The AMA on EMRs

Technology is a repeated refrain in the ongoing national health care dialog. The virtues are well known, especially to readers of this blog. Studies have been enacted by numerous foundations and organizations that show the massive savings of both money and time that electronic medical records (EMRs), properly implemented, can provide. By the same token, the discussion of EMRs also brings up a consistent set of issues that are of concern to medical providers: cost of implementation, privacy issues, and technical standards.

Thanks to the online edition of AMedNews, we can take a look at the American Medical Association's views prior to the hard copy's release date of July 7, 2008, addressing this triple header of concerns.

On standards:

As work continues to develop a national strategic plan for health IT, including any coordination of the multiple government initiatives already under way, it is essential that doctors have a strong voice. It is physicians, after all, who will be expected to invest heavily in making the system work.

The AMA also stresses that physicians with small practices should be given a voice in this discussion since they comprise the majority of medical practices in the United States. This push for standards, compatibility and systems thinking is one that is at the core of George C. Halvorson's approach. Involving the actual physicians in the crafting of these standards is extremely important. After all, they will, as pointed out above, be footing the bill.

On privacy:

To boost confidence in an integrated network, the Health Insurance Portability and Accountability Act's privacy and security rules that apply to physicians, as well as other health care professionals and health plans, should be extended to any party that works with confidential health care records. This would include workers' compensation carriers, researchers, life insurance issuers, employers, marketing firms, health IT and personal health record vendors, and health information exchanges.

Doctors, says the AMA, do not need to see an expansion of their HIPAA obligations. The organization states that this would slow down transmission of patient data as new restrictions are implemented. Instead, their proposal hinges upon expanding the privacy strictures of HIPAA to apply to anyone handling this confidential data.

On implementation:

Physician reimbursements already are under intense pressure, and the Congressional Budget Office itself has released a report doubting estimates of extraordinary, health IT-related savings. It's no surprise that many practices, especially small ones, find it justifiable to avoid health IT investment. Meaningful grants, loans and other financial incentives are essential for giving physicians the financial security they need to accept and accrue the benefits of health IT.

With the cost of implementing EMRs quoted at $37, 000 per practicing physician (and that is a starting number that does nothing but increase), these sort of incentives seems to be in order. It would be a nice change from the perverse incentive standards of the modern day medical profession.

The article goes on to relate the AMA's position as it attempts to influence the U.S. Congress, which even now is deliberating the proper ways to push expansion and implementation of health information technology. Go take a look and see for yourself what your opinion is of their stance.

SOURCE: "Removing health IT barriers: The AMA advocates that federal legislation to encourage technology use should incorporate physicians' ideas, particularly in regard to technical standards, privacy and financing." 07/07/08
photo courtesy of Daquella manera, used under its Creative Commons License

Privacy, Electronic Health Records, and Consensus

Electronic medical records. Electronic health records. Personal health records. It doesn't matter whether you refer to them as EMRs, EHRs, or PHRs, the concept is still basically the same. Since the subject is one near and dear to us here at the Health Care Reform Now! Blog, it should come as no surprise to you that we are very excited about the best practices standards released last Wednesday by the Markle Foundation.

In an attempt to bring some of the spirit of the Health Insurance Portability and Accountability Act (HIPAA) to the digital arena, Markle has debuted their standards with some heavy hitters backing it. Google, Microsoft, Intuit, WebMD, Aetna, the AMA, and others have all stepped up to the plate on this one in an attempt to create a true set of industry standards and policies.

Research shows that more than half of modern Americans are interested in the advantages of having easily accessible online records. It also shows that one of the greatest barriers on the consumer level is fear of privacy issues. With a large segment of both the major and minor players in health care already on board at the time of announcement we could be well on our way to making it a non-issue.

Marianne Kobalsuk McGee over at Information Week took note of another vitally important aspect of this announcement:

Meanwhile, for other companies looking to jump on to the consumer personal health record bandwagon, the framework has been assembled early enough in this emerging market so they too can develop their products and services with the framework's privacy policies and practices in mind, Diamond said.

I have the distinct feeling that this is going to have repercussions across the industry. It seems that progress is being made. Now to keep an eye on the implementation of these standards...

SOURCE: "Google, Microsoft Back Online Health Records Privacy Framework" 06/26/08
photo courtesy of dominiekth, used under its Creative Commons license

Microsoft EMRs: What's in a Name?

Amalga. It's a name you will be hearing quite a bit about if you follow the news about electronic medical records. Amalga is Microsoft's new name for their portfolio of health care oriented applications. Marianne Kolbasuk McGee reports for Information Week:

The new "Amalga" brand is now the umbrella name for all Microsoft enterprise health care industry software, including products formerly known as Azyxxi and Hospital 2000, which were products Microsoft acquired. Microsoft's Amalga brand offering spans clinical, operational and financial functions in health care.

In addition to its Amalga product line for hospitals and other health care providers, Microsoft last October entered the consumer health care market with HealthVault, a platform that provides free Web-based health-related search and personal health record tools.

Touting new technology "on the architecture side" that provides better security and reliability, Microsoft seems to be continuing the consolidation of its efforts into a more vertical approach. These new enhancements are slated for general availability in fiscal 2009. Products under the Amalga name cover a wide array of information management needs throughout all aspects of the health care industry.

With its Microsoft Amalga product, formerly known as Azyxxi, Microsoft offers health care providers with a "unified intelligence system" that enables doctors and other clinicians to "get data anywhere data is stored to help them make more intelligent clinical decisions," said [Microsoft health solutions group's general manager of enterprise marketing Davide] Vigano. In most hospital environments, there are multiple disparate systems and applications in many departments, making it very difficult for say, an ER doctor, to access a patient's radiology or drug information in other systems, said Vigano.

Microsoft Amalga helps health care provider access that information to make better clinical decisions, he said. Azyxxi, now renamed Microsoft Amalga, was originally created by doctors and developers at from MedStar Health's Washington Hospital. Microsoft acquired the software in July 2006 and since then has been enhancing it for use by other organizations.

Right now Microsoft's seven early adopters of the software include a variety of different types of hospitals and health care providers. They include MedStar, New York-Presbyterian Hospital, Johns Hopkins Health System, Novant Health (in North and South Carolina), H. Lee Moffitt Cancer Center & Research Institute in Tampa, Florida., St. Joseph Health System (including its entire operations in California, west Texas, and eastern New Mexico); and the Wisconsin Health Information Exchange, a regional health information organization, or RHIO.

The software suite known formerly known as Hospital 2000, targeted at a global market, has experienced a name change as well. It is now the Microsoft Amalga Hospital Information System. As pointed out in the Information Week article, both Azyxxi and Hospital 2000 were originally developed by smaller independent companies and then acquired by the software giant.


SOURCE: "Microsoft Re-Names Its Enterprise Health Care Software" 02/13/08
photo: screencapture of the Microsoft's Amalga page