Novocain Immunity and Meaningful Use: How prepared are patients and practitioners for 2014?

Can Meaningful Use eliminate the pain red tape causes?

If you talk to anyone in the medical community and say the words 'meaningful use,' chances are any clinician or physician will understand what you mean. What about patients? This is probably going to be the biggest change in the way doctors and patients interact on every level yet, if one were to coin the phrase 'meaningful use' in general public; the response would likely be something akin to a deer caught in the headlights.

Simply put, Meaningful Use is very important yet, no one knows about it.

The fact is that most patients have no idea that the days of going to this specialist and signing a release of these records to that other specialist and back on to your general practitioner are numbered. They have no idea that secure, instant messaging with your doctor, all of your doctors for that matter, is right around the corner. Meaningful Use Stage 2 goes into full effect in 2014.

I have a feeling some practitioners and HCO's would like to keep it that way. Because Meaningful Use is more patient focused and keeping them satisfied as a consumer is more important; practitioners without a good 'bedside manner' will have to develop one quickly.

You see, Meaningful Use completely revamps the way doctors and patients will communicate. On many levels, it makes physicians more accountable for getting the whole story and getting it right the first or second time. It all but eliminates the 'take two aspirin' syndrome when a patient comes in and hands over health records that clinically spell out what they often cannot verbalize. It allows for instant communication and eliminates the need for countless (and billable) follow up visits due to incomplete paperwork.

In other words, Meaningful Use will make healthcare more efficient for everybody, but only if doctors and HCO's are on board.

So where does Novocain immunity fit into all of this?

Upon joining Talascend, I relocated to Maryland: New doctors, new dentists, new everything. Shortly after moving and during a routine checkup, I found I needed a filling. There's only one small problem: I am immune to Novocain in regular, recommended doses. My old dentist knew how to keep my mouth numb. My new dentist didn't believe me. Three shots later and only about a 15 minute window to work with, she was a believer. The third shot wore off in the last 5 minutes and they couldn't give me more, so I had to deal with the pain while we were wrapping up.

Why bring it up? The whole conversation and disbelief would have been avoided if meaningful use were in full force. If I could have instantly requested my dental records from my old dentist in Upstate New York, not only would my new dentist have learned I wasn't full of hot air, but that my old dentist has figured out a way to keep my mouth numb so that work could be completed without rushing. Because of current HIPAA laws, I had to fill out paperwork; in person; in Upstate New York, to get my old dentist to share the process with my new one. Not even a phone call is considered legal without a signed document.

This plays out in nearly every medical office that has not participated in the first stage of Meaningful Use. There is so much waste to be eliminated through implementation. Doctors have instant access and can see more patients, or, spend more time with patients during a day. They can order a prescription for you right from their smart phone. Patients get the benefit of clarity when talking in a clinical setting. They also have something to back up their claims when going into a new physician's office right then and there: not while waiting for their paperwork to arrive.

As a Healthcare IT staffing professional, I know one thing is for certain: There will be a big rush in the next two years for HIT talent in order to become Meaningful Use compliant. Then again, it could go 'bust' because of lack of buy-in from physicians and HCO's; but I wouldn't count on it.

What do you think?

Education, not legislation, is the key to lower healthcare spending.

In 2005, the British chef and media personality Jamie Oliver launched a highly successful campaign to raise awareness of the poor quality of food being served in British schools. The result was to transform the way Britain thinks about school food, delivering healthier, balanced meals and most importantly, educating children early about the benefits of eating properly. Oliver himself was awarded an MBE by the Queen (a civilian medal of honor for service to the country.) His approach has been used with great success across Europe.

Then he came to America.

You can watch the details of Oliver’s treatment at the hands of US school employees he met and the US media in general on YouTube (‘We don’t want to eat lettuce all day, who made you king?’) sufficed to say he was shot down in flames from minute one, and he returned home having failed completely.

Recent discussion about the growing cost of healthcare delivery remains focused on the level of investment necessary to keep the nation healthy, but to endlessly debate legislation and government investment misses the long term issue entirely.

The spiraling cost of healthcare in the US may be the direct result of defensive medicine, malpractice and government mandated programs like EHR, but there is no question where the real answer to reduced health care spending lays – healthier people.

It is education and not legislation that is the real answer.

The British chef and campaigner for healthy food 

in schools suffered a series of media beatings.

When Jamie Oliver was sent packing so emphatically by a firmly united front of American education workers, local media and national TV personalities, this country missed a major opportunity to start the move toward lower healthcare costs. 

Regular exercise, healthy eating and the limitation of obviously dangerous practices like smoking and heavy drinking are the keys to lower spending. This begins and ends with personal choices. The earlier we begin to encourage these choices the better.

One of the many reasons David Letterman gave Jamie Oliver (a long time friend of his incidentally) for why he would fail was the power of fast food chains. They’re not going anywhere, he says.

A typical McDonalds in London

McDonalds is not going away, but it can be forced to evolve. In the UK, it has. Gone are the gaudy red signs and plastic furniture, in favor of subtle dark green and high-spec leather chairs. Salads are not an after thought, they are a key part of the menu, as are many other healthy choices. You can still get a Big Mac if you want one, but McDonalds knows its future success depends on delivering more healthy options because they are simply what the consumer wants.

We the people are in charge of what fast food chains serve. We have the power in the long term to reduce the cost of healthcare in this country through the way we live. It’s happening in other countries, we could make it happen here.  

This would dramatically shift the debate about healthcare spending. 

High unemployment and major skill shortages. A problem with only one solution.

By Josh Kaplan

Is there really such a thing as the wrong kind of job?

With job creation on the lips of every aspiring and incumbent politician, it’s ironic that Washington DC itself is one of the main centers of the imbalance.

Washington DC has seen a boom in IT jobs in 2011

The DC area has experienced a steady decline in job opportunities since a slight peak in March of this year. Based on the number of jobs placed online by hiring companies and agencies, 2011 has ended badly for the capital’s job market.

But for Computer Systems Analysts, Web Developers, and Network and Computer Systems Administrators the outlook is much more positive.

A report this week from wantedanalytics.com shows a significant increase in IT jobs in the area.

The trend is likely to continue into 2012. The question is what to do about it. As we’ve seen across the engineering industry, massive requirements for skills only create jobs if there are people with the right skills to fill them. Without the right skills available in the market, you have urgent open vacancies that contribute nothing to job creation.

Bridging the gap between mass unemployment and skill short market places is a problem with only one long term solution: training. The shortage in IT has been self created. When healthcare companies – one of the areas at issue - moved to 1099 contractors instead of retaining their in house talent, they lost the skills they need with familiarity and experience of their organization to get the job done.

There is clearly a major opportunity to retrain large numbers of unemployed workers if proper programs are put in place either by the government or by the private sector.

As demand increases, project delivery will only suffer more. It’s time to look seriously at retraining options.

In the meantime, IT professionals would be well advised to pack a bag and head for DC. 

Two reports, one conclusion: EHRs need more support in implementation

by Josh Kaplan

A report released today by AmericanEHR partners is not the first to highlight major shortfalls in EHR uptake across physician practices. It’s not even the first this week. A study by healthcare research firm SK&A, released Tuesday, provides more cause for concern.

Physicians have until 2015 to make 'meaningful use' of 

EHR systems

Most of the findings from both reports are predictable: EHR uptake is proving more difficult in smaller practices with fewer physicians; double the number of patients and you double the level of adoption; satisfaction is higher wherever the respondent has been involved in the EHR selection process.  No surprises in the bulk of the findings.

However, some of the stand-out statistics are genuinely shocking:

(1) 21% of physician offices are unaware of EHR government incentives.

These incentives, provided for by the 2009 stimulus package, include $64,000 dollars over six years for Medicaid and $44,000 over five years for Medicare. Physicians become eligible for the incentive by demonstrating ‘meaningful use’ of EHR Technology.  

(2) 73% of physician offices without an EHR have not determined any time frame for EHR adoption.

In 2015, hospitals and doctors become subject to financial penalties through Medicare if they have not adopted electronic health records, yet the vast majority have not even considered a timeframe for implementation.

(3) 49% of respondent physicians received less than the 3-5 days recommended training on EHR systems.

Moving from adoption to meaningful use and ultimately to genuine added value requires proper training and this is not being received by half of the physicians responding.

As 2012 approaches, the majority of physicians’ offices remain disengaged and ill informed. Even those that have adopted EHRs are not providing sufficient training to make the systems effective.

If EHR adoption is to reach targeted levels, it’s vital that those implementing the systems know when, why and how they should do it. That means having a timescale for implementation, knowledge of the incentives and penalties and ultimately, a plan to properly train the end user.