can be sure that a business sector is in a bubble, when the actual doing of a service or delivery of a product is ignored. Those who do the actual work are disparaged as old-fashioned. Their work is summarized by a few catch-phrases. The top end is clustered with people eager to reconstruct the paradigm of whatever it is that they do.
    In the Roaring 20’s, local business and manufacture went national, and corporations like Amalgamated This and Consolidated That began to pop up, making tin wire and top hats, bicycles and ladies’ corsets. It didn’t matter what they made – as long as they were New and National!
    In the dot-com bubble, everything that could be called DIGITAL would, and the service – whatever was being sold – was irrelevant.
    And now, American Healthcare is Quality Enterprise Driven by those who cannot apply a dressing. Who needs to know about neurosurgery, if it can be reverse-quality-engineered?
    “The irony is: every other industry has been doing this. It’s about supply chain integration–all those things that other industries have already nailed.” The only way to keep this stupid myth believable is if doctors were sealed inside a bubble that differed from any other enterprise, service and manufacturer. People had been talking about all these things throughout the history of medicine – in fact, the history of medicine in the last hundred years HAS been innovation.
    The idea that we can swoop in and teach these turkeys how to add and subtract, reflects the hubris of the trillion-and-some dollar Iraq war, where we were to be greeted as liberators. We weren’t, and still aren’t.
    Politics aside, hubris gets you killed, makes businesses fail, injures the sick and harms the dying. After the host weakens, the techno-parasites will move on to some other host. The only thing keeping healthcare alive is the hostage myth – that people will pay ANYTHING for their health. That’s rapidly failing. We are keeping this monstrous parasite fed at a billion dollars a day. And when the physiology collapses, it will suddenly stop.

  7. Thomas Guastavino
    August 23, 2016 at 7:31 am

    Matthew 7:26-27
    ACOs are doomed to fail because the foundation they are built upon makes no sense.

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