|
November 12, 2007 |
|
IN THIS ISSUE
Editor's Column: More Informatics Problems: Ills That Physicians
Cannot Treat
Dr.
Silbergleit Honored With 'Clinic Day'
Medicare Cuts A
'Go' Unless Congress Acts Now
MRSA Update From MDPH
Bill Would Authorize $100M In Trauma Center Grants
DMC Wins Top
Honors For Medical Website
Minds Of Medicine: Surgery's Newest Frontier Hits Airwaves |
|
Click Here To Contact Us
|
|
Editor's Column: More Informatics Problems: Ills
That Physicians Cannot Treat
By JOSEPH
WEISS, MD
Could those in Michigan who want to gird the globe with shared
health information, put a hold on that effort? They need to act on
more pressing problems.
For example: on Oct. 10, 2007 newspapers reported
that the Veterans Administration hospitals will no longer provide
information on cancer patients to the Cancer National Surveillance
Registry. The VA has contributed information since 1972, but this
year announced it would do so no longer to protect patient privacy.
The VA could cite no incident in the 44 years of giving this
information where a breech occurred in a patient’s privacy. The VA
is the largest hospital network in America. When the VA hospitals
set a precedent, it becomes a beacon for others to follow. No doubt
a number of hospital chains would like to maintain their proprietary
systems for the control it brings. These hospital systems will raise
the sanctity of patient privacy to keep their information systems
exclusive and intact.
Could informatic visionaries divert from their vision of
tomorrow and instead bring pressure now on the VA to rescind its
order?
There is another health information problem at the local
level of Southeast Michigan. In radiology, the fashion is to provide
patients receiving MRIs, CT scans, arteriograms and other special
imaging procedures with a disc of the images obtained. The
radiologist instructs l the patient to give the disc to doctors who
want to review the images. These discs are not a wonderful addition
to informatics. There is no uniformity in formatting, no reliability
that the physician can download the disc , no readily identified
icons on the menu bar and no help button to explain how the disc
operates.
Keep in mind that the patient waits, expecting a summary of
what the doctor reviewed. The patient anticipates an immediate
response from the physician. The physician wants to respond but
cannot.
Informatics gurus must solve this problem for Michigan
physicians before recruiting us for a nationwide system of
information exchange.
Then ask us to join your task forces for networking, and we
will.
Share Your
Thoughts on this Article
Back to top
|
Dr. Silbergleit Honored With 'Clinic
Day'
Transplants:
Today and Tomorrow was the topic at hand for the 50th
Annual Allen Silbergleit, MD, Clinic Day at the Anthony M. Franco
Communications Center in Southeast Michigan Nov. 7. Dr. Silbergleit
is Senior Associate Editor for the Detroit Medical News. Below is a
tribute written by St. Joseph Mercy Oakland Chief of Staff Stanley
Dorfman, MD.
When Dr. Allen
Silbergleit was recruited to then-St. Joseph Mercy Hospital from
Wayne State University in 1966, a small, annual Clinic Day
lectureship had already been held for several years. As a young
surgical scholar in his 30s, Al Silbergleit immersed himself in
every educational program in the hospital, including Clinic Day.
This annual event became the highly successful flagship program of
the academic year and Al has been Chairman for much of its 50-year
existence. For many of the medical staff, the Clinic Day program has
always been synonymous with Al Silbergleit.
Over the years,
“Dr. Al” has been active in every facet of education at St. Joe’s.
In the early years, he was the savior of the Surgery Residency
Program, which had been scheduled for closure, and for 40 years
directed the successful program in an era that saw the closure most
small programs in Michigan and the United States. Perhaps less well
known are some of his other contributions to the hospital. In the
1960s, he founded the Pulmonary Laboratory and the
Respiratory/Ventilator Service, which made possible the
establishment of the Intensive Care Units. In the early 1970s, he
was a key founder of the Oakland Health Education Program (OHEP),
later named the Southeast Michigan Center for Medical Education (SEMCME),
and now the largest community-based medical education consortium in
the United States.
Fast-forward to
the mid 1980s. Al Silbergleit championed the TNM tumor
classification system in this hospital when he became the hospital’s
Cancer Liaison Physician and was the Principal in the hospital
planning and subsequent accreditation from the American College of
Surgeons – Commission on Cancer as a Teaching Hospital Tumor
Registry, an honor usually limited to larger hospitals. Over the
years, his many innovations in surgery and education brought
recognition to the hospital.
In 2005, the
Medical Staff Executive Committee voted unanimously to name the
annual Clinic Day program in his honor, each program henceforth to
be known as the Allen Silbergleit Clinic Day.
Share Your
Thoughts on this Article
Back
to top
|
Medicare Cuts A 'Go' Unless Congress Acts Now
Doctors are pressing lawmakers to pass an update that reflects
increases in the cost of caring for Medicare patients, according to
the American Medical Association.
In what is
becoming an annual rite, physicians are again fighting to prevent a
reduction in Medicare payments. This time, however, the cut is in
the double digits and is the largest ever.
The Centers
for Medicare & Medicaid Services final 2008 Medicare physician fee
schedule rule institutes an average 10.1 percent pay cut effective
Jan. 1, 2008, although the percentage will vary by specialty,
practice and geography.
The rule also
lists the 74 quality measures to be used in the Physicians Quality
Reporting Initiative in 2008. It specifies that a $1.35 billion fund
adopted last year will go to the PQRI and not toward easing
physician pay cuts. The regulation also delays finalizing most of
the latest revised physician self-referral, or "Stark," rules.
Medical
organizations called the 10.1 percent reduction unacceptable.
"Congress must
step in to replace the cut with payment increases that keep up with
medical practice costs," said American Medical Association Board of
Trustees Chair Edward L. Langston, MD. "Next year's 10.1 percent
physician payment cut is bad news for America's seniors as 60
percent of physicians say the cut will force them to limit the
number of new Medicare patients they can treat."
Dr. Langston
suggested using $54 billion in what doctors view as excess payments
to private Medicare health plans to offset the cut. These Medicare
Advantage plans received 112 percent of the amount that traditional
Medicare paid for each senior's care in 2006.
Another
one-year payment cut reversal -- which would be the sixth in a row
-- is not good enough, said American College of Physicians President
David C. Dale, MD. "We have been fighting this annual battle over
and over again. The Senate needs to join the House in passing
legislation that will pay for positive updates in the next two
years."
The 2008
Medicare pay cut for doctors is twice as large as the 5 percent cut
physicians avoided this year because Congress declined to adjust the
payment formula to take into account the 2007 payment freeze. That
decision made scrapping this year's payment reduction billions
cheaper. But it also meant that the 2008 cut would have to be two
times as high to get reimbursement back in line with the level
called for in the Medicare formula.
Not every
specialty would be affected equally if next year's reduction stands.
Although the 10.1 percent average fee cut applies across the board,
other factors adjust the net effect. For example, anesthesiologists
would get a 4 percent boost because of changes in their practice
costs formula, the pay rule states.
But other
physicians face net cuts -- some as high as 13 percent, such as
nephrologists. Most reductions fall between 9 percent and 12
percent.
Fee
calculations also were affected by the three-year update of
geographic adjustment factors in this year's rule. CMS uses the
geographic adjustment factor -- an index of work and liability costs
-- to benchmark physician operating costs around the country, which
influences its overall physician fee calculations. In 2008, rural
Maine will receive the highest geographic increase at 5.9 percent,
while Detroit's index will decrease by 4.3 percent -- the biggest
drop.
Congress looks for a solution
Lawmakers
continue to work on legislation to prevent next year's cut.
In the House,
an Energy and Commerce Committee staff member said leaders are
sticking with the Medicare physician pay provisions adopted as part
of its State Children's Health Insurance Program reauthorization
bill in early August. The measure would have increased reimbursement
0.5 percent in 2008 and 2009 each.
Cuts to
Medicare Advantage health plans' payment would have largely funded
the boost. Specifically, these cuts would have lowered Medicare's
regional benchmark payments to insurance companies, ended a
stabilization fund used to share risks with insurance companies and
eliminated indirect medical education payments to teaching
hospitals.
These changes
would reduce enrollment by more than half of the projected 12.5
million enrollees in 2012, according to an Oct. 10 Congressional
Budget Office analysis. Today 8.2 million people are in these health
plans.
But the
provisions were removed in the House-Senate compromise SCHIP bill in
an attempt to maintain a veto-proof Senate majority. Many Senate
Republicans oppose cutting private health plan payments.
Still, Sen.
Max Baucus (D, Mont.), chair of the Senate Finance Committee, would
prefer to adopt a two-year payment fix by shifting some Medicare
Advantage payments to fund physician reimbursement, said panel
spokeswoman Carol Guthrie. But Republican members' support of such a
measure was not clear at press time.
Self-referral rules delayed
Under the
final payment rule, physicians will have more time to prepare for
and comment on most of the third revision of physician self-referral
rules. CMS delayed finalizing them and planned a later comment
period.
One exception
is a rule that prohibits markups by the physician or supplier on the
technical or professional components of diagnostic tests when tests
are performed outside of the physician's or supplier's office.
The AMA is
concerned about the increasing complexity of the Stark rules,
according to AMA Executive Vice President and CEO Michael D. Maves,
MD, MBA.
In the final
rule, CMS also identified the 74 standards that will be used in the
Physicians Quality Reporting Initiative in 2008. The agency plans to
publish the details of the entire measure set at a later date. Also,
CMS will continue to accept stakeholder input on the standards,
which were narrowed from an initial list of 148. The agency
estimates that PQRI physician bonus payments for 2008 will remain
around 1.5 percent of allowed charges.
Share Your
Thoughts on this Article
Back to
top
|
MRSA Update From MDPH
Recent reports
on the prevalence of
Methicillin-resistant Staphylococcus Aureus (MRSA), and recent unfortunate student deaths associated with MRSA have
prompted much telephone activity and many questions regarding
available data in Michigan.
Individual
case reports of MRSA are not reportable in Michigan; therefore
prevalence rates for either Healthcare Associated - MRSA (HA-MRSA)
or Community Associated - MRSA CA-MRSA) is unknown.
Outbreaks are,
however, reportable to the local health jurisdiction. An outbreak is
defined as "three or more culture positive cases in a facility or in
a community that are epidemiologically linked where
transmission/spread is plausible."
MDCH has an
educational brochure and poster detailing prevention of MRSA:
MDCH MRSA Prevention and Control
Tri-Fold Brochure
MDCH MRSA Prevention and Control Poster
Resource Update: 10/24/2007
The Centers
for Disease Control and Prevention (CDC) has released a new web site
that will help answer many questions about management of MRSA in
Schools. The web site is listed here below. This was not included on
the HAN last Thursday, as it recently became available.
http://www.cdc.gov/Features/MRSAinSchools/
Treatment guidelines for CA-MRSA
The CDC has
websites that provides information on
HA-MRSA prevention and control
and
CA-MRSA prevention and control.
Share Your
Thoughts on this Article
Back to
top |
Bill Would Authorize $100M In Trauma Center Grants
Sens. Patty Murray (D-Wash.) and Kay Bailey Hutchison (R-Texas)
have introduced a bill that would authorize $100 million in annual
grants to trauma centers nationwide, with most of the funds awarded
to facilities with the largest financial losses related to charity
care,
Hearst/Detroit News
reports. The legislation would establish three new grant programs.
"When a trauma patient can't afford treatment, the trauma center
itself absorbs the cost of care," Murray said, adding, "And this is
putting ... many of our trauma centers at serious risk." According
to the
National Foundation for Trauma Care, at least 19 trauma centers
nationwide have closed since 2000 (Dlouhy,
Hearst/Detroit News, 11/9).
Share Your
Thoughts on this Article
Back to
top
|
DMC Wins Top Honors For Medical Website
Detroit’s own Emery King won 1st place for the Medical Video Library
he produces and stars in on the Detroit Medical Center’s (DMC)
website www.dmc.org. The user-friendly website and video collection
was designed for everyday citizens to better understand medical
procedures and to get a first-hand look at surgeries.
The 3-5 minute vignettes chronicle health care breakthroughs unique
to the DMC. Users can view the videos, print versions of each in
English, Spanish and Arabic, forward video links to family and
friends, and request an appointment with the featured physician all
with the click of a mouse.
“I am honored to win this award. What we have created at the Detroit
Medical Center has changed the landscape of healthcare. Now when
people are looking for information about a particular surgery, they
can find it all in one place. They can get a layman’s description of
the procedure, hear from an actual patient about their experience,
connect directly with the doctors who perform the procedures, in
addition to watching a video of the actual surgery,” said Emery
King, DMC Communication Director.
The award was given out at a ceremony in Las Vegas, Nevada on
Sunday, November 4, 2007, at the 8th Annual eHealthcare Leadership
Awards where 1,100 entries from a wide range of healthcare
organizations around the country were represented. Each organization
had the opportunity to enter under one of 17 classifications to
compete against other organizations of comparable type, size, and
resources within a 12 category bracket. King took home the Best Rich
Media award.
King came to the DMC from a long, celebrated career in television
and radio reporting. For 19 years, King was a key member of the WDIV-TV
news team. Prior to arriving in Detroit, King was a White House
correspondent during the Reagan administration.
Share Your
Thoughts on this Article
Back to
top |
Minds Of Medicine: Surgery's Newest Frontier Hits Airways
Surgery is a field noted for amazing advances. Through the years,
surgery has evolved, bringing us brain and open-heart surgery,
minimally invasive or laparoscopic surgery and now even robotic
surgery. As these surgeries became more complex, the need for more
advanced training has also increased.
Last week’s Minds of Medicine: Surgery’s Newest Frontier followed
Henry Ford Hospital’s Marwan Abouljoud, MD, of Grosse Pointe Park,
one of the country’s best transplant and liver surgeons, as he
removed a tumor on a patient’s liver using the very latest in
robotic-assisted surgery. The show followed Mounir Hider, from
Dearborn, through his initial meeting with Dr. Abouljoud through his
surgery and the beginning of his recovery.
Robotic surgery patients often recover up to 50 percent faster than
those who undergo traditional surgery. Although the surgery is more
challenging for the surgeon, Dr. Abouljoud believes it will give
Hider the best chance at a full recovery.
Minds of Medicine: Surgery’s Newest Frontier, aired at 7 p.m.
Saturday, Nov. 10 on WXYZ-TV Channel 7, was the latest in a series
of medical shows locally produced in cooperation with WXYZ and Henry
Ford Health System.
Hosted by Paul W. Smith, morning radio personality for WJR AM 760,
Minds of Medicine provides an inside look at the doctors and nurses
at one of the nation’s top-rated hospitals.
Saturday’s program also took a look inside the new Center for
Simulation, Education and Research at Henry Ford Hospital, which
allows doctors to train on robotic surgical equipment like those
used by Dr. Abouljoud to remove his patient’s tumor.
This 12,000-square-foot training facility cost more than $5 million
dollars to build and is the largest in the Midwest. At the center,
trainers can simulate both emergency and routine situations, from
labor and delivery to laparoscopic surgical procedures.
The facility houses two operating theaters, (one with a $1.6 million
da Vinci robot system), six clinical rooms, a minimally invasive
procedure lab with more than 30 stations, and two classrooms.
Fully-equipped, reconfigurable rooms simulate surgery, labor and
delivery, intensive care, emergency and routine hospital scenarios.
There are full body, $100,000 mannequins (SimMan) as well as
mannequins for pelvic exam, blood pressure, post-partum hemorrhage
and CPR/Defibrillation.
Simulation technology has been proven to increase safety and improve
training in a number of areas including airlines, NASA, and, more
recently, medicine, says Scott Dulchavsky, MD, chair of Surgery at
Henry Ford Hospital.
An airline pilot will practice a difficult landing hundreds of times
on a simulator prior to taking the controls of a plane; a surgeon’s
skill is similarly increased by completing operative tasks on a
simulator.
The center enables nurses, physicians, residents, students and other
health care providers to continuously enhance clinical skills. In
addition, there is an advanced audio-visual capability that records,
plays back, and archives each simulation for future review and
education. The AV technology also allows live simulations in the
center to be beamed into classrooms around the world.
Share Your
Thoughts on this Article
Back to
top |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
This publication brought to you by Natinsky
Publishing Network.
Problems seeing this email? You may view it online at http://www.wcmssm.org
To subscribe or unsubscribe to this newsletter contact
info@wcmssm.org |
|
