"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