EHR and physician burnout

Electronic health records (EHR) have the potential to greatly improve the quality of care. EHRs allow multi-specialty teams to access the same underlying medical information and eliminate the issue of miscommunication due to poor physician hand writing. At the same time, EHR increase data entry burden. Is the benefit of EHR worth the cost? One…

Is Uber a substitute for ambulances?

According to a paper by Moskatel and Slutsky (2019), the answer appears to be ‘yes’. In this paper, we ask whether UberX’s entry into a city caused substitution away from traditional ambulances for low‐risk patients, reducing overall volume. Using a city‐panel over‐time and leverage that UberX enter markets sporadically over multiple years, we find that…

Death by 1000 clicks: Where EHRs went wrong

An interesting article over at Kaiser Health News on electronic health records (EHRs): But 10 years after President Barack Obama signed a law to accelerate the digitization of medical records — with the federal government, so far, sinking $36 billion into the effort — America has little to show for its investment…Today, 96 percent of…

Would telehealth increase the price of health care?

Health Affairs December 2018 issue focuses on telehealth.  The general assumption is that telehealth is an unambiguous good.  Getting access to health care providers–particularly those who live in remote areas or have transportation challenges–is certainly a good thing. But could telehealth increase the price of health care? In this thought exercise, pretend for a moment that…

Why shopping for health insurance is hard

The premise is simple.  Create markets, let consumers choose the products that fit them best, and the competition will lead to higher quality and lower prices.  That is the premise behind the Affordable Care Act’s health insurance exchanges.  A necessary condition for this to work, however, is that patients have visibility into the quality and…

What does “value” mean to patients?

There are numerous value frameworks being developed by an alphabet soup of organizations including ACC/AHA, ASCO, ICER, MSKCC, NCCN, and others.  These organizations generally represent providers or payer perspective on value.  But what does “value” mean to patients? The National Patient Advocate Foundation (PAF) provides their thoughts in a recent white paper titled “The Roadmap to…