By Dr. Raj Bhandari and Terry L. Austen

Special to the Mercury News

Patients in the Kaiser Permanente San Jose Hospital are seeing something new when a physician or nurse visits their rooms. The doctors and nurses themselves aren’t different; they continue to provide their patients with superior care and service.

But a piece of equipment they bring with them — a wheeled cart with a computer screen on top — is a significant difference, and it’s an example of what will help dramatically improve health care in America.

The cart-borne computer is wirelessly connected to a huge database containing the medical history of our members, as well as the latest recommended treatments for a wide range of medical conditions. The database contains all outpatient and inpatient visit information, diagnostic images such as X-rays and mammograms, allergies, specialists’ notes, lab tests and prescriptions. And it is all part of KP HealthConnect, the largest nongovernmental electronic medical record (EMR) system in the United States.

Electronic medical records are a cornerstone of President Barack Obama’s health reform effort, and as part of his effort to stimulate the economy, he has dedicated some $19 billion to make EMRs a national reality.

Why? Electronic medical records improve the quality of care. A fully functional EMR system gives physicians, nurses and technicians a patient’s comprehensive medical history at the point of care, whether it’s in the doctor’s office, the emergency room or in a skilled nursing facility. It is also remotely accessible for specialists and others who are on call, allowing them to make informed decisions that expedite patient care.

EMRs have the potential to increase efficiency and contain costs by reducing duplication and improving patient safety, and they do this by harnessing the incredible power of computers — their ability to calculate, to network, to automatically check facts and to provide targeted research results — and applying that power to medical care.

In health care systems with fully implemented electronic medical records, physicians and nurses no longer need to spend valuable time looking through several files for paper records that are often incomplete.

Now, for example, emergency department physicians with a fully functional EMR system can see a patient’s previous hospitalizations, medications and diagnoses when that patient shows up complaining of chest pains. That means treatment can begin more quickly and success is more likely.

Medication is safer, too: Prescriptions written by physicians using the EMR system are spell-checked and legible, and the computer automatically combs the patient’s history for potentially dangerous drug interactions and alerts the doctor.

In the hospital, medications are bar-coded and scanned at bedside to help ensure the right patient is getting the right drug in the right dose at the right time.

Of course, EMRs should not be a one-way street. In integrated health care systems, patients can use their home computers to increase convenience by making appointments online, ordering prescription refills that are delivered to their home, viewing their lab results through secure Web pages, and e-mailing their physicians — all at no additional cost.

Last year, thanks to these online tools tied to EMRs, Kaiser Permanente members had 6 million e-visits without using a gallon of gas.

Notes jotted on paper and placed in multiple files where doctors rarely see them are a remnant of a fragmented, inefficient model of medical care. In the 21st century, Americans expect — and deserve — more.

Dr. Raj Bhandari is physician-in-chief and Terry L. Austen is senior vice president and area manager for Kaiser Permanente San Jose Medical Center. They wrote this article for the Mercury News

Above article published on http://www.mercurynews.com/opinion/ci_13534802

While few practices and hospitals currently use aggregated patient data, the number is expected to increase, and a new study touts the information’s benefits.

By Pamela Lewis Dolan, amednews staff.

One of the biggest untapped benefits of electronic medical record adoption is the secondary uses of the data that are being collected, concludes a study by PricewaterhouseCoopers.

The study, “Transforming Healthcare through Secondary Use of Health Data,” found that practices and hospitals have seen aggregated data from their electronic medical records identify patterns that have allowed them to improve outcomes, reduce errors and increase revenue opportunities.

But the number of institutions using the aggregated, or secondary, data in this way is very small, though it is expected to grow in the next two years.

“Almost every constituent in the [health care] industry that has to make a decision around what type of health care to deliver and when could use this kind of data and the information that aggregating it can produce,” said Dan Garrett, health IT practice leader at PricewaterhouseCoopers.

The report found that among those organizations already using some form of secondary data, 59% have seen quality improvements, 42% have achieved cost savings, 36% have seen patient/member satisfaction improve, and 29% have increased revenue. The biggest users of secondary data are hospitals and physicians, while health plans are the farthest behind.

The survey found that although 95% of physicians are not opposed to using secondary data, many are sensitive to how it should be used. Patients also are concerned.

“We all know we need to use this data, but they also know we can’t risk security,” Garrett said.

The PricewaterhouseCoopers report came from an e-mail survey conducted in June of 732 health care executives, 482 physicians, 136 payers and 114 pharmacy/life sciences organizations.

Above article published on http://www.ama-assn.org/amednews/2009/10/19/bise1023.htm

By Neil Versel,

More than three-quarters of healthcare executives surveyed by PricewaterhouseCoopers say that information contained in EMRs could become their most valuable asset over the next five years as “secondary use” of EMR data takes off. But this won’t happen until technology improves, more standards get harmonized and, most importantly, the healthcare industry resolves lingering privacy concerns, according to a PwC survey released early this morning.

With billions of dollars in federal health IT stimulus funds set to flow into healthcare in the next few years, secondary use of electronic health data will “grow exponentially,” PwC says, citing a finding that 65 percent of healthcare executives expect their data-mining activity to spike within two years. About 90 percent of respondents believe that secondary use of EMR data will help their organizations make significant improvement to the quality of care.

There may be some legal barriers to overcome, however, before healthcare organizations can unleash the full power of patient-specific healthcare data. Also of concern to healthcare executives are privacy implications of data mining and the bad PR that could result from unauthorized use. This study literally just hit the wires, but we can’t wait to hear Dr. Deborah Peel’s thoughts on this last point.

Above article published on http://www.fierceemr.com/story/healthcare-execs-see-emr-data-their-most-valuable-asset/2009-10-01#ixzz0VEq13Kan

While few practices and hospitals currently use aggregated patient data, the number is expected to increase, and a new study touts the information’s benefits.

By Pamela Lewis Dolan, amednews staff,

One of the biggest untapped benefits of electronic medical record adoption is the secondary uses of the data that are being collected, concludes a study by PricewaterhouseCoopers.

The study, “Transforming Healthcare through Secondary Use of Health Data,” found that practices and hospitals have seen aggregated data from their electronic medical records identify patterns that have allowed them to improve outcomes, reduce errors and increase revenue opportunities.

But the number of institutions using the aggregated, or secondary, data in this way is very small, though it is expected to grow in the next two years.

“Almost every constituent in the [health care] industry that has to make a decision around what type of health care to deliver and when could use this kind of data and the information that aggregating it can produce,” said Dan Garrett, health IT practice leader at PricewaterhouseCoopers.

The report found that among those organizations already using some form of secondary data, 59% have seen quality improvements, 42% have achieved cost savings, 36% have seen patient/member satisfaction improve, and 29% have increased revenue. The biggest users of secondary data are hospitals and physicians, while health plans are the farthest behind.

The survey found that although 95% of physicians are not opposed to using secondary data, many are sensitive to how it should be used. Patients also are concerned.

“We all know we need to use this data, but they also know we can’t risk security,” Garrett said.

The PricewaterhouseCoopers report came from an e-mail survey conducted in June of 732 health care executives, 482 physicians, 136 payers and 114 pharmacy/life sciences organizations.

Above article published on http://www.ama-assn.org/amednews/2009/10/19/bise1023.htm

A new electronic tool that will put family medical history at doctors’ fingertips – alerting them to a patient’s increased risk for birth defects or pregnancy complications - will be developed through a three-year cooperative agreement with a $1.2 million grant from the Health Resources and Services Administration, Genetic Services Branch.

The National Coalition for Health Professional Education in Genetics (NCHPEG) will lead the project and will work with the March of Dimes, the Genetic Alliance, and the Newton Wellesley Hospital of Partners Healthcare to adapt or create a new tool doctors can use to gather a woman’s consistent family history information and analyze it immediately to improve patient care.

“Taking a patient’s family health history is an important way for doctors and other health care providers to evaluate the risk of common conditions such as heart disease or premature birth,” said Joseph McInerney, executive director of NCHPEG. “With this grant, we can improve how prenatal providers gather and use family health history to improve the health of their patients.”

“This project allows us to use state-of-the-art technology and apply a sophisticated understanding of genomics and family history to give more Americans a healthy start in life,” said Alan R. Fleischman, MD, senior vice president and medical director of the March of Dimes. “We hope doctors will use this new family health history tool to identify women at risk for having preterm labor or an infant with a birth defect. It will give women the information they need to improve their health and that of their babies.”

Patients in doctors’ offices will fill out a standardized family history questionnaire using a computerized tablet, instead of paper and Open. The information will be analyzed electronically, and the tool will provide red flags and recommendations for health care providers based on current professional guidelines. Providers may be prompted to ask more questions or to send a woman to a genetic specialist.

The tool also will encourage health care providers to update and use family history data throughout the lifespan of any female patient. The long-term goal is for the family history information to be combined with the patient’s other medical information into an electronic health record (EHR). The proposed health history tool will focus on existing prenatal and women’s health topics, including newborn screening, and will be compatible

with the U.S. Surgeon General’s family history tool, the “My Family Health Portrait” Web-enabled program.

Above article published on

http://www.chiroeco.com/chiropractic/news/8279/1100/HHS-directs-funds-for-integrating-family-history-into-EHRs/