E-DMN - July 16, 2007

July 16, 2007

Editor's Column: Making Friends American Medical Style
July Office Managers Meeting A Success
Judge Curbs Karmanos' Move
Oakwood Kicks Off Sports Medicine Fellowship
DMC Wins Praise For Heart Failure Treatment
Study Shows EMR Break-Even Point At 16 Months

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Editor's Column: Making Friends American Style

By JOSEPH WEISS, MD
In an article in the July issue of the American College of Physicians Observer, Robert Doherty writes that: "physicians can drive health care reform but are unlikely to succeed without support from patients and the companies who pay much of the health care bill."

What is Doherty saying? He is talking in favor of health care change, whether that change means reform or not we will know only over time. What change or reform is he talking about? He is being coy about the reorganization of medical care. Will coverage come from a single payor, i.e. the federal government, or through private insurance aided by federal subsidy, an expansion of what we have now?

Doherty suggests that physicians must combine forces with patients and employers; his suggestion is too vague. What the physician community needs to do is have the AMA, AOA, AARP, National Association of Manufacturers, United Auto Workers, American Hospital Association, and American Nurses Association come together. In turn, that group should agree on the issues: government pay vs. market payors, the meaning of universal coverage, and the role of the medical home (a relatively new administrative strategy that focuses on primary care physicians), HMO, PPO, or private practice.

Then we would have a coalition with power, then we would speak for more then ourselves, then we would hear others take up the rally for change previously called for by ourselves alone. To preserve our independence we must join with others. However, not with anybody, but with other groups that will merge their needs with ours.

July Office Managers Meeting A Success

WCMSSM and MSMS hosted a July 10 breakfast seminar for medical office and group managers in southeast Michigan, at the Lochmoor Country Club in Grosse Pointe. The event was well attended with 16 attendees. It started with breakfast at 8 a.m. and ended shortly after 9 a.m. Rob Beattie, MSMS membership, was there to give out information and answer questions. Karen Hopman spoke briefly about the benefits of joining the Michigan Medical Group Management Association. Adam Jablonowski, WCMSSM Executive Director, and Jason Riske, WCMSSM staff, helped host the event.

Julie Novak, Director of Operations and Medical Economics & Health Care Delivery, MSMS, discussed the new Blue Cross Blue Shield of Michigan contract. Leaders from the MSMS and the Michigan Osteopathic Association have been meeting with Blue Cross representatives over the last two months to discuss proposed revisions to the Traditional and TRUST contracts for physicians. Because of a recent US District Court Settlement in Florida, all Blue Cross plans were required to change certain business practices. The current contracts are decades old and written before contracting for administrative services began. The definition of “covered benefit” remains an issue. MSMS is making plans to educate members, physician organizations, and group manager to prepare to review the contract prior to receiving it from BCBSM.

Colin Ford, Director, Government Relations, MSMS, gave a summary of the Fair Contracting legislation that MSMS has drafted. The legislation is directed at resolving several issues encountered by physicians participating with BCBSM and other insurers. Key provisions in the legislation include: Creating a non-discrimination clause for physicians who are eligible to contract with insurers, Limiting timeframe for which insurers may seek retroactive payment for services that were previously approved, providing greater definition of the term “covered service,” and requiring disclosure of fee schedule and fee schedule methodology.

Judge Curbs Karmanos' Move

Last week Wayne County Circuit Court Judge Gershwin Drain ruled that the Karmanos Cancer Institute cannot move from the Detroit Medical Center to the former St. John Riverview Hospital on Detroit’s east side.

The judge granted DMC’s request for a preliminary injunction to stop Karmanos’ plan and agreed with DMC that Karmanos’ contracts with DMC obligate the cancer treatment facility to remain in Midtown on the DMC campus. Drain also acknowledged the financial loss DMC expected if Karmanos moved, estimated by DMC to be $109 million in services that Karmanos currently buys from the DMC.

In a July 10 statement, Karmanos said it "is obviously disappointed with today's ruling. We have a different understanding of the agreement and we felt we had a strong case. We are considering our options and will determine if we will appeal."

Mike Duggan, president and CEO of the DMC, told the Detroit News: "This is a great day for the DMC. The judge ruled that everything we did was correct."

Oakwood Kicks Off Sports Medicine Fellowship

For the first time in Oakwood history, a primary care sports medicine fellowship is available. The fellowship was introduced last year, coinciding with the arrival of Steven Karageanes, DO, associate director and medical educator, Oakwood Healthcare System (OHS). The fellowship, under the leadership of Dr. Karageanes and in conjunction with medical education, will provide MDs and DOs in various areas of medicine the opportunity to train and learn the specialty of sports medicine for one year. Since gaining approval from the Accreditation Council for Graduate Medical Education (ACGME), two fellows have already been signed.

“It is important for the fellows to learn all they can and to work directly with athletic trainers and surgeons. This fellowship will prepare them to treat a multitude of injuries and illnesses in a variety of settings,” said Karageanes.

The primary care sports medicine fellows will spend time caring for a diverse athletic population including men and women of every age and athletic ability, working closely with both Plymouth high school and Wayne State University (WSU) athletics. They will also develop expertise in diagnosing and managing injuries related to sports and exercise including: injury prevention, pre-participation evaluation and rehabilitation. Although the fellows will function under the supervision of Dr. Karageanes, they will assume significant responsibility in providing sports medicine care for the local community.

Sarah Bancroft and Luisa Aloe will be the first physicians to complete a sports medicine fellowship with OHS. Once they have completed the program, they will be equipped to practice as leaders in sports medicine.

After completing her undergraduate studies at Michigan Technological University, Dr. Bancroft attended the Medical College of Wisconsin then began medical school at the Wayne State University School of Medicine, where she graduated in 2004. With her residency completed at OHS in June, Dr. Bancroft is excited to continue her learning experiences in a familiar atmosphere.

Much of Dr. Aloe’s passion for sports medicine stems from her involvement in sports, which varies from softball, volleyball and basketball, to her college career in rugby at U of M.

Dr. Aloe attended the University of Michigan, Ann Arbor, and the University of Toledo School of Medicine. Aloe completed her residency in Miami, at the Jackson Memorial Hospital associated with the University of Miami. Currently, she is practicing in general pediatrics.

DMC Wins Praise For Heart Failure Treatment

Two Detroit Medical Center hospitals, DMC Sinai-Grace and DMC Harper University, ranked above the national average their treatment of heart failure patients. The list included data from 4,807 hospitals across the United States, reported DMC. Of those hospitals, only 38 were ranked above the national average, with the DMC counting for two of those 38. Only three health systems in the entire nation had two hospitals above average – the Detroit Medical Center, the Cleveland Clinic and the Community Healthcare System located in Indiana, according to a DMC statement.

The survey, compiled by the Centers for Medicare and Medicaid Services (CMS) and the federal Department of Health and Human Services, compared the number of deaths within 30 days of hospitalization for patients receiving treatment for heart failure. The results are meant to assist the public in assessing how well their area hospitals care for patients with specific types of medical conditions including heart failure and heart attacks. The results of this survey can be found at www.hospitalcompare.hhs.gov.

Study Shows EMR Break-Even Point At 16 Months

A new study to be published in the July issue of the Journal of the American College of Surgeons shows that one academic medical center recouped its investment in electronic health records within 16 months. The new analysis counters concerns of health care providers reluctant to invest in electronic medical records systems.

The widespread loss of paper medical records in New Orleans after Hurricane Katrina is one of several factors behind the recent push to get surgeons and other health care providers to go electronic, according to David A. Krusch, MD, FACS, of the University of Rochester Department of Surgery and co-author of the study.

"Health care providers most frequently cite cost as primary obstacle to adopting an electronic medical records system. And, until this point, evidence supporting a positive return on investment for electronic health records technologies has been largely anecdotal," said Dr. Krusch.

The study measured the return on investment of installing electronic health records at five ambulatory offices representing 28 providers within the University of Rochester (NY) Medical Center. Starting in November 2003, the offices implemented a Touchworks EHR system from Chicago-based Allscripts over the next five months. The study compared the cost of activities such as pulling charts, creating new charts, filing time, support staff salary, and transcription when done electronically in the third quarter of 2005, versus the cost of those same activities performed manually in the third quarter of 2003.

The University of Rochester Medical Center estimated that the new electronic medical records system reduced costs by $393,662 per year, nearly two-thirds of that coming from a sharp reduction in the time required to manually pull charts. Given that its electronic system cost $484,577 to install and operate, it took the University of Rochester Medical Center 16 months to recoup its investment. After the first year, it cost about $114,016 annually to operate the new system, which translates to a savings of $279,546 a year for the medical center, or $9,983 per provider.

The complete study, “A Pilot Study to Document the Return on Investment for Implementing an Ambulatory Electronic Health Record at an Academic Medical Center", will appear in the July issue of the Journal of the American College of Surgeons. In addition to Krusch, Dara L. Grieger, MD, of the University of Rochester Department of Surgery and Stephen H. Cohen, MN, CPE, also co-authored the article.

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 71,000 members and it is the largest organization of surgeons in the world. For more information, visit www.facs.org.

This publication brought to you by Natinsky Publishing Network.

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