Electronic Medical Records: Imagining the End Game Shapes The System, So Who Gets to Imagine the End Game?

“When you have a hammer, everything looks like a nail.” When you are a doctor, it is all about you.

According to Dr. David Kibbe, spokescritter for the American Assoc. of Family Physicians, the whole point of switching to electronic medical records is: “for doctors’ offices and hospitals to be able to easily share patient information, something the vast majority can’t do today. That would cut down on mistaken and unnecessary procedures and give doctors faster access to more accurate information about patients’ medical histories and drug regimens.”

But there are, in fact many other advantages to electronic medical records. One, for example, is to facilitate patient choice of doctor or specialist by making it easy for the patient to access, or provide access, to all medical records in one place. Right now, my ability to switch from my current practitioner to another practitioner is dependent on my collecting my medical info and moving it to my preferred doctor. The law requires my current Doctor to allow this, but it does not require them to make it easy for me.

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The Media Ownership Endgame: Martin's Opening Gambit on Newspaper-TV Cross Ownership

As I’ve said before, Kevin Martin plays a mean game of hardball — but an honest one. And while I’m happy to have him on the right side in limiting cable market power, it makes fighting on the media ownership side an utter bitch and a half. Like Belichik prepping the Patriots, Martin has carefully studied the mistakes of Michael Powell, studied the strategies of the media reform movement, carefully considered his own strengths and weaknesses, and set up his game plan with a determination to win.

This tends to make some of my friends and colleagues in the movement hate Martin personally, or get bogged down in the distractions and the moves Martin throws. But that’s as stupid as letting yourself get distracted by trash talk. To win this fight, we need to keep our eye on the game, stay nimble, have our own special teams prepped, and remember we’re in this to win in the long haul.

With this in mind, we turn to the opening moves in Broadcast Media Ownership Endgame. Martin already has one key advantage in that because he is the Chairman, he can set the agenda. He controls the timing and can float trial balloons, decide when to hold new hearings or release new studies, and finally declare when he wants a vote. Martin demonstrated his skill in this over the last month, gradually building to the end game, alternating period when nothing seemed to be happening with sudden frenzied activity. Each such move requires us to mobilize resources and exhaust ourselves, and forces us to make process demands for more time and reasonable opportunities for comment. Martin can then chose to acede to our requests in a limited way, letting a deadline slip a few weeks or postponing something by a month. This makes it look like Martin is being reasonable and accommodating, and casts us in the role of partisan foot draggers. Worse, it makes it increasingly difficult to mobilize our troops, because how many times do we have to fight and win these minor skirmishes over procedural issues and timing? People get tired of the issue, or think we already won when what we achieved was merely a temporary respite. Then, like a matador administering the coup de grace on the exhausted bull, Martin plunges his point directly into the heart. (‘Scuse me a minute, I need to check to see if my ears and tail are still attached.)

But Martin has now clearly committed to the final moves of the end game with a PR blitz/charm offensive similar in many ways to his approach in the 700 MHZ proceeding. And, as with the C Block “open access” condition, I do not expect Martin to make signifcant changes to his proposal now that he has put himself out in front and committed to a public position. Martin the Matador has dropped the cloak and gone for the sword. The question is whether the media reform bull is as exhausted or confused as Martin thinks, or if we still have sufficient wits and stamina to give him a surprise.

More below . . .

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The 700 MHz Auction Pre-Show: Live from the AT&T/Aloha Bowl!

The pre-game show for the 700 MHz auction has definitely gone into full swing. Lets ignore for the moment the purely regulatory shenanigans such as Verizon’s war of litigation and regulatory maneuver. Let’s pause for a moment to consider some of the player training and pre-game jockeying for position. Notably, today’s big announcement that AT&T will buy Aloha Partners 700 MHz licenses.

“Whoa!” I hear you cry. “How did Aloha Partners (or anyone else) get 700 MHz licenses? I thought the auction wasn’t until January!” Well, for reasons I will address below, the FCC actually auctioned some of these licenses back in 2002 and 2003. Aloha Partners won a fair number of them dirt cheap (since at the time no one knew if the broadcasters would ever finish the digital transition and get off the spectrum), and then began a steady stream of acquisitions, culminating in the purchase last month of Lin TV’s 700 MHz licenses, giving them a total of 270 licenses overall and healthy coverage in the major markets of the southwest, south, east coast, and portions of the midwest. (You can see and old map of the major coverage areas here.)

And now, in what has become the all too familiar paradigm for the telecom world, AT&T has turned around and swallowed Aloha Partners 700 MHz licenses. What does this mean? What impact for the auction? For other deals? Will this impact the regulatory end game?

My speculations are even wilder-ass than usual, given the utter lack of real data. But if you’re up for a walk through the entrails with me, see below . . . .

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