Molly Merrill, Associate Editor

ANNANDALE, VA – President Obama called for fixing the broken healthcare system by building upon investments made in electronic medical records in a town hall meeting held Wednesday.

The town hall was held at Northern Virginia Community College in Annandale, Va., where the president took questions the public submitted online regarding healthcare reform.

“I know that people say the costs of fixing our problems are great - and in some cases, they are,” Obama said. “The costs of inaction, of not doing anything, are even greater. They’re unacceptable. And that’s why this town hall and this debate that we’re having around healthcare is so important.”

The president highlighted the continued use of electronic medical records as one way to help drive down costs.

“We already made those investments in the Recovery Act - because when everything is digitalized, all your records - your privacy is protected, but all your records on a digital form - that reduces medical errors. It means that nurses don’t have to read the scrawl of doctors when they are trying to figure out what treatments to apply. That saves lives; that saves money; and it will still ensure privacy,” the president said.

Obama said the government has already identified $950 billion over 10 years that will be used to pay for healthcare reform. He said this “doesn’t even include the savings that we’re going to get from prevention, or the savings that we’re going to get from health IT - because in using congressional jargon, which I’m never supposed to do because nobody understands it - it’s not scorable.”

“And what that means is, is that the Congressional Budget Office can’t identify exactly how much you would save - even though everybody believes that it will end up saving a lot of money, we can’t put a hard number on it,” Obama said.

The president ended his speech by calling for the American people to “stand up and say now is the time.”

“We can create a healthcare system that gives you choice, allows you to keep your doctor, drives down costs, makes sure that every American doesn’t have to worry if they lose or change their jobs. That’s our aim. That’s our goal. We’re going to make it happen this year.”

Above article published on

http://www.healthcareitnews.com/news/obama-highlights-it-tool-fix-healthcare

Electronic Medical Records: An Obamanomic Step Toward Improved Health Care

Mary Anne Simpson

The Obama Administration’s goal to improve the entire health care system in the USA begins with an incremental first step by introducing nearly 500,000 physicians to electronic medical records via the American Recovery and Investment Act 2009. Some physicians, hospitals and clinics throughout the world all ready use some form of health care management software which includes electronic medical record programs.

The focus of the latest efforts is to digitize all existing patient medical records, store the records on a portal which is available to both patient and provider for the purpose of engaging patient participation and of equal importance cut down on medical errors. As with all seemingly benign objectives certain concerns have been expressed on the how, why and where of achieving this primary goal.

The Idea Was Born in Science:

The National Academies is comprised of the National Academy of Sciences, National Academy of Engineering, Institute of Medicine and the National Research Council. In 2007, the Rosenthal Foundation sponsored the lecture series, “Transforming Todays Health The focus of the latest efforts is to digitize all existing patient medical records, store the records on a portal which is available to both patient and provider for the purpose of engaging patient participation and of equal importance cut down on medical errors. As with all seemingly benign objectives certain concerns have been expressed on the how, why and where of achieving this primary goal.

The Idea Was Born in Science:

The National Academies is comprised of the National Academy of Sciences, National Academy of Engineering, Institute of Medicine and the National Research Council. In 2007, the Rosenthal Foundation sponsored the lecture series, “Transforming Todays Health Care Workforce to Meet Tomorrow’s Demands.” The preeminent Harvey V. Fineberg, M.D. PhD and President of the Institute of Medicine and his colleagues set forth a new attitude and direction for medical care delivery which included electronic medical records.

Citing the analogy of Bob Evans, a Canadian health care economist, “before adding more sugar to a cup of tea, make sure you stir the sugar all ready in the cup.” The problem of shortages for primary health care physicians, physician assistants and registered nurses comes down to poor utilization of their time. Dr. Kevin Brumback, M.D. Professor and Chair of the Department of Family and Community Medicine at the University of California, San Francisco says way too much time is being spent by physicians doing rudimentary tasks that someone with limited training or a computer could do.

Dr. Brumback doesn’t believe electronic medical records, (EMR) is a panacea for all that ails the health care system, but it will free up time physicians spend reviewing paper files, scheduling lab tests and notifying patients of results. The main point is to bring the patient into the health care system, by putting the health records on-line using a secure HIPAA web site wherein patients could see their medical file, schedule appointments, view lab results and form questions for their next physician visit. The active patient could order age appropriate tests like mammograms, colon cancer screenings and other annual tests

Care Workforce to Meet Tomorrow’s Demands.” The preeminent Harvey V. Fineberg, M.D. PhD and President of the Institute of Medicine and his colleagues set forth a new attitude and direction for medical care delivery which included electronic medical records.

Citing the analogy of Bob Evans, a Canadian health care economist, “before adding more sugar to a cup of tea, make sure you stir the sugar all ready in the cup.” The problem of shortages for primary health care physicians, physician assistants and registered nurses comes down to poor utilization of their time. Dr. Kevin Brumback, M.D. Professor and Chair of the Department of Family and Community Medicine at the University of California, San Francisco says way too much time is being spent by physicians doing rudimentary tasks that someone with limited training or a computer could do.

Dr. Brumback doesn’t believe electronic medical records, (EMR) is a panacea for all that ails the health care system, but it will free up time physicians spend reviewing paper files, scheduling lab tests and notifying patients of results. The main point is to bring the patient into the health care system, by putting the health records on-line using a secure HIPAA web site wherein patients could see their medical file, schedule appointments, view lab results and form questions for their next physician visit. The active patient could order age appropriate tests like mammograms, colon cancer screenings and other annual tests

Above article published on

http://www.physorg.com/news161935473.html

The recently adopted package increases support for research into the best treatments for the same medical conditions or illnesses.

By Doug Trapp, AMNews staff.

Washington – A conservative backlash against comparative effectiveness research provisions in the stimulus package could be the first sign of a difficult health reform debate to come.

The stimulus act enacted Feb. 17 provides $1.1 billion to federal agencies for evaluations of the effectiveness of different drugs, devices and procedures on the same medical condition. The infusion is a huge increase over existing funding for comparative effectiveness research.

But the provision attracted unwanted attention as the stimulus bill moved forward. The House Appropriations Committee’s summary of the version it approved on Jan. 15 said the bill would help determine which drugs, procedures and medical interventions are “less effective and in some cases, more expensive.” Mentioning cost savings as a potential benefit of the research language was enough to lead conservative media outlets, from the Washington Times to radio host Rush Limbaugh, to conclude that an era of government-rationed health care was coming.

The speculation also was fueled by bill language creating a panel of federal government leaders to recommend federal priorities for comparative effectiveness research. A November 2008 white paper by Sen. Max Baucus (D, Mont.), chair of the Senate Finance Committee, cited a Congressional Budget Office estimate that $700 billion of the nation’s annual $2.3 trillion health spending is ineffective, said Dennis Smith, former director of the Centers for Medicare & Medicaid Services’ Center for Medicaid and State Operations and a senior fellow at the Heritage Foundation.

Some GOP members of Congress, including Sen. Mike Enzi (R, Wyo.), spoke out against what was seen as a potential for additional government power over health spending. “The bureaucracy, not doctors and patients, will have the power to make decisions about which treatments folks can and can’t have,” Enzi said Feb. 13.

Robert Doherty, the American College of Physicians’ senior vice president for governmental affairs and public policy, said some conservatives were looking far into the future when they objected to the act’s research provisions. “This was viewed by some as the opening skirmish in a broader battle over the role of government in health care,” Doherty said. The ACP and the American Medical Association supported the comparative effectiveness provisions and funding in the stimulus package, called the American Recovery and Reinvestment Act of 2009.

The final version of the bill did not specifically include cost as part of comparative effectiveness research. The House Appropriations panel’s report summarizing the House-Senate negotiations that produced the final version said the research funding “is not to be used to mandate coverage, reimbursement or other policies for any public or private payer.”

“There are a lot of dots [conservatives] are connecting. And the dots are certainly not connected in the bill,” Doherty said.

Adding “clinical” to “comparative effectiveness” in the bill’s language would have clarified that the research won’t include costs as a factor, but the stimulus act didn’t do that, said Gail Wilensky, PhD, a former Medicare administrator and senior fellow at Project Hope, an international health advocacy organization. “That is, in my mind, a permissive difference,” she said.

Smith agreed on the need to compare treatments, but he worries about any payer, especially Medicare and Medicaid, having too much influence in the medical payment system.

Doherty said the concerns about government intrusion are overblown. “All it really does is provide additional funding to the National Institutes of Health and the Agency for Healthcare Research and Quality to build upon their existing work they are doing in comparative effectiveness.”

Doctors and patients need more rigorous evidence about treatments’ effectiveness, Doherty said. Informed patients might be more likely to choose a less-invasive treatment if its outcome is similar to surgery or another more invasive option.

Government funding of research isn’t a perfect solution, said Roy Poses, MD, a clinical associate professor of internal medicine at Brown University in Rhode Island who has researched clinical epidemiology and evidence-based medicine. “But in the absence of research, the government might use something else to make coverage decisions that might be even less valid,” he said.

Doherty said several ACP members contacted him after the association said it supported the stimulus bill, which was controversial among conservatives for a variety of reasons. “So it was hard to separate the health care provisions from one’s overall views of the stimulus bill. For more conservative physicians … a lot of them didn’t like the idea of the stimulus bill, period.”

The print version of this content appeared in the March 16, 2009 issue of American Medical News.

Above article published on http://www.ama-assn.org/amednews/2009/03/09/gvsb0309.htm