"Welcome to our company blog. Within these blog posts, we hope to share our insights on clinical quality management, the patient-centered medical home, chronic disease management in primary care, evidence-based medicine, and the use of technology in ambulatory care settings."

- David Morin, CEO and Donald Nease Jr., MD, Chief Medical Officer

Ready for Consumer Empowerment? Back in the days when I was the Vice President of a publishing company, we started publishing email addresses of writers. People found this a very convenient way to write letters to the editors and writers and it was widely used. Many great e-conversations were had. But, there was also a very small group of people that wrote nasty, inflammatory emails to us. They wrote in ways they'd never converse with you face to face. It's very easy to be ridiculous when you are anonymous. Consider that, in 2008, there are thousands of "rate my" sites out on the web, a ton of bloggers and the ability to post a comment on just about anything. It's now coming to health care. Angie's List, Health 2.0, Rate my Doctor, etc… Anyone can post a comment about a provider or practice. 99% will be good and constructive. 1% will drive you crazy. They will be the ridiculous, anonymous ones that will write in manner that would not be expressed in a verbal conversation. Someone having to wait an extra 5 minutes in a waiting room can tell the world about it. They don't care that you just had to deal with chest pain as a presenting condition for the patient before them, this person had to wait an extra 5 minutes and they're mad! I don't believe this wave will be stopped and I'm surprised it hadn't started sooner. So, what can you do? Get ahead of the wave and go on the offense. Embrace the internet. Give people an outlet to communicate with you before flaming you on the web. Post your own statistics on your care delivery. Get people to post good and honest things about you . Don't compromise your care delivery, but be cognizant of what's happening. You won't stop 'em all, but a little more interaction will go a very long way. And, you may find that the glowing reviews you will receive on the internet will be of great value. Dave Morin CEO Cielo MedSolutions

Type "personal health record" into your favorite search engine and you will be overwhelmed with the number of vendors offering such a solution. I'm intrigued with the variety of stakeholders offering such solutions; software start-ups, employers, payors, EMR vendors and portal and search engine providers all have a PHR that they think you should be using. I'll bet there 100s of PHR solutions now available. When evaluating these solutions, a few characteristics are key for adoption: From the patient's perspective: Ubiquity and Patient Ownership - the PHR record is ultimately the property of the patient. It must be transportable into every situation in which a patient needs it and it must be accessible by the patient at any time. Adds Value - a record on it's own has value, but a PHR solution that can add value around the record is of great value. Care reminders, links to literature are all examples. Is Correct - those that populate from claims data will be populated with data that was never intended for clinical documentation, only for reimbursement. If you diagnose that wheezing patient with asthma and that patient, who is ultimately found to NOT have asthma, sees he's asthmatic in his personal health record, might 1) decide this PHR can't be trusted and not use it or 2) call your practice in a panic asking why you never told him he was asthmatic (and have trust issues with you as a provider). From the provider's perspective: Easily accessed - and I mean "easy"! When the average visit is 16.5 minutes, even one minute to fumble through access of this record will make this a no -deal. Complete Picture - a PHR that only tells a part of the story isn't of much value if the provider still has to go back and verify and document everything. Is Correct- if it doesn't provide accurate clinical data, there's no reason to use it. Any PHR vendor that would find any of the bullets above to not be in their best interest is probably one that won't survive. That leads me to think right now that vendors such as Google, Microsoft and Revolution Health probably represent the best strategies, IF they can provide the features above. Dave Morin CEO Cielo MedSolutions

If you haven't yet seen it, check out the Flip Video Camcorder. There an incredible amount of buzz surrounding the product yet it is one of the simpliest camcorders on the market. Read "Simplicity: What’s Next in Business Software", a recent editorial on sandhill.com. The author argues that the new winners in the software market will focus on keeping their products focused and very ease-to-use and resist the temptation to add so many features they become virtually unnavigable. Your cell phone now has more computing power than many of the first commercial computers. As such, your cell phone has a host of features that have nothing to do with calling someone. How many of these features do you really use? You probably use, 95% of the time, just the very basics - calling people and maybe texting them. Why is it then that we think health care software needs to be feature-bloated to be the "right one"? Isn't a simple solution, targeted to the exact needs of a practice, truly the best? I've seen so many software evaluations that focus on how many features a product has, features that we know most users will never use, it concerns me that sight has been lost about why a software solution is needed in the first place. Aren't our jobs complex enough that we don't need software to add to the complexity? Quit worrying about "features" per se - worry about the problem you need to solve, worry about how quickly the product can be adopted by your practice, worry about investing in something that can easily carry you forward into the unknown future. You will find the software answer to these questions is a product that is very focused, very easy to use and very malable. The Flip camcorder has probably just 10% of the features of the newest, whiz-bang camcorders from the major vendors. It's inexpensive but not the cheapest. I just searched "camcorder" on Amazon.com and sorted by "bestsellers" - the top 5 bestsellers were all Flip camcorders. Hmmmmm... Dave Morin CEO Cielo MedSolutions

This morning I had the great pleasure of listening to a presentation from Charissa Shawcross, NP, of Joy-Southfield Health and Education Center and David Law, PhD, of Joy-Southfield Community Development Corp. Both are deeply involved in a free clinic in Detroit and with free clinics, in general, in Southeast Michigan. What they presented is really scary. There are 47 million uninsured Americans, a number growing each day. In Detroit: 1 in 4 residents do NOT have health care there is 1 primary care provider for every 17,000 residents in Detroit sudden infant death rates are two times the national average and there's additional depressing statistics if you want them... The Joy-Southfield Health and Education Center (a free clinic on the west side of Detroit) simply cannot grow fast enough to keep up with demand. There is an 8 week waiting period for new patients (many free clinics in Detroit cannot take ANY new patients) and this only gets worse each month. The people I have met that support and work in free clinics are relentless, hard-working people that probably work over 70 hours each week to keep them running, funded and staffed. These people need to be recognized; they are providing an unmeasureable benefit to a population without a voice and in many ways ignored by our politicians. Running a free clinic isn't glamorous work, it's tough and probably quite stressful. But I see, in the eyes of these people, a passion and determination that is unselfish and laudable. The rest of us need to support their work and pay attention to the issues of the uninsured and underinsured because in the end we all end up paying for it in a lot of different ways. Dave Morin CEO Cielo MedSolutions