Author Archives: Steve Downs

Bringing OpenNotes to Geisinger

May 20, 2013, 12:59 PM, Posted by Steve Downs

Doctor listening to man's breathing

In a post this week on the Kevin MD blog, Jon Darer, chief innovation officer for the Division of Clinical Innovation at Geisinger Health System, discussed Geisinger's decision to roll out OpenNotes to most of its physicians and patients.

Geisinger's approach highlights the choices that will be facing many health systems: The results of the OpenNotes study, published last fall, provide compelling evidence to go forward in general, but there is a need to be careful and thoughtful about how to do so. Different specialties and different patient populations have special circumstances that need careful consideration. And each institution has its own culture to be navigated. As more early adopters like Geisinger move forward, we'll learn more about how best to implement this practice and through that learning, make it more widely available. — Steve Downs

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When Moneyball Meets Medicaid

May 16, 2013, 8:00 AM, Posted by Steve Downs

Dr. Nirav Shah Dr. Nirav Shah, New York Commissioner of Health

New York State Commissioner of Health Nirav Shah is the Billy Beane of health care.

Let me explain. 

Billy Beane—the general manager and minority owner of the Oakland Athletics—and made famous in the book Moneyball: The Art of Winning an Unfair Game by Michael Lewis, was made even more famous when Brad Pitt portrayed him in the movie adaptation. (Generally speaking, having Brad Pitt portray you is a good way to get famous.)

For those who aren’t familiar, Moneyball is about how, under Beane’s unconventional leadership, “the Oakland Athletics achieved an amazing winning streak while having the smallest player payroll in Major League Baseball. (Short answer: creative use of data.)” (Thank you, New York Times.)

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500+ Geisinger Doctors Adopt OpenNotes

May 8, 2013, 8:00 AM, Posted by Steve Downs

OpenNotes: Health care leaders speak out

“Today, Geisinger Health System, one of the nation’s premier health systems, is taking an important step to expand OpenNotes. We hope other systems follow Geisinger’s lead to share doctors’ notes with patients, giving them information they can use to participate more meaningfully in their care." – Steve Downs

This excerpted post by Geisinger CEO Glenn Steele, MD, first appeared in October 2012, when results from the OpenNotes pilot were released. Geisinger was one of three health systems that participated in the study.

…As a health system CEO who also is a doctor, I believe it is an ethical imperative that our patients at Geisinger know everything that we know about them. And, I think it’s a logical imperative that if we can open up our medical visit notes to our patients, we’ll find out what they understand and what they don’t, so we can answer questions and work as partners to chart a path to better health.

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Need Innovative Health Solutions? Ask a Kid

Apr 22, 2013, 8:30 AM, Posted by Steve Downs

Stephen J. Downs

Sometimes the best ideas come from unexpected sources – beyond technology, beyond research, beyond clinical trials. Sometimes, the future of health and health care lies somewhere else: in the people who will bring it about.

And sometimes, those people are children.

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OpenNotes: The Results Are In

Oct 3, 2012, 6:00 PM, Posted by Steve Downs

Steve Downs Steve Downs

Originally posted on The Health Care Blog.

A few years ago, Tom Delbanco and Jan Walker pitched us with a simple idea: Patients should routinely be able to see the notes that physicians write about them.  Now it’s true that we all have the legal right to see these notes, but obtaining them is anything but routine. The process involves phone calls, faxes (sic), duplicating fees and all sorts of other demoralizing steps. The net result is that reviewing your doctor’s notes about you is a rare experience.

Tom and Jan said that the physicians with whom they had spoken about this idea were split. Some were interested, some were resigned: They recognized that transparency was an increasingly powerful wave and that the world seemed to be heading this way, and the others thought they were crazy—notes were for documentation and communication among doctors and were never intended for patients.  The arguments were of a religious quality—they were about belief and values.  The obvious solution was to test the idea and let data help sort it out.  Today, with the publication of the study results in the Annals of Internal Medicine, that debate is now illuminated.

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