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| 2004 MACKINAC POLICY CONFERENCE: GM chief: Time for health care fix is now |
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| Detroit Free Press |
| June 5, 2004 |
| Kim Norris |
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Soaring health care costs are crippling the competitiveness of U.S. companies, and fixing that should be the top priority for whoever wins November's presidential election, the top executive of General Motors Corp. told a conference of Michigan's political and business leaders Friday.
"It is well beyond time for all of us to put partisan politics behind us and get together to address this health care crisis," GM Chairman and Chief Executive Officer G. Richard Wagoner told the Detroit Regional Chamber's annual conference on the state's economic future, at Mackinac Island.
It was a year ago almost to the day that Bill Ford, chairman and CEO of Ford Motor Co., told the Mackinac Island gathering that the cost of health care "scares me enormously."
"It's the biggest issue on our plate that we can't solve," Ford said last year. "Health care is just out of control."
But in the 12 months since Ford publicly confessed his deepest fears, most business leaders agree that not nearly enough has been done.
Health care costs are rising at 14 percent to 18 percent a year, Wagoner said, and now consume 15 percent of our nation's gross domestic product, much more than in other developed nations.
First Ford, and now Wagoner, want a national debate on the problem that will lead to new ways of controlling, and perhaps paying, America's hospital, drug and doctor bills.
The call for government intervention represents something of a sea change in the thinking of corporate America, which provides health care coverage for 57 percent of Americans.
"For many years, U.S. employers were quite confident that they could take this on themselves and didn't want the government involved," said Larry Levitt, vice president of the Kaiser Family Foundation, an independent, nonprofit, private foundation focusing on health care.
"They felt that market forces and negotiating leverage would address the issue. But when you have enormous companies like GM and Ford saying they're powerless, it tells you something. If GM tells you they can't do anything, how is the corner grocery store supposed to cope?"
Increasingly, businesses have stopped coping. Larger companies have shifted more of the costs to workers. Smaller companies are dropping coverage at accelerated rates, and new companies don't offer it to begin with.
As a result, the number of uninsured has risen -- to 4.3 million, or 15 percent of Americans, according to the U.S. census.
As costs continue to rise at a feverish pace and the uninsured population grows, people are looking increasingly to the government for solutions.
"You can't be a presidential candidate without a plan," Levitt said. "There is a growing view that a more global solution is needed but nothing close to a political consensus over what to do.
"You can see it in the recent Medicare reform. Republicans wanted a market based with private plans; Democrats wanted to give negotiating power to the federal government to lower prices."
The idea of universal coverage has been advanced by labor organizations and some business leaders, as well as politicians. Less discussed is who will pay for it.
The concept of a single payer -- which is a bureaucratic way to say the federal government covers the bills -- is advanced at some peril. Opponents conjure up images of nation-states and socialism. Proponents note the federal government already insures about 80 million Americans through the nation's two largest insurance programs -- Medicare, for seniors, and Medicaid, for poor people and people with disabilities.
President Bill Clinton attempted to address the health care crisis in the 1990s. Led by his wife, Hillary, the administration advanced a employer-based program for extending coverage to all workers. Unemployed people would have received subsidies to help them pay for coverage.
The United States is the only industrialized country in which employers are the major payers of health care.
GM, the largest private purchaser of insurance in the world, spent $4.8 billion on the benefits for its 1.1 million employees, retirees and dependents. That adds about $1,400 to the cost of every car and truck GM sells in this country.
Ford spent $3.2 billion for 650,000 people in 2003.
Yet even though the United States is spending over $1 trillion a year on health care, Wagoner noted that it ranks 12th out of 13 industrialized nations in 16 of the top health indicators, such as infant mortality and obesity.
Wagoner said the recent passage of the federal medical drug benefit for retirees -- part of the Medicare reform legislation -- was a big help for companies that pay for the health benefits for a large retiree population, as do the U.S. automakers.
"It's not a panacea for us," Wagoner said, "but it's a good start in recognizing the role that government needs to play in addressing the competitive issues arising from the health care crisis."
Doctors and other health care professionals say costs are going up primairly because they can treat many more ailments, more effectively, than ever before. But more care means more bills.
Too many discussions about health care costs become finger-pointing without results, said Elliott Joseph, president of St. John Health, one of the Detroit area's major hospital systems.
"We suffer from very small thinking," he said.
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| Online medical records may just save your life |
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| Detroit Free Press |
| April 5, 2004 |
| Mike Wendland |
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Here's the scenario: You're in a car accident late one night and rushed unconscious to a hospital emergency room.
Doctors need to do surgery. Before doing so, they first must know more about your medical history. But since you can't talk, your family doctor's office is closed and the medical records from other illnesses, injuries and your most recent physical are inaccessible, the ER doctors are forced to start from scratch.
Blood work, tests, X rays and other diagnostic information that already exists has to be redone, all as the clock ticks and precious time slips away in treating your new injuries.
There has to be a better way. And in Michigan, there just may soon be, as the Michigan Electronic Medical Record Initiative (MEMRI) gets ready to test a program that will use the Internet to quickly access all the medical records a person creates throughout the health care system. Immediate access to such information would provide timely and potentially lifesaving information to the doctors who need those records in times of emergency.
"The more information we can get about a patient, the better we can treat that patient," said Dr. Charles Shanley, the chairman of MEMRI and a vascular surgeon and critical care specialist at Beaumont Hospital in Royal Oak.
It would also save the state an estimated $350 million a year in health care costs by eliminating the duplication of tests and improving efficiency.
MEMRI has been under way for two years, lining up technology companies and health care providers as partners and addressing concerns about privacy and the confidentiality of sharing patient records over the Internet.
"Clearly, privacy has been the biggest issue," said David Ellis, MEMRI's executive director. "We're confident that the security we have designed into the technology and the system itself addresses those legitimate concerns."
No records would be viewed without specific patient authorization. And the original records themselves would remain wherever they were initially stored; only the specific information needed for treatment or diagnosis would be retrieved.
That's resulted in some influential support for the project.
Michigan Gov. Jennifer Granholm has officially endorsed MEMRI, claiming that it will improve the quality of health care in Michigan. So has the Michigan State Medical Society.
The nation's intense concern over homeland security and emergency preparedness has also brought strong interest from federal officials. In the event of a catastrophic event or a medical or biological incident causing mass casualties, having medical records immediately accessible would greatly enhance patient care.
Ellis said MEMRI plans to seek federal funding to help launch the pilot program. Beaumont Hospital, the Detroit Medical Center, Crittenton Hospital in Rochester, Michigan Endocrine Consultants in Berkley, and the Grunberger Diabetes Institute in Bloomfield Hills have agreed to participate as pilot sites and to provide patients.
Sun Microsystems has donated the computers and technology to link the sites.
But backers need $150,000 in funding, something MEMRI members say they hope to accomplish through meetings with Detroit's major automotive companies and suppliers and other corporate and health industry interests.
"Something like $1,200 of the price of a new car goes for medical coverage for the autoworkers," Shanley said. "So anything like this that can streamline those costs is something we think will be favorably received by the Big Three."
The pilot program could get under way by midsummer.
Details of the plan can be found at www.memri.us.
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| Health Files on Tap for Migrants |
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| Wired |
| October 25, 2002 |
| Lia Steakley |
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... seasonal field workers move with the changing harvest, their medical records lie scattered like seeds among various rural clinics.
Sonoma, California-based Medical Management Resources (MMR) intends to change that by offering a bilingual version of its software application followMe.
Funded by an $80,000 grant from Rural Communities Assistance, Visitantes Información Acceso (VIA) will equip migrant farmers in Sonoma County with an e-mail account, an ID card and server space to store medical records.
"Many workers have significant health care needs, including chronic medical conditions," said Cynthia Solomon, founder of MMR. "Most of these workers rely on rural health clinics and federally funded migrant clinics for their health care. Once they are treated and move on, there is no way to track their health status or treatment plan."
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The idea is to enable workers traveling up California's coast picking oranges in Fresno, lettuce in Monterey and wine grapes in Sonoma to log on to VIA's website from the nearest Internet port and access every detail of their medical history.
"When patients come into the ER, they may take medication for blood pressure, but they don't know the exact name or dosage of the prescription. Then the doctors have to start from scratch," said Kathy Ficco, executive director of medical access for St. Joseph Health System in Sonoma County, which will test the program in December.
VIA plans to make immunization records, prescriptions, treatment plans, illnesses, allergies, physicians and contact information for the last clinic the patient visited instantly available.
... at a time when identity theft incidents abound, and California ranks first in identity theft victims and second in the rate of incidents, security is a top concern.
Although VIA e-mail accounts and patient data are encrypted and stored separately on MMR's server, and the software complies with the Health Insurance Portability and Accountability Act, those precautions might not be enough.
"An entity that stores personal info can share it with anyone that they have a contract with for reimbursement purposes," said Dr. Paul Billings, founder of GeneSage, a producer of Web-enabled tools in the genetics field. "Any (such) system needs to have a way for the customer to know when files have been accessed, and by whom and for what reason." ...
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| Symposium to feature award-winning CPR systems | | | | | | | HIMSS News | | October 17, 2002 | | Staff | | | | | In conjunction with the Eighth Nicholas E. Davies Award
presentation, HIMSS will host the Davies Award Symposium, which
provides a rich source of computer-based patient records (CPR)
experiences, lessons, and solutions shared among healthcare
professionals all over the world. Plus, Maimonides Medical Center
and Queens Health Network, this year's Davies Award winners for
excellence in implementing CPR systems, will share their first-hand
knowledge of how to manage a complex CPR project and provide
functionality to users.
The symposium will be held in San Antonio, TX, on Sunday,
November 10. To register and learn more about the symposium,
click here or contact Sean Roberts at 312-915-9273.
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| | | | Wilensky on IT Initiatives | | | | | | | HIMSS Newsbreak Sep 30 - Oct 14, 2002 | | October 14, 2002 | | Staff | | | | | Click here for HIMSS website
WITH THE ECONOMY STRUGGLING AND MEDICARE MOVING TO CUT HOSPITAL PAYMENTS, FUNDING FOR INFORMATION TECHNOLOGY IS GETTING TIGHTER BY THE MINUTE. IN TIMES LIKE THESE, WHAT HAPPENS TO IT INITIATIVES THAT PROMISE TO REDUCE MEDICAL ERRORS AND IMPROVE THE QUALITY OF CARE? TO FIND OUT, HIMSS NEWSBREAK INTERVIEWED A SENIOR BUSH ADMINISTRATION ADVISOR. GAIL WILENSKY IS COCHAIR OF THE PRESIDENT'S TASK FORCE ON IMPROVING HEALTHCARE FOR VETERANS. SHE WAS ALSO DEPUTY ASSISTANT FOR HEALTH POLICY DEVELOPMENT UNDER THE FIRST PRESIDENT BUSH. WE ASKED HER IF THERE WAS ANY HOPE OF INCREASED GOVERNMENT FUNDING FOR IT.
"There's no hope unless there is really credible evidence that improved quality and patient safety is occurring in some institutions. And at that point, there could be a lot of pressure to alter the way that Medicare makes its payments to allow for additional payments for quality. The problem has been that the data's not been very good to be generous."
WILENSKY SAYS THAT CURRENT STUDIES ON THE EFFECTIVENESS OF COMPUTERIZED PHYSICIAN ORDER ENTRY AND OTHER VAUNTED IT TECHNOLOGIES HAVE SO FAR FAILED TO MAKE A BUSINESS CASE FOR THEIR PURCHASE. STUDIES THAT EXAMINE THE USE OF IT ACROSS SEVERAL HOSPITALS ARE NEEDED TO BUILD A CASE. WHAT WOULD MOST IMPRESS GOVERNMENT AND PRIVATE INSURERS, SHE SAYS, IS EVIDENCE THAT IT CAN CUT THE NUMBER OF MEDICAL ERRORS.
"We clearly need to get a much better handle on the dimensions of the problem, but, more importantly, what seems to work and make a difference? Making better data available either because of reduced liability issues or because increased error really does cost employers and payers money ought to be able to convince them to pay more for systems."
WILENSKY CALLS HOSPITALS "SCHITZOPHRENIC INSTITUTIONS" FOR THEIR SIMULTANEOUS DEVOTION TO HIGH TECH CLINICAL GADGETS AND PAPER-BASED RECORD KEEPING. SHE HAS NO DOUBT THAT THEY CAN BENEFIT FROM BETTER IT SYSTEMS. BUT THE KEY WORD HERE IS "BETTER," NOT MORE.
"I believe that part of what it's going to take to be able to make that kind of transformation is going to be better information systems. Information systems that talk to each other from different departments and that are thought through in a much more fundamental way than now occurs, where each department gets to order its favorite piece of equipment in terms of information systems and you end up with twenty different legacy systems that can't deal with each other."
WILENSKY OFFERS THIS FINAL PIECE OF ADVICE FOR GETTING PAYERS' TO SUPPORT IT SPENDING. DON'T INVEST IN A TECHNOLOGY BECAUSE IT LOOKS IMPRESSIVE - INVEST IN IT BECAUSE IT SOLVES THE PROBLEMS YOU HAVE NOW.
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| | | | CPR Gives Nurses MoreTime for Patient Care | | | | Higher quality care; easing of the nursing shortage | | | | IDX press release | | November 4, 2002 | | unknown | | | | | | University of Pennsylvania researchers recently found significantly higher (up to 7%) post-surgery mortality rates in hospitals that have higher patient/nurse ratios. The study appeared in the October 21st issue of JAMA.
Clearly, the fewer patients per nurse nurses, the more time each nurse can spend per patient, and the better the care. Another study reported at IDX's website, shows that computerized patient records can effectively give nurses more time with patients. Not only does the quality of care improve, but also pressures of the nursing shortage are eased...
The study took place at PeaceHealth St. Joseph Hospital, a 253-bed, two-campus medical center in Bellingham, WA. It found that online clinical documentation can halve the time needed to perform charting functions such as recording patient vital signs or noting when medications are administered. The study also found that nurses using paper-based systems typically spend about 30%, or more than three hours per 12-hour shift, on documentation. Using online documentation freed up an additional 1.5 hours per nurse per 12-hour shift, according to the researchers.
The study was designed to measure time spent by nurses completing defined documentation tasks using the IDX LastWord enterprise clinical system and to compare it to the time required to perform the same tasks at hospitals that use a paper-based documentation system. | | | | back to top | | |
| | | | Recent statistics on CPRs in use | | | | | | | HIMSS website | | November 4, 2002 | | HIMSS | | | | | | A recent HIMSS study found that use of an electronic medical records system (EMR) (meaning what MEMRI prefers to call a computerized patient record, or CPR, system) varies by medical practice specialties. While 30% of respondents indicated an EMR was in place in their practice, some 42% of respondents working in an internal medical practice said they have an EMR, followed by multispecialty practice (33%), family practice (30%), and specialty practice (i.e., dermatology, gastroenterology), 27%. | | | | back to top | | |
| | | | Health Care Crisis | | | | IoM calls IT and EMRs to the rescue | | | | | November 27, 2002 | | Institute of Medicine | | | | | | The National Academy of Sciences/Institute of Medicine has released a report stating that the nation's healthcare system "is confronting a crisis" and urging the federal government to support various pilot programs, including testing the use of information technology in healthcare delivery. Specific issues addressed were the high cost of healthcare, and pressures on a system supporting millions of uninsured patients. The four areas of proposed projects are medical malpractice; community health centers; treatment of chronic illnesses and information technology; and computerizing medical records and reducing paperwork.
We believe this same message applies at the state level, and encourages the new Michigan administration to support MEMRI's initiative, which will contribute to a resolution to the Medicaid crisis through the creation of a cost-saving, quality-enhancing, patient-centered, patient-owned electronic medical record system. | | | | back to top | | |
| | | | EMRs and Regulatory Reform | | | | A recent report to the Secretary for Health & Human Services | | | | | November 21, 2002 | | Secretary's Advisory Committee on Reg. Reform | | | | | | Excerpt from Report of the Secretary's Advisory Committee on Regulatory Reform The Secretary of Health and Human Services' Advisory Committee considered the report during its November 21, 2002 meeting:
...The Committee also discussed the value of using an electronic health record to improve health care quality by increasing the accuracy of information and reducing the need for redundant documentation by multiple clinicians. As an example, the Committee learned about the electronic health record developed by the University of Pittsburgh Medical Center (UPMC), when some of its members had an opportunity to witness a demonstration of the UPMC smart card. These smart cards, which include numerous security features for protecting private health information, are being used by hospital staff to access comprehensive medical history and insurance information, and will provide patients access to their own medical information. The Committee believes that such innovation will increase the accuracy, accessibility, and transferability of important health information. The Committee recognizes that it may be difficult to achieve consensus in the process of building an electronic health record, but that regulators should encourage these efforts. [Emphasis added] | | | | back to top | | |
| | | | Medical group advocates putting records on Web | | | | | | | Detroit Free Press | | December 2, 2002 | | Mike Wendland | | | | | | The press is beginning to take note of MEMRI. Here is a concise review by Free Press technology columnist Mike Wendland.
(Correction: The article may give the impression that the University of Michigan and Beaumont Hospital are partners in the upcoming pilot project. While we hope this may eventually be the case and while we have had enthusiastic input from individuals at those and other institutions, no formal agreements have been sought with them or with any other provider as yet.) | | | | back to top | | |
| | | | Cyber-state.org, MEMRI Collaborate to Improve Health Care in Michigan | | | | | | | Press release | | December 4, 2002 | | MEMRI and Cyber-state.org | | | | | Cyber-state.org, MEMRI Collaborate to Improve Health Care in Michigan
DETROIT, December 4, 2002: The Michigan Electronic Medical Record Initiative (MEMRI) today received the endorsement of Cyber-state.org and its parent organization, the Ann Arbor-based Altarum Institute. Cyber-state.org is the leading nonprofit organization promoting the use of information technology in Michigan to improve the life of every Michigan citizen. Altarum is a nonprofit research and innovation institution that researches, develops and delivers advanced informatics and knowledge tools to societal customers in the healthcare, national security and energy, environment and transportation sectors.
MEMRI (http://www.memri.us ) is a nonprofit initiative to implement a statewide, standardized secure electronic medical record system for Michigan that would improve the quality of health care for patients in the state while protecting patient privacy. The new system would also result in significant cost reductions for healthcare consumers and providers. Cyber-state.org (http://www.cyber-state.org ), a member of the Altarum family, is a non-partisan organization that was founded as the result of a 1998 Michigan Information Technology Commission report warning that the state's private and public-sector organizations were unprepared to take full advantage of information and communication technologies in ways that better its citizens' lives including making Michiganians healthier. Altarum has been a regular innovator and supplier of advanced information technology tools, including the Michigan Childhood Immunization Registry (MCIR), to the Michigan Department of Community Health.
"MEMRI, Cyber-state and Altarum share the same crucial goal," said Cyber-state President Katherine Willis. "We are all trying to find better ways to use information technology tools, including Michigan's growing broadband Internet infrastructure, to improve the quality and better manage the cost of health care services being provided to Michigan residents. There is no greater imperative for Michigan than getting the cost of quality health care under control and we know that innovative information technology tools can make a real and positive contribution."
MEMRI was founded in response to patient, health care provider and insurer dissatisfaction with the current state of medical records technology in Michigan and nationwide. Currently, most medical records are stored in paper files or in proprietary medical records libraries in health care providers' internal systems. Accessing a patient's medical records at a variety of providers can be a time-consuming and frustrating, if not impossible, process.
"Timely access to medical records saves lives and reduces errors by giving health care providers the information they need to make informed decisions at the point of care," explained David Ellis, interim executive director, MEMRI. "In addition to improving care this also decreases the cost of health care and makes the entire health care process more efficient for the provider and more convenient for the patient, without any sacrifice in terms of quality or access."
The MEMRI model envisions a collection point or portal for the temporary assembly and display of an individual patient's medical record scattered around multiple provider systems. Much like the independent networks that enable ATM transactions at third-party banks, MEMRI will not itself maintain a central medical records database, but facilitate the sharing of information on a private, secure, and transient basis.
About MEMRI:
MEMRI is a Michigan-registered nonprofit corporation dedicated to improving healthcare quality and lowering healthcare costs in Michigan through the implementation of a statewide, standardized electronic medical record.
About Cyber-state.org:
A member of the Altarum family, Cyber-state.org is a nonprofit organization committed to ensuring that all Michigan residents are able to benefit from information technology. Comprising representatives from public, commercial and nonprofit organizations across the state, the coalition fulfills a key recommendation made by the Michigan Information Technology Commission, a group convened in 1998 by the W.K. Kellogg Foundation, The Herbert H. and Grace A. Dow Foundation and the Council of Michigan Foundations.
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| | | | MSU doctors to stop using paper records in 30 clinics | | | | | | | Lansing State Journal P. 1C | | December 4, 2002 | | Tracy Burton | | | | | | Paper-based medical records will be replaced with a $2.5 million
electronic system, called Logician, in 30 Michigan State
University (MSU) Health Team clinics, according to MSU heath
team chief information officer Michael Szkotnicki. The system
improves efficiency by not only allowing approved users access
to a patient's medical history but to also research generic drug
alternatives and check insurance coverage and patient allergies.
The system also organizes test results for easy analysis and allows
patient information to be easily transferred between clinics to
improve communication. Szkotnicki says new services will be added
to the system in the next few years to improve efficiency. | | | | back to top | | |
| | | | Electronic Health Records survey | | | | | | | ERI website | | November 20, 2002 | | Medical Records Institue | | | | | An "Overview Version" of the Medical Records Institute Survey of Electonic Health Record Trends and Usage is available online at no cost. The results are based on 761 provider responses from April 15th through May 16th, 2002. The survey provides insights into the:
- Management, administrative, and clinical motivations driving the need for Electronic Health Record systems
- EHR applications and functions being implemented or planned
- Web-based, ASP, and wireless applications being implemented or considered
- Data capture methods being employed
- Major barriers to EHRs and the user strategies to address them
- Data security concerns and implementation plans
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| | | | Physician Recalcitrance | | | | Opportunity for Michigan to Break the Mold | | | | New York Times | | December 18, 2002 | | Editorial | | | | | | "A survey of practicing physicians has revealed disheartening evidence that the doctors themselves may be the biggest obstacle to effective reform," says the New York Times December 18, 2002 editorial. It notes that "Less than a quarter of the doctors think it would be very effective to use computers instead of paper forms to order drugs or to include pharmacists on hospital rounds, two approaches that have been shown to reduce medication errors in hospitals," and concludes that "With the evidence growing ever stronger that medical errors are a danger to many patients, it is disturbing to find such retrograde attitudes among physicians. Reform can succeed only if the medical profession gets behind changes that expert groups and plain common sense suggest could significantly reduce the harm caused by medical errors."
MEMRI urges Michigan physicians to break the mold and set the standard for the nation going forward, by sending us a letter or email expressing support for the MEMRI initiative. It will help us in our efforts to persuade the entire physician community. | | | | back to top | | |
| | | | CDR case study in Michigan | | | | | | | PDF file | | December 18, 2002 | | Reliance Software Systems | | | | | | Here is a very recent case study on a web-based clinical data repository (CDR) product installed at 469-bed Providence Hospital and Medical Centers in Southfield, Michigan. Providence is a member of the St. John HealthSystem of Detroit, which is an Ascension Health affiliate.
The system enables and incorporates a CPR and CPOE, among other things. The short case study paper is especially useful in providing some data on cost savings from various elements of the implementation. | | | | back to top | | |
| | | | MEMRI in the [HIMSS] News[break] | | | | | | | HIMSS Newsbreak | | December 9, 2002 | | HIMSS | | | | | | Following is a partial transcript of the HIMSS Newsbreak first broadcast on December 9, 2002:
THE U.S. HEALTHCARE SYSTEM IS UNABLE TO MEET CURRENT NEEDS, LET ALONE FUTURE ONES. THAT ACCORDING TO THE FEDERAL INSTITUTE OF MEDICINE. THE IOM, IN A LATE NOVEMBER REPORT, PROPOSED USING PILOT PROJECTS IN THREE TO FIVE STATES TO TEST REFORMS INCLUDING UNIVERSAL HEALTH COVERAGE AND USING INFORMATION TECHNOLOGY TO COMPUTERIZE MEDICAL RECORDS. AT LEAST ONE STATE IS ALREADY TRYING TO LAUNCH SUCH A PILOT. A MICHIGAN COALITION OF PROVIDERS, INSURERS AND TECHNOLOGY VENDORS WANTS TO GIVE THE STATE’S PATIENTS ONLINE-ACCESS TO THEIR MEDICAL RECORDS. DAVID ELLIS IS INTERIM EXECUTIVE DIRECTOR OF THE COALITION. HE ADMITS THE BIGGEST HURDLE THE GROUP FACES IS THE CONCERN THAT PATIENTS’ PRIVACY WILL BE VIOLATED IF THEIR RECORDS ARE PUT ONLINE.
Ellis: There’s a strong need to unlock the public’s alleged distrust of a centralized medical records database. And we think we have a solution to that. The first is by having a distributed as opposed to a centralized database. And the second is by making sure that we use the federated identity protocol and not a centralized identity protocol. With those, a level of privacy can be assured that could not have been assured even a year ago.
THE INITIATIVE HAS ALREADY LINED UP AN IMPRESSIVE LIST OF SUPPORTERS, INCLUDING SUN MICROSYSTEMS. SUN IS HELPING DESIGN THE ARCHITECTURE OF THE PROPOSED NETWORK. UNDER THE PLAN, PATIENTS WOULD DETERMINE WHO HAS ACCESS TO THEIR MEDICAL FILES. ELLIS ESTIMATES THE 100 MILLION DOLLAR SYSTEM WOULD SAVE THE STATE MORE THAN THREE TIMES THAT AMOUNT EACH YEAR BY REDUCING PAPERWORK AND ADMINISTRATIVE BURDENS.
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| | | | Stop and take notice | | | | A personal story (used with permission) | | | | Email to MEMRI | | December 30, 2002 | | Becki Kraus | | | | | Subject: Greetings!
Time: 12:19 PM, 30/12/2002 (Mon)
From: "Rebecca K. Kraus"
To: "'david@memri.us'"
Every now and then a project comes along that is so vitally important - it
makes one stop and take notice. The MEMRI project is just that. For ten
months, my mother and I have fought the red tape involved in accessing
medical records and coordinating care for my father. The concept that MEMRI
supports would help end this nightmare.
Becki Kraus
President
Transitions Consulting Group LLC
Troy, Michigan | | | | back to top | | |
| | | | Doctors Belong in Hospitals, Not Courtrooms | | | | | | | New York Times | | January 6, 2003 | | LLOYD M. KRIEGER | | | | | | In an article about the malpractice sitation, plastic surgeon Lloyd Krieger writes:
"Patient records should be better coordinated - while taking care to protect privacy - so that doctors can easily gain access to a patient's complete history. My mechanic has better records on my car than I have on some of my patients. Peer review of the day-to-day care of patients should be the first line of defense against poor care . . . . "
The EMR achieves peer review. Every doctor who looks at the record can see how their peers diagnosed and treated the patient in the past.
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| | | | HMO Kaiser plans to put its medical records online | | | | | | | Wall Street Journal, Feb. 4, 2003 | | February 4, 2003 | | Rhonda L. Rundle | | | | |
In what may be the most ambitious move yet toward electronic medical records, Kaiser Permanente, the nation's largest nonprofit health-maintenance organization, Tuesday will announce plans to spend $1.8 billion to automate its patient files.
Kaiser, with 8.4 million members in nine states, said its goal is to have the automated records up and running in three years. With such a system, the HMO would make portions of each patient's records available online to members, who would be able to check recent medical-test results, see their complete immunization history and review their current medications, among other things.
To accomplish the electronic shift, Kaiser will purchase a system from Epic Systems Corp., a Madison, Wis., software concern, and abandon a decadelong effort to develop such a system itself.
Click here for full story (WSJ Online subscribers only)
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| | | | Old data systems a health care burden | | | | Handling bills, claims sends costs climbing | | | | Boston Globe | | February 4, 2003 | | Beth Healy | | | | | When President Bush took aim last week at bloated medical bills, he blamed lawyers, bureaucrats, and insurance companies for driving up costs. But there is a hidden culprit he did not mention: woefully outdated back-office technology. The medical system has invested heavily in new ways to heal patients, but it has neglected the nuts-and-bolts business of managing bills and records.
Of all the intractable challenges in health care, updating bill collecting and claims processing might seem the simplest to address. But the $1.4 trillion health industry for years has lagged the rest of the economy in high-tech spending. Only agriculture and education spend less.
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| | | | EMR-related job posting | | | | Info. Mgt./EMR director | | | | | January 13, 2003 | | James S. Urbanski | | | | | In line with MEMRI's promotion of the installation and use of CPRs/EMRs, we are happy to help providers find staff to help them meet those objectives. Following is a posting supplied by Information Systems Executive Recruiters:
Director, Health Information Management/Electronic Medical Records
Candidate assumes global responsibility for overall Health Infromation
Management policies, procedures and operations across a multi-site
healthcare system. Accountable for the development, implementation, and
operational goals involving the electonic medical records.
Requirements:
- BS/MS in Health Information Management
- Registered/certified RHIA
- Minimum of 10 years in Health Infromation Management, and 5 years with director and/or senior manager experience
Contact:
James S. Urbanski
President
Information Systems Executive Recruiters, L.L.C.
248-647-0850
jim@iserllc.com
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| | | | Electronic Records Find Long-Term Use | | | | | | | Health Data Management | | February 1, 2003 | | Beckie Kelly Schuerenberg | | | | | | Continuing care physicians and nurses at the Kaiser Permanente continuing care department, which serves long-term care patients in 65 nursing homes and rehabilitation centers in the Denver area, can now remotely access and update patient information
from all 65 sites medical records via laptops and dial-up connections. Patient care is improved because patient information moves with patients who receive care from
different physicians. The caregivers can also access lab results and other important treatment information remotely. The new system also enables Kaiser to track long-term information to improve quality.
Health Data Management
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| | | | Off the Charts | | | | | | | CIO, Vol. 16, No. 8, P. 46 | | February 1, 2003 | | Koch, Christopher | | | | | | Change management is key to getting physicians to adapt to a paperless system. Following a “big-bang” implementation, involving just two large rollouts for outpatient
clinics then the inpatient facility in 1999, University of Illinois Medical Center doctors are now so used to the electronic system that they become impatient when the system
experiences (rare) problems. Change was achieved first through leaders among nurses,
who often feel hospital inefficiencies most acutely, and the number of doctors who still refuse to use the paperless system is declining.
CIO
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