Author Archives: Zack Meisel

Electronic Health Records Interoperability: Friend or Foe

Apr 3, 2013, 9:00 AM, Posted by Zack Meisel

Zachary Meisel, MD, MPH, MSc, is an emergency physician, assistant professor of emergency medicine at the University of Pennsylvania's Perelman School of Medicine, a Robert Wood Johnson Foundation (RWJF) Clinical Scholar, a senior fellow at the Leonard Davis Institute of Health Economics, and a columnist on health care issues for Time.com. This is part of a series of essays, reprinted from the Leonard Davis Institute of Health Economics’ eMagazine, in which scholars who attended the recent AcademyHealth National Health Policy Conference reflect on the experience.

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The standing-room-only crowd at the AcademyHealth National Health Policy Conference’s “Life After HITECH: Health IT Policy 2.0” session was a testament to the big stakes, high emotion and dramatic clinical implications that characterize every aspect of the electronic health records debate.

The session, moderated by former National Coordinator for Health Information Technology David Blumenthal, was one of the liveliest of the entire conference. It impaneled current National Health Information Technology (HIT) Coordinator Farzad Mostashari along with Christine Bechtel, who sits on the Government Accountability Office’s Health IT Policy Committee, and Paul Tang, the chief innovation and technology officer at the Palo Alto Medical Foundation.

Patient Privacy Issue

One issue was the national push for universal electronic health records (EHR) systems—a drive now fueled by HITECH Act funding but tangled in many discussions about unintended consequences. The first and most prominent has pivoted around worries related to patient privacy.

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Narratives to Promote Evidence - Or Why the U.S. Preventive Services Task Force Should Get Ira Glass to Tell the Story of the Science

Nov 21, 2011, 12:00 PM, Posted by Zack Meisel

By Zachary F. Meisel, MD, MPH, MS

Since the commentary that Jason Karlawish, MD, and I published recently [Journal of the American Medical Association, November 9, 2011] recommending that scientists and guideline developers consider personal narratives to advance, translate and disseminate evidence, we have heard lots of comments on this concept (some supportive, some critical, and many requests to expand upon it).

To be clear, we recommended always leading with the science; the narrative piece comes after the evidence is in. Finding and telling stories that speak to the science may not be easy to do, but it is essential when confronted with the dual challenges of a) unscientific narratives that flood the news and talk shows, and b) that data, when presented void of context or connections to which people can relate, is unlikely to motivate trust and behavior change.

However, some of the pushback taps into legitimate concerns. A Scientific American forum on the article has become a deeply political discussion about the lines between advocacy and science. Our take: of course the line between science and advocacy should be as thick as possible. And yes, when scientists (and those charged with translating the science) tell stories, it might very well smack of personal bias.

What Jason and I were arguing is that it shouldn’t be that way. One of the reasons that narratives feel wrong to some who live in the space of science and data is that it isn’t tradition to engage in the realm of stories. But traditions aside, there are no inherent reasons to shun narratives if they are grounded in good science. We are advocating for an evolution (or revolution?) in these customs. If you start with the science or evidence, then use stories to promote and maximize their uptake and translation, it’s not bias.

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