Intelligent Healthcare Information Integration 9/4/09

From the Mouths of Babes

Ok, I know this is not directly an HIS tale, but with all the hubbub about healthcare reform here in the US and with healthcare information technology being touted as one of the linchpins to its reformation, I figure this is at least tangentially relevant … plus, maybe a bit of a hoot to boot.

In my office today with a mom and her three rather rambunctious young’uns, I heard perhaps the most brilliant idea for lowering healthcare costs and increasing patient care outcomes that I could imagine. Of course this little jewel didn’t spring from my lips nor those of the other adult in the room. It sprang from the untarnished brilliance of a six-year-old.

As the terrible trio was bouncing around, off, and into every nook and cranny they could find, the middle child, our precocious little thought leader, suddenly and without apparent provocation stated, “You know, if we kids would behave, you could probably charge my mom less money.” Exactly what inspired this nugget of insight to pop from his mouth, I can only conjecture. Regardless, it hit me like a bolt of enlightenment straight out of the Buddha himself.

Absolutely, there are parents I would gladly provide with the daily Blue Light Special if only they would encourage their precious darlings to not crayon my walls, tear my vinyl, rip my books and magazines to smithereens, ram chairs into walls, pull paper towels endlessly from the dispenser, etc., etc., etc. I would undoubtedly save significant wear and tear costs, which I would gladly pass along to healthcare crisis community tills.

Furthering this notion, what if we could charge everyone, adults, kids, and everyone else, a reduced fee for good behavior? You know, things like showing up for scheduled appointments, taking medications as prescribed, making healthier lifestyle choices, and just generally being punctilious. Wouldn’t that help lead to some of the “clinical outcomes management” goals for improving healthcare quality we all seek? Wouldn’t that help lower healthcare costs by bringing about improved health at lower cost? (Prevention versus pound of cure and all that.)

I guarantee you that if I could lower my charges for patients who are “being good”, I would gladly forego the $44,000 in reimbursement bucks; happily buy my next round of server, pen tablets, or EHR tools from my own coffers; and let the ARRA funds go toward building the bridges for data sharing and aggregation we all really need to accomplish something with all this information. Talk about your meaningful use!

"Out of clutter, find simplicity. From discord, find harmony. In the middle of difficulty, lies opportunity." – Albert Einstein

Dr. Gregg Alexander is a grunt-in-the-trenches pediatrician and geek. His personal manifesto home page…er..blog…yeh, that’s it, his blog – and he – can be reached through http://madisonpediatric.com or doc@madisonpediatric.com.

News 9/3/09

From: Curious George “Re: OSHA. I hear that hospitals are definitely on their toes in case an OSHA inspector drops in for a chat. Do you have any information on how many physician clinics are being targeted by OSHA? Have you heard of anyone who has and what their top five non-compliant issues were? I’d like to hear from practice managers what they are doing with regards to OSHA and how many have actually ever been audited, and what your take on this is. How serious is the threat of inspections are in our business because the articles I read were way beyond that book of MSDS pages most of us have stuck somewhere, but rarely update – not to mention all the other issues we could be hit with during a visit.” I’m glad to some asking around. In the meantime, I’d also like to hear from any practice managers (or doctors or consultants) who have opinions on this.

Patient-centered medical home models provide patients better primary care, without adding additional costs. Medical home patients had 29% fewer ER visits and 11% fewer hospitalizations than patients utilizing services in a traditional primary care environment. Group Health Cooperative conducted the one-year study and found that providers relied heavily on e-mail and made the most of technology, including EMRs. Providers also reported burn-out rates 20% lower than the control group.

Time magazine also took a look at the growth of retail clinics and says these practices “are rapidly becoming to the health-care industry what Fotomat was to the camera world.” The Fotomat analogy is particularly interesting given that Fotomat closed its online presence just this week. Of course, the cute little drive-up kiosks closed several years ago as Fotomat’s one-day photo developing service became obsolete with the advent of one-hour photo processing, then digital photography. Which all leads me to wonder if the growth of telemedicine will one day make retail clinics obsolete.

ZirMed introduces a new package that includes eligibility verification, claims management, and electronic remittance, targeting smaller practices with its new ZirMed One product, which essentially bundles three stand-alone products into one.

athenahealth’s Maine Operation Center is named one of the 2009 Best Places to Work in Maine.

Delaware’s Board of Medical Practice sets the maximum rates for copying patient medical records at $2 per page for the first 10 pages. The maximum per page fee declines based on volume and 50 cents is maximum per-page fee after the first 60. Though the costs are currently for both paper and electronic records, the board is considering lowering the fees for electronic records.

Pfizer agrees to pay the government a whopping $2.3 billion to settle a healthcare fraud case. Pfizer was accused of fraudulently marketing the anti-inflammatory drug Bextra and illegally promoting other drugs. It’s the Justice Department’s largest healthcare fraud settlement ever.

Atlanta Women’s Specialists puts out a press release about the benefits of its EMR system, which includes increased staff efficiency and safer care. The practice posts and flags abnormal test results within 24 hour, sends prenatal records directly to the hospital, and exchanges information with other medical practices via the Medicity Novo Grid. The practice will soon deploy smart phones as well.

We are looking for some guest columnists to share their knowledge on HIT in the ambulatory world. In particular, we’d love a clinician who is willing to share his/her EMR journey. If that’s not your thing, but you have other relevant insights to share, let send over an e-mail.

AHRQ plans to collect data from phyicians and pharmacies to identify what accelerates and what hinders the adoption of e-prescribing. The two year study will include interviews physicians, administrators, and pharmacists across 110 different organizations in order to determine what real or perceived barriers can be obstacles for physician practice and pharmacies.

Bridge Community Health Clinic (WI) partners with Healthport to implement practice management, EMR, and RCM solutions.  Bridge is an FQHC serving 21,000 patients a year across three locations.

E-mail Inga.