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| Goals and Objectives |
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| Goals |
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| MEMRI's goal is to build an EMR from the data generated from standard
healthcare transactions. Aggregated and de-identified to protect patient
privacy, the database of all EMRs will also allow purchasers, providers,
and patients to make more meaningful comparisons among providers and
health plans in terms of cost, quality, value, and availability of
healthcare services. (The Detroit Regional Chamber, for one, has called
for a public policy initiative to establish just such a database -
see Detroit Regional Chamber (2001). "Health Care Stakeholders
Initiative: Summary and Action Steps." Occasional paper. (June).)
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| It would also enable government, academic, and public health research
institutions to track diseases and infections and monitor, on a real-time,
ongoing basis, the state of Michigan health, and thereby be in a position
to derive more timely and effective policies and interventions. |
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| Individual EMRs will be dynamically assembled using data contained
in standard transactions from the various sources from which the data
originates. With the adoption of the HIPAA mandated transaction standard
for healthcare attachments, virtually every form of clinical information
will become available in a standardized electronic format. Each part
of the treatment spectrum will contribute its share. Per HIPAA requirements,
patients will have access to and ultimate control over the contents
of their identifiable record. |
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| The technology to do all this is here now. Products and technologies
designed to provide shared Web services and extract data from legacy
systems and present them in uniform web-based formats are available
today. Several dozen commercial EMR products are already available
and some are being implemented in a handful of Michigan hospitals.
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| The main issues are not technological; rather, they are matters
of leadership and commitment. Commitment and leadership are required
by the healthcare industry as a whole and by government. Hospitals
and physicians lack the financial and technical ability to undertake
a statewide project alone. But they have shown a desire and a willingness
to participate. |
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Priorities |
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| MEMRI's top priorities are (1) to build consensus and support
among business leaders, healthcare leaders, legislators, and citizens
by showing them through meetings and publicity that lives can be saved,
suffering reduced, and costs cut without compromising privacy and
security, and (2) simultaneously to architect the statewide EMR
system. |
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| Previous efforts to institute a statewide EMR have been thwarted
by concerns over privacy/security, system costs, technical feasibility,
and unwillingness to share what some organizations mistakenly view
as valuable proprietary data. Consensus and support is necessary to
achieve the high degree of cooperation whose absence has thwarted
previous efforts. |
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| Technological standards and capabilities for private and secure
data sharing among disparate organizations are now in place. To specify
how the standards and capabilities will be applied to the MEMRI initiative,
work is proceeding with MEMRI's technology partners Sun Microsystems
and Rootlevel, Inc., to define requirements and implement a pilot
system across 4-5 healthcare organizations. |
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| Objectives |
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Alert and inform citizens, legislators, business leaders, and
healthcare leaders about the situation and options;
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Address the key related public policy issues of privacy, healthcare
costs, and healthcare quality;
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Catalyze consensus for action;
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Build pilot systems to demonstrate high-impact cost and quality
outcomes;
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Plan and facilitate the statewide adoption of the resulting
solution across all patient populations; and
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Put patients at the center of the healthcare system - empowered
to manage and control their own EMR.
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