Do you know what’s in YOUR (health) wallet??

VeHU audience poll question resultsI’m at the gigantic HIMSS health IT conference in Orlando, in the consumer pre-conference. In my opening talk I briefly mentioned something I’ve said for years:

Have you looked in your chart? Your medical record? Do you know for a fact that there are no errors in it?

Most audiences appear intrigued and thoughtful at this. But ha ha ha, at HIMSS (people who work in health IT), on Twitter there are two interesting reactions:

  • Several different people tweeted it, showing unusual interest in it, and more than a dozen retweeted those
  • Anda whole bunch of people are saying “Who says?? What’s the source??” 

How fascinating. Well, here’s what I know about it.

  • 18 months ago I spoke at the Veterans eHealth University, a virtual university for people who work in the VA (veterans’ administration) health system. They asked me to submit some interactive audience response questions.
  • One was to ask the audience if they had checked their own record. The results are in the slide above. (Sorry about the typos – that’s how the A/V guys typed it into the computer.) Results:
    • 50 / 66 (76%) said no, they’d never looked. (Have you?)
    • Of the 16 who had looked:
      • 5 (31%) weren’t sure whether there were errors.
      • Of the 11 who were sure:
        • 7 found mistakes (64%)
        • 4 found the record was perfect (36%)

So, roughly: of those who had checked, about 2/3 found mistakes: missing allergies, wrong medications, wrong diagnoses, etc.

Since then, depending on the audience, I’ve asked this of other audiences. Every time of those who’ve checked, about 2/3 found errors. Every time.

This is not a peer reviewed journal article.  I’d love to see one! I also encourage all health IT speakers to ask their own audiences. Maybe mine aren’t typical, somehow.

And by the way – if you’re skeptical, do you know if your record contains everything doctors and nurses should know about you, and doesn’t contain errors?

As always, discussion is welcome!

It’s like the old Capital One commercials – do you know “What’s in your wallet?


Updates added later:

  • At the British Columbia Patient Safety & Quality Council conference later that week, in a post-keynote workshop, I asked the room about this:
    • Of more than 100 in the room, eight had examined their entire records.
    • Of those, six had looked errors, and two had found them completely accurate.


High Reliability Organizing: new conference next month

hro_bannerRegular readers know that in everyone’s efforts to improve health and care, I’m fascinated by work in other sectors too, because a lot of the ways that medicine falls short of its potential have been solved in other industries.  Our failure to use those methods (too often) is not just a disservice to patients – it’s a disservice to clinicians who work hard, too.

My friend Jim Conway, a titan in the world of safety and quality improvement (LinkedIn), told me about a new conference that may interest you too, if you work in improving quality. He’s keynoting.  I’ll be attending even though I’m not speaking, because anything that semi-retired Conway will focus attention on is good enough for me. As a small new event they’re looking for other sponsors, too, in addition to the Joint Commission on Accreditation of Health Care Organizations and Dow Chemical:

Institute for High Reliability Organizing

  • March 28-30, Fort Worth, hosted by The University of North Texas Health Science Center
  • Organization website here.
  • Event website here.
  • Registration here.

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My slides for Brookings Institution webcast

Updated at noon – fixed missing links

Event: “Involving Clinicians in Payment and Delivery Reform: The Role of Social Media and MOOCs.” The event’s website is here and the Twitter archive on Symplur is here. I’m on a panel 11-11:45 and they can’t display slides, so I’m posting some here, selected based on what I’ve heard in the previous panels. Social media busts through boundaries!


“When I’m 64…” oy, mixed feelings

Today I turn 64.  So let me introduce to you the act you’ve known for all these years: Sgt. Pepper’s Lonely Hearts Club Band, performing “When I’m 64″:

Notes about the song:

  • When the song finishes, the rest of the album will play – stop it if you wish. See also the playlist, at bottom.
  • If you don’t know the song’s history, you must read it on Wikipedia. Did you know Paul started it as a teen, and the song features a clarinet trio?

Happy birthday(?)

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The circle of life: another family death, and a glorious child

Dorron & family, 2007

Dorron & family, 2007

Photo of Steve


I have such conflicted feelings about this. Another brother’s death, as the circle of life continues. It. Just. Feels. Wrong.

Having survived my own near-death seven years ago, I celebrate being alive whenever I can. So it hit me like bricks last May when my younger brother Steve died, and again in December when my best friend Dorron died. These were the first unexpected deaths I’ve ever experienced close to me.

And they were both eight years younger than me. Incomprehensible. It just doesn’t make sense, a life ending with eight years less experience??

My brother Ken


And then two days ago I learned that another brother, Ken, age 62, has died unexpectedly. So now our six siblings are down to four.

I just freakin’ don’t know how to process this. I don’t like it, I’m not rational, of course it’s not rational, it grabs the brain at a far more primitive level than logic can ever address.  I’m rereading my post about Steve’s death, and boy is it on target. Death has been around a lot longer than human thought has, and it’s apparent to me that we as social creatures are constituted to not like it, and get upset when one of our tribe disappears.

Ken, like Steve, smoked and drank. Nothing like having some public health statistics step up and kick you in the face.

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Health quality people – important last call: NQF’s annual meeting

NQF event logo (click to visit site)

A quick note to DC policy people:

Chart of medical spending in America (source:’s a shift in the wind, and you may want to join what I think is an important conference this Thursday and Friday. The National Quality Forum, an independent organization that defines quality measures for industry to use, is having its annual conference and membership meeting.

As regular readers know, I’ve often said that medicine is the only industry I know where quality isn’t defined by the customer, the patient, the ultimate stakeholder. That’s starting to change: NQF is now actively engaged in shifting to make patient point of view a core part of the process.
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A new era: the “consumer-patient,” via Inquire Healthcare

Inquire Healthcare home screen

A new website launched last month. I’m not involved with the organization, but I almost wish I were, because what I’m seeing is what I hope we’ll see everywhere, for every medical need.

The site is, a project of the non-profit Health Care Incentives Improvement Institute (HCI3). It’s the first time I’ve seen a new term that I love: “consumer-patients.”

(Some activated consumers hate the term “patient” and some activated patients hate the term “consumers.” My own views are in the glossary of Let Patients Help. Here I want focus on what you get when you mix the best of both – because that’s what they’re after on this site.)

It’s got three things I’ve never seen combined: shopping tools, self-assessment tools, and community activist tools. How’s that for a toolbox to create change? (Again, I wish I were bragging about my own work, but I never heard of them until they launched.) Specifically:

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Recent posts on other sites, 2/2/14

Note to email subscribers: I’m not sure which of today’s posts you’ll get first. If you haven’t seen today’s other post, about my July Blue Button speech, please see it below. It’s an important declaration about the future of health IT.

Last weekend I started something I hope to continue: a weekly post summarizing things I’ve written on other blogs. I’m doing this to keep in touch with subscribers here, as I reach out through other channels.
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Finally! Composite video of my call to action at Blue Button Plus Developer Challenge (New York, July 22)

Blue Button Plus event artLast month I blogged that a “lost speech” had finally surfaced. It was my closing speech at an event last July, and said why this moment (this year, this series of conferences) is an essential turning point:

“The event was a conference conducted by our Department of Health & Human Services to educate and encourage software developers about the “Blue Button Plus” initiative. … which is really important for the future of health IT, and not just in America; this innovation initiative will change what patients and families are capable of.”

And I said:
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Video of my AMIA keynote is live

In November I posted about how fun my opening keynote was at AMIA, the American Medical Informatics Association. See that post for tweets from the event and discussion.  It was great fun – a conference of 2,000 information science geeks – people who understand data, especially what it’s for and why data quality is important!  Boy does it save time when you start from a common view.

This week AMIA’s Jeff Williamson got  me the video of the speech.  Here it is, with Dr Danny Sands introducing me. (He’s one of the revered figures in the association; they’re also the ones who published his 1998 article on doctor-patient email.) See notes below about what makes this talk different from others.

(If you can’t see the video, view it online.)

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