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    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

    Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

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Invitation to Participate

By Flavio Zoppini

Dear Dr. Marcinko,

I am contacting you to ask the ME-P to become a partner for the 4th Global M-Health App Developer Economics.

The 4th Global MHealth App Developer Economics is conducted in partnership with Global Health Alliance and established global mHealth players and healthcare publishers like Happtique, HIMSS, WIP and Pharmaphorum.

Our partners will help us to make this project the largest mHealth app development study globally.  The target audience for the study is mHealth app developers and publishers as well as decision makers in the healthcare industry and institutions that oversees mHealth activities.

Results will be presented on the mHealth Summit in Berlin May 2014.

Partner benefits:

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  • Brand will be part of the largest study about mHealth apps.
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  • Invite survey participants. The study will be largely based on the results of a global online survey which has been launched last week.

Here is a link to the survey. Take the survey

Write about the results of the study once it is finished.

Here are some topics the study is covering:

  • Impact on healthcare: e.g. how will mHealth apps help to reduce healthcare costs?
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  • Trends: e.g. what will be the main distribution channels for mHealth apps in five years?
  • The market’s current status: e.g. what are the main reasons for publishing mHealth apps?
  • Innovation: e.g. how do APIs change the way mHealth apps deliver their services?

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Assessment

We would like you to join the team of partners for this project.  I look forward to your ME-P reader feedback.

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Impact of Health Information Technology

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An HIT Infographic

[By HIMSS Clinical Informatics Community]

Practicing clinicians have indicated strong support for the ability of health IT to overcome communication challenges among care providers. Considering that a series of Institute of Medicine reports on errors in healthcare have led to widespread recognition that siloed practices and inadequate communication are primary contributors to medical errors, continued endorsement for health IT will lead to better communication and enhanced quality of care.

The results come from the 2013 iHIT study conducted by HIMSS and HIMSS Analytics, released during HIMSS13, the organization’s annual conference and exhibition. The study was designed to explore the role of health IT from an inter-professional communication perspective. More than 500 clinician respondents working in a care delivery setting provided information on the value of health IT in support of quality care.

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Assessment

According to the study, the health IT tools in place at the provider organizations of respondents support various clinical processes and provide improved access to the information needed to prepare for delivery of care. This includes having improved access to information needed on patients transferring to a clinician’s unit/caseload, ultimately resulting in enhanced levels of patient care.

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The Legal eHR [Extreme Caution Ahead]

Is there such a thing?

By Dr. David Edward Marcinko MBA CMP

[Editor-in-Chief]

Electronic medical and healthcare records [eMRs and eHRs] are a hot topic and the subject of many positive and negative posts and comments on this ME-P; and around the healthcare space. Personally, I am agnostic on the subject – trending against – for most physicians at this point in time.

In other words, the technology is just not there yet regarding “ease of use”, inter-operability, common transmission and security standards, and common platform, etc. This is reminiscent of the early days of the word processing industry, when I first used Edix-Wordex, Leading Edge, Word Perfect, Word Star, ASCII, PFR-Write, PC-Write, etc.  It was both exciting and confusing, being a writer and editor, at that time. Sorta like working in an electronic Tower of Babel; or using the many disparate eHR systems existing today?

I am not a Luditte, however. I’m a former American Health Information Management Association (AHIMA), and Healthcare Information and Management Systems Society (HIMSS), member. And, I’m certain that eHRs will be pervasive one day, but I’ll reserve my opinions, my money and information security, and my patient’s data until then. After all, I am a MSFT-Word® guy today as I thank Bill Gates for consolidating the formerly competitive, and chaotic, word processing software space. Yes, sometimes monopolies are a good thing! 

Malpractice Issues

Moreover, it seems I have been a Cassandra [the daughter of King Priam and Queen Hecuba of Troy] of sorts, crying aloud about the professional liability and medical malpractice issues of eMRS; here on this ME-P, during my speeches and lectures, as wells as in our books and CDs. All to no avail; until now!

Links: https://medicalexecutivepost.com/2009/12/23/will-electronic-records-raise-the-legal-standard-of-care-and-increase-malpractice-risk/

I suppose this is a product of my prior work as a licensed insurance agent for the State of Georgia, a malpractice reviewer, a court approved medical-legal expert witness, and author of the book: “Risk Management and Insurance Planning for Physicians and their Advisors”.

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Assessment

Q: And so, is there a legal eHR and is it different from traditional eHRs?

A: You bet there is!

Read Link: http://www.himss.org/content/files/LegalEMR_Flyer3.pdf

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Think I am still mis-guided, or worse, paranoid? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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The Continuing Debate over Electronic Medical Records Systems

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Are We There Yet? – In Healthcare Organizations

[By Richard J. Mata MD, MS]

Dr. Mata

Paper-based medical records have been in existence for centuries and their gradual replacement by computer-based records has been slowly underway for over twenty years in western healthcare systems.

Computerized information systems have not achieved the same degree of penetration in healthcare as is seen in other sectors such as finance, transportation, and the manufacturing and retail industries.

Further, deployment has varied greatly from country to country and from specialty to specialty and in many cases has revolved around local systems designed for local use.

The DHHS

In a 2005 DHHS study, national penetration of electronic health records (EHRs) may have reached over 90% in primary care practices in Norway, Sweden, and Denmark (2003), but has been limited to 17% of physician office practices in the U.S. (2001-2003). By 2011, and the ACA, this number may now be approaching 20-25% in the US but adoption may actually be slowing.

The ISMS Vision

According to the Illinois State Medical Society there is a “Sweeping Vision for EHRs”:

  • EHRs will provide a comprehensive view of all patient information
  • Quality of care will be improved.
  • Physicians will more easily be able to review the “complete” medical record.
  • An appropriately configured EHR system will provide “alerts” and “notices” to help health care providers incorporate best practices into patient treatments. Ideally clinical decision support should be built in and be evidence-based.

Medical errors can be reduced:

  • Treatment and administrative costs will be reduced.
  • Public health will be improved.

Defining Electronic Records Systems

The 2003 Institute of Medicine (IOM) Patient Safety Report describes an EHR as encompassing:

  • a longitudinal collection of electronic health information for and about persons;
  • [immediate] electronic access to person- and population-level information by authorized users;
  • provision of knowledge and decision-support systems [that enhance the quality, safety, and efficiency of patient care] and
  • support for efficient processes for health care delivery.

IOM Report

A 1997 IOM report, The Computer-Based Patient Record: An Essential Technology for Health Care provides a more extensive definition:

A patient record system is a type of clinical information system, which is dedicated to collecting, storing, manipulating, and making available clinical information important to the delivery of patient care. The central focus of such systems is clinical data and not financial or billing information. Such systems may be limited in their scope to a single area of clinical information (e.g., dedicated to laboratory data), or they may be comprehensive and cover virtually every facet of clinical information pertinent to patient care (e.g., computer-based patient record systems).

The EHR definitional model document developed by the Health Information and Management Systems Society (HIMSS, 2003) includes “a working definition of an EHR, attributes, key requirements to meet attributes, and measures or ‘evidence’ to assess the degree to which essential requirements have been met once EHR is implemented.”

IOM Re-Deux

In another IOM report, Key Capabilities of an Electronic Health Record System [Tang, 2003], identifies a set of eight core care delivery functions that EHR systems should be capable of performing in order to promote greater safety, quality and efficiency in health care delivery. The eight core capabilities that EHRs should possess are:

  1. Health information and data. Having immediate access to key information – such as patients’ diagnoses, allergies, lab test results, and medications – would improve caregivers’ ability to make sound clinical decisions in a timely manner.
  2. Result management. The ability for all providers participating in the care of a patient in multiple settings to quickly access new and past test results would increase patient safety and the effectiveness of care.
  3. Order management. The ability to enter and store orders for prescriptions, tests, and other services in a computer-based system should enhance legibility, reduce duplication, and improve the speed with which orders are executed.
  4. Decision support. Using reminders, prompts, and alerts, computerized decision-support systems would help improve compliance with best clinical practices, ensure regular screenings and other preventive practices, identify possible drug interactions, and facilitate diagnoses and treatments.
  5. Electronic communication and connectivity. Efficient, secure, and readily accessible communication among providers and patients would improve the continuity of care, increase the timeliness of diagnoses and treatments, and reduce the frequency of adverse events.
  6. Patient support. Tools that give patients access to their health records, provide interactive patient education, and help them carry out home monitoring and self-testing can improve control of chronic conditions, such as diabetes.
  7. Administrative processes. Computerized administrative tools, such as scheduling systems, would greatly improve hospitals’ and clinics’ efficiency and provide more timely service to patients.
  8. Reporting. Electronic data storage that employs uniform data standards will enable health care organizations to respond more quickly to federal, state, and private reporting requirements, including those that support patient safety and disease surveillance.”

Assessment

After reviewing the above, are we there yet in – 2011?

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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Defining Electronic Medical Record Systems

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Does Linguistic Obfuscation Exacerbate our Use Ambivalence?

[By Dr. Richard J. Mata; CIS, CMP™]

[By Dr. David E. Marcinko; MBA, CMP™]

The 2003 Institute of Medicine (IOM) Patient Safety Report [1] described an EHR [2] as encompassing:

  • a longitudinal collection of electronic health information for and about persons;
  • [immediate] electronic access to person- and population-level information by authorized users;
  • provision of knowledge and decision-support systems [that enhance the quality, safety, and;
  • efficiency of patient care] with support for efficient processes for health care delivery.

The IOM Report

A 1997 IOM report, The Computer-Based Patient Record: An Essential Technology for Health Care, provides a more extensive definition:

A patient record system is a type of clinical information system, which is dedicated to collecting, storing, manipulating, and making available clinical information important to the delivery of patient care. The central focus of such systems is clinical data and not financial or billing information. Such systems may be limited in their scope to a single area of clinical information (e.g., dedicated to laboratory data), or they may be comprehensive and cover virtually every facet of clinical information pertinent to patient care (e.g., computer-based patient record systems).

The HIMSS Model

The EHR definitional model document developed by the Health Information and Management Systems Society (HIMSS, 2003) includes:

“a working definition of an EHR, attributes, key requirements to meet attributes, and measures or ‘evidence’ to assess the degree to which essential requirements have been met once EHR is implemented.”

 

The IOM Model

Another IOM report, Key Capabilities of an Electronic Health Record System [Tang, 2003], identifies a set of eight core care delivery functions that EHR systems should be capable of performing in order to promote greater safety, quality and efficiency in health care delivery:

8 Core Principles

Today, we realize that the eight core capabilities that Electronic Health [Medical] Records should possess are:

  1. — Health information and data. Having immediate access to key information – such as patients’ diagnoses, allergies, lab test results, and medications – would improve caregivers’ ability to make sound clinical decisions in a timely manner.
  2. — Result management. The ability for all providers participating in the care of a patient in multiple settings to quickly access new and past test results would increase patient safety and the effectiveness of care.
  3. — Order management. The ability to enter and store orders for prescriptions, tests, and other services in a computer-based system should enhance legibility, reduce duplication, and improve the speed with which orders are executed.
  4. — Decision support. Using reminders, prompts, and alerts, computerized decision-support systems would help improve compliance with best clinical practices, ensure regular screenings and other preventive practices, identify possible drug interactions, and facilitate diagnoses and treatments.
  5. — Electronic communication and connectivity. Efficient, secure, and readily accessible communication among providers and patients would improve the continuity of care, increase the timeliness of diagnoses and treatments, and reduce the frequency of adverse events.
  6. — Patient support. Tools that give patients access to their health records, provide interactive patient education, and help them carry out home monitoring and self-testing can improve control of chronic conditions, such as diabetes.
  7. — Administrative processes. Computerized administrative tools, such as scheduling systems, would greatly improve hospitals’ and clinics’ efficiency and provide more timely service to patients.
  8. — Reporting. Electronic data storage that employs uniform data standards will enable health care organizations to respond more quickly to federal, state, and private reporting requirements, including those that support patient safety and disease surveillance.” [3]

Assessment

With all the confusion surrounding terms like quality improvement and “meaningful use” which can mean major Federal dollars to the coffers of a medical practice, clinic or hospital; are we still confused about basic definitional terms?

And, does eMR linguistic obfuscation exacerbate our use ambivalence and encourage physician/dentist eMR avoidance?

Conclusion

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References:

[1]   See http://www.himss.org/content/files/PatientSafetyFinalReport8252003.pdf.

[2]   EHR (electronic health record) is often used interchangeably with EMR (electronic medical record).  In this discussion, EHR will be used consistently.

[3]   See http://www.iom.edu/.

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About Remember It Now Patient-Centric Health Services

What it is – How it works – Where is it from?

By David Edward Marcinko; MBA CMP™

[Publisher-in-Chief]

RememberItNow was a featured company at the recent 10th annual HIMSS conference. It reports to be the best way for patients to take control of their health, or the health care of loved-ones. Their simple to use, patient-centric eHealth services are available online, anytime. There is no software to download, or upgrades to manage. The firm helps patients remember to take their medications, create a care community, get organized, provide long-distance care, and more. It is designed to be simple to use and make life easier http://www.rememberitnow.com

Mission

The folks at RememberItNow believe patients should spend more time doing the things they enjoy, and less time worrying about taking medications, remembering appointments, tracking prescriptions, reordering supplies and scheduling medical care, etc. RememberItNow is privately funded.

Video: http://prezi.com/irjw0cqiv1cu/introducing-rememberitnow/

My story – Back in the Day

Almost ten years ago, I was invited to attend a venture capitalist technology forum at Georgia Tech University, here in Atlanta. One of the very smallest firms [non-health care] I reviewed was called RememberIt.com. It was billed as a personalized email and online reminder service. I discussed the concept with a very young red-haired man-child named Jeffrey Tacca, president and chief executive officer. He had no employees at the time. Although Jeff was impressive, I was not a fan of his concept.

Nevertheless, if I recall correctly, he received first round funding in the amount of $1.5 million dollars and was accepted into the Georgia Tech start-up business incubator. I tried to keep track of his company throughout the years, to little avail. But, later I learned that RememberIt.com merged with Boardroom, Inc [a large paid subscription firm that publishes newsletters targeting personal, business, health and finance issues], enabling them to enhance users’ experience by providing personalized tips and information from its silo of newsletters. For example, if a RememberIt.com user requested weekly reminders to lose weight, they also received links to related articles on topics such as healthy living or finding the right fitness routine, etc. Users also were able to log-on to track events, special occasions and other commitments. This is no longer a unique concept today, but was state-of-the-art back then.

Assessment

According to my investigations, RememberitNow.com is unrelated to the RemembIt.com of above. The firm is based in Orinda, CA and is headed up by Pamela Swingley [Founder] and Phil Wang [Engineer]. So, if I am mistaken – please tell me. We’d love to share this success story on the ME-P and I’d like to know what ever happened to Jeff Tacca?

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Give em’ a click and tell us what you think? Is this a very sophisticated solution, to a very minor problem?  Do we simply need to exchange bad habits, for good habits, regarding self health responsibility?

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