August 30th, 2011 by Lucy Hornstein, M.D. in Health Policy, Opinion
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Race is a medically meaningless concept.
Spare me the few tired cliches about prostate cancer, diabetes, and sarcoidosis being more common in blacks than whites, or even the slightly increased risk of ACEI cough in patients of Asian descent. We screen Jews of Ashkenazi descent for Tay Sachs without any racial labeling. All that information is readily accessible under the Family History section of the medical history. It is no more than custom which dictates the standard introductory format including age, race, and gender. It turns out I’ve blogged about this before at some length (pretty good post, actually). What is new is the advent of electronic medical records.
Much hullabaloo has been made about federal stimulus funds allocated to doctors as payments for adopting EMRs; “up to $44,000!” Here’s the problem with that figure, though, including how it breaks down (source here): Read more »
*This blog post was originally published at Musings of a Dinosaur*
August 15th, 2011 by Lucy Hornstein, M.D. in Opinion
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Seven months into 2011, things look very different than they did this time last year at my office. Not only have I been using an electronic medical record for nine months now, but I’ve also been submitting claims electronically (through a free clearinghouse) using an online practice management system. I’ve also begun scanning patients’ insurance cards into the computer, as well as converting all the paper insurance Explanation of Benefits (EOBs) into digital form. I’ve even scanned all my office bills and business paperwork and tossed all the actual paper into one big box. As of the first of the year I even stopped generating “daysheets” at the end of work each day. After all, with my new system I can always call up the information I want whenever I need it.
How did such a committed papyrophile get to this point? It is the culmination of a process that actually began last summer with the purchase of an adorable refurbished little desktop scanner from Woot ($79.99, retails for $199, such a deal!) The organizational software is useless for my purposes, but it does generate OCR PDFs, which makes copying and pasting ID numbers from insurance cards into wherever else they need to be a piece of proverbial cake. The first step was to start Read more »
*This blog post was originally published at Musings of a Dinosaur*
July 15th, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy, Opinion
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In the 12 years since our government acknowledged we had a problem with racial disparities in health care, we’ve made significant progress in reducing them. Steep declines in the prevalence of cigarette smoking among African Americans have narrowed the gap in lung cancer death rates between them and whites, for example. Inner city kids have better food choices at school. The 3-decade rise in obesity rates, steepest among minorities, has leveled off.
Still, racial disparities persist across the widest possible range of health services and disease states in our country. The racial gap in colorectal cancer mortality has widened since the 1980s. Overall cancer death rates are 24% higher among African Americans. Sixteen percent of African American adults and 17% of Hispanic adults report their health to be fair or poor, whereas only 10% of white American adults say that. The number of African Americans and Hispanics who report having access to a primary care physician is 30-50% lower than white folks who have one.
How can EMRs Help? Read more »
*This blog post was originally published at Pizaazz*
July 14th, 2011 by DrWes in Health Policy, Opinion
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* Bzzzzzaaaaapp *
Suddenly, the light went out. There was complete and utter darkness. Then, about 3 seconds later, the lights returned. My computer with its flat screen poised before me, remained dark. I hesitated a moment, then pushed the power button. Within a few more moments, the computer restarted. All seemed intact.
But what if it wasn’t?
Today with our myriad of computer systems, electronic medical records, e-mail messages, paging systems, digital xray machines, blood chemistry analyzers, automated blood pressure cuffs, etc., etc., etc., what would happen if we had no power or functional electronic medical record, just for a week?
Could our health system function?
We have entered the era when our medical students and residents have never entered a written order and “flagged it.” Our unit secretaries wouldn’t have a clue how to take off an order from a “flagged” chart. How would we order a stat portable chest xray without a computer? And what about our written notes. Would they include the date and time in the lefthand column, or would that be forgotten in our hurry to write our manual progress notes? Would our digital phone systems work? How about our pagers? Doctors can no longer find manual blood pressure cuffs on our wards since hospitals have moved to automated blood pressure cuffs that upload their readings into the electronic medical record automatically. Have our nurses and medical assistants lost the art of taking a manual blood pressure? Read more »
*This blog post was originally published at Dr. Wes*
March 14th, 2011 by DrWes in Health Policy, Opinion
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Give me your medication list and I’ll tell you your health problems. It happens every day in emergency rooms across the country as confused elderly patients present for an acute problem unable to describe their past medical history, but equipped with a list of medications in their wallet:
Metformin = Type-2 diabetes
Synthroid = Hypothyroidism
Lipitor + Altace + Lasix + Slo-K = Ischemic cardiomyopathy
Lexapro = A little anxious or depressed
Viagra = Well, you know…
I bet I’d be right better than 90 percent of the time. Now, imagine you’re a pharmaceutical company wanting to target people with those chronic diseases. Where might you find them?
No problem. Just pay the insurers to provide you patients’ drug lists. No names need be exchanged in keeping with HIPAA requirements. But the drugs list attached to folks’ cable TV box? Perfect. You’re in — with no legal strings attached. Then, according to the Wall Street Journal, just fire away with that targeted direct-to-consumer advertising on TV, courtesy of your local healthcare insurance provider.
No wonder our healthcare industry movers and shakers love the electronic medical record. Healthcare privacy? What healthcare privacy?
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
