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

Study for a test and you’ll earn a good grade. 

Follow the recipe and you’ll get a moist cake.

Water your garden and you’ll have luscious bouquets.

These instructions are almost innate truths to our lives: If-Then statements that make sense and we accept as the standard because they are time-tested, well-experimented paths to success in school, baking and gardening. We know that water helps plants grow because it has been researched. We know that a cup of flour instead of two cups for a recipe yields a better tasting product because it’s been tested. We can see from the A written in red at the top of test (or are children’s) that studying paid off. We accept these practices because they are standards.

Researchers are finding that some standards-of-care in the world of medicine have become the so-called standard without clinical guidelines, hard data or evidence. According to a New York Times article in December, a report in The Journal of the American Medical Association found that only about a third of clinical guidelines reviewed current medical evidence and fewer than half followed any kind of standard format.

The gap created by the failure to include and study evidence and standards posits a scary situation for patients because evidence-based guidelines are critical to protecting public health from bad medicine. You wouldn’t want to serve a cake with unmeasured ingredients to your friends just like you wouldn’t want to serve your patients via guidelines that lack evidence.

 In standardizing care through pay-for-performance incentives, large insurers like Medicare may increasingly reward doctors for following clinical guidelines. Before that happens, though, it will be critical to establish better standards for the standards — especially for children. Collaborating with an independent review organization like AllMed can help doctors and payers know what the evidence-based guidelines and standards-of-care for a breadth of medical diseases are. 

To read the full essay, click here

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

Sparking up an age-old debate between physician-owned hospitals and non-profit hospitals, a new bill passed by the U.S. House of Representatives this month will hamper the expansion of facilities owned by doctors as reported by the Rapid City Journal this week. See article

The concern stems from cases where a patient has an injury and is then scheduled for surgery in the hospital in which the physician owns. It is difficult to monitor the interests of each doctor and whether he/she simply wants to be sure that the patient is receiving the proper care, or if there is a conflict of interest.

One side of the coin is that many doctors run a physician-owned facility to avoid the bureaucracy that typically comes with a larger hospital. Opposing opinions suggest that other factors are considered when there is profit involved, and the existence of these hospitals is due in part to a loophole in a federal law.

It isn’t possible to say that this issue is always a conflict of interest, or strictly to see that the patient receives the proper care. Every facility is different and instead should be monitored accordingly.

Healthcare payers can ease their concerns of over-utilization, while ensuring proper care for their patients by using an independent review organization like AllMed to help make medical necessity determinations for their patients. 

How long should a patient stay on a medication? According to a study released last July, extending antibiotic treatment past the time it takes to cure Lyme disease doesn’t do any real good.

What’s more is that these antibiotics could be harming the patient, prolonging post-Lyme disease symptoms like fatigue, mood problems, and muscle and bone pain.

A New York Times article surveys this problem, which was initially brought up by the Journal of Neurology.

So how do you know how long to keep a patient on a medication? Using an independent review organization can help payers make the decision for use and prescription of antibiotics.

Read the full article here: http://www.nytimes.com/2007/05/29/health/29prog.html