University of Arizona Medical Center, $10 million in the red in operations, to spend $100M on new EHR system

In my Oct. 2006 post "$70 million for an Electronic Medical Records system?" I wrote:

... healthcare doesn’t have the capital for clinical IT misadventures, and I believe when the issues become more public in this industry sector and information flows about mismanagement and abuses (as is happening in the UK ’s Connecting for Health project) [now abandoned as described here - ed.], the fallout won’t be pretty.

Here's an example of an organization in profound ardent technophile-driven Ddulite mode:

UA Medical Center to spend $100M on new records system

Tucson's largest health-care organization expects to spend upward of $100 million on getting its two hospitals talking to each other.

Right now, the inpatient medical record systems at the University of Arizona Medical Center's two campuses aren't speaking to each other.

The lack of communication is resulting in more work for healthcare providers in the University of Arizona Health Network.

[How much more work, exactly, and how much would a non-cybernetic solution cost? These issues seem never to be mentioned - ed.]

The $1.2 billion, nonprofit company employs nearly 7,000 people.

The network is installing a new, uniform electronic medical records system for all patients at its two hospitals - UA Medical Center - University Campus and UA Medical Center - South Campus - and at outpatient centers as well.

... Project leaders predict it will result in a more efficient organization with fewer medication errors and better patient care.

... The new system's benefits will certainly trickle down to patients, said Clint Hinman, an experienced pharmacy director within the network who is directing the computer upgrade program.

[Note once again the absolutist statements of deterministic benefit and beneficence, based on scant supportive evidence and increasing contradictory evidence, that I bolded above - ed.]

I note that $100 million+ is probably enough to pay for AN ENTIRE NEW HOSPITAL or hospital wing ... or a lot of human medical records professionals.

Executives and project leaders have probably never read any of the literature at the reading list here or at my academic site here, or if they have, choose to be blind to it and trusting of literature such as ONC's sloppy-science "should not have been published in its present form" health IT cheerleading here.

Most important of all:

It's not advisable to gamble with $100 million in that fashion, especially under these conditions:

... BUDGET ISSUES

Spending $100-million-plus on electronic medical records is a lot of money for a network that as of mid-January was at $10 million in the red in operations, BUT network spokeswoman Katie Riley said the electronic medical records are not to blame.

[Capitalization and emphasis of the "but" mine - ed.]

This statement is both representative of a healthcare system gone overboard - you don't spend on luxuries when you're $10 million in the red - and is a non-sequitur.

Who cares if the EHR's are not to blame for the system being $10 million in the red? That does not seem like a good reason to go ahead and spend $100 million (which will probably balloon to several times that figure, hence I will use $100 million++) on a very risky gamble.

Further, all it will take is a few of these mishaps to put the system further in the red.

I should also ask: will medical and other staff be laid off to afford the new systems, in effect trading people for computers?

To spend $100 million++ on HIT when you're already $10 million in the red on operations is, in my view, financially reckless.

-- SS

Stress, baking, and a new venture

The stress of being a professor has been absolutely brutal on me. With the teaching prep, grant proposals,  research group management, departmental/professional service, and all the other things I do - I really feel like my head is going to explode. I can't think of a time I've ever felt this stressed, except maybe as an undergraduate in college, or when I had a colicky newborn.

Since it's generally not socially acceptable for professional women to show any emotions other than joy, I started taking my work stress out on bread. As soon as I get home, off goes the smile and out comes the flour. I douse the counter, grab all my ingredients, add water, and knead. They say 8-10 minutes, I usually go for 30-40. To me the end product is not so much about making a delicious, well-proportioned, beautiful loaf of bread as it is about beating the crap out of my enemies.

About six months ago, after a particularly bad day at the office, I decided to start making my dough resemble particularly troublesome colleagues before I kneaded the heck out of it. At first it was just little motifs here and there - a jutted chin, a moustache, glasses. Then I started getting more elaborate, with different kinds of food dye for the hair and eyes, sprinkles for whiskers, etc.

I got pretty good at these "bread sculptures". In fact, so good, that I couldn't bear to destroy them. The best thing I could do was bake them, photograph them, then place them on the porch for the small animals to nibble upon.

Here's the thing: I *love* this. I enjoy bread sculpting so much, I can't imagine doing anything else with my life. This professor thing is just a sham, a veil hiding my eyes from the real world: the world of people-shaped bread.

So I told my chair I needed a leave of absence for "personal reasons" (I suspect he thinks I'm pregnant). I went down to the bank, took out a small business loan, and rented a store in the center of town.

No emails. No meetings. No websites. Just bread.

You, PCS vs. Jack Kruse MD, DDS

I'm going through a period of intense disillusionment with the state of this larger diet/nutrition/fitness ancestral/paleo/whole-foods/LC community on the internet and beyond.  By far the greatest contributor to this disillusionment has got to be the meteoric rise of one Dr. Jack Kruse, NEUROSURGEON! , although there are certainly others adding to the malaise.  

The other day I forced myself to re-read -- more slowly this time -- his Holy Trinity post from the night of his Paleo Summit presentation.  Now, apparently Quack Frost (there are just so many good names for this guy, I have to rotate them for him!) has some inside information on how Lance Armstrong trains in the cold.  And Phelps too?  He implies that he does.  But in the Paleo Summit he states affirmatively that Phelps spends 18 hours a day in a 50 degree pool.  This is how myths start, because I just Googled "Phelps cold adaptation" and I come across this.  Folks I don't have a medical degree.  I was, however, a swim instructor, pool rat and lifeguard in my yoot (as My Cousin Vinny would say).   So I suppose one could claim that I have some special experience that qualifies me to know that nobody trains in anything near 50 degree swimming pools.  And yet it turns out that most people know this, even if it's from a report that says so-and-so went missing in 65 degree water with the dire prognosis of survival.  The fact that a doctor would even say this, let alone repeat it (Phelps is cited over 10 times in the Holy Trinity post alone) is disillusioning in and of itself.  That others seem to accept this without skepticism is disheartening.  That still others now repeat it as fact, moreso.

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The Eocene Diet

65 million years ago, a massive asteroid slammed into the Yucatan peninsula, creating a giant dust cloud that contributed to the extinction of terrestrial dinosaurs.  In the resulting re-adjustment of global ecosystems, a new plant tissue evolved, which paved the way for the eventual appearance of humans: fruit.  Fruit represents a finely crafted symbiosis between plants and animals, in which the plant provides a nourishing morsel, and the animal disperses the plant's seeds inside a packet of rich fertilizer.

Fruit was such a powerful selective pressure that mammals quickly evolved to exploit it more effectively, developing adaptations for life in the forest canopy.  One result of this was the rapid emergence of primates, carrying physical, digestive and metabolic adaptations for the acquisition and consumption of fruit and leaves.  Primates also continued eating insects, a vestige of our early mammalian heritage. 

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