In a step toward reducing mistakes and standardizing medical practices, North Shore-Long Island Jewish Health System, a major hospital group in New York, has announced the most sizeable effort to adopting digital health records.

The group's investment is a $400 million commitment that would put digital health records in 13 of its hospitals. The plan offers "its 7,000 affiliated doctors subsidies of up to $40,000 each over five years to adopt digital patient records. That would be in addition to federal support for computerizing patient records, which can total $44,000 per doctor over five years."

Stated the New York Times, "The federal program includes $19 billion in incentive payments to computerize patient records, as a way to improve care and curb costs. And the government initiative has been getting reinforcement from hospitals. Many are reaching out to their affiliated physicians — doctors with admitting privileges, though not employed by the hospital — offering technical help and some financial assistance to move from paper to electronic health records. "

Digital health records can improve the health outcome for patients and reduce costly administrative fees and costs for hospitals. "Indeed, the rationale for investing in digital records is that the technology can be used to help monitor and measure the results of care, providing the evidence needed to shift remuneration away from the current fee-for-service system, which encourages more tests, more procedures and more pills prescribed."

To read the full article, click here: http://www.nytimes.com/2009/09/28/technology/28records.html?scp=1&sq=September+28+2009&st=nyt

David Leonhardt, a columnist at the New York Times, writes about the economic consequences of medical malpractice and waste in his latest column, The Economic Scene.

Leonhardt brings to surface many poignant points regarding what we physicians and payers call best practices of medicine. If we were to follow an overwhelmingly established and strictly adhered to set of protocols for cases, we might be able to elimintate excess waste and reduce costs in the overinflated cost of healthcare in the United States.

Leonhardt makes his argument based off of facts, rather than off of passionate political arguments. For example, he cites both the AMA and the lawyer's trial association which both state that about $60 billion a year is wasted within the healthcare industry.

That $60 billion is roughly three percent of the total sum of medical spending. Interestingly enough, only three percent of all medical cases are sought after as malpractice damages.

Does that mean we're making ado about mere pennies when it comes to covering up for malpractice fears?

To read the full article about malpractice and spending, click here: http://www.nytimes.com/2009/09/23/business/economy/23leonhardt.html?_r=1&scp=6&sq=September+23+2009&st=nyt

New York-Presbyterian Hospital, whose centers and clinics account for 20 percent of all health care provided in New York, is the first large institution to move beyond the pilot stages of online digital records, a New York Times article reports.

New York-Presbyterian is beginning to offer consumer-controlled health records for patients this week.

Although online medical records have been available for years, a nearly non-existent percentage of Americans have them today, mainly because getting useful patient and medical information into personal health records into an online form is time-consuming, mind-numbing and error prone, the article stated.  However, Microsoft and Google have announced partnerships within the past few months with large health care providers, including Cleveland Clinic, Mayo Clinic and Kaiser Permanente to overcome these barriers.  

Dr. Mehmet Oz, a heart surgeon at New York-Presbyterian said in the New York Times that “one significant benefit [of online personal health records] is the mobility of information and ease of access to an online personal health record.

Moving from papers-in-files to a digitized office is just one of the many scores of changes transforming our society. AllMed, an independent review organization, is online, too. AllMed’s Web site offers an array of resources that, much like online personal health records, eases the painstaking task of research and discovery; we compile all the information you need to keep it at the ease of your fingertips…literally.  

To read the full article, click here: http://www.nytimes.com/2009/04/06/technology/companies/06health.html?ref=health

Despite most of the negative limelight forced upon those in Wall Street, more and more headlines are popping up, regaling of the less-than-desirable conditions in the medical field. Insurance companies are being sued for dishonesty; hospitals are starting to crumble financially; patient-doctor trust is waning. At dire times, when the light of srutiny is nearly blinding, we can often get caught up in trying to keep our heads up--trying to survive--that we forget that we are lucky enough to do the very thing that we love the most.

For health professionals, that one thing is medicine. A new book titled, "Cutting for Stone," by Dr. Abraham Verghese of Standard University, helps doctors remember why they do what they do. Verghese, who over the past year, has been reminding doctors, medical educators and medical students about the importance of the physical exam, or what he refers to as “bedside skills,” in modern medical practice, brings out the artistic quality--the aesthetic experience--of medicine in his new book.

The New York Times book reviewer, Dr. Pauline Chen, wrote:

"After reading through several of these passages about doctoring, I could not help but feel about Dr. Verghese as the young Marion Stone did about his first doctor-teacher. “He invited me to a world that wasn’t secret, but it was well hidden. You needed a guide. You had to know what to look for, but also how to look. You had to exert yourself to see this world. But if you did, if you had that kind of curiosity, if you had an innate interest in the welfare of your fellow human beings, and if you went through that door, a strange thing happened: you left your petty troubles on the threshold.”

To read the full book review, please click here: http://www.nytimes.com/2009/02/13/health/12chen.html?ref=health

Tara Parker-Pope, a health and wellness blogger for the New York Times, recently posted a blog deciphering the results of a recent Oregon Health and Science University study that claims that certain scans for back pain might be inefficient and do more harm than good for the patient.

According to the OHSU study, back pain patients who underwent scans didn’t get better any faster or have less pain, depression or anxiety than patients who weren’t scanned. More importantly, Parker-Pope points out that the OHSU data suggested that patients who get scanned for back pain may end up with more pain that those who are left alone.

Why are these results important to health payers and hospitals? Because: Those same studies suggest that more than half the patients who see a doctor for back pain undergo X-rays or another imaging study as a result. These tests might not be necessary, the studies say. Dr. Roger Chou, associate professor of medicine at Oregon Health and author of the study wrote that “We [doctors] think we’re helping patients by doing a test, but we’re adding cost, exposing people to radiation and people may be getting unnecessary surgery.”

Rather than have patients under the impression they are in worse conditions than they might actually be, doctors need to focus on practicing the best standards-of-care to ensure that patients are receiving the correct medicine they need to keep their body and mind healthy. An independent review organization like AllMed can help you, as doctors and payers, make the right decision to ensure the best standards-of-care for patients.

To read the full article and to link to the study, click here

Most people wouldn't think that the health care industry would suffer from the current economic recession enveloping the country. After all, health care is a necessity, whether the country is swimming in riches or drowning in debt. However, hospitals around the country are finding out that recession can wound even the most fastidious of health care providers.

Hospitals across the nation, such as Shands AGH in Gainesville, New Jersey, are merging together, morphing from non-profit to profit and, if experiencing severe enough problems, closing the doors for good. All over, hospitals are cutting costs by avoiding renovations, cutting staff hours and positions, and outsourcing services like housekeeping and security, making staff shortages even more prominent.

According to a health news article on Yahoo!, hospitals employ five million people in America. They are currently "reporting that donations and investment returns are down, patient visits are flat and profitable diagnostic procedures and elective surgeries are declining as people with inadequate insurance delay care." Coupled with "stingy reimbursements from commercial insurers and high labor and technology costs," it's of little wonder why hospitals are beginning to feel the credit crunch.

What the Yahoo! article fails to mention is a remedy or preventative measure that hospitals can take to help curb unnecessary costs. Using an independent review organization, like AllMed, can help hospitals and payers alike make the best, most time and cost efficient decisions for patients and doctors. Although independent review organizations require fees, the money and time saved, coupled with the confidence of that always-correct decisions that AllMed makes, is worth the extra cost of outsourcing to an independent review organization like AllMed.

To read the full article on Yahoo!, click here

Maintaining a healthy line of communication is key to just about anything in life. But what if it could save lives? An article in the NY Times illustrates the benefits of open communication that doctors and nurses are finding in operating rooms around the world. By utilizing a 19-item checklist that ranges from a brief introduction of each team member, to confirming that all of the necessary equipment for surgery is available and sterilized, team members in the OR are cutting down on surgical complications and deaths.

A study conducted by the World Health Organization monitored statistics for one year in hospitals ranging from the US and Canada, to the Philippines and Tanzania. The results were notable as the average death rate dropped from 1.5 percent to 0.8 percent when a checklist was used. The rate of complications also decreased from 11 to 7 percent.

Taking the time to hear about each team member and what they do creates an open dialogue which is conducive to good communication and thus a safer environment for the patient – which is the first priority.

Patient safety should be considered at all turns, while precautions are taken in any and every area of practice. Using an independent review organization like AllMed to conduct external peer reviews is another option to help facilitate healthy, open communication in a hospital, and helps to increase patient safety.

To read the full article click here.

Should hospitals be allowed to make mistakes? This seems to be the question on mind in a recent New York Times article about University Hospital in Syracuse, New York. University Hospital is reportedly "not a good hospital. In fact, in late 2006 a state commission recommended that it be scaled back and merged with another hospital."

The scale-back and merge suggestions didn't follow through however, despite the fact that the evidence was strongly against University Hospital. Its patients were three times as likely to develop infections stemming from hospitals as were patients at the average New York hospital, according to 2006 statistics.

Patients need to be able to trust their hospitals. They need to be able to walk into the operating room, emergency room and physicians' offices knowing that they are going to be receiving the best care from their doctors. How can hospitals, especially ones that are failing, assure this trust?

One avenue a hospital can take, as suggested by the article, is applying for accreditation by the Joint Commission. Another avenue a hospital can take is outsourcing to an independent review organization, such as AllMed, to ensure that it is making the right decisions for its patients, rather than its doctors. Check our AllMed to learn about best practices, common errors and how AllMed can help hospitals reach standards of care in order to avoid the snowballing errors of University Hospital.

To read the full article, click here.

Technology is definitely a cool thing these days. Just watch the commercials on television and you'll understand how abundant and incredibly viable and accesibly to the masses technology is: We can get the internet from our cell phones, take video with our digital cameras and look at photographs posted 10 minutes ago to check road conditions over the internet. Technology is amazing and it's just getting better.

But what happens when technology doesn't work properly? A recent New York Times article surveyed the issue of less-than-stellar technology in the medical world: "Scans--more sensitive and easily available than ever--are increasingly finding abnormalities that may not be the cause of the problem for which they are blamed. It's an issue particularly for the millions of people who go to the doctors' offices in pain." Why is it an issue? Because, scans are expensive, time consuming and often uncomfortable and mentally-taxing on patients...and unnecessary procedures lead to unnecessary costs for everyone.

Instead of relying on scanners (and their confusing results), doctors should set up rules of best practices to rely on in order to give patients a routine diagnostic procedure as well as to expunge any unnecessary costs. Using an independent review organization such as AllMed can help hospitals determine best practices, such as when to use a scan or when to try a different diagnostic approach, when working with patients.

To read the full article, click here.

It is no mystery that doctors work long hours--really long hours. Yet, what can happen when doctors and surgeons work too long and put in too many hours? What's more, who is to say how long is too long? A November article in the New York Times surveyed just this problem. The writer, a well-established doctor, relives her life as an intern and making it into residency. She tells of first year mistakes to more grave problems, like judgment errors that cost her colleagues their jobs and her patients their lives.

The article points out a vital problem in hospitals: In striving to be the best, doctors and hospitals alike can often overlook simple safety issues, such as mandating working hours, allotting for drastic and life-threatening mistakes. Using an independent review organization can help monitor the hours your doctors put in, ensuring that your hospital maintains high patient safety retention. 

Read the full article here: http://www.nytimes.com/2008/11/07/health/chen11-06.html?_r=2&oref=slogin

The Cleveland Clinic, one of the nation's most prominent medical research centers, has begun publicly reporting its business relationships that any of its 1,800 staff doctors and scientists hold with drug and device makers, the New York Times reports.

The clinic's decision for such wide-spread disclosure comes as the nation's doctors and hospitals are under incredibly ballooning pressure to address potential financial conflicts of interest that can, and do, occur when they work closely with companies to develop and research new drugs and devices. The decision is commendable, considering that the majority of Americans take what they learn from the media and other authoritative figures as truth, without questioning the formula behind it.

Of course, the clinic's decision comes as atonement for past conflicts of interest after several of the clinic's doctors came under fire several years ago when the news media disclosed some of their financial links. The clinic opted to publicly disclose this information after a group undertook significant review of the clinic's past endeavors.

Aside from being a golden rule taught by our mothers, disclosing information and being honest should become a best practice for maintaining patient trust and safety as well as institutional integrity. An independent review organization can help hospitals and research clinics identify potential conflict of interest. Through thorough show and tell, a hospital can literally wipe its hands clean from possible conflicts of interest situations.

To read the full article, click here: Cleveland Clinic Discloses Doctors' Industry Ties

Most doctors know what it takes to be a good doctor: High scores in medical school, competent striving during residency and consistent and accurate diagnosis. But what does it take to be a respected doctor?

An article in the New York Times written by a doctor, suggests six habits of highly respected physicians. Dr. Kahn believes that an etiquette-based approach to doctoring abets ensuring that patients aren't just healthy, but are happy as well. Furthermore, adhering to an outline etiquette helps ensure that doctors are held to the same standards and helps to deter possible evaluation.

Kahn's six habits of etiquette are:

1. Ask permission to enter the room; wait for an answer

2. Introduce yourself; show your ID badge

3. Shake hands

4. Sit down. Smile if appropriate

5. Explain your role on the health care team

6. Ask how the patient feels about being in the hospital

Independent Review Organizations such as AllMed can help your hospital and doctors establish an etiquette protocol such as Dr. Kahn's outline. 

To read the full article, click here:

The Cleveland Clinic, one of the nation’s most prominent medical research centers, has begun publicly reporting its business relationships that any of its 1,800 staff doctors and scientists hold with drug and device makers, the New York Times reports.

The clinic’s decision for such wide-spread disclosure comes as the nation’s doctors and hospitals are under incredibly ballooning pressure to address potential financial conflicts of interest that can and do occur when they work closely with companies to develop and research new drugs and devices. The decision is commendable, considering that the majority of Americans take what they learn from the media and other authoritative figures as such, without questioning the formula behind it.

Of course, the clinic’s decision comes as atonement for past conflicts-of-interest after several doctors came under fire several years ago when the news media disclosed some of their financial links. The clinic opted to publicly disclose this information after a group undertook significant review of the clinic’s past endeavors.

Aside from being a golden rule taught by our mothers, disclosing information should become a best practice for maintaining patient trust and safety and institutional integrity. Through thorough show and tell, a hospital will literally be able to wipe its hands clean from possible conflict-of-interest situations.

To read the full article, click here: http://www.nytimes.com/2008/12/03/business/03clinic.html?_r=1&adxnnl=1&adxnnlx=1228323635-aJpCMwDNiiy9q1hLc+YTlA

Cancer is not a word anyone likes to hear, especially when statistics like the fact that 1.4 million new cases of it will be diagnosed this year float around the media. A New York Times article featured a Seattle woman whose colon cancer puzzled her doctors.

Karen Pasqualetto was, admittedly, frustrated over the multiple diagnoses and prognoses she received. In the article Pasqualetto claims, “I don’t feel I have a doctor who is looking out for my care. My oncologist is terrific, but he’s an oncologist. The surgeon seems terrific, but I have found him through my own diligence. I have no confidence in the system.”

When patients don’t have confidence in the medical system, obviously there are systemic problems within the oncological medical world. Cancer is undoubtedly hard to treat, as it requires a minimum of three doctors. Treatment decisions are tough, too. Furthermore, the quality of cancer care varies among doctors and hospitals, muddling the ability to distinguish what is the best treatment.

The inability to choose a best treatment is even admitted by government and medical groups. A 1999 report by the Institute of Medicine in Washington stated that, “There is a wide gulf between what could be construed as the ideal and the reality of [one’s] experience with cancer care.”

One avenue hospitals and doctors could travel down to ensure the best practices for cancer treatment is referring cases to independent review organizations. IROs like AllMed can use their clinical expertise to decide what is the best practice for the patient, every time. Moreover, referring difficult-decision cases to IROs helps hospitals establish a consistent treatment plan.
To read the full article, click here:
http://www.nytimes.com/2007/07/29/health/29Cancer.html?_r=1&oref=slogin

The World Health Organization issued a list of safety checks last week that aims to reduce complications and deaths from the rising numbers of operations now being performed worldwide. The list entails safety checks that will improve anesthetic safety, avoid infections and improve communication among surgical team members. According to W.H.O., these safety checks could halve the rate of surgical complications.

With the new safety checks, standards of practice in hospitals will mostly like change…the question is how it will change it.

Read the full article

If you didn't get a chance to watch the latest episode of Frontline on PBS, I highly recommend that you take the time to see it. It will help you to understand how other advanced countries have organized their health care systems, and the strengths and weaknesses of each approach.

You can watch it online by Clicking Here

This piece advances our knowledge of how health care provides better access at lower cost in other countries, while maintaining acceptable standards of quality. It dispels the belief by many Americans that only the profit motive can drive people and organizations to excel -- particularly in health care. It also shows how universal coverage can work, without necessarily going to a single payer system -- even in countries like Germany that are far more liberal than the U.S.

We can learn a lot from this program as we ready ourselves for the challenging task of transforming our health care system in the next several years.