May 30th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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The development and use of an electronic medical record is extremely important for communication, rapid diagnosis and clinical decision making, increasing efficiency in working up patients, decreasing the cost of duplication of testing and time delays in medical care and treatment.
There are many other advantages of using a functional electronic medical records. A person could be anywhere in the world and have his medical information immediately available. The results of all testing should immediately be communicated to the treating physician. All imaging studies should be digital.
Patients’ physicians could immediately read and use them for their clinical decision making.
These are only a few of the advantages of the electronic medical record. Read more »
*This blog post was originally published at Repairing the Healthcare System*
February 5th, 2011 by Veronica Sikka, M.D., Ph.D. in Health Policy, Opinion
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In 1986, when Congress passed the Emergency Medical Treatment and Active Labor Act (EMTALA), hospitals and ambulance services were mandated by law to stabilize anyone needing emergency healthcare services regardless of citizenship, legal status, and/or insurance status.
This was instituted at the time to prevent the prevalent practice of “dumping” — refusing to treat patients because of insufficient insurance or transferring or discharging patients on the basis of anticipating high diagnosis and treatment costs. While the implications of this law are indeed very noble in providing undifferentiated care to all patients based solely on healthcare needs and not financial status, it has unfortunately led to many patients presenting to the emergency department (ED) for primary care issues.
The misconception is that the care in the ED is similar if not better (because of increased access to consult services and imaging) and quicker than waiting to see your primary care physician (PCP). A 2010 study published in Health Affairs found that 14 percent to 27 percent of visits to hospital EDs are nonemergent, such as minor infections, strains, fractures, and lacerations. The study found that all of these cases could have been appropriately triaged in urgent care centers or retails clinics.
England has a model that may be a potential solution. The healthcare goal of the National Health Services (NHS) is to “treat the right patients in the right place at the right time.” The NHS employs nurses and paramedics to handle 999 (their equivalent of our 911) triage calls with more appropriate triaging of patients based on acuity. Read more »
