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October 1, 2007
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IN
THIS ISSUE
Editor's
Column: Time To Put the Cart Before The Hoarse
Health
Info Exchange Needs A Few Good Docs
Reid Leaves
Strong Legacy At WSU
AMA Pushes Congress
To Preserve Medicare Money
WSU
Med Student Earns NIH Fellowship
Recovering
The Soul
Children's
Hospital Hosts Psych Lectures
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Editor's
Column: Time To Put The Cart Before The Hoarse
By
JOSEPH WEISS, MD
Everyone talks about universal coverage, even the Mayo Clinic is
forwarding its own plan. The New York Times reported in its
Sept. 15 edition that Mayo sponsored a meeting of health care experts
who concluded that in this country every individual should have health
care insurance.
The Mayo group, like the individuals running for president,
advocates that the premiums should come from a combination
of the individual, the employer, and the government. Among
politicians, the Mayo recommendations are the most popular.
Others running for president, such as Mitt Romney, say
that health insurance should be a state initiative. Rudy
Giuliani, believes tax refunds are the way to encourage
universal coverage.
All this is hoarse talk. Left untouched is the question:
what plan does the individual need? We have not yet arrived
at a consensus on what constitutes a “basic” health plan.
Until either the candidates or the expert committees present
the elements of a health insurance plan that provides necessary
coverage, we cannot dialogue about cost, who will pay the
cost, let alone how plans for care fit our expectation
of access and quality.
At the state level, MSMS has a taskforce working to define
the features of a basic health care insurance plan that
will provide adequate care. No doubt, other bodies are
grappling with the same issue. But, as yet, no group has
come forward with the features of the “basic” plan.
Common sense tells us, that everyone can’t have coverage
for the diagnosis, treatment or prevention of every sickness
and/or mishap that mankind risks. However, we know that
the market is full of cut rate plans that cost $100 a month
and cover nothing but administrators’ salary and advertising
space. We need individuals covered not with paper pages,
but with substantive insurance.
We need to hear from people who understand what we can afford
for care, and at what time in an individual’s life those
aspects of care that need attention.
The politicians should stop shouting themselves hoarse on
how to divvy up the cost of care. Instead, expert panels
should convene to determine what should be contained in
the insurance plans to provide adequate and appropriate
coverage for each individual.
We first must fill the cart and then we can decide how heavy
the horse to carry the load.
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Health
Info Exchange Needs A Few Good Docs
By
PAUL NATINSKY
“There are physicians and there are physicians,” WCMSSM Executive Director Adam
Jablonowski told an audience of about 100 at a kickoff meeting for the Southeast
Michigan Health Information Exchange (SEMHIE) Thursday at the Hospice of Michigan
in Detroit.
That
there were only about four doctors in the audience underscored
his point: The nascent health information sharing movement
in Michigan, and particularly Southeast Michigan, needs
physician participation. It needs practicing physicians
who treat patients on a daily basis and not just administrative
physicians who represent large organizations.
SEMHIE
is one of nine regional health information exchanges across
the state, and one of seven funded by a $4.5 million start-up
grant. The start-up money is intended to facilitate concrete
plans to share health information between “stakeholders” that
include doctors, hospitals, employers and government agencies.
The
benefits of such collaborations range from instant access
to patient medical histories and drug allergies in emergencies
to better and more accurate research and recordkeeping.
Barriers to sharing information center on trust issues
between the parties that accumulate and control such information
and privacy laws that present a much greater challenge
for the health care industry than, say, the banking and
finance industries, which have long been able to quickly
and accurately been able to share consumer credit information.
In
health care, patient information resides in “silos,” or
independent data bases maintained by doctors’ offices,
hospitals, insurers, employers, government agencies and
others. While the information is plentiful, it can only
be accessed easily by the parties that collect it.
Part
of the stimulus for information sharing comes courtesy
of an urgent effort by the Bush administration to achieve “transparency” in
the US health care system by the year 2010. While Bush’s
timeline is regarded by most as unrealistically aggressive,
federal dollars are flowing toward the cause and progress
is being made.
Key
aspects of a health information exchange include a self-sufficient
business model, a system that is “patient-centric” (benefits
patients by making info exchanges directly beneficial to
them) and interoperable (easy to integrate with one another).
The
$4.5-million grant represents a first step toward actually
executing a health information exchange. SEMHIE currently
labors under “operating rules,” a placeholder for an actual
board of directors, set of bylaws and formal organizational
status as a corporation or 501(c)(3). Speaker after speaker
at the kickoff meeting issued a clarion call for participants
in the 12-month process that will ultimately lead to independent
status and a formal request for proposals to bring in a
vendor who will create the health information exchange.
University
Bank (Ann Arbor) President Stephen Ranzini said barriers
to a successful health information exchange are political
and social, not technological. He analogized the evolution
of ATMs in which an idea emerging in Denver spread through
the uniting of regional standard-producing organizations
resulting in the establishment of fluidly functioning system
that has become part of the cultural fabric of the United
States.
The
only functioning health information exchange in Michigan
exists in the northern part of the state (Marquette). Establishing
such a system in Southeast Michigan is considerably more
complicated because of the size of the population and number
of stakeholders involved.
Enter
Altarum Institue, an Ann Arbor-based, non-profit health
care research firm that specializes in “health informatics.” Altarum
controls $1.1 million of the $4.5 million statewide grant
and, with the Greater Detroit Area Health Council and other
stakeholders, is charged with facilitating the process
that will result in an independent health information exchange
for Southeast Michigan.
Physicians,
who were intentionally squeezed out of Hillary Clinton’s
health care reform plans in the 1990s are virtually being
begged to participate in this groundbreaking effort. Last
November, seven months before the grant money was awarded,
the stakeholder search was expanded and specifically widened
to include WCMSSM and the Oakland County Medical Society.
Jablonowski and OCMS Executive Director Donna LaGosh chair
key workgroups and are eager to recruit physician members
to SEMHIE.
Despite
the state of Michigan’s economy and the embarrassing prospect
of an imminent government shut-down, the state is actually
well ahead of the curve in its pursuit of operational health
information exchanges. Ranzini said so as did national
expert Janet Marchibroda when she visited Michigan in June.
To
participate, please contact Adam Jablonowski at arj@msms.org or
visit www.semhie.org
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Reid
Leaves Strong Legacy At WSU
By
PAUL NATINSKY
In an interview with DMN last fall, Wayne State University School
of Medicine Dean Robert Mentzer, MD, spoke of a new direction being
carved by the Medical School. After many years in the “top 40” research
institutions (based on grant money from the National Institutes of
Health and other kingmakers) WSU now faces a reshuffling in the annual
award of grant dollars. It has to reestablish itself in the competitive
world of research institutions.
The
Medical School had applied for a grant to start an initiative
within the current vein of grant-making zeitgeist – translational
medicine. Translational medicine is a fancy term for moving
research science into clinical practice quickly, an effort
by NIH to expedite research progress into clinical practice.
WSU’s
School of Medicine got the grant. It just initiated a call
for proposals and the chips will fall where they may. But,
the School of Medicine needn’t have worried. Irvin Reid
had their back. Despite a steady stream of higher education
cuts, a casualty of Michigan’s recent economic woes, Reid
told Dean Mentzer he’d come up with the funds if the feds
didn’t.
That
play was not at all out of character for Reid, who along
with his wife, according to the Detroit Free Press, personally
pledged $600,000 to the university. Reid also wasn’t afraid
to ask others to pony up. Under his decade-long tenure
fund-raising, also according to the Free Press, grew from
$27 million annually to $80 million.
So
far, Reid is not saying where he is going or what he is
doing, or even why he is stepping down (“It is time” is
hardly a credible reason for a man making $374,000 a year
as a well-liked university president). Stay tuned for further
details, but wherever he winds up and for whatever reason
he is leaving, medicine in Southeast Michigan will be sorry
to see him go.
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AMA
Pushes Congress To Preserve Medicare Money
The
American Medical Association (AMA) National House Call
campaign visited Kansas City Thursday and urged residents
to help press Congress to stop scheduled Medicare cuts
that threaten patients’ access to care. Unless Congress
intervenes, Medicare will slash physician payments 15 percent
over the next two years beginning on Jan. 1, 2008.
A
recent AMA survey found that 60 percent of physicians say
they will be forced to limit the number of new Medicare
patients they treat when the government cuts payment rates
beginning next year.
“Payments
to physicians aren’t keeping pace with the costs of practicing
medicine, and our concern is that, as shown in the government’s
own data, seniors are already finding it more difficult
to find a new physician,” said AMA Immediate Past President
William G. Plested III, MD. “According to MedPAC, the government
commission that advises Congress on Medicare issues, 24
percent of Medicare patients who are looking for a new
primary care physician are having trouble finding one.”
“We
need the Senate to act now. Kansas Senators Pat Roberts
and Sam Brownback have been supportive in the past, and
we appreciate that support. But the Medicare patients in
Kansas they represent need them to fix this problem now
by working in the Senate for a solution that provides urgently
needed relief,” Dr. Plested said.
“The
AMA encourages patients to get involved through the AMA’s
Patients Action Network. So far, more than a million have
signed on.
We’re
asking them to urge the Senate to take action to provide
meaningful relief from drastic Medicare physician payment
cuts,” said Dr. Plested.
The
toll free number is (888) 434-6200.
“Congress
needs to act to preserve seniors’ access to care and put
Medicare on a firm foundation for the future. Congress
must keep its promise to America’s seniors,” said Dr. Plested.
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WSU
Med Student Earns NIH Fellowship
John
Lillvis, a student in the WSU School of Medicine MD/PhD
program, recently received a prestigious fellowship from
the National Institutes of Health. The grant covers Lillvis’s
stipend, National Research Service Award-level tuition
and health-care costs for six years. The title of the project
is “Immunity and the Pathogenesis of Abdominal Aortic Aneurysms.”
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Recovering
The Soul
An
Integrated Approach to Health & Wellness
Friday, October 26, 2007
7:30 a.m. - 1:30 p.m.
University of Detroit, Mercy
4001 W. McNichols Road
Detroit, MI 48221
Click
here to Register Online
(Link will open in new window)
Come hear internationally recognized Larry Dossey, MD, speak on Recovering
the Soul and Barbara Dossey, PhD, RN, AHN-BC, FAAN speak
on The Healing Environment:
What do we mean? Both are authors and mind-body medicine
experts who will discuss how healing is promoted by attending to
the delicate interaction of body, mind and spirit, and how centuries-old
concepts can be successfully applied in the care of patients and
everyday living.
Four breakout sessions will be offered:
- Healing
Body, Mind and Spirit: Interventions for Healthcare Providers
- The
Importance of Hope in Healing: The Importance of Spirituality
in Recovery
- Appreciative
Presence®: Using Touch to Support the Body, Mind & Spirit
- Spiritual
Assessment: An Interdisciplinary Approach
This
half-day conference, which is pending approval of four
CME and CEU credits, is geared to special interests to
physicians, nurses, clergy and spiritual care providers,
social workers, residents and healthcare students. Click
here to see the agenda. Symposium fee $60.
For more information, please call (313) 966-3510.
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Children's
Hospital Hosts Psych Lectures
October
9, 2007 - Jocelyn McCrae, PhD, of Children's
Hospital of Michigan, will be presenting, "Psycholgical
Aspects of Pediatric Sickle Cell Disease: Assessment and
Intervention" 1:30pm - 2:30pm at Children's Hospital
of Michigan - Main Auditorium. Lunch provided at
1:15pm. Free
November
1, 2007 - Margaret Semrud-Clikeman, Ph.D, of Michigan State
Unviersity, will be presenting, "Neuroimaging in Autistic
Spectrum Disorder and ADHD" 1:30pm - 2:30pm at Children's
Hospital of Michigan - Main Auditorium. Lunch provided
at 1:15pm.
Free
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