Tuesday, September 30, 2008

Electronic Medical Records in the Aftermath

Alright, you've seen me post about the advantages of using electonic medical records many times over the lifespan of this blog. Now I have a practical, real world scenario to share with you, one that hits very close to home for me as someone who lives on the Gulf Coast.

As you may have heard, we have had some bad weather down here, specifically Hurricanes Gustav and Ike. As a matter fact, evacuation during these storms took your humble narrator off line for several days resulting in a lack of postings here for roughly a week.

The people of Texas, our neighbor to the west, took a beating much like the one that Louisiana and Mississippi took three short years ago during Hurricane Katrina. A beating that has left thousands of people scattered, their homes and medical records decimated by the storm winds.

MediConnect Global, Inc., is a company that provides EMR services, and today they prove the worth of digital records in a huge way.

Via The MediConnect Blog:

MediConnect has retrieved or received requests to retrieve thousands of medical records from organizations in the areas most affected by Hurricane Ike, Hurricane Gustav, and Tropical Storm Fay. MediConnect will donate digitized copies of medical records to individuals, physicians, hospitals, law firms, insurance carriers or independent agents located in the designated disaster areas who submit a request accompanied by a HIPAA-compliant patient authorization. Those who need their records can go to www.mediconnect.net to begin the process of getting any records that may be in MediConnect’s archive.

As someone directly affected by these storms, I cannot express my happiness at this news. We often speak of the savings in time and efficiency that EMRs can bring to the overall health care equation. Now we have a practical illustration of another important aspect of implementing them: disaster recovery.
SOURCE: "Medical Records Lost During Hurricanes Replaced by MediConnect Donation" 08/29/08
photo courtesy of karllehenbauer used under its Creative Commons license

Monday, September 29, 2008

Health Care Falls Off The Radar

The New York Times has debuted a new blog this weekend called Health Care Watch which kicks off with a bang as it makes inquiries into why health care seems to suddenly be missing from the ongoing Presidential debate.

Blogger Ezekiel Emanuel, an oncologist, is the chairman of the Department of Bioethics at the National Institutes of Health. He likens the current political situation regarding health care to that of chronic vs. acute health conditions.

The current state of the economy as bailout becomes the word on everyone's lips is an acute condition. The sub-prime mortgage meltdown is another one. Both are immediate and painful, having symptoms that demand immediate attention. The health care crisis is a chronic ill, like heart disease or diabetes, one with far reaching a deadly ramifications if left untreated, but lacking the sharp immediate pain of the previously mentioned conditions. Anyone following this blog or other sources of info addressing the issue of chronic ills knows how much harder to deal with and more expensive they are.

In Mr. Emmanuel's words

[...] More encouraging is that at least Mr. Obama and his advisers also recognize that solving the deep problem of the economy cannot be done without solving the health care mess. Economic, tax and health care policy are inextricably linked. Middle-class incomes have hardly grown in 30 or more years (except for five years in the 1990s when health care costs were moderated), budget deficits are escalating and will only worsen and investment in education and other engines of long-term economic growth are declining.

These problems are all driven by health care. Rather than go to wage increases, almost all of the growth in workers’ productivity has been swallowed up by rising health care costs. Medicare cost increases are the tsunami that will drown the federal government in red ink; health care — Medicaid and insurance for state workers — is now the No. 1 item in state budgets, consuming tax receipts used to support primary, secondary and college education.

His premise is that in order to cure the ills our economy is currently suffering, we need to address the state of health care in our nation. In this regard, the acceptance speeches from both sides of the aisle are less than encouraging. In Sen. Obama's speech, less than a minute was devoted to health care, approximately 100 words out of 4,900. Sen. McCain's is even more worrisome with less than 50 words out of his 4,000 word speech covering health care issues -- a whopping two sentences.

Let us hope that this issue finds itself back on their radar soon. Health care is suffering a chronic set of ills that impact our entire economy and touches almost every single American.

SOURCE: "What’s Happened to the Health Care Debate?" 09/28/08
photo courtesy of benfrantzdale used under its Creative Commons license

Friday, September 26, 2008

American Heart Association

Health care. Meaningful health care. Affordable health care. These are central to the American Heart Association's call to both of the current Presidential candidates.

Via MarketWatch:

The American Heart Association today unveiled six principles on healthcare reform as the presidential candidates begin a series of debates, the first scheduled for Friday, Sept. 26, at the University of Mississippi. With a vision of a stronger healthcare system, the association's 2008 Statement of Principles on Health Care Reform outlines critical issues that must be addressed to ensure high-quality, affordable healthcare for all Americans.

"We are committed to approaching healthcare reform from the perspective of the patient," said Daniel W. Jones, M.D., Immediate Past-President of the American Heart Association and Vice Chancellor of the University of Mississippi. "The goal is to create a dialogue among our elected officials, particularly focusing on the needs of individuals who have or are at risk for cardiovascular disease and stroke."
And a lovely list of principles it is indeed:
  • Everyone in America should have meaningful, affordable health care coverage
  • Benefits of a preventative nature should be an essential part of that coverage
  • Everyone should have high quality and affordable health care
  • All health care disparities based on gender, race, or geographic location must be eliminated
  • National prioritization of biomedical and health services
  • The pool of health care workers needs to be expanded through a substantial, sustained program of support for medical and clinical education/training
The MarketWatch press release has a lot more on the subject to help provide some context. Click the "SOURCE" link below for more information.

SOURCE: "American Heart Association Calls on Presidential Candidates to Adopt the Organization's New Principles on Healthcare Reform" 09/24/08
photo courtesy of CarbonNYC, used under its Creative Commons license

Thursday, September 25, 2008

EMRs Introduced as a Bill in Congress

U.S. Representative Pete Stark has struck a blow for electronic medical records by bringing the issue to the floor of congress, and just as importantly includes language that allows patients the right to sue for wrongful use of those records.

One of the consistent bugaboos facing the acceptance of EMRs has been that of privacy. In an era of data aggregation and the widespread harvesting of any and all sorts of demographic info, the worry about misuse of the data is a continuing concern to most people. Stark's bill would allow patients to request and audit trail of their data and its use. In addition, the Health-e Information Technology Act of 2008 also contains provisions requiring notification within 60 days if any sort of breach in privacy of these electronic records has occurred.

The general concept is the leveraging of Medicare and creation of financial incentives as reported by Medical News Today:

Rep. Pete Stark (D-Calif.), chair of the House Ways and Means Health Subcommittee, introduced a bill Monday that aims to create a national system of electronic medical records that would use Medicare reimbursement to encourage hospitals and physicians to adopt new technologies, CongressDaily reports. The measure would create a series of incentives for physicians and hospitals that utilize an approved health information technology system. It also would encourage adoption of the new technologies by providing funds through a matching grant program geared toward those who provide care in low-income, rural and medically under served areas, not-for-profit facilities and providers who receive little or no Medicare incentives.
SOURCE: "Rep. Stark Introduces Bill To Create Electronic Medical Records System, Strengthen Privacy" 09/17/08
photo courtesy of ArtNow314, used under its Creative Commons license

Wednesday, September 24, 2008

Benefits Executives Chime in on Presidential Health Care Plans

One group of Americans that has been following the health care propositions of our presidential candidates very closely is the one made up of benefits executives across the nation. No matter which way things fall, they will find their jobs and approach seriously impacted.

Sen. McCain's approach wold remove the tax exclusion for workplace-supplied benefits. Sen. Obama's would force all employers to offer health benefits. Neither option thrills those whose job it is to administer said benefits. American employers provide the majority of non-governmental health care benefits and either stance stands to cause major changes and complications in the way they do business, a particularly stressful thing to contemplate during the times of economic uncertainty. Still, of the two unpopular plans, Sen. Obama's is seen as the lesser of two evils.

Catherine Arnst of BusinessWeek reports:

The Washington law firm Miller & Chevalier Chartered, together with the American Benefits Council, a trade association, surveyed 187 benefits officers this summer at large U.S. companies to determine their views on the direction of health-care policy in 2009. The respondents were asked their opinion of several health-care reform proposals, without identifying the reforms with any candidate or political party. When asked about "pay or play," the position favored by Obama that would require employers to either provide health care for employees (play) or pay a tax to the government, 46% of respondents said it would have a strong negative effect on their workforce. But 74% said a repeal of the employee tax exemption for employer-based health coverage—McCain's proposal—would have a strong negative effect.
So while both plans are greeted with a less than enthusiastic reception, almost exactly three quarters of benefits execs find the McCain plan to be far more damaging to them. James Klein, president of the Americans Benefits Council, has an explanation of why:

[...] "Companies know they are going to end up paying the bill anyway so they want to continue to have an influence on how those benefits are designed and who is held accountable," he says.

What they don't want, however, is a patchwork system of state reforms. Several states, led by Massachusetts and Maine, have enacted or are considering some form of universal coverage involving employers. But 81% of the respondents support maintaining federal standards, and 84% oppose regulation of employer-sponsored health plans at the state level.

The logic is pretty obvious, especially when you consider the way large companies generally have assets and holdings in multiple states. Federal standards can keep things consistent across the playing field whereas if the individual states regulate the industry, companies could be facing as many different sets of divergent regulations as there are states that they operate in.

The administrative costs alone would probably skyrocket considerably.

SOURCE: "Benefits Execs Prefer Obama's Health-Care Plan" 09/18/08
photo courtesy of I am K.E.B., used under its Creative Commons license

Tuesday, September 23, 2008

The Veterans Health Care Budget Reform Act

Even though my father is deceased, I still remember the trials and tribulation he underwent during the years following Viet Nam. Suffering a 100 percent disability, he logged many hours with doctors and even more in attempting to deal with the complexities of the way we handle the health care of our country's veterans. Despite attempts to make sure that I heard none of it, I often overheard discussion between my parents about the troubles they constantly had with delays and shortfalls in the system.

Enter a few courageous U.S. Senators and Representatives and The Partnership for Veterans Health Care Budget Reform.

This partnership, which represents almost 8 million members, came out last Thursday in support of legislation presented in Washington by Senate Veterans' Affairs Committee Chairman Daniel Akaka (D-Hawaii), House Veterans' Affairs Committee Chairman Bob Filner (D-Calif.), and a variety of bipartisan co-sponsors to introduce major and historic reforms in veterans health care. Focusing on budget reform, the goal is to provide "sufficient, timely and predictable funding for veterans' health care programs."

The partnership itself is a group comprised of AMVETS, Blinded Veterans Association (BVA), Disabled American Veterans (DAV), Jewish War Veterans (JWV), Military Order of the Purple Heart (MOPH), Paralyzed Veterans of America (PVA), The American Legion, Veterans of Foreign Wars (VFW), and the Vietnam Veterans of America (VVA).

Via MarketWatch:

The new legislation, called the "Veterans Health Care Budget Reform Act", would authorize advance appropriations for Department of Veterans Affairs (VA) health care programs one year in advance of the start of the fiscal year, an idea favored by more than 80 percent of American voters, according to a survey released today by the Disabled American Veterans.

The Veterans Health Care Budget Reform Act would also require the Government Accountability Office (GAO) to audit VA's budget forecasting model and report to Congress and the public on the integrity and accuracy of the model. With these estimates in hand, Congress would be greatly enhanced in their ability to develop and enact sufficient funding levels for VA health care.

"While funding levels have increased in recent years, particularly over the past two years, Congress has failed to approve a new VA appropriation bill on time for 19 of the past 21 years," said DAV Commander Ray Dempsey. "Our polling results show that the American people overwhelmingly support a proposal to have Congress approve VA's health care funding one year in advance to once and for all end these delays," Commander Dempsey said.
If this works, it should drastically reduce the number of conversation like the ones my parents did not want me to hear. No matter what opinion one may have of the various wars and conflicts in which these men participated, the fact remains that they fought to protect us here at home. We owe them the best we can offer.

SOURCE: "Historic Legislation to End Delays in Veterans Health Care Funding" 09/18/08
photo courtesy of NARA via pingnewsused under its Creative Commons license

Monday, September 22, 2008

Health Care Navigation

Health care. If you cannot access it, it does you no good. This is one of the driving principles of overall health care reform. It has been a frequent theme that millions of people lack this access due to lack of health care coverage. It has also been consistently touched upon that people in rural areas experience a lack of access due to lack of proximity to health care facilities. These are not the aspects of health care access that I will be covering today.

Instead, I would like to draw your attention to the disparity in access experienced by ethnic minorities. Lisa Risetta at The Salt Lake Tribune reports on a new way to help equalize this imbalance:

[Harold] Freeman conceived the patient navigator - a new kind of health care worker who would steer patients through the complexities of the health care system.

Today, Freeman's navigators are seen as one solution to America's well-documented racial and ethnic disparities in medicine. Federal health officials are spending $75 million to test patient-navigator pilot programs around the country, including one that spans Utah and Montana and aims to help American Indians.

American Indians and Alaska Natives, both men and women, continue to have the country's poorest five-year survival rates for most kinds of cancers.
Poverty is one factor here; understanding is another. In the Byzantine processes of the contemporary system, those who speak English as a native language are often confused. Those for whom it is a second language can find it impenetrable. It does no good to see a doctor and be unable to understand or implement his instructions. Navigators help to ease the confusion and encourage participation in the system, improving the overall outcome for many.

SOURCE: "Navigators help minority patients overcome barriers in medicine" 09/19/08
photo courtesy of girl_named_fred, used under its Creative Commons license

Friday, September 19, 2008

Booster Shots: Compare and Contrast

Susan Brink at the LA Times is a jewel! As the blogger for their Booster Shots health care blog, she certainly delivers the goods. I have often stated that self-education on health care matters is incredibly important and have tried to provide the best resources possible for those doing so.

As I was Googling around this morning, compiling resources for a post full of comparative analysis, I stumbled across her column from September 17 which is chock full of them. Instead of re-inventing the wheel, today I am going to showcase this neutral, concise, and fact-filled collection of information with you, our readers.

I must confess, I do love her "no nonsense approach" as evinced in the intro to her Booster Shots piece:

Don't say you didn't know, or can't understand, the presidential candidates' plans for dealing with America's healthcare crisis. Don't say you don't get how they might affect you. It's all out there, analyses from independent, nonpartisan groups as well as from very partisan groups. You can have a quick, thumbnail, side-by-side peek at how each candidate sees the future of healthcare. Or you can dig into papers examining the economic and societal impacts of each plan.
She hits a vast array of resources both partisan and non-partisan beginning with the candidates' own campaign websites. She throws it all out there for you in a few short paragraphs replete with pertinent hyperlinks.

Another thing I really appreciate is her neutrality on the subject:
The bottom line from the healthcare economists who examined each candidates' proposal is that the Obama plan won't curb the escalating costs of healthcare in the U.S., the most expensive system in the world. And McCain's plan won't reduce the number of uninsured, and likely would increase their ranks.
I highly advise bookmarking this one, go give it a read!

SOURCE: "McCain, Obama health plans critiqued" 09/17/08
photo courtesy of happysnapper, used under its Creative Commons license

Thursday, September 18, 2008

The Return of Elizabeth Edwards: Health Care Sytem Immoral

Elizabeth Edwards has returned to the public health care reform discussion for the first time since last August when news of her husband's affair hit the media. She spoke in Philadelphia, PA, on the night of the 16th.

Melissa Dribben of The Philadelphia Equirer reports:

Speaking knowledgeably and with dollops of relaxed good humor, Edwards told the audience of 200 people at the National Constitution Center that the current health-care system is immoral and "fails everyone except the extremely wealthy."

Seated onstage in a plush chair, the 57-year-old wife of former Democratic presidential candidate John Edwards used her experience as a patient with incurable breast cancer to illustrate lapses in the current system. But she was careful to say that the responsibility lies both with individuals, who need to take good preventive care, and insurance companies, which should be concerned with long-term health instead of short-term savings.
As a sufferer of incurable breast cancer, Mrs. Edwards has a voice that commands attention in matters of health care reform. Her direct experience with the system provides a veracity that is seen as lacking on the part of many in politics today. Another factor is that she does not see either of the current candidate's plans for health care reform to be ideal, although she has no problem in stating which one is her preference.
Except for one subtle remark about the "Republican vice presidential candidate's" opposition to stem cell research, Edwards maintained a relatively neutral political stance. Neither presidential candidate is proposing the kind of universal and comprehensive coverage that Americans deserve, she said. But of the two, Edwards said, Democratic Sen. Barack Obama's plan, which would mandate coverage for children, will move the nation more in the right direction.
In addition to the statements above, she once more reiterated her opinions about John McCain's personal health issues and their impact upon his perspective in this matter. Sen. McCain's multiple melanomas have been treated under his military health plan, which provides extensive coverage even though most private insurance plans in the U.S. would deny coverage on these pre-existing conditions.

The debate continues to heat up, and one must wonder if the media eye will pay more attention to Mrs. Edwards' health care activism or the peccadilloes of her husband. John Edwards has stated that he will stay out of the public eye until after November 4 in order to keep from clouding the issues or distracting from the focus of the Democratic Campaign.

SOURCE: "Elizabeth Edwards calls health-care system immoral" 09/17/08
photo courtesy of ariedana used under its Creative Commons license

Wednesday, September 17, 2008

Health Care, Politics, and Disputed Numbers

It is to be expected that the claims made by political candidates will not only come under scrutiny, but also be hotly disputed across the board. So it is in the 2008 Presidential Campaign. Since universal care is within reach depending on circumstances, it behooves us to take a good look at the claims being made.

Kevin Sack, who blogs on The Caucus (The New York Times' political blog), brings us one of the aforementioned disputes in the form of quotes from the McCain camp juxtaposed against a panel of economists:

Senator John McCain’s top domestic policy adviser, former Congressional Budget Office director Douglas J. Holtz-Eakin, recently said in a conference call with reporters that Mr. McCain’s health care proposal would “put 25 to 30 million individuals out of the ranks of the uninsured, into the ranks of the insured.” In an article released Tuesday, a panel of prominent health economists concludes that Mr. Holtz-Eakin’s projection is off by, well, 25 to 30 million.
The McCain strategy, as unveiled so far, includes removing the tax exempt status of employer-provided health care while counterbalancing it with individual tax credits to make purchasing individual care less burdensome.
Within a few years, however, the trend would reverse, the study asserts. That is because, according to Mr. Holtz-Eakin, the McCain health care tax credits would be indexed to “regular inflation,” presumably the Consumer Price Index, which is typically lower than annual increases in health care costs. Unless costs can be substantially reined in, the credits would therefore enable fewer people to afford coverage each year, leading to an eventual rise in the number of uninsured.
Their findings agree with those of the Urban Institute and the Brookings Institution last July which also predicts initial effectiveness followed by a steady upward creep in the number of uninsured. According to The New York Times, Holtz-Eakin did not respond to their request for a comment.

SOURCE: "Journal Disputes McCain’s Health Care Claims" 09/16/66
photo courtesy of SoggyDan, used under its Creative Commons license

Tuesday, September 16, 2008

Senate Finance Committee: Health Care Incentives and IT

Last Tuesday, a Senate Finance Committee hearing saw health care experts calling for adoption of health IT, an overall increase in transparency and pay-for-performance programs to improve care and reduce costs.

These are two issues that we have returned to over and over during the course of this blog. The current incentive system in place is, as George C. Halvorson put it in Health Care Reform Now!, perverse. A move towards performance-based metrics and payments is something that could go a long way towards re-aligning the cumbersome and costly approach used today. Health care IT is well known as a means of not only trimming down administrative costs but also as a way to increase efficiency and eliminate a majority of duplicate testing and paperwork-driven errors.

Via Healthcare IT News:

"We believe that aligning financial incentives is the right approach to pushing quality to a higher level," [Greg] Schoen [MD, regional medical director of Fairview Northland Medical Center in Princeton, Minn.] said. "By creating a positive incentive to improve quality, pay-for-performance is an engine for improvement and can be a framework for fundamental transformation."
He is far from the only one bringing these views to the Senate. Samuel R. Nussbaum, MD, executive vice president of clinical health policy and chief medical officer at WellPoint, Inc., was also present and vocal as was Peter V. Lee, executive director of the National Health Policy at the Pacific Business Group on Health.

Also via Healthcare IT News:

Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee said he would hold two more healthcare reform hearings this year.

With healthcare spending outpacing the overall economy and inflation, "we simply cannot afford to continue paying for inappropriate or inadequate medical care," he said.

The time is right for change. We have labored too long under the non-system that currently holds sway. All of the differing elements needed are aligning to make this the perfect time to implement true reform of American health care. Now.

SOURCE: "Experts push transparency, P4P, and healthcare IT for healthcare reform" 09/10/08
photo courtesy of Marion Doss used under its Creative Commons license

Monday, September 15, 2008

I.T. is It!

John Engler, President and CEO of the National Association of Manufacturers and former governor of Michigan, has a wonderful piece up on The Hill right now about the importance of health care Information Technology and the legislation supporting its implementation.

As the immediacy of skyrocketing gas prices and the economic instabilities of 2008 seem to have overshadowed health care in much of the political discussion surrounding the race for the White House, Mr. Engler reminds us of the importance of the long view.

We have covered the reasons why electronic medical records and other forms of health care IT are a necessary part of the overall equation on many occasions. What Mr. Engler reminds us is why it is imperative to push legislation through Capitol Hill immediately:

On Sept. 8, over 100 associations, businesses, unions, patient and provider groups signed a joint letter to Congress urging passage of health information technology legislation this year. Health IT has overwhelming bipartisan support in both the House and the Senate, and yet the American people are still waiting for Congress to act. [...]

The life-saving, cost-reducing benefits health IT legislation can deliver to the American public make its passage imperative this year. Next year, a new administration will take office and, in the shuffle, health IT legislation could stall, forcing Americans to wait even longer.
Once the transition to a new administration begins, many things will be in flux. One thing that will not change is our moral imperative as a nation to ensure access to health care and coverage to our fellow citizens.

Please take a moment and read Mr. Engler's piece and refresh your knowledge of exactly why this is such an important issue.

SOURCE: "Don’t let health IT legislation flatline " 09/11/08
photo courtesy of Paolo Margari, used under its Creative Commons license

Friday, September 12, 2008

Retail Health Care: Redux

So what do you do if you do not have a regular health care provider and you need preventive care or care for a simple illness? According to a new study by the nonprofit RAND Corporation, you are the type of patient who would patronize a retail health clinic.

If you have missed my prior postings on the subject and have not run across the concept elsewhere, a retail health clinic is a small clinic with limited facilities that is located inside another store. Pharmacies and big box stores seem to be the usual locations they spring up in, at least so far.

At the moment, the U.S. has approximately 1,000 of these clinics, and estimations say the number will grow to a possible 6,000 by 2011. The trend is still in its comparative infancy, but like many kids, it seems to be growing fast. The RAND study is the first recorded examination of the patient demographics for this new wave of retail health care.

Via The Washington Post:

"These clinics appear to attract patients who are not routine users of the current health care system. For these patients, the convenience offered by retail clinics may be more important than the continuity provided by a personal physician," lead author Dr. Ateev Mehrotra, a professor at the University of Pittsburgh School of Medicine, said in a RAND news release.
The numbers are interesting, and bear out my predictions of earlier posts. People seem to be gravitating to this as an alternative to the perceived cost and hassle of seeing a primary care doctor. To be frank I am looking forward to seeing some of these here in New Orleans. I would certainly consider using them if they were available.
  • 43% of Retail Clinic patients were in the 18 to 44 age range as opposed to to 23% of those visiting primary care physician offices.
  • 39% percent of Retail Clinic patients had a primary care doctor, compared with 80% surveyed nationally.
  • Retail Clinic visits paid for out-of-pocket decreased from 100 percent in 2000 to 16 percent in 2007.
  • Roughly 90% of visits to retail clinics were for preventive care (medical tests) or for treatment of simple conditions or immunizations . These same conditions make up 18% of primary care visits and 12% of emergency department visits.

SOURCE: "Retail Clinics Attracting Those Without Regular Doctors" 09/10/08
photo courtesy of ernestl, used under its Creative Commons license

Thursday, September 11, 2008

Biden Speaks on Health Care, Slams McCain Plan

Well the airwaves, newspapers and Internet are full to bursting with news and commentary related to the Presidential race, particularly now that the VP choices have been made on both sides of the aisle.

On the Democratic Party's side, Sen. Joe Biden is moving forward as an outspoken and determined VP choice for Sen. Obama. In a recent speech in Mehlville, Missouri, speaking to a socially conservative, predominantly blue collar crowd, he tied the growing unease about health care to the rising unemployment that the community has recently experienced. He then issued a no nonsense warning to the crowd about the net result of the McCain proposal on this subject.

Via Jo Mannies at STL Today:

[...]taxing American workers' health care is not the answer, he said. Under McCain's plan, Biden said, a person earning $50,000 a year, with employer-provided health care worth $12,000 a year, would be subject to income taxes on all $62,000. Now, no taxes are levied on their health care benefits.

McCain has been highlighting his proposed $5,000 a year tax credit to offset some of that tax hike, but Biden said that at least $7,000 would still be subject to the tax.
Sen. Biden then went on to state that the change in structure proposed by the McCain ticket would cause more employers to drop health care coverage. An assertion that carries quite a punch, especially in the context of the American working class.

At a town hall earlier that day, Sen. Biden called it a "moral obligation" for the government to make health care available to all U.S. citizens.

SOURCE: "Bid focuses on healthcare, rips Republicans, in Mehlville stop" 09/10/08
photo courtesy of IowaPolitics.com, used under its Creative Commons license

Wednesday, September 10, 2008

Health Care High Tech

Technological advances are one of the things that we all hope will help drive down the overall cost of health care. Electronic medical records (EMRs) are frequently shown by a wide array of studies to cut a huge amount of administrative costs out of the overall equation. Other innovations could be extremely useful as cost cutters once out of the research phase.

CBCNews out of Canada takes a quick look at some of these advances, and also looks at the source. Their conclusion is that the real "cutting edge" of medical tech advancement is occurring in small companies and start-ups. Citing the more adventurous profile of companies that rely on angel investments and the need to maintain revenue streams on the part of larger, established ones, the article then proceeds to put forth a few examples.

Right off the bat, they go to what I consider one of the most important areas of medical tech: electronic medical records.

Philadelphia-based Hx Technologies wants to unlock the power of computer networks (a very '90s concept) and suck costs out of the system by making it easier to transport diagnostic images like CT scans. Amazingly, shuttling these images to doctors for second and third opinions is still done the old-fashioned way — by hand.

[...]Launched in 2000, Hx Technologies estimates that it can eliminate extra tests — and save the U.S. medical system $5 billion (US) to $6 billion a year — by storing medical images so they can be accessed in encrypted form over the Internet.

They then proceed to take a look at some other innovations, including (believe it or not) robot nurses. It is a fascinating view of the cutting edge.

SOURCE: "Hot technology that could change health care" 09/08/08
photo courtesy of Liz Henry, used under its Creative Commons license

Tuesday, September 9, 2008

Google Your Health Records

Ten years ago this week, a new search engine made its debut. Little did anyone know at the time what a phenomenon Google would become in the intervening decade. The phrase "Google it," has become enshrined in our collective lexicon as meaning "search the Internet." Even those who do not use the Internet much or often know its meaning. In short, Google has become enshrined in our culture in much the same way a scant few other brands have. Kleenex, anyone?

Now the power of Google is being brought to bear on Electronic Medical Records. PublicRadio.org's Money Marketplace show takes a solid look at the newest news from the Internet titan, exploring both pros and cons of the new searchable online approach.

Of particular interest is the trust factor. Many people who wish to move to EMRs are worried about data mining, hackers and the other privacy bugaboos that come up whenever you discuss Internet-based programs like this.

WBUR's Martha Bebinger reports:

Still, I wonder, what will Google do with this information? HIPAA, the federal law that controls the release of patient records, does not govern these online medical records programs.

Halamka pulls up the Google Health privacy rules:

Halamka: We will never share your data. We will never data mine. We will never advertise based on your health data. You know, it's not, "Oh, I'm a diabetic; we're having a sale on glucometers at XYZ.com." They've truly built firewalls between the advertising and personal health record.

Carlton Doty: I think they're walking a fine line there.

Carlton Doty, a senior analyst at Forrester Research, says Google or Microsoft or any of their health records competitors are also creating a major advertising venue.

The article covers many other aspects of the system and includes a walk through the setup and a really useful analysis of the overall features of the new Google offering. Check out the transcript or listen to the original program here.

SOURCE: "Google's next search: Medical records" 09/06/08
photo courtesy of extraketchup, used under its Creative Commons license

Monday, September 8, 2008

Health Care In Campaign 2008

Ladies and Gentlemen, fasten your seat belts! The next 60 days or so will be abuzz as our esteemed candidates make their final lap in the race for the Oval Office. It's the final stretch and the point where the voting public really crystallizes their decision on whom to vote for.

Making an informed decision requires sound information. I hope the following is helpful in that regard.

  • Research!America's President, Mary Woolley, talks with NPR about the findings of a questionnaire sent to both campaigns. A questionnaire requesting "policy details on issues such as health care coverage, stem cell research, the Medicare prescription drug benefit, and funding for NIH, FDA and CDC." [Listen Here]

  • The Kaiser Network presents a new regular feature, Blog Watch. "Blog Watch, published on Tuesdays and Fridays, tracks a wide range of blogs, providing a brief description and relevant links for highlighted posts." [Blogwatch]
I will try to share as many resources as I can over the next two months. These are important decisions for our nation and the health of its citizens. It is our responsibility as citizens to become engaged for the benefit of both ourselves and our children. It is up to us to do our part. Our country needs health care reform now!

SOURCE: "Questionnaire Distills Candidates' Health Policies" 08/13/0
SOURCE: "Kaiser Network BlogWatch" 09/05/08
photo courtesy of CommandZed, used under its Creative Commons license

Thursday, September 4, 2008

Hurricane Hiatus

Dear Readers,

Due to weather events in New Orleans, home of your Blog Editor, regular maintenance of this blog has been suspended. We expect to resume daily postings and management on Monday, September 8 -- weather permitting.

With Thanks for Your Understanding and Patience,

George "Loki" Williams

Wednesday, September 3, 2008

EMRs: My Thoughts in Exile

Regular readers have no doubt caught on to the fact that I am based in New Orleans. For the second time in three years this simple fact has caused me to take my family into exile as severe weather threatens my city. Gustav may have missed New Orleans, but his effects are felt by two million of us evacuated out of southern Louisiana.

The gridlock on the road was disturbing and constant. The A/C had to be switched off in order to conserve gasoline since there was no ready way to acquire more. Two of my cats almost died of heatstroke and my wife and I both became ill. Until last night, the prior three days had included only four hours dedicated to sleep, and those were spent on a friend's floor in the midst of numerous other refugees.

Now, as I sit in Ohio at my best friend's house, I think back on it. This is the second exodus that my family and I have undergone in the past three years. In the context of my work on this blog, it becomes especially meaningful. You see, if Electronic Medical Records were a universal standard, it could save lives in a situation like this.

Two million people evacuated according to the news. Two million including the elderly, the disabled and children. I know. I shared the road with them for endless hours as the southern heat beat down upon us. I had visions of medical emergencies occurring either on the road or when my fellows reach their destinations. For the most part, I would be willing to wager that medical records were often left behind. I know they were in our case.

If there were a solid standardized system in place to handle all of these records digitally, a lot of these issues would evaporate. What made me think of it was sitting here in Ohio on my friend's porch and having a wasp land on my arm. You see, I am highly allergic to insect stings. If it had tagged me, I would be on my way to the emergency room. EMRs would communicate this and my other allergies even if there was no one around to do so.

Think about it. I have often written about the way that EMRs would reduce medical costs, particularly admin costs. That is highly desirable. In the final analysis, it is the enhanced safety for my neighbors and friends that is of ultimate importance. Two million people. The newsman on CNN called it the largest evacuation in American history. That is in addition to those displaced by failing levees in the midwest and fires on the west coast.

They can save lives, and that, my friends, is the most important reason we need them.