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    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

    Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

    Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

    Later, Dr. Marcinko was a vital and recruited BOD  member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.

    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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What are the Most Impactful Technologies in Healthcare Today?

A Survey

By: http://www.MCOL.com

***

***

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

***

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™  Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

 

On Healthcare Data Aggregation

 Electronic “Disease” Registry Data Used to Identify Care Gaps

By http://www.MCOL.com

***

***

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.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

***

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Healthcare Technology in the News

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By Staff Reporters

Healthcare consumers show mounting interest in virtual, on-demand care
Fierce Healthcare, August 14, 2017

Transforming the mHealth Experience With Digital Health Assistants
HIT Consultant, August 14, 2017

Google buys smartphone health monitoring startup Senosis
Pharma Phorum, August 14, 2017

Could Trump’s Opioid Emergency Boost Telemedicine, mHealth Use?
mHealth Intelligence, August 11, 2017

Trump Administration Takes on VA Telehealth Opportunities
The Natonal Law Review, August 11, 2017

More and more businesses are offering telehealth services as an employee benefit
MedCity News, August 9, 2017

VR Glasses Give Doctors a New mHealth Tool to Treat Concussions
mHealth Intelligence, July 31, 2017

New Senate bill seeks to reduce restrictions on telemedicine use
MobiHealth News, July 31, 2017

The allure of health care for tech giants
Axios, July 20, 2017

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.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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10 Reasons Why People Should Not Fear Digital Health Technologies

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Fear NOT!

By  Bertalan Mesko, MD PhD 

10 Reasons Why People Should Not Fear Digital Health Technologies

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e061d80a-6884-4496-b9a9-d910c7d54f15

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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.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

HDS

HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET

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***

An MD’s Venture Back to Microsoft Windows 10

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A Review

By Robert E.H. Khoo MD FRCS(C) FACS

http://www.colondoc.com.

***

disruptive

***

My Venture Back to Microsoft – a Review of Windows 10

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.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

***

[HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET]

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[Mike Stahl PhD MBA] *** [Foreword Dr.Mata MD CIS] *** [Dr. Getzen PhD]

***

Health IT Vendors Ponied-Up Political Cash to Both Parties

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The Presidential Election 2012

This November saw healthcare executives pay big campaign money to both political parties.

Health IT vendors, however, upped the ante this election year, paying out some hefty donations of their own. Judith Faulkner, CEO of Epic, and Allscripts CEO Glen Tullman are among this year’s top spenders.

Source: http://www.govhealthit.com/news/infographic-health-it-vendors-pony-political-cash-both-parties?topic=75

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.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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How to Get Started in Healthcare IT [Video Presentation]

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An Encore Presentation from a ME-P Thought-Leader

By Ann Miller RN MHA [Executive-Director]

In this ME-P, Shahid N. Shah MS shares his best advice for information technology workers looking to get started in the healthcare industry.

Mr. Shah is also known as the Healthcare IT Guy [http://www.healthcareguy.com] informing us about technology issues in the healthcare field.

Link: http://www.physbiztech.com/video/shahid-shah-how-get-started-healthcare-it

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More Expert Advice from Leaders in Healthcare Management

And, sourced below are related interviews with these experts:

  • Todd Linden, President and CEO of Grinnell Regional Medical Center (about rural healthcare management);
  • Paul Levy, former CEO of Beth Israel Deaconess Medical Center; and
  • Dr. Robert Wachter, Professor of Medicine, University of California, San Francisco (author of “Understanding Patient Safety” and the blog “Wachter’s World”).

Link: Health Administration Degrees http://www.healthadministrationdegrees.com

Assessment

Shahid also authored Chapter 13 on eMRs, HIT and Clinical GroupWare [INTEROPERABLE e-MRs FOR THE SMALL-MEDIUM SIZED MEDICAL PRACTICE] in our best-selling book, the “Business of Medical Practice” http://businessofmedicalpractice.com/chapter-13-2/

So, the text and videos are worth a look www.BusinessofMedicalPractice.com Our colleague, and uber hospitalist Robert Wachter MD, is also mentioned in the book.

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.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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Update on Tablet Usage in the Health Care Industry

A Growing Trend?

By Cyndi Laurenti

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The rapidly evolving technological era has ushered a host of industries into the digital world, including the medical field. Health care professionals in private and public institutions and even masters and PhD programs are quickly learning the immense benefits of utilizing technology in their practices and this has specifically included the use of the tablet computer.

Convenience and Mobility

In addition to the convenience tablets offer in size and mobility, more and more production companies are creating interfaces and programs specifically geared towards the healthcare industry and the tablet computer makes them more accessible and dynamic than the traditional clipboard. This is crucial in an industry where time is of the essence and life-changing decisions are made from moment to moment. Having a tablet computer puts the latest resources and tools in doctors and other health care professionals’ hands so they can make decisions efficiently.

Brand Neutral?

Although Tablet computers tend to be associated with the most popular brands like the iPad by Apple, a recent survey of 178 doctors indicated that even though the healthcare industry wants a tablet, it may not necessarily want the iPad in particular which does not have all the applications they require.

A whole industry of tablets has been specifically designed to meet the medical field’s particular needs, one example being the motion computing tablet PC. The West Clinic in Memphis which was founded by Supportive Oncology Services (SOS) and which caters for over 10,000 patients found that the motion computing tablet computer enabled them not only to streamline information between patients and physicians, but that it also lead to an improved quality of care and life for their patients and increased efficiency for their caregivers.

Other Healthcare Early Adopters

Another facility that adapted the use of tablet computers is the Lancaster General Hospital in Lancaster, PA, which has been rated as one of the top 100 hospitals for its efficiency and quality of care. The doctors and nurses are currently using 170 tablet computers in 21 units for a variety of tasks. Jon White, M.D. called it a ‘productivity tool’ and it is utilized around the hospital for patient safety through an application that assigns drugs through a unique bar code which ensures the right patient is getting the right medication and dose. It is also used to access patient records from anywhere in the hospital, review patient orders or test results, and access a library of medical reference information.

A third facility that utilizes the tablet computer is St. Mary’s Medical Center, an acute care facility in Evanville, Indiana, that provides inpatient and outpatient care. The tablet computer has currently replaced their paper-based patient charts, and cut down nurses’ charting times significantly.

Assessment

There is little doubt that the tablet computer has and will continue to revolutionize the healthcare industry. Tremendous positive changes have been made like the streamlining of once time-consuming and arduous processes. This increased efficiency ultimately translates into quality care for patients and the continued advancement of the medical field.

Conclusion      

And so, 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.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

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About the eHealth Initiative and the Foundation for eHealth

What they are – How they work

By Staff Reporters

The eHealth Initiative and the Foundation for eHealth Initiative are independent, non-profit affiliated organizations, whose shared mission is to improve the quality, safety, and efficiency of healthcare information technology [HIT].

Protean Stakeholders

Both organizations are focused on engaging diverse stakeholders–including hospitals and other healthcare organizations, clinician, consumers and patient groups, employers and purchasers, health plans, manufacturers, public health agencies, academic and research institutions, and public sector stakeholders–to define and then implement specific actions that will address the quality, safety and efficiency challenges of domestic medical care through the use of interoperable HIT.

Membership

Since 2001, the eHealth Initiative has represented a diverse membership that is improving HIT. Over the years, eHI membership has grown to over 200 organizations.

Coalition Growth

In 2005, eHI launched the eHI Connecting Communities Membership, a rapidly growing coalition of leaders representing more than 200 state, regional and community-based initiatives focused on improving health through information exchange.

In 2009, eHI adopted the Information Therapy (Ix) Action Alliance. The IxAction Alliance, previously a part of the Center for Information Therapy – an eHI member – resides at the intersection of patient-centered care and HIT, focusing on issues relating to the prescription and use of targeted health information to help people make good health decisions and lead healthy lives.

Join Our Mailing List 

Assessment

The adoption of e-health initiatives promises to revolutionize health care in the United States by reducing errors, improving the quality of care delivered, reducing costs, and empowering consumers to better understand and address their own health care needs.

eHI is one of the few organization that represents all stakeholders in the industry. eHI advocates for the use of health IT that is practical, sustainable and addresses stakeholder needs, particularly those of patients.

Conclusion

So, give em’ a click and tell us what you think: www.eHealthInitiative.org Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Dr. Mark Leavitt says “Trust me”

On eMRs – Just Go for IT

By Darrell K. Pruitt; DDS

Neil Versel, a frequent contributor to FierceEMR, posted an article titled “CCHIT’s Leavitt: Don’t wait for final rules to proceed with EHR.”

http://www.fierceemr.com/story/cchits-leavitt-dont-wait-final-rules-proceed-ehr/2010-02-18#comment-778

Half-Baked Ideas 

Even though many states are spending eHR stimulus bucks as fast as they can on half-baked, expensive ideas that enrich HIT stakeholders, most physicians and most all dentists are delaying investing tens of thousands of dollars in HIT fantasy until HHS Secretary Kathleen Sebelius gets her act together. Sebelius is in way over her head. She hasn’t even settled on the definition of “meaningful use” for crying out loud.

Soon to Be Former CCHIT Leader 

Foot-dragging upsets the soon to be former head of CCHIT Dr. Mark Leavitt. He says doctors should put caution aside and just go for it.

“We believe that it’s risky for providers to wait until all the federal rules are final. If you wait to purchase an eHR until the rules are final and the accreditation process for certifying bodies is complete, I will put my reputation on the line and say that you will not achieve meaningful use in 2011.”

Assessment 

So, Dr. Leavitt, even as you are no longer wanted at CCHIT and are leaving in less than six weeks, you promise American doctors that your reputation is like (stimulus) money in the bank. Will you co-sign loan agreements? Talk is cheap, Dude.

Conclusion

And so, 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, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

VIDEO: Cool New HIT Gadget for Physicians?

3D Head-Tracking Interface

By Ann Miller; RN, MHA

[Executive-Director]

According to SoftwareAdvice.com, Apple is the hottest topic in the tech blogosphere these days. Even if you ignore all news of the “iSlate,” and the new tablet PC, dozens of rumors abound.

Head Tracking Technology

One interesting idea is a patent for 3-Dimensional head-tracking. Instead of using a mouse and keyboard, Mac users simply move their head or body to control an image on screen. Some think this technology would perfect for healthcare.

Video Presentation

Here’s a short video from Houston Neal to help you visualize the device:

http://www.softwareadvice.com/articles/medical/apple-3d-head-tracking-for-doctors-1011410/

Conclusion

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Is the HITECH Act Unconstitutional?

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Parts 1 and 2

[By Alberto Borges; MD]

Is the HITECH Act Unconstitutional? – PART 2

Is the HITECH Act Unconstitutional? – PART 1

Dr. Borges is a ME-P thought-leader in private practice. He is an associate clinical professor of medicine at the George Washington University in Washington, DC.

Assessment

Check out his website at http://msofficeemrproject.com

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.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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What is a HIT Security Firewall?

Understanding Concepts and Terms

By Dr. Richard J. Mata; MIS

www.HealthcareFinancials.com

Firewalls are devices or systems that control the flow of health information network traffic between networks or between a host and a network. A firewall acts as a protective barrier because it is the single point through which communications pass. Internal information that is being sent can be forced to pass through a firewall as it leaves a network or host. Incoming data can enter only through the firewall.

www.HealthDictionarySeries.com

The Federal publication NIST Special Publication 800-41, Guidelines on Firewalls and Firewall Policy provides details of firewalls and firewall product selection that are beyond the scope of this post.

Implications Beyond Internet Connectivity

While firewalls and firewall environments are often discussed in the context of Internet connectivity, firewalls have applicability in network environments beyond Internet connectivity.

For example, many corporate healthcare enterprise intranets employ firewalls to restrict connectivity to and from internal networks servicing more sensitive functions, such as the accounting or personnel department. By employing firewalls to control connectivity to these areas, an organization can prevent unauthorized access to the respective systems and resources within the more sensitive areas. The inclusion of an internal firewall environment can therefore provide an additional layer of security that would not otherwise be available.

Imperfect Security

Although firewalls afford protection of certain resources within an organization, there are some threats that firewalls cannot protect against: connections that bypass the firewall, new threats that have not yet been identified, and viruses that have been injected into the internal network.

Assessment

It is important to remember these shortcomings because considerations will have to be made in addition to the firewall in order to counter these additional threats and provide a more comprehensive security solution.

Conclusion

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Hospital Materials Management Information Systems [Part 2]

Fundamentals of Software Implementation

By David J. Piasecki; CPIM

By Hope Rachel Hetico; RN, MHA

Dr. David Edward Marcinko; MBA

www.HealthcareFinancials.com

The singular focus of any Hospital Materials Management Information System (HMMIS) is to deliver significant improvements in the ability of hospital facilities, networks, and other healthcare organizations to optimize the processes and work flows associated with materials management systems and reduce the costs related to inventory, durable medical equipment, pharmaceuticals and supply chain management (SCM).

Understanding Strategies

Strategically, hospitals must exploit contemporary technologies and connectivity with suppliers and trading partners to:

  • improve patient care and safety,
  • increase efficiency,
  • drive down costs, and
  • optimize inventory levels.

Software Implementation

As with the selection process written about previously, ERP software implementation may also require outside assistance.  Whether you use consultants from the software vendor, a business partner, or an independent firm, the implementation plan will likely be the same.  It’s very important to listen to consultants and be prepared to dedicate the resources outlined in the implementation plan.  A common mistake made by healthcare entities going through their first major implementation is to underestimate the complexity of their operations, the extent of system setup and testing, and the impact the implementation will have on their operation.

ERP Implementation

Here is an outline of a common scenario in single-hospital ERP implementations.

  • The consultants warn of the consequences of not dedicating adequate resources.
  • Management publicly agrees but privately thinks the consultants are crying wolf.
  • Implementation fails or goes poorly.
  • Management claims “how could we have known?”

Don’t let this be you.  The only thing to assume about the implementation is that it that it will be much more difficult than expected, it will take longer than you expected, and it will cost more than expected.

Like most other projects, the success of a software implementation will be based upon the skill of the people involved, training, planning, and the effort put forth.  Plan to have the most knowledgeable employees heavily involved in the system setup and testing.  

Testing Programs

Adequate time should be dedicated to make sure every aspect of every process is thoroughly tested.  An example of a detailed testing program is listed below:

  • Does the purchase order [PO] receipt screen have all the information needed to perform the receipt such as vendor item number, item description, unit of measure?
  • What happens when we receive more than the PO quantity?
  • What happens when we receive less than the PO quantity?
  • What happens when we enter multiple receipts against the same line?
  • What happens if someone tries to change the PO quantity after we have entered a receipt?
  • What happens if one changes the PO quantity at the same time we are entering a receipt?
  • What happens when we reverse a receipt?
  • What happens when we reverse a receipt after it has been paid?
  • What happens if the ordered unit of measure is different from the stocking unit of measure?
  • What happens when we receive an early shipment?
  • What happens when we try to receive against a cancelled PO?
  • What happens when we change the receipt location?

After the system has been thoroughly tested, employee training begins. Remember, dealing with unexpected issues is the norm; you don’t also need to be training employees after the system is supposed to be operating.

Hands-On Training

The training should consist of hands-on training and include written procedures for the tasks performed.  For most positions, make sure that each employee has entered the equivalent of at least a full day’s transactions during the training.  Using an actual day’s transactions is a good way to make sure the variety of transactions an employee is likely to encounter have been experienced. The most common mistake made in training is a lack of adequate repetition. Just because someone was able to perform the task once, during a training session on a Saturday three weeks prior to “going-live” does not mean they will be able to perform the task with system start-up. If they have repeated the task many times over a series of training sessions, they are much more likely to remember how to do it. 

Assessment

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Watch the data. During and immediately after the implementation it is incredibly important to watch the data and make sure everything is working as planned. Monitor the status of orders, purchase orders, and delivery orders paying specific attention to “stuck orders” or other exceptions. Conduct some aggressive cycle counting of fast-moving items to make sure transactions are working correctly. 

Conclusion

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Spotlight on the “Health Tech Today” Video Launch

Video Clip from Microsoft

By Staff ReportersConnected Doctor Health 2.0

Health Tech Today is a new monthly, on-line video series at the intersection of health and information technology.  The show premiers November 10th 2009, but you can view a video trailer of their first show on the link below, right now

HealthBog

HealthBlog includes thoughts, comments, news, and reflections about healthcare IT from Microsoft’s worldwide health senior director Bill Crounse MD, on how information technology can improve healthcare delivery and services around the world.

Link: http://blogs.msdn.com/healthblog/default.aspx

Assessment

Please help them spread the word. Blog about it. Tweet your friends. Post information about Health Tech Today on Facebook.  Health IT has a new voice. We think you’ll like what you see.

Conclusion

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Ask an Advisor about “Meaningful-Use”

Do dentists qualify for “meaningful use” incentives under ARRA?

By Ann Miller; RN, MHA

[Executive Director]

Chairman's Seat

A simple and direct query asked by an ME-P subscriber.

Channel Surfing

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. 

Conclusion

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The VistA Client Server System

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What it is – How it works

By ME-P Staff ReportersME-P Rack Servers

According to Dr. Richard Mata MS, a client-server system configuration occurs when one or more “repository” computers [ known as “servers”] store large amounts of data but perform limited processing. Communicating with the server(s) are client workstations that perform much of the data processing and often have graphical user interfaces (GUIs) for ease of use.

High Functionality

Both customizability and resource use is high, depending on the desired sophistication. Many clinical medical information systems that process data directly related to patient care use this configuration.

VA Example

For instance, the Veterans Health Administration, which has implemented what is likely the largest integrated healthcare information system in the United States, uses client-server architecture. Known as the Veterans Health Information Systems and Technology Architecture (VistA), this system provides technology infrastructure to about 1,300 care facilities, including hospitals and medical centers, outpatient facilities, and long-term care centers. VistA utilizes a client-server architecture that links together workstations and personal computers using software that is accessed via a graphical user interface.

Assessment

Overall, for hospitals that have the financial and manpower resources for a significant investment in IT, client-server architectures are the fastest-growing and typically the most preferred of the system architectures, due in large part to their local adaptability and flexibility to meet changing hospital and medical center needs.

Conclusion

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List of Healthcare IT Trade Associations

Advancing Medical Practice Success with Strategic Relationships

By Staff ReportersHDS

To be efficient in healthcare delivery today, doctors must partner and understand the resources and affiliations that are available to them. Here is a brief list of several healthcare trade associations and leading industry vendors submitted for your review.

AHIMA
The American Health Information Management Association (AHIMA) is the premier association of health information management professionals. AHIMA’s 51,000 members are dedicated to the effective management of personal health information needed to deliver quality healthcare to the public. Founded in 1928 to improve the quality of medical records, AHIMA is committed to advancing the health information management profession in an increasingly electronic and global environment through leadership in advocacy, education, certification, and lifelong learning.

EHRA
HIMSS EHRA is a trade association of Electronic Health Record (EHR) vendors that addresses national efforts to create interoperable EHRs in hospital and ambulatory care settings. HIMSS EHRA operates on the premise that the rapid, widespread adoption of EHRs will help improve the quality of patient care and the productivity of the healthcare system. The primary mission of the association is to provide a forum for the EHR vendor community relative to standards development, the EHR certification process, interoperability, performance and quality measures, and other EHR issues that may become the subject of increasing government, insurance and physician association initiatives and requests.

HIMSS
HIMSS (Healthcare Information and Management Systems Society) is the healthcare industry’s membership organization exclusively focused on providing leadership for the optimal use of healthcare information technology and management systems for the betterment of human health. Founded in 1961 with offices in Chicago, Washington D.C., and other locations across the country, HIMSS represents approximately 17,000 individual members and some 275 member corporations that employ more than 1 million people. HIMSS frames and leads healthcare public policy and industry practices through its advocacy, educational and professional development initiatives designed to promote information and management systems’ contributions to ensuring quality patient care.

HITSP
The Healthcare Information Technology Standards Panel serves as a cooperative partnership between the public and private sectors for achieving a widely accepted and useful set of standards specifically to enable and support widespread interoperability among healthcare software applications, as they will interact in a local, regional, and national health information network for the United States. Comprised of a wide range of stakeholders, the Panel will assist in the development of the U.S. Nationwide Health Information Network (NHIN) by addressing issues such as privacy and security within a shared healthcare information system. The Panel is sponsored by the American National Standards Institute (ANSI) in cooperation with strategic partners such as the Healthcare Information and Management Systems Society (HIMSS), the Advanced Technology Institute (ATI), and Booz Allen Hamilton. Funding for the Panel is being provided via the ONCHIT contract award from the U.S. Department of Health and Human Services.

HL7
Health Level Seven is an American National Standards Institute (ANSI)-accredited Standards Developing Organization (SDO) operating in the healthcare clinical and administrative data arena. It is a not-for-profit volunteer organization made up of providers, vendors, payers, consultants, government groups, and others who develop clinical and administrative data standards for healthcare. Health Level Seven develops specifications; the most widely used being a messaging standard that enables disparate healthcare applications to exchange keys sets of clinical and administrative data.

MSHUG
Microsoft Healthcare Users Group (MS-HUG) unified with the Healthcare Information and Management Systems Society (HIMSS) as part of the HIMSS Users Group Alliance Program in October 2003. The unification strengthens the commitment of HIMSS and MS-HUG to better serve their members and the industry through a shared strategic vision to provide leadership and healthcare information technology solutions that improve the delivery of patient care.

WEDI
The Workgroup for Electronic Data Interchange [WEDI’s] goal is to improve the quality of healthcare through effective and efficient information exchange and management. They aim to provide leadership and guidance to the healthcare industry on how to use and leverage the industry’s collective knowledge, expertise, and information resources to improve the quality, affordability, and availability of healthcare.

Assessment

As the health information technology industry evolves, we will continue to contribute our expertise to foster ideas that shape the future of healthcare by offering more examples similar to the above.

Conclusion

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Dr. Pruitt Invites Dr. Cohen to Discuss eDRs

Where is the ADA’s Representative?

By Darrell K. Pruittpruitt; DDS

He or she should have been talking with me long ago. I have the audience and I’m giving you that opportunity I promised you, Dr. Donald Cohen.

Rest Easy

I’m aware that I possibly make you uncomfortable, considering how “unprofessionally” I’ve publicly treated lesser devoted HIPAA consultants. Rest easy! As soon as I read your article, I could tell that you’re different from your colleagues I’ve met. First of all, like me, you’re a dentist. That’s very important. Secondly, your credentials are impressive and reveal that compliancy is not a hobby for you like it is for others. Nobody can accumulate a history as impressive as yours without professional dedication. The last point, and the most important of the three, you seem honest about HIPAA compliance.

A Professional

It wasn’t lost on me that in your article you were professionally non-judgmental of the Rule. Instead of trying to justify a defenseless law, your job is to help dentists comply with the mandate as it is written or risk significant fines. Like tax-collecting, someone’s got to do the job of delivering bad news. You have a legitimate purpose to be involved in the dental industry, even if what you teach makes little difference at all if a dentist’s records are breached. I argue that following the inevitable bankruptcy from a breach, HHS fines are hardly a deterrent. And that is the issue: eDRs containing patient identifiers are too risky for the marketplace.

Electronic Dental Records

I think you would have to agree that eDRs are going nowhere until records are safe, and encryption is not going to be sufficient to protect dentists against dishonest employees. Ambitious bureaucrats in waiting, such as HIPAA consultants Travis Criswell, Sharalyn Fichtl, Kelly Mclendon and Olivia Wann – not a dentist among them – hooked their careers to the HIPAA mandate to avoid the tough sales jobs competition otherwise demands in the free market. All four share an authoritarian misconception that since it is the law, dentists will be forced to purchase their products – even if they are utterly senseless. I think we both know that they are oh so wrong. I promised earlier to give you an opportunity to publicly support truth in eDRs if you so choose. Perhaps we could rationally discuss in front of everyone how dentists can wriggle free of the approaching mess. There is no pressure here, other than this is public invitation. Since you haven’t made unrealistic claims about eDRs like others have, I am not interested in hounding you further. I simply ask you to consider responding to the article I posted in your name on PennWell titled “Dr. Donald Cohen’s opportunity.”

http://community.pennwelldentalgroup.com/forum/topics/dr-donald-cohens-opportunity

Assessment

I sincerely appreciate the respect you have shown me, and I pledge to afford you the same. Of all the consultants I have approached with my concerns about HIPAA and eDRs, you are the first to even acknowledge a problem simply by posting my concerns. I think you have the courage to face the realities of the marketplace, while others foolishly think dentists are a captive market.

Note: I submitted this to be posted following an August 28th press release posted by HIPAA consultant Dr. Donald Cohen titled, “Dentists Should Know about New HIPAA Rules.”

http://www.dentalblogs.com/archives/administrator/dentists-should-know-about-new-hipaa-rules/comment-page-1/#comment-35672

If you are interested in discussing the topics of interoperability with fax machines, de-identified eDRs and security that surpasses paper records, in front of you is the opportunity to address your largest audience yet, Dr. Cohen. I’m self-syndicated.

Note: Do you realize that if Dr. Cohen takes me up on the offer, this will be the first time two dentists have openly discussed eDRs on the Internet? Do you think it’s about time?

Conclusion

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About HealthDataRights.org

Mitigating the Unintended Consequences of HIPAA

By Staff ReportersWaiting for Medical Records

Many patients and pundits opine how today’s HIPAA regulations [written in the relative paper based stone age] say that while doctors must provide a copy of your records, they can take a month to do so. And, if they want, they can say that’s not enough and take another month. However, when a patient needs medical care; that time-line is not acceptable.

Enter a Website and Start a Movement

According to the website www.HealthDataRights.org, in an era when technology allows personal health information to be more easily stored, updated, accessed and exchanged, the following rights should be self-evident and inalienable. We the people:

  • Have the right to our own health data.
  • Have the right to know the source of each health data element.
  • Have the right to take possession of a complete copy of our individual health data, without delay, at minimal or no cost; if data exist in computable form, they must be made available in that form.
  • Have the right to share our health data with others as we see fit.

Assessment

These principles express basic human rights as well as essential elements of health care that is participatory, Health 2.0 appropriate and in the interests of each patient. No law or policy should abridge these rights.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Visit the site, join the movement by signing their petition, and tell us what you think. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Henry Louis Gehrig, eMRs and Healthcare Reform

What’s the “Iron Horse” Got to Do with Health IT?

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]Jacobetti VA

According to UPI reports from Charlestown, WVa on August 24 2009, at least 1,200 veterans across the country were mistakenly told by the Veterans Administration [VA] that they suffered from a fatal neurological disorder.

Link: http://www.msnbc.msn.com/id/32541579/ns/health-health_care/

Panicked Veterans

One of the leaders of a Gulf War veterans group is reported to have said that panicked veterans from the states of Alabama, Florida, Kansas, North Carolina, West Virginia and Wyoming contacted the group about the error. Denise Nichols, the vice president of the National Gulf War Resource Center, reportedly blamed a “coding error” for the mistake. In medicine, we call this a “false positive.”

About Henry Louis “Lou” Gehrig

Henry Louis “Lou” Gehrig (June 19, 1903 – June 2, 1941), born Ludwig Heinrich Gehrig, was an American baseball player in the 1920s and 1930s; chiefly remembered for his prowess as a hitter, the longevity of his consecutive games played record and the pathos of his tearful farewell from baseball at age 36, when he was stricken with a fatal disease. Of course, Gehrig was known as the “The Iron Horse” for his durability. Yet, the irony is that Amyotrophic Lateral Sclerosis [ALS], or Lou Gehrig’s disease [sometimes also called Maladie de Charcot] is progressive and fatal. Lou died in 1941 after developing the illness. Will the same death-spiral happen to eHRs and Obama care?

Link: http://www.lougehrig.com

Assessment

Having rotated through the VA system as a young medical student back-in-the-day, I have never been a fan. It smacked of socialized medicine and government plutocracy, and was never a leading-edge example of domestic healthcare, in my informed opinion. Recent HIPAA administrative, security, IT and clinical medical errors are well known. So, to blame the mix-up on an insurance billing and “coding error” seems somewhat disingenuous. Especially now, at a time when eMRs and the Obama Administration’s healthcare reform itself is being vigorously debated by the citizenry. I mean, are there no human checks and balances? Would there be any human intervention if a public healthcare policy was adopted?

Of course, we have written about military medicine previously on this Medical Executive-Post, and devoted an entire channel to it. And, I do realize that more than fifty percent of us receive similar governmental care in some form, or another [Medicare, Medicaid, CHIPS, the Indian and Prison Healthcare Systems, etc].

Link: https://healthcarefinancials.wordpress.com/category/military-medicine/

Nevertheless, shall we give a new moniker to this mistake? How about “Lou Gehrig’s coding error”, and document it in our www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Is it even fair to relate this “isolated incident” to the current healthcare reform debate, the eMR conundrum and/or similar discussions on health Information Technology [IT]? Tell us what you think. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Integration of Hospital Automatic Data Collection Technologies

Review of Automatic Data Collection Equipment

By David J. Piasecki, with
Hope Hetico; RN, MHA

While hardware costs of automatic data collection [ADC] equipment continue to come down for hospital and healthcare organizations, the cost of integration will often prove to be the project buster. Software and integration costs will often be several times the cost of the hardware, especially in smaller health system operations where only a few devices will be used. Integration of ADC technologies is also far from standardized.

www.HealthcareFinancials.comHO-JFMS-CD-ROM

Example:

For example, when implementing a system with portable terminals, one integrator may create a program on the terminals that will write directly to the file on the host system, another may create programs on a separate server to do this, another may write or modify a program on your host system and use terminal emulation software, and another may use a screen mapping tool to reformat an existing program to be used on the portable device. So, make sure to speak with several integrators to ensure the best solution. Also, make sure to participate heavily in equipment selection and program/process design (prompts, data input) to ensure a system that provides the highest levels of accuracy and productivity.

Real-Time Locator System 

A real-time locator system (RTLS) uses RFID technology that provides the objects they are attached to the ability to transmit their current location.  The system requires some type of RFID tag to be attached to each object that needs to be tracked, and RF transmitters/receivers located throughout the facility to determine the location and send information to a computerized tracking system. While it sounds like a great way to eliminate “lost” inventory, the systems are still too costly for most inventory-tracking operations and are more likely to be used to track more valuable assets.

Screen Mapping/Screen Scraping

This software provides the functionality to change the arrangement of data fields on a computer screen that accesses a mainframe computer program. Screen mapping is frequently used in combination with terminal-emulation software to “remap” data fields from a standard mainframe program to be used on the smaller screen of a portable hand-held device.

Speech-Based Technology

Speech-based technology, also known as voice technology is really composed of two technologies:  (1) voice directed, which converts computer data into audible commands, and (2) speech recognition, which allows user voice input to be converted into data.  Portable voice systems consist of a headset with a microphone and a wearable computer.

Terminal Emulation

Software used on desktop and portable computers is available that allows the computer to act like a terminal connected to a mainframe system. If you have a networked desktop PC and are accessing mainframe programs (green screen programs) you are using terminal emulation. Terminal emulation is also a common method used to connect portable computers (as in pharmacy bar-code ADC systems) to mainframe software.

Warehouse Management System

Computer software designed specifically for managing the movement and storage of materials throughout the healthcare system warehouse or chain of command generally controls the following three operations:  (1) put-away, (2) replenishment, and (3) picking.  The key to these systems is the logic to direct these operations to specific locations based on user-defined criteria.  Warehouse Management Systems (WMSs) are often set up to integrate with ADC systems. 

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Can you think of any other data integration technologies?  Tell us what you think. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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Kelly Mclendon RHIA censors D. Kellus Pruitt DDS

By Darrell K. Pruitt; DDS

Dateline: 8.15.09

pruitt

Dear Kelly Mclendon, Registered Health Information Administrator

You are beginning to make me feel insulted, and I will not have that. I just noticed that the last two comments I submitted to your Website, www.spacecoastmedicine.com, on August 9 and 10, are still “awaiting moderation.”

http://www.spacecoastmedicine.com/2009/08/electronic-records-for-all-patients-mandated-by-2014.html#comment-89 

(For clarity, the comments which scared Mr. Mclendon are copied below) 

Over five days have passed, and I want you, your readers and my readers to know that I spent a lot of time preparing those two pieces exclusively for you at your invitation for comments. You are as sincere as I am, aren’t you? 

When I’ve caught others in the squeeze you might be experiencing, several have pleaded that the censorship was an innocent oversight, and did the right thing immediately by posting everything I send them (include this comment, please). And then again, there are a few slow-learning, command-and-control types who think they cam still somehow control the content of their Websites. Like you, Kelly, an anonymous dentalblogs.com editor whom I call “Nancy” by default, also informed me that my comments were awaiting indefinite moderation. What a foolish, rookie mistake that proved to be. For example, if you google “dentalblogs.com,” my article “Dentalblogs.com hates D. Kellus Pruitt DDS” is their 4th hit. It seems to be very popular. 

How’s this for the title of a comment that should make it to your first page by Monday: “Kelly Mclendon RHIA censors D. Kellus Pruitt DDS”? Please, no phone calls. 

D. Kellus Pruitt; DDS 

Dateline 8.9.09 

I’m sure physicians’ businesses are no different than dentists’ when it comes to the liability of data breaches – especially considering the giddy, mindless momentum of HITECH-empowered HIPAA. If a computer is stolen in a burglary, compromised by a dishonest employee who sells IDs on the side, or otherwise hacked, and the dentist reports the tragedy according to the letter of the law, it inevitably means bankruptcy even before the feel-good fines are levied by HHS (HIPAA) and the FTC (Red Flags Rule) for not having required irrelevant documentation of administrative trivia in order. What were our lawmakers thinking? 

I guess the HIPAA blunder proves that when politicians, insurers and healthcare IT entrepreneurs get together in vendor clubs like CCHIT, the only government-approved eHR certification authority, they can mandate damn well any law that suits their needs. 

Allscripts CEO Glen Tullman, who is an influential friend of Barack Obama as well as a Trustee of CCHIT told Bloomberg.com reporter Alex Nussbaum in an interview almost a year ago that providers should make the financial commitment “to ensure that doctors have some skin in the game.” 

Glen Tullman is only one reason our nation’s healthcare IT industry stinks from the top down. 

D. Kellus Pruitt; DDS

Dateline: 8.10.09 

Thank you, Kelly Mclendon, for providing a rare venue to possibly clear up a few items of uncertainty about eHRs in dentistry. First of all, if a technological advancement such as eDRs does not pay for itself, even with government subsidies, who pays for it? That seems like a quick way to increase the costs of dental care – and for what? How do dental patients benefit from expensive HIT solutions when the telephone, fax machine and US Mail serve us fine? 

Digitalization of records offers no benefits to dental patients. Only stakeholders who would grab our patients’ money benefit from HIT. Everyone else loses. Trusting, naive dental patients lose the most. 

Electronic dental records are expensive hazards. If you can think of a lame reason for them, please let me hear it. You can bet I’ve crushed it before. I’ve been down this road with others many, many times. 

Within a week, the government will price computerization smooth out of dentistry. Over 90% of dentists have patient identities on their computers today. If HIPAA is enforced, with or without the Red Flags Rule, I predict that less than half of the nation’s dentists will be computerized a year from now. 

As for your argument that eHRs somehow provide up-to-date and otherwise superior medical histories for dental patients, think about this: If someone changes a paper medical history, it leaves a paper trail. If an insurance thief alters allergies on a digital record to suit his or her own needs, nobody in the emergency room can tell. Whoever said “Paper kills,” lied. It is a catchy PR pitch, though.

Conclusion

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Borges versus Kvedar Video eHR Debate

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The Great HIT Debate

[By Staff Reporters]Boxing Gloves

All ME-P subscribers and readers are invited to watch a debate between Dr. Alberto Borges and Dr. Joseph Kvedar. In the original broadcast, by HCPLive, both participants were asked some very interesting questions about health information technology [HIT] when posed to them. And so, if you were unable to attend the live event, it is now re-broadcasted in podcast form for your review.

About Alberto A. Borges; MD

Al Borges is Founder and CEO of the MS Office eMR Project http://www.msofficeemrproject.com He is the project author, visionary and main content developer for the independent website. As a board certified physician, he practices oncology, hematology, and internal medicine in Arlington, Virginia. He is also a clinical professor at the George Washington University Medical School. Dr. Borges is a colleague and thought-leader for the ME-P

About Joseph C. Kvedar; MD

Joe Kvedar is the Founder and Director of the Center for Connected Health http://www.connected-health.org The Center is known for applying communications technology and online resources to increase access and improve the delivery of quality medical services and patient care outside of the traditional medical setting.  A division of Partners HealthCare; the Center for Connected Health works with Harvard Medical School-affiliated teaching hospitals, including Massachusetts General and Brigham and Women’s Hospitals. Dr. Kvedar is also a board-certified dermatologist and Associate Professor of Dermatology at Harvard Medical School

Podcast Link: http://www.hcplive.com/hcplive/great_debate

Assessment

Feel free to email questions, or to post follow-up comments, for all our viewers to consider and respond. The principals are asked to weigh-in, as well.

And the Winner is … ?

Conclusion

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Hospital Automated Data Collection

Understanding Data Capture Technologies

By David J. Piasecki, with
Hope Hetico; RN, MHA

Automated data collection (ADC), also known as automated data capture, automated identification (AutoID) or automated identification and data capture (AIDC), consists of many different technologies. Bar codes, voice systems, RFID, OCR, laser scanners, vehicle mounted and wearable computers are all part of ADC management and hospital inventory activities.

www.HealthcareFinancials.comHO-JFMS-CD-ROM

Six-Figure Projects

However, the fear of six-figure project costs often prevent many small to mid-sized hospitals and healthcare systems from taking advantage of these technologies. The key to implementing cost-effective ADC systems is to know what technologies are available and the amount of integration needed to implement them. Applying this processing knowledge in a healthcare organization will help in developing the scope of any project. Limiting projects to or prioritizing by those applications that have a high benefit/cost ratio allows these operational improvement technologies within a reasonable budget. 

Example:

For example, adding a keyboard-wedge bar-code scanner to an existing personal computer (PC) or blade terminal in a nursing station is a very low-cost method for applying ADC to existing hospital reporting applications. This type of hardware is inexpensive and the only real programming required is to add a bar code to the proper form (work order, pick and delivery slip, etc).

Review of the ADC Technologies

Some of the current hospital data capture technologies include the following:

a. Bar Codes

b. Bar-Code Scanners

Laser or CCD 

Auto-Discrimination

Keyboard-Wedge Scanners 

Fixed-Position Scanners

c. Portable Computers

d. Batch versus Radio Frequency

e. Hand-Held Devices

f. Vehicle-Mounted Devices

g. Wearable Systems

h. Voice Technology

i. Optical Character Recognition

j. Light Systems

Assessment

Driven by a need for improved data capture, asset management, staff mobility and standardized medication administration to name a few benefits, hospitals are likely to invest much more heavily in ADC and Wi-Fi technologies over the next five years, according to this new research report.

Link: http://www.eweek.com/c/a/Health-Care-IT/WiFi-Healthcare-Systems-to-Hit-49B-878082/

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think. Can you think of any other hospital data capture technologies? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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Dictionary of Health Insurance and Managed Care

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Whither the Dictionary of Health Insurance and Managed Care?

HDS

A simple query that demands a cogent answer!

Why do we need the Dictionary of Health Insurance and Managed Care, and, why do payers, providers, benefits managers, consultants, and consumers need a credible and unbiased source of explanations for their health insurance needs and managed care products?

The Answer is Clear!

Health care is the most rapidly changing domestic industry. The revolution occurring in health insurance and managed care delivery is particularly fast. Some might even suggest these machinations were malignant, as many industry segments, professionals, and patients suffer because of them. And so, because knowledge is power in times of great flux, codified information protects all people from physical, as well as economic harm.

We appreciate the support of our sponsors. So, click-on on the links and review all dictionary products.

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About MeaningfulUse.org

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A Dedicated Terminology Website

By Staff Reporters

Understanding and defining the new era of healthcare information technology in America.

The ARRA and HITECH concept of “meaningful use” for e-MRs is nebulous and ill defined. This new website is intended to be a collaborative destination site in order to promote the national dialogue and education around the term, “meaningful use”, by providing the HIT community a single-central location to access resources, influence and discuss the definition of “meaningful use” and learn how to take advantage of the HITECH stimulus funds.

HDSAssessment

According to the site, registration for the www.MeaningfulUse.org discussion board is only used for the purpose of posting and will not be used for any marketing purposes. The site is supported by the Association of Medical Directors of Information Systems (AMDIS) and sponsored by Compuware Corporation.

Conclusion

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How to Become a ME-P Thought-Leader

Answering a Growing Chorus of Inquiries

By Professor Hope Rachel Hetico; RN, MHA, CMP™

[Managing Editor]hetico

The Medical Executive-Post is the complimentary companion blog to the premium peer-reviewed quarterly subscription journal: Healthcare Organizations [Financial Management Strategies]. While the perspective of our blog is private medical practitioners, the focus of our e-journal on CD-ROM is large medical groups, healthcare organizations, hospitals, healthcare-systems, ASCs, emerging healthcare institutions and medical business entities  TABLE OF CONTENTS

HOFMS

The ME-P is for Doctors

 

Currently, the ME-P is being developed as a common venue for medical professionals to share their insights on how to best manage a private medical practice. A well-established practice will have a solid financial and executive-management foundation, and will have protocols, procedures and contingency plans in place before they are ever needed in an emergency. And so, we seek new-wave and next-generation input from physicians, osteopaths, podiatrists, dentist, nurses, PAs, CRNAs and optometrists who have experience starting and running medical practices in the Health 2.0 modern era. The goal is better patient care as doctors avoid costly or tragic management mistakes.

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The ME-P is for Financial Advisors and Management Consultants

Physician advisors like attorneys, accountants, practice managers, medical billing experts, insurance agents, commercial realtors, healthcare IT experts and others are invited to display their expertise, too. You may not become rich here, but you may become famous, or at least develop an excellent client base from the doctors and practitioners reading your articles, posts and comments! Financial advisors, CMAs, CFAs, MBAs, PhDs, CFP® and Certified Medical Planners [CMP™] are also invited to strut “cognitive-stuff”, as free-labor publishing entrepreneurs! Then, we aim to unite both sectors for success.  

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Steps to Becoming a Thought-Leader

1. Send us an email with your bio and contact info.

2. Tell us why you want to write for the ME-P.

3. Send in an original writing sample.

We may follow-up and discuss your credentials and the topics you’re interested in writing about.

Assessment  

Speaking engagements, travel to exotic locales, and print or e-book chapter contributions may all be in your future because of your career launching contributions to the ME-P. Everyone has something to share and teach, and we look forward to learning from everyone joining us here. And, please feel free to contact us for deeper involvement in all www.MedicalBusinessAdvisors.com, www.HealthDictionarySeries.com or www.CertifiedMedicalPlanner.com activities. Take your career to the next level with the ME-P.

HDS

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Medical Coding and Billing Vocabulary

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Basic HIT Nomenclature and HIPAA

[By Richard J. Mata; MD, MIS, CMP™ [Hon]

For the Health Information Technology [HIT] department of a hospital, clinic or medical practice and its coders, the following medical vocabularies are mandated by the Health Insurance Portability and Accountability Act [HIPAA].

Diseases 

For diseases: the 9th or 10th International Classification of Diseases (ICD) Clinical Modification should be used.  ICD9-CM is maintained by the Centers for Disease Control National Center for Health Statistics, while ICD-10 is maintained by the World Health Organization.

Procedures

For medical procedures: a combination of ICD-9-CM, Current Procedural Terminology maintained by the American Medical Association, the Current Dental Terminology maintained by the American Dental Association, and Healthcare Common Procedure Coding System (HCPCS) maintained by CMS, which is also used for medical devices.

Pharmaceuticals

For drugs: these should be coded according to their National Drug Code classification.

Assessment

“A recent change to Medicare policy made by the Centers for Medicare & Medicaid Services (CMS) helps ensure claims processing isn’t delayed when the only missing information on the CMS-1490S form is the provider or supplier’s National Provider Identifier (NPI).

CMS Transmittal 1747, Change Request 6434, issued May 22, notifies A/B Medicare Administrative Contractors (MAC) and carriers of editorial changes to Medicare policy in Pub. 100-04, Medicare Claims Processing Manual, chapter 1 regarding the monitoring of claims submission violations and the handling of incomplete or invalid claims.

In either case, as stated in the transmittal, “If the beneficiary furnishes all other information but fails to supply the provider or supplier’s NPI, the contractor shall not return the claim but rather look up the provider or supplier’s NPI using the NPI registry.”

http://www.aapc.com/news/index.php/2009/06/missing-npi-no-reason-to-deny-says-cms/

Conclusion

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Dictionary of Health Information Technology and Security

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Whither the “Dictionary of Health Information Technology and Security?”

DHITS

A simple query that demands a cogent answer!

There is a myth that all stakeholders in the healthcare space understand the meaning of basic information technology jargon. In truth, the vernacular of contemporary medical information systems is unique, and often misused or misunderstood. It is sometimes altogether confounding.

Terms such as, “RSS”, “eHRs”, “DRAM”, “ROM”, “USB”, “PDA”, “NPI”, “CCHIT”, and “DNS” are common acronyms, but is their meaning AND functionality truly understood?

We appreciate the support of our sponsors. So, click-on on the links below and review all dictionary products.

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HDS

 

 

 

Link: http://www.findbookprices.com/author/Hope_Hetico

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Military Electronic Dental Records [eDRs]

US Defense Department Leads the Way

By Staff Reporters

MilitaryAccording to Peter Bauxbaum on May 13, 2009, the Defense Health Information Management System [DHIMS] is in the process of deploying AHLTA [Armed Forces Health Longitudinal Technology Application] Dental; a module eDR included with the new AHLTA 3.3 release.

It is the U.S. military’s first integrated dental and medical electronic health record.

Link: http://govhealthit.com/articles/2009/05/13/dod-electronic-dental-record.aspx?s=GHIT_190509

Assessment

And so, when will eHRs for osteopaths [eOsteoRs], podiatrists [ePodRs] and optometrists [eOptRs] become available? Is this an occasion when the military is an early HIT adopter?

Conclusion

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American Recovery and Reinvestment Act Primer for Physicians

Free ARRA Webinar Series

By Staff Reporters

Resident LaptopAre you ready to maximize American Recovery and Reinvestment Act (ARRA) opportunities in your medical practice?

The Webinar Series

This webinar series is designed to support physician practices as they prepare for a new health care environment. As new information becomes available, experts and health care leaders representing diverse sectors will review key components of ARRA and offer insights on the impact to the physician community.

Topic: Stimulus 101: Basics of the Health Information Technology Provisions

When: Thursday, May 21, 12:00 PM CST

Presenters:

  • Glen Tullman, Chief Executive Officer – Allscripts
  • Margaret Garikes, Director of Federal Affairs – AMA

Assessment

Plus, hear from practices using eHR systems and how they made the transition.

Registration: https://cc.readytalk.com/cc/schedule/display.do?udc=1ip8sqjax7frw

Conclusion

And so, your thoughts and comments on this Medical Executive-Post, and webinar series, are appreciated; especially from seminar participants. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

MSFT Amalga Video for Hospitals and Health Systems

It Was One Year Ago Today … Updated for 2009

By Staff Reportersstk128477rke

Release of a new unified intelligence system allows enterprise health providers to unlock the power of all data from their existing IT systems.

REDMOND, Wash. — April 9, 2008

Microsoft Corp. today announced the availability of Microsoft Amalga, the new unified intelligence system that allows hospital enterprises to unlock the power of all their data sitting in isolated clinical, financial and administrative solutions.

What it is – How it works

Amalga is part of the Microsoft Amalga Family of Health Enterprise Systems, a portfolio of enterprise-class health solutions that provides rich integration, giving clinicians and executive’s quick access to valuable, up-to-the-minute information across their health enterprise. Microsoft also announced the availability of the Amalga family of health enterprise products across Europe at conhIT 2008, a healthcare IT conference being held in Berlin this week (http://www.microsoft.com/emea/presscentre).

Health Vault

The patient compliment to Amalga is MSFT’s Health Vault initiative which helps consumers collect, store, and share critical patient health information, for free.

www.HealthVault.com

Assessment 2009

Video interview, by Matthew Holt, originally appeared on The Health Care Blog [THCB] on April 16th, 2009.

Link: http://www.thehealthcareblog.com/the_health_care_blog/2009/04/interview-microsoft-health-solutions-.html#comments

Conclusion

And so, your innovative thoughts and constructive comments on this Medical Executive-Post are appreciated?

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The Business of Medical Practice [3rd Edition]

By Hope Rachel Hetico RN, MHA, CMP™

[Managing Editor]biz-book7

Dear Colleagues,

As you may know, we are commencing work on the third edition of our best selling book: The Business of Medical Practice

TOC 1st: http://www.amazon.com/Business-Medical-Practice-Maximizing-Doctors/dp/0826113117/ref=sr_1_8?ie=UTF8&s=books&qid=1231111232&sr=1-8

TOC 2nd: http://www.springerpub.com/prod.aspx?prod_id=23759

Invitation to Contribute

Accordingly, we would be honored for you to consider contributing a new or revised chapter, in your area of expertise, for a low-effort but high-yield contribution. Our goal is to help physician colleagues and management executives benefit from nationally known experts, as an essential platform for their success in the healthcare 2.0 business industry. Many topics are still available: [health accounting and costing; law, policy and administration; Medicare fraud and abuse; coding and insurance; HIT, grid and cloud computing; finance and economics, competitive models, collaboration and leadership, etc].

Support Always Available

Editorial support is available, and you would enjoy increasing subject-matter notoriety, exposure and public relations in an erudite and credible fashion. As a reader, or preferably a subscriber to the ME-P, your synergy in this space may be ideal. Time line for submission of a 5,000-7,500 word chapter is ample, and in a prose writing style that is “wide, not deep.” 

A Health 2.0 Initiative

And, be sure to address health 2.0 modernity. Update chapters from the second edition are also available. 

Definition: https://healthcarefinancials.wordpress.com/2008/09/12/emerging-healthcare-20-initiatives

Assessment

Please contact me for more details, if interested. A best selling-book is rare; while a third-edition volume even more so. Join us in this project. Regardless, we trust you will remain apostles of our core ME-P vision, “uniting medical mission and financial profit margin”, promoting it whenever possible.

Front Matter Link: frontmatter1advancedbusinessmedicine4 

Contact Info:

MarcinkoAdvisors@msn.com

770.448.0769

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Allscript’s Glenn Tullman is Video Interviewed

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Video Clip from the HIMSS Meeting

By Ann Miller; RN, MHA

[Executive-Director]

stk323168rknThere is a major controversy in the modern healthcare community over eMRs and how to pay for them; or even if they are effective in improving medical outcomes. Of course, by eMRs we mean interoperable medical records that span the pan-healthcare ecosystem; and not just the stand-alone digital records that many, if not most, physicians use in their daily practices to some degree or another.

Link: https://healthcarefinancials.wordpress.com/2009/03/10/on-the-hitech-act-of-2009/

Proponents

As readers of the ME-P are aware, one vocal camp supports certification and eMR industry mandates, standards, and governmental initiatives, etc. The recent $20 billion taxpayer input from the Obama Administration, courtesy of HITECH, further emboldens CCHIT and related wonks.

Opponents

One the other hand, one vocal ME-P opponent is dentist Darrell Pruitt. He and many others believe that current eMRs may be too expensive, unwieldy, and counter-productive. This camp advocates a mix of other data sources, technology processes and doctor/patient education to get us where we need to be in terms of improving medial outcomes; quicker and less expensively.

Assessment

Rather than read, research and write more on this controversy, which was apparently a red-hot topic at the recent HIMSS meeting, we have embedded a video link of Glen Tullman [CEO of Allscripts] and Mark Leavitt, [Chair of CCHIT], below.

Link: https://healthcarefinancials.wordpress.com/2009/03/02/cchit-is-prejudiced-and-lacks-diversity-%e2%80%93-an-indictment/

It even includes a clip of Jonathan Bush, CEO of AthenaHealth. And, although they don’t all agree; some common ground may be developing in this controversial issue.

Source: This link originally appeared on The Health Care Blog [THCB], by Matthew Holt.

Link: http://www.thehealthcareblog.com/the_health_care_blog/2009/04/cats-and-dogs-on-film–tullman-leavitt-bush.html#comments

Disclaimer:We are members of AHIMA, HIMSS, MS-HUG and SUNSHINE. We just released the Dictionary of Health Information Technology and Security, with Foreword by Chief Medical Information Officer Richard J. Mata; MD MS MS-CIS, of Johns Hopkins University; and the second edition of the Business of Medical Practice with Foreword by Ahmad Hashem; MD PhD, who was the Global Productivity Manager for the Microsoft Healthcare Solutions Group at the time.

Conclusion

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On Continuity of Medical Care and HIMSS

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Considering Pay-for-Retention [P-4-R]

By Darrell K Pruitt; DDSpruitt5

Here is the question on lots of minds these days; how can we change the way medical providers are paid so they are both incentivized and adequately compensated to provide consistent, high-quality, patient-centered medical homes?

My Novel Idea

Here is a solid, common sense idea; increase providers’ pay gradually according to how long the doctors retain patients – who are free to choose any doctor they wish.  Consistency is the mortar of a medical home [i.e., pay-4-retention]. 

An Ounce of Prevention 

If prevention, which predates eHRs by thousands of years, is more than just a modern buzzword, the nation can still shave much more expense from health care by promoting continual, personalized care for consumers than from digital health records alone – void of prevention incentives. Who in the audience still cannot understand that concept? Think of it this way. How do business leaders in the land of the free retain the best employees? They pay bonuses. Even waiters get tips to encourage interest in providing service consumers will return for. What do US physicians get?  Guaranteed cuts in their Medicaid payments over the next decade. Physicians no longer encourage their children to become doctors. Surprised? Scared? 

Consumers Should Rule 

In place of consumers ruling their healthcare in the US, well-positioned, giant stakeholders have persuaded lawmakers to offer physicians bonus money (that will later be taken away), not for curing patients, but for using digital records “in a meaningful manner.” It’s called “Mark and Michael Leavitts’ Clicking for Cash.”  Since the rules are made up along the way, they change like the weather. That is why the larger and more progressive medical facilities pay bonuses to retain their best “Coders” and other informatics specialists who keep up with the current Ingenix-styled games in order to maximize profits. It is my opinion that health care IT’s complexity works well with the economic stimulus plan to improve employment in the nation. Entrepreneurial stakeholders will continue to be movie-star popular right up until the complete collapse of Medicare.  Then they’ll be impossible to find www.HealthDictionarySeries.com

HIMSS 

Have you ever heard of HIMSS?

“The Healthcare Information and Management Systems Society (HIMSS) is the healthcare industry’s membership organization exclusively focused on providing leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare.”

– From the HIMSS Web site.

HIMSS Annual Meeting 

A week ago, HIMSS convened its annual convention in Chicago. The keynote speakers for the four day event were actor Dennis Quaid; followed by the Chairman and CEO of Kaiser Foundation Health Plan, George C. Halvorson; then the economist and former Chairman, Board of Governors of the Federal Reserve, Alan Greenspan, and finally; Jerry M. Linenger, MD, MSSM, MPH, PhD, Captain, Medical Corps, USN (Ret.), NASA Astronaut, and Space Analyst, NBC News. As one can tell, healthcare IT has lots of momentum. In fact, Dave Roberts, the HIMSS vice president for government relations confidently told Bob Brewin on NextGov.com

“The e-records initiative is an entitlement program like Social Security.” 

http://www.nextgov.com/nextgov/ng_20090406_1509.phpdhimc-book9

Another Entitlement Program – Entitlement for Whom

In Regina Herzlinger’s 2007 book “Who Killed Health Care?” the Harvard School of Business professor argues that entitled stakeholders, including a few ambitious members of HIMSS, are destroying health care in the name of reform. In the first half of her 260 page book, she spells out entrepreneurial malfeasance in simple well-annotated terms. In the last half, she describes why Consumer-Driven Health Care [CDHC] makes sense to her. Professor Herzlinger does not specifically mention the words “medical home” in her book, yet she emphasizes the importance of continuity of care. To promote continuity, she suggests that managed care insurance policies be extended to three years duration and longer.  Although she also does not mention dentistry, it is obvious to me that since chronic illnesses like diabetes are exacerbated by poor oral health, continuity of care in dentistry is of special importance.  It occasionally takes years to improve some patients’ oral health care. And sometimes we fail.

Assessment 

If these assumptions about continuity of care are accurate, it follows that the physical and economic health of the nation depends on long-term medical insurance contracts with employers and freedom-of-choice in providers. So is prevention worth holding ourselves accountable to consumers for once? Maybe it is just me, but I think unprecedented truth in healthcare will soon emerge regardless of stakeholders’ needs for confusion and obscurity.  It is called consumerism.  And it goes hand-in-hand with the Hippocratic Oath, the free-market and common sense.

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Social Media in Health 2.0

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Emerging Collaborative Trends

[By Staff Reporters]

stk166326rkeAll readers of the ME-P are aware that social media is going to play a significant role in health 2.0 initiatives going forward.

Social Media Use Growing

According to Dan Bowman of FierceHealthIT, on April 3, 2009, whether we want it to happen or not, social media – much like mobile technology – is going to play a big role in the future of healthcare. From professional networks, to collaborative consumer media and doctor rating websites, healthcare professionals across the nation are jumping on the bandwagon. And, with the federal government pushing physicians’ offices to utilize electronic medical records, it is only a matter of time before healthcare make a concerted push into social media, as well.

Publishers and Editors

“As a medical, practice management and health economics writer for almost four decades, I appreciated how electronic connectivity and social media facilitates communication in a quick and effective manner, and allows broadcast to large groups of people”

Dr. David Edward Marcinko; MBA

[ME-P Publisher-in-Chief]

The Research

A Manhattan Research survey found that 60 million US healthcare consumers use social media to find healthcare information online. A similar survey found that 60 percent of physicians are interested in, or are already using physician social networks. That same study concluded that “physicians who are currently participating in online physician communities and social networks write a mean of 24 more prescriptions a week than” their more old-fashioned counterparts.

Assessment

Of course, more Rxs – or more medical care for that matter – is not a quality indicator at all. Nevertheless, social media is not to be taken lightly.

Link: http://www.fiercehealthit.com/tags/ozmosis?utm_medium=nl&utm_source=internal&cmp-id=EMC-NL-FHI&dest=FHI

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Wal-Mart’s Health Information Technolgy Game Plan

CCHIT Meet Sam Walton

By Darrell K. Pruitt; DDSpruitt3

Dana Blankenhorn posted an article recently on zdnet titled “Wal-Mart Selling Windows Health Records.”

Link: http://healthcare.zdnet.com/?p=1966

After reading it, I opened a good, cost-effective fortified breakfast wine and began hammering out my comment that I copied below, long before the sun came up.  Hope you enjoy it.  I’m going to get some sleep. 

Looks Like Rein

Coach Glen Tullman’s traditionally favored and tough Allscripts-Misys team originating in CCHIT meets Walton’s consumer-supported, nimble team from Arkansas in front of Sam’s home town crowd. As a sports fan and occasional off-color commentator standing on the sidelines, Dana, I think this ball game could get exciting. The weather is perfect for sloppy, poor conditions and heaven knows that these two ideologies share history.

Wal-Mart HIT 

Some odds-makers say Wal-mart’s success in selling healthcare IT at Sam’s Club prices and quality is likely to take off in their patented free-market style in the next few months. 

The big question is; could this threaten federally-favored Allscripts’ early advantage? 

For example; if things get competitive, and the value of MDRX starts to falter under natural pressure, will Trustee Tullman call on the reserve strength of his exclusive Club CCHIT to out-flank the quick and slippery Sam’s Club wide-ended attorneys?  Some say that if CCHIT suddenly selects surprising, deceptive and occasionally lame applications for certification requirements – that happen to already reflect Allscripts pre-determined game plan – it is a cinch to give Tullman’s team a head start around their strong side with a pulling guard or three from the right (weak side) to lead interference.

Assessment 

Will Sam protest such a rule? You bet. It could get messy. Snot could fly. 

Here is the question on this reporter’s mind. If close calls are occasionally ruled in the home team’s favor, will Tullman move on down the road? I like to watch the cheerleaders.

Conclusion

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Problems with HIT in Minnesota

The Continuing eHR Saga

By Darrell K. Pruitt; DDSpruitt2

If you were one of fifty governors who decide to jump off a cliff because flying looks so cool, would you proudly race to be the first to grab the air? Blissfully, Minnesota Governor Tim Pawlenty is way ahead of the pack. He’s so confident in healthcare information technology [IT]  that he doesn’t even have to watch where he’s going – leaving him free to smile for the cameras. Now that’s cool.

Initial Ambitious Plans

Attention ME-P readers! Please gather around to watch a world-class belly-flop of a gutsy statewide eHR mandate. A few years ago, Governor Pawlenty had ambitious plans to lead the nation with an interoperable eHR system that was touted to include all providers – that means Minnesota dentists as well. Your landing could be vertical and abrupt, Pawlenty.

CCHIT Approved? 

In fairness to a brick, back in 2005 Pawlenty could not have predicted the economic collapse that began three years later, nor could he have known about the subsequent $19 billion eHR money that would be made available to providers – but only if they purchase healthcare IT software that is approved by the Certification Commission for Healthcare Information Technology (CCHIT).

CCHIT Laggards 

Even if the descending Pawlenty could have predicted the recent changes in the terrain, including the CCHIT qualification, he would have never guessed that to this day in March of 2009, the certifying commission would still be yet to certify even one single electronic dental record – thereby blocking Minnesota dentists from copious federal help in their efforts to become compliant in Pawlenty’s brave new state.

“The government is actually looking for places to spend the money where there is a strong likelihood of success stories”.

Mike Ubl

Executive Director Minnesota Health Information Exchange

[Owned by Blue Cross Blue Shield of Minnesota, HealthPartners, Medica, Fairview Health Services, UCare and the Minnesota Department of Health].

Link: http://www.twincities.com/ci_11830085

And that after this is accomplished, and the brave new world begins – When all men are paid for existing and no man must pay for his sins”.

-Rudyard Kipling

The CCHIT qualification was incredibly bad luck for Pawlenty’s nifty ideas of interoperability with all providers. When Minnesota dentists discover that they must pay $30 thousand for software they don’t want in order to practice in paradise, some may just swallow their pride, sell the portable ice-fishing house, and move to slow-moving Iowa.

Dentists, MDA and the ADA News

Why the surprisingly quick landing? If Pawlenty actually gave any consideration for dentistry at all, just like everyone else, he must have assumed that dentists’ concerns about digital records would be adequately attended to by the Minnesota Dental Association [MDA] and the American Dental Association. It was easy to make that mistake because of the enthusiasm for eDRs radiating from ADA Headquarters and expressed in confident terms in ADA News Online articles that have since stopped appearing.  Most eDR enthusiasts naturally assumed that by now the majority of dentists in the nation would be saving money, lives and trees with paperless practices. However, the ADA has been nowhere to be found for a long time. As it turns out, the professional organization has still not yet even contacted the certifying commission. We know this, because when I personally contacted CCHIT a few weeks ago, it caught them off guard. I was told that I was one of the first to ever mention dentistry.

Link: https://healthcarefinancials.wordpress.com/2009/03/02/cchit-is-prejudiced-and-lacks-diversity-%e2%80%93-an-indictmen

No Endorsements

To show how far the ADA has slipped, and as an example of its flagging influence on membership, I doubt that more than 5% of American dentists have made the ADA-endorsed leap from paper to digital. Why should they? It makes good business sense to wait, and most dentists are not techno-silly. Consider this; Even if a dentist is happy with a costly eDR system that demanded unanticipated time and effort to learn, in less than a year, CCHIT could determine that his or her favorite system is not worthy of certification because it does not integrate with physicians’ one-size-fits-all, CCHIT-certified eMRs. Tough luck, Minnesota dentists! Uncertified eDRs will be outlawed, while favored, large healthcare IT companies in Madison and Chicago will profit and pay more state taxes with Twin-Cities’ dollars. By then, all the stimulus money will be gone and lawmakers will no longer be giddy about eHRs due to the imminent explosion of data breaches everywhere caused by moving too fast. No return on investment [ROI] there. 

Assessment 

Still, Tim Pawlenty could have never known, yet away he sails with a stupid grin on his face.

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Don’t Rush Into eHRs

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Address Medical ID Theft

1-darrellpruitt

[By Darrell Pruitt; DDS]

Yesterday, an important message titled “Don’t Rush eHRs Without Addressing Medical ID Theft” was posted on ModernHealthcare.com by Martin Ethridgehill, a provider training specialist with Blue Cross and Blue Shield of New Mexico.

Link: http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20090302/REG/303029965

Mr. Ethridgehill points out that if a patient’s electronic medical identity is stolen by someone for health insurance benefits, critical information about the patient can be imperceptibly altered, leading to accidental death in an emergency room for any number of reasons.  Furthermore, he points out that even if the real patient is aware that his or her record is tainted by a false patient’s data, it is very difficult to get the comingled record cleared up.

I have also read elsewhere that HIPAA actually impedes resolution of the nightmare because the Rule also protects the privacy of the false patient – prohibiting the real patient from examining his or her own health record.

Reasons to Go Slow 

Ethridgehill is particularly critical of the EHR industry which lately has downplayed the importance of patient privacy in order to sell dangerous products.  He gives these reasons for the need to slow down in the rush for interoperability:

  • “Adding safety and records mitigation protocols ensures patient safety as an ongoing concept and practice.”
  • “No industry would be allowed to operate, where the officials in charge of it stated that the market or other bodies would be responsible for creating safety procedures. Can you imagine if the auto industry stated, “We make cars, let the market figure out how to regulate safety”? I doubt that Congress or any other body would consider these people as remotely credible, yet I hear time and time again these statements being made in public and private forums by executives, lobbyists, and even so-called healthcare leaders.”
  • “For the public and providers to embrace a product that has no regulation, no built-in safeguards and obviously no importance to safety from the makers of these products, why would Congress expect the American public or healthcare providers to embrace a product or concept that involves the unregulated risk of injury, death, or staggering liability opportunities, let alone without any hope of remedy or proper relief?”

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Doctors Censoring Patients

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Another Emerging Ethical Dilemma

[By Hope Rachel Hetico; RN, MHA, CMP™]hetico6

Much has been said, and much has been written, about the various healthcare 2.0 initiatives and the new-wave patient collaborative schemes among medical stakeholders. Even our federal government, vis-a-vie, the American Recovery and Reinvestment Act [ARRA], of 2009 [“stimulus”] has increased funding related to health information technology [HIT] for physicians, hospitals and healthcare organizations; hopefully to benefit us all.

Information Technology Money

In fact, according to Steve Lieber, President of the Health Information Management Systems Society [HIMSS], about $20 billion will be investment into health information technology [HIT] at one time. Some money will flow into the current calendar year, some dollars will flow in subsequent years, and some funding will be available until spent.

Consumer-Oriented Websites

And so, it comes with surprise and dismay to me that some doctors may be telling their patients to censor themselves – or find another physician. This, of course, is anathema to consumer oriented websites like RateMDs and Vitals.com, etc. These sites give internet users the chance to recommend and review physicians and hospitals nationwide.

Unethical Behavior

But, some ethicists believe that such self-interested behavior is not professional and when a doctor acts primarily out of self-interest, it is ethically suspect. For example, according to Fox News on February 19, 2009, among groups spearheading the move to censor is a company called Medical Justice® which says it’s only helping protect doctors from online libel as an “emerging threat” within the medical profession. Founder Dr. Jeffrey Segal, a former neurosurgeon robustly supports the consumer rating sites in theory, but in practice they aren’t properly monitored and can do irreparable harm to a doctor’s reputation – especially when people pretending to be former patients write phony reviews.

Assessment

Medical Justice® has been mentioned on this forum before, and according to its website

Medical Justice® creates a practice infrastructure to prevent, deter, and respond to frivolous medical malpractice suits.  A membership-based organization, Medical Justice® is relentlessly committed to protecting physicians’ reputations and practices.

Link: http://www.medicaljustice.com

The Center for Peer Review Justice is also a related group of physicians, podiatrists, dentists and osteopaths who have witnessed the perversion of medical peer review by malice and bad faith.

Link: https://healthcarefinancials.wordpress.com/2008/04/17/physician-peer-review

Industry Indignation Index: 65

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IBM and Google Health

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[Partners for Online Personal Health Records

By Staff Reporters]

computer-hardwareAccording to MarketWire, February 5, 2009, IBM, Google and the Continua Health Alliance [CHA] announced new software that will enable personal medical devices used for patient monitoring, screening and routine evaluation to automatically stream data results into a patient’s Google Health Account [GHA] or other Personal Health Records [PHR].

PHR Value Extension

This breakthrough extends the value of PHRs to patients and also helps to ensure that such records are current and accurate at all times. Once stored in a PHR, the data can also be shared with physicians and other members of the extended care network at a user’s discretion.

Daschle and e-Health Reform

Of course,Tom Daschle’s recent decision to withdraw his nomination as the Department of Health and Human Services [DHHS] secretary clouds hopes that President Obama will make significant progress on health-care reform in his first 100 days in the White House. But the problems of unaffordable medical bills and millions of uninsured are not going away, and a deepening recession has more Americans feeling worried about their jobs and insecure about their health benefits.

Assessment

The breakthrough of this triumvirate extends the value of PHRs to consumers and also helps to ensure that such records are current and accurate at all times. Once stored in a PHR, the data can also be shared with physicians and other members of the extended care network at a user’s discretion.

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An Open Letter on eMRs from Hayward Zwerling MD

On eMRs Dangers and Expenses

Submitted by Darrell K. Prutt; DDS55909808

Like communicable diseases that nobody wants to discuss; eMRs are dangerous, incredibly expensive and not worth having for free.  

A Fresh Look at eMRs

A couple of weeks ago, Hayward Zwerling, M.D. uncovered a fresh look at what makes current eMRs so lame, and clinically described the underlying problem in a blunt way that only a doctor with clinical experience can do. Dr. Zwerling’s informative comment on Boston.com is in response to Lisa Wangsness’ Jan. 1 article, “Letter highlights hurdles in digitizing health records.”  

We should have known that CCHIT would draw parasites for natural reasons.   

http://people.boston.com/articles/nation/?p=articlecomments&activityId=6778798549471809193

Dr. Hayward Zweling Speaks

Under the Federal Government’s direction, CCHIT has been given the task of promoting IT (information technology) within the health care industry. Approximately half of CCHIT’s Board of Directors work for medical insurance companies, commercial medical informatic companies, physicians employed by very large group practices or eMR companies. As a result, CCHIT’s priorities have been tailored to reflect the interests of it’s Board of Directors, rather than the needs of the physicians and the health interests of our society at large.

CCHIT Force

CCHIT is now attempting to coerce physicians to purchase specific, expensive and “CCHIT certified” electronic medical record programs, which are designed to collect medical information. This information is “quantified; ” thereby creating a huge repository of all US healthcare interactions. As 16% of the US GDP is spent on healthcare, the amount of information that will be stored in these databases is massive and will eventually be available (for sale) to third parties. One can logically conclude that those organizations that have access to this information will be able to exert a hugh influence on the future of US healthcare.

Enter the Non-CCHIT Vendors

There are now several hundred non-CCHIT certified eMRs on the market which provide low cost and innovative solutions that are not otherwise available to physicians. If CCHIT’s influence remains unchecked, many small eMR companies will be forced out of business. The end result will be extremely disruptive to small medical practices, while forcing them to adopt expensive and bloated software while creating a frighteningly comprehensive healthcare database.

Unique Position

As a practicing physician who also has more than 15 years experience incorporating IT into small medical practice, I am in a unique position to understand the needs of the healthcare community and the potential of health IT. I am a firm believer that the appropriate use of health IT can improve the quality of healthcare. However, it is my opinion that the Federal Government needs to force the Certification Commission for Health Information Technology to alter their priorities so that they mirror the needs of the the majority of the medical community, rather than the interests of CCHIT’s Board of Directors and their representative companies. This can only be accomplished by replacing CCHIT’s Board of Directors, who has a financial interest in the health information technology industry, with people who have no financial connection to the medical-health IT-pharmaceutical industrial complex.

Eisenhower’s Farewell Address

In President Eisenhower’s Farewell Address, he said ” … we must guard against the acquisition of unwarranted influence … by the military-industrial complex … Only an alert and knowledgeable citizenry can compel the proper meshing of the huge industrial and military machinery … so that … liberty may prosper …”

The size of US’s medical-health IT-pharmaceutical industrial complex now rivals the size of its’ military-industrial complex and the parallel between the two industries is too obvious to be discounted. If we choose to ignore this historical precedent, then the future of healthcare in the USA will be controlled by several powerful industries, whose priorities do not necessarily parallel the health interests of our society. And once these industries take control of the health industry, their political influence will ensure that they will remain in control for many decades into the future.

Hayward Zwerling; MD, FACP, FACE

President, ComChart Medical Software

The Lowell Diabetes & Endocrine Center

Information Resources, LLC, Denver, Colorado

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HIT and Privacy Issues

Join Our Mailing List

Complications Retard Links to Medical Data

[By Staff Reporters]56371998

According to the New York Times, January 18, 2009, President-elect Barack Obama’s plan to link up doctors and hospitals with new information technology, as part of an ambitious job-creation program, is imperiled by a bitter and seemingly intractable dispute over how to protect the privacy of electronic medical records [eMRs and eHRs].

Health Law Policy and Administration

Lawmakers, caught in a cross-fire of lobbying by the health care industry and consumer groups, have thus far been unable to agree on privacy safeguards that would allow patients to control the use of their medical records.

Congress Steps-In

Congressional leaders plan to provide $20 billion for such technology in an economic stimulus bill whose cost could top $825 billion. The Times reported in a speech outlining his economic recovery plan, that Mr. Obama said, “We will make the immediate investments necessary to ensure that within five years all of America’s medical records are computerized.”

Assessment

Digital medical records could prevent medical errors, save lives and create hundreds of thousands of jobs, as Mr. Obama has said in the past. But, can they really? Many posts and comments on this blog suggest otherwise. 

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[Un] Predictable HIM Behavior

Predictable Reaction – Unknown Results

By Darrell K. Pruitt; DDSpruitt8

I posted this on the PennWell forum, and notified Lisa A. Algeo, editor of Advance for Health Information Professionals website, that I intend to adjust her reputation. 

http://community.pennwelldentalgroup.com/forum/topics/itching-to-start-something-in?page=1&commentId=2013420%3AComment%3A23719&x=1#2013420Comment23719

A few weeks ago, on December 15, when I posted “Itching to Start Something in HIM’s neighborhood,” I think we all suspected that my Advance website project would not end well for Advance. 

http://community.pennwelldentalgroup.com/forum/topics/itching-to-start-something-in

This is how I closed the initial comment of the doomed conversation:  “If I get any action, I’ll post it here on this thread. If there are no responses from the stakeholders, we’ll have some fun with the website itself.”

Time to Have Fun 

You knew it would happen. I consider it my civic duty to make an example of the Advance website and its archaic, slow-moving editorial policies.  I intend to make it clear to impressionable good ol’ boys that these days, customers should never be taken for granted.  Any one of us can reach out and grab you.  And now, the time has come to publicly adjust the reputation of an editor to show you how it is done.

Advance for Health Information Professionals

It looks like the information management specialists at the Advance for Health Information Professionals website cannot manage this provider’s information. That is regrettable, but it is as predictable as human nature in the absence of competition. The leaders of the Advance website, which caters to healthcare IT vendors, forgot that providers like me are the market.  That is a predictable poor business habit that reliably develops when there is lack of accountability in the marketplace.  It was this mentality produced the 1975 East-German Trabant automobile – the worst car ever.  Four years later, similar market protectionism in the US spawned the 1979 Ford Pinto – the second worst car ever.  Now we have eMRs that are so poor that they require Medicare kick-backs to entice doctors to even try them. 

History to Decide

In a few years, history could easily show that value and safety in healthcare didn’t matter as much to the Obama administration as preserving American jobs in the healthcare IT industry. That would be a harmful and avoidable waste.  As far as I can tell, it is up to me to stop healthcare IT before it gets to dentistry, any way I can.  If it becomes entertainment, so be it. Up until today, I had been graciously allowed to post occasional comments following the inviting Advance article “Help Write the History of HIM (Health Information Management).”  (no byline)

http://community.pennwelldentalgroup.com/forum/topics/will-pawlenty-drive-dentistry

Medical Executive-Post

Over the last month, I provided the website some of my best (polite) work.  Versions of the several of the pieces I posted on the Advance website went on to become fairly popular with Medical Executive-Post’s audience.

https://healthcarefinancials.wordpress.com/?s=darrell+pruitt+dds

Creative Disagreements 

Even though I was admittedly looking for a [polite] fight going into this adventure, I still thought there was a chance that information professionals, of all people, would be interested in an accurate history of HIM – including the perspective of a provider who is on the business end of their expensive and dangerous products.  As incredible as it sounds, it turns out that some information professionals don’t want truth at all. Creative history is not beyond the ethics of this type of ambitious, mandate-hugging collection of entrepreneurs.

Many of you who should know better; still cite a widely discredited 2005 Rand study that estimates that $77 billion will be saved in healthcare if providers will just go ahead and purchase expensive IT products. It makes no difference to this crowd that the study – funded by healthcare IT interests – was transparently one sided in favor of those who purchased the results as a business investment.

Advance Editor Responds 

Yesterday, shortly after submitting “Will Pawlenty drive dentistry out of Minnesota?” to the Advance website, I received the following email from Lisa A. Algeo, editor of Advance for Health Information Professionals (except dentists).

Hi Mr. Pruitt;

“I’m going to stop posting your comments, as they really aren’t relevant toward the article you’re posting on. Our audience does not consist of dentists.”

Sincerely,

Lisa A. Algeo

Editor

LAlgeo@advanceweb.com

Assessment

It is my opinion that Lisa A. Algeo and Advance for Health Information Professionals are irrelevant.  Now let’s see if I can make my opinion stick on Google, just like I did for another Advance contributor, Mark Rempe, vice president of Iron Mountain Health Information Services. 

Reference: (See “Bad move, Mark Rempe”) http://community.pennwelldentalgroup.com/forum/topics/itching-to-start-something-in?page=1&commentId=2013420%3AComment%3A22893&x=1#2013420Comment22893

Or; just googlesearch his name – my comment will return to his first page soon. Information is the product and digitalization the tool. Not the other way around. 

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Was this predictable HIM behavior from Advance? 

Note: Dr. Pruitt blogs at PenWell and others sites, where this post first appeared.

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Healthcare Economics Stimulus

The $100-B Question

Staff Reporterscapital

Reporting in a January 6, 2009 article in Politico, Chris Frates says the healthcare industry could potentially gain more than $100 billion from the $775 billion economic stimulus plan that President-elect Obama and congressional Democrats are now assembling.

 

Insiders Speak

Frates reports that some pundits opine the vast majority [$80 billion] will be earmarked for state Medicaid programs. Apparently, President-elect Obama now realizes that many states have been put into a bad financial position, with failing budgets and increasing pressure on Medicaid programs, and massive layoffs across the country.

Health IT Earmarks

The other $20 billion would likely go to updating medical care delivery with health information technology. The money probably will be distributed as pay-for-performance [P4P] rewards, with some of it being used as grants to hospitals and healthcare systems that need help building IT infrastructures.

Assessment

Link: http://www.politico.com/news/stories/0109/17119.html

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Can Obama achieve his stated healthcare goal of complete eMR adoption within five years?

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

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The Case Against Inter-Operable eHRs

Let the Conversation Begin

pruitt1

By Darrell Kellus Pruitt; DDS

If someone says computerization in dentistry is inevitable, remind them that the metric system is inevitable as well.  Sometimes inevitable takes a long time though – even when it makes sense.  Interoperable dental records don’t.

Contrary to what healthcare IT stakeholders promise to win financing from a newbie Obama administration, interoperable eDRs will increase my cost of providing care, increase my liability as a businessman and endanger my patients’ health and welfare. Those are just three of many reasons why I intend to firmly stand in the way of their adoption until security problems are resolved to my satisfaction. I dare not grow discouraged, for there are far too many depending on me. 

If my grandchildren are to benefit from the miracles of trusted Open Source Evidence Based Dentistry, we must not allow today’s temporary collection of reckless stakeholders to burn consumers’ trust in eDRs even once. 

It is for these reasons that I watch very closely for the mention of eHRs on the Internet.  I am particularly alerted to danger when someone tells lawmakers that they have their own special plans for my patients’ dental records – without first discussing them with me.  I’m funny that way about my Hippocratic obligations and I don’t care what anyone thinks.

The Professor and IT Advocate

Valerie Powell, PhD., a professor of informatics at Robert Morris University, began commenting about dentistry and eHRs on ModernHealthcare.com in April.  She has posted five comments.  Her most recent appeared on November 25, and it was in response to my counterpoint titled “Dentistry EHRs not necessarily inevitable.”

http://modernhealthcare.com/article/20081124/REG/311249951

I continued my point-by-point critique of her uninformed ideas right here on the Medical Executive-Post in an article titled “Dental eHR Controversy Continues.”

https://healthcarefinancials.wordpress.com/2008/11/28/much-more-on-dentistry-and-the-ehr-controversy/

Valerie Powell never returned a response.

www.HealthDictionarySeries.com

Today, Powell’s name popped up on my google-alert.  She was interviewed for an article posted on the Pittsburgh Tribune-Review, written by Allison M. Heinrichs and titled “Experts lobby to add key dental data to medical records.”

http://www.pittsburghlive.com/x/pittsburghtrib/s_603452.html

She and her lobby went over my head.  That was wrong, as well as foolish.

I must say this in defense of her courage, however. In the last two years, Valerie Powell PhD., is the only person in the US who is publicly pushing for interoperable health records in dentistry.  She continues to hopefully plod along even though there are no longer any dentists promoting them – from what I can tell.  The ADA long ago gave up on unwittingly pushing dentists to go paperless. In fact, because of the palpable resentment among membership over being misled about the NPI number, the ADA Department of Dental Informatics [ADA-DDI] no longer even suggests that members sign up for them.  Just ask the department for yourself at NPI@ada.org

Tell them I sent you. They know who I am.

Even the eHR debate that limped along on PennWell was seemingly unnoticed by not only representatives from the ADA Department of Dental Informatics [ADA-DDI] but also by software vendors whose very market awaited their responses.  There still must be a dozen or so unanswered questions about eHRs in dentistry featured on this thread.  Does it not seem strange to anyone else that dental software firms are not tripping all over each other to get the names of their products in front of thousands of dentists for virtually no cost?  Transparency on the Internet certainly beats traditional advertisement if a business can tolerate the matching accountability.

Other than Dr. Powell, why do you think healthcare IT stakeholders are so shy?  And when they do speak up, why do they continue to over-stretch worn out rationalizations rather than offer tangible reasons for eHR adoption in dentistry? 

For example, the lame Hurricane Katrina excuse for digitalization of dental records was stupid even before it was approved by some committee as a talking point.  For anyone here in west Texas, it sounds really, really silly.  Here is another almost extinct slow-moving talking-point I like to lampoon, “Someone can steal paper charts just as easily as they can steal digital records.”  Is there anyone in the nation who can argue that point successfully?  Please step forward; Your audience awaits. 

Recently, I heard a fresh, incredible reason why dentists should computerize – malpractice protection.  Someone who really should have known better told me with a straight face that there are not only more negligence lawsuits filed in dentistry than digital privacy breaches, but that if a dentist has a paperless practice, almost all malpractice lawsuits could be prevented.  I find it hard to believe that a dentist could be so naïve.  Or worse, that a dentist would assume a colleague is so naïve.

Regardless of bald lies mixed in with irrelevant talking points, some rationalizations for connectivity are better than others.  But that still does not mean dentists must computerize their practices to accomplish worthy goals.  For example, one thing Dr. Powell understands on a professional level is the importance of dental health in overall health.

“The research shows that there is a close relationship between diabetes and periodontal disease, also with stroke, respiratory disease, and kidney disease. Some research shows that certain oral diseases are associated with conditions that lead to low birth weight.  And yet dentists and physicians aren’t communicating. I really don’t believe we’re going to get an optimal improvement in clinical care until we take care of this problem.”

Valerie Powell, PhD [Piittsburgh Tribune-Review]

Dr. Powell’s goal is sound, and I cannot argue with her about the urgent need for better communications between all healthcare providers.  In fact, with the sudden downturn in the economy, it so important that we quickly gain control of the expensive and preventable chronic illnesses she mentions, that the nation cannot afford to wait until dentists are paperless.  That could be decades.  The $25 billion bailout that the healthcare IT industry is requesting will be squandered in part for political favors by members of Dr. Powell’s lobby.  I call that churning profits.  That was the old, inefficient way of doing things in dentistry.

We need something now and we need something that will cost virtually nothing.  We need a system for better communications that can be erected in less than six months and will allow taxpayers to keep their $25 billion.  Above all, in order to make this work, we must avoid HIPAA as much as possible.

I’ve put some thought to the serious problem that Dr. Powell describes.  I think I have found a hybrid solution that will not require dentists to become HIPAA-covered entities to communicate more effectively with physicians’ computers.  In fact, physicians also don’t have to be covered entities.  And no, it is not a person-to-person phone call – an increasingly underrated form of communication in my opinion that also does not require HIPAA’s involvement. 

Do you know what the solution is yet? 

Keep reading. There’s more. A solution?

My solution would allow e-prescribing to occur in dentistry, without the dentist having to “volunteer” for a dangerous NPI number.  This would help Glen Tullman, the shy CEO of Allscripts – a monster stakeholder in e-prescriptions.  Otherwise, poor Glen is fresh out of ideas.

http://community.pennwelldentalgroup.com/forum/topics/glen-tullman-ceo-of-allscripts?page=1&commentId=2013420%3AComment%3A22103&x=1#2013420Comment22103

Committees just do not creative thinkers make.

That’s not all! The hardware necessary already exists in most dental offices, and can be obtained for less than $200 at any electronics store.  And just wait until my solution is combined with state-of-the-art voice-recognition capabilities.  All communications with physicians and pharmacies could be done chair-side in the presence of the dental patient without having to store their identifying information digitally anywhere.  All that is needed is a universally acceptable paper format and an acknowledgement that paper is going nowhere soon – thank goodness. 

So what is the revolutionary idea?  It is so simple it will knock you down.

(Drum roll)…  Make eDRs and eMRs compatible with common fax machines as a requirement for ONCHIT accreditation.

Wow!  Now how difficult was that?

Assessment

I invite Dr. Valerie Powell, Dr. Franklin Din, or anyone else interested in finding a solution rather than funding, to discuss with me problems with my idea.  I happen to think it is a cheap, common sense solution that will give us all the benefits Powell promises without excessively endangering anyone other than dental software vendors looking for bailout money. Another difference is my plan has a chance in hell of working www.HealthcareFinancials.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. What do you think? What is your plan? Let the conversation begin.

Note: Dr. Pruitt blogs at PenWell and others sites, where this post first appeared.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

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Obama and Health IT

Works Progress Administration

capital

By Darrell K. Pruitt; DDS

In an article posted on www.ModernHealthcare.com HITS staff writer Matthew DoBias writes: 

 

“President-elect Barack Obama said that his economic recovery plan to create 2.5 million new jobs in part will rely on ‘technology and healthcare modernization,’ a nod toward increasing the use of health information technology among physicians and hospitals as well as the trained staff who will be needed to run it.”

http://www.modernhealthcare.com/article/20081126/REG/311269965

Economic Recovery

The title of the article is “Obama links healthcare reform to economic recovery.”

http://www.modernhealthcare.com/article/20081126/REG/311269965

More Expenses

I was afraid that this would happen. It looks like American citizens are going to help pay for economic recovery through the additional medical expenses necessary for trained healthcare IT staff.  I guess it is still a far better plan for getting us out of a depression than a world war.

As a healthcare provider who has many patients who will go without dental care if I raise my fees to cover the cost of healthcare IT, plus the additional costs of HIPAA compliance, doesn’t that make Obama’s plans counter to the Hippocratic Oath?  Don’t forget the indisputable fact that electronic dental records are more likely to cause dental patients harm than good.

Assessment

Obama scares me. When a customer enters my place of business, they want to pay for safe dentistry, not mandated, busy work jobs carrying tremendous liability that are designed to stimulate the economy.

Conclusion

And so, your thoughts and comments on this Executive-Post are appreciated.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

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