Wayne County Medical Society of Southeast Michigan

May 4, 2009

Editor's Column: Another Look At Information Technology
Letter: Medicine And The Pharmaceutical Industry
Medicaid Faces Budget Scalpel
MSMS, Counties Relay Concerns To MedAssurant
WSUSOM Students To Address State Legislators
Oakwood Invests In Dearborn 'Mixed Use' Development
Wayne State Assistant Dean Accepts Foreign Post
MSMS, AMA Team Up To Offer IT Help For Members

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Editor's Column: Another Look At Information Technology

By JOSEPH WEISS, MD
Analysts of health care, critics and futurists agree that information technology (IT) is the way to make health care more efficient and save money at the same time. An integral part of IT is the personal electronic medical file. As envisioned by Google, Microsoft, WebMD and other giants running the Web, the personal electronic medical file would contain a patient’s total health record. Through a series of prompts the individual would put on record, via the Web page, the following: past and present diagnoses, conditions, medications, allergies, surgeries, immunizations, laboratory tests, family history of diseases and diagnoses, and insurance coverage and its limitations.

Going to the health websites of Google (www.google.com/health), Microsoft (www.healthvault.com), and WebMD (www.webmd.com/phr) will reveal the first problem: making the record. Putting together the health record these sites require is tedious and the multiple drop \-down menus are difficult to complete.

The second problem is making this information at once private for the individual and, at the same time, readily available to physicians. One of the purposes of having the health record Web-based is to allow physician access. However, people feel that the information they are provided on the Web site is sensitive, personal, and subject to misuse by employers and strangers. No health record site had solved the problem of making this health record readily available to physicians, let alone the instances when the patient arrives unconscious or delirious. In addition, the record should keep information out of reach from individuals the patient does not want to give access.

The third problem is the approach itself. In most instances, physicians can garner the information they need by a review of the patient’s current medication. Knowing the patient’s medical regimen gives a physician a good idea of the conditions for which the patient is receiving treatment. More information such as family illness comes up in particular cases and asking the right questions is what we spent at least half our medical training learning how to do. Furthermore, if a patient is unconscious or in a state of altered mentation, having a one page listing of medication taken in a wallet or purse provides a health record that is readily accessible under a wide variety of medical circumstances.

What the computer should do is to encourage an individual to word-process their current medication list. We should not view the computer in medicine as a tool for the complete and complex; rather, the technology should bring out what is simple, straightforward, and within the capacity of anyone with a keypad.

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Letter: Medicine And The Pharmaceutical Industry

By EMANUEL TANAY, MD
Powerful propaganda machine operated by big pharmaceutical and insurance companies has had detrimental impact upon the public opinions and practice of medicine. Thousands of gift baring representatives visit medical offices regularly and exert influence upon the practice of medicine. Physicians are put under pressure by the “ask your doctors” advertising to the public. These commercials, in emotional translation, mean that if your doctor is any good he will prescribe the advertised drug. The exorbitant prices for some drugs border on grotesque. The justification is research and development. Great deal of the funds is spend on promotion. Government and universities finance nearly all basic research.

The standard treatment for a inoperable prostate cancer is Lupron injection administered by a nurse. Each injection costs $2000. The patient usually receives one injection every three months for two years. Pharmaceutical industry and the insurance companies have an obligation to the stockholders to make profit. Medical ethics is not their concern but they exercise enormous influence upon practice of medicine.

Dr. Tanay is a retired Wayne State University Professor of Psychiatry.

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Medicaid Faces Budget Scalpel

Late last week word leaked that Gov. Jennifer Granholm will make significant cuts to Michigan’s Medicaid program. MSMS and other health care groups have learned that Granholm plans to issue an Executive Order on Tuesday, May 5, that would cut the state budget for the last quarter of this fiscal year, including a 4 percent cut to Medicaid funding. MSMS will hold a news conference in Lansing on Monday to argue against the cuts to the health care safety net.

Medicaid serves 1.7 Michigan resident, but the rolls are growing by thousands per month as an increasing number of Michiganians find themselves jobless and without health coverage. Hospitals have reacted similarly to physicians, but nursing homes might be the most vulnerable to immediate effects. “We think this could topple some facilities,” said David Seaman, a vice president with the Michigan Health and Hospital Association, in reference to nursing homes. Seaman's remarks were made to the Detroit Free Press.

MSMS is urging members to immediately contact their legislators using links created for that purpose on the MSMS website (www.msms.org).

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MSMS, Counties Relay Concerns To MedAssurant

Last week, MSMS hosted a meeting with senior staff at MedAssurant. Attendees at the meeting included senior MSMS staff, county society executives representing Oakland and Genesee counties, representatives from Michigan Medical Billers Association and Michigan Medical Group Management Association, and members of the BCBSM staff.

Included in the agenda was an opportunity for MedAssurant to provide an overview of their company and their role in the current reviews, on behalf of the insurance carriers. We in turn did the same. More than half of the meeting was used to discuss the problems and concerns you, our members and administrators, have brought to us. I believe the message was delivered quite clearly that the process is at best a minor intrusion into your business and at worst a significant burden in terms of time and resources.

Numerous suggestions were made to improve this process, including vastly improving the communications to your practice prior to reviews, on the day of the reviews, and subsequent to the reviews. We are also seeking legal clarification through MSMS legal counsel of your rights in this process and a definition of what the terms and conditions of the contracts actually dictate in terms of compliance. We asked and were supported by MedAssurant in our request to be at the table in improving this process.

Finally, it is my belief and that of some others that congressional contacts should be considered to educate those who could possibly do something about this mandate at the very top (in Washington).

I would like to thank MSMS for convening this meeting, particularly Rebecca Blake and Stacie Saylor. I was pleased to be able to share the concerns of our members and also hear other perspectives at the table. As always we will keep you updated as we move forward.

Thank you for your support!

Donna Welch LaGosh, Executive Director
Oakland County Medical Society

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WSUSOM Students To Address State Legislators

Three of the five Wayne State University students selected to present their research to state legislators as part of Michigan Graduate Week attend the School of Medicine.

Daniel Barkmeier, Anna Valina-Toth and Amanda Lawson-Gedman traveled to Lansing on April 23 to represent WSU among the 60 graduate students from 15 colleges and universities who displayed their research for lawmakers at the Capitol Building. The displays were part of Michigan Graduate Education Week, April 20-24, proclaimed by Gov. Jennifer Granholm. The week is designed to highlight the importance of graduate education and its impact on employment opportunities in the state.

“The importance of such an event cannot be stressed enough at a time when the state is cutting appropriations to the research-intensive universities,” said Ambika Mathur, Ph.D., assistant dean of Combined Degree Programs and Postdoctoral Affairs for the School of Medicine. “The presentations by our students served to demonstrate to the legislators the excellence in research training that is provided to students at Wayne, and in particular by the faculty and training programs in the School of Medicine. This was underscored by the two MD/PhD students presenting at this event, both of whom have been awarded prestigious individual fellowships. This type of recognition of our student success is important to raise the awareness of the excellence of graduate training in the School of Medicine and Wayne StateUniversity as a whole amongst the legislative body of our state. This served as a great opportunity for the students to interact with our elected officials and to serve as ambassadors of the university and the medical school.”

Dr. Mathur, also a professor of the Department of Pediatrics, said WSU’s Graduate School sent e-mails to all graduate program officers across all schools and colleges soliciting applications from graduate students. An internal committee reviewed all submitted scientific abstracts from the students and conducted interviews with them before selecting the five best to send to Lansing.

Valina-Toth holds a much-coveted F31 fellowship awarded by the National Institutes of Health. Barkmeier is the recipient of an award from the Epilepsy Foundation.

Barkmeier, who has completed two years of medical school and is in his third year of graduate school, said his research was well received. “Several visitors told me stories of people close to them who had epilepsy and expressed their gratitude and optimism for my project.”

His research involves attempting to gain a better understanding of epilepsy and development of a possible cure. “After studying human brain tissue removed during epilepsy surgery, we have identified the key molecular pathways involved in epilepsy,” he said. “My project is to create an animal model that accurately mirrors these pathways and then to use this model to test new, targeted therapeutics.

“I am honored to be given the chance to show our community the wonderful research that takes place at Wayne State,” Barkmeier said.

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Oakwood Invests In Dearborn 'Mixed Use' Development

Oakwood leadership last week joined representatives from Midwest Health Center, the City of Dearborn and Redico Development Company to break ground on the Dearborn Town Center development project – a mixed use development that will offer multi-specialty medical care, retail, office space and an assisted living facility for seniors located on the corner of Michigan Avenue and Schaefer in the heart of downtown east Dearborn. The $70 million Dearborn Town Center project will serve the citizens of Dearborn, Detroit and southeast Michigan.

“Oakwood has made a commitment to revitalize downtown east Dearborn by investing in a state-of-the-art development and we are proud to partner with Midwest, Redico Development Company and the City of Dearborn in order to make this investment a reality,” said Brian Connolly, President and CEO, Oakwood Healthcare, Inc. (OHI). “Oakwood and Midwest share a longstanding presence in the Dearborn community and we are eager to bring this project to life and serve our friends and neighbors in this region.”

The property sits on a historic and highly visible street corner – land that was formerly Montgomery Ward. The vision for the project is to create a village atmosphere through a comprehensive mix of services. Oakwood and Redico will jointly own the medical office development, which will span more than 125,000 square feet of the development.

In January of this year, Oakwood acquired all five Midwest Health Center locations from Dr. Mark Saffer and his partners, including offices in Dearborn, Detroit, Livonia, Romulus and Taylor. Management of the day-to-day operations of the facilities will continue to be overseen by Dr. Saffer’s management company. The Dearborn Town Center will serve as the new home of the Dearborn Midwest Health Center, which has been serving the community for many years.

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Wayne State Assistant Dean Accepts Foreign Post

Christopher Green, MD, PhD, assistant dean for China/Asia-Pacific for the Wayne State University School of Medicine, has been appointed a professor of the Chinese Academy of Sciences.

The academy, Dr. Green said, is the equivalent of the United States National Institutes of Health. The appointment as professor to the academy required a nomination and election. Dr. Green was sponsored for the honor by the academy’s Institute of Biophysics, the location of the clinical Brain and Imaging MRI Center of Excellence in Beijing. The center is the country’s key lab for brain and cognitive neurosciences.

“The appointment means I have a ready open door when I try to have conversations in hospitals and medical establishments,” Dr. Green explained. “I deal with hospitals and academic institutions, and they treat me very well. The Wayne State University School of Medicine is very well known here. I have a very easy sell when arranging partnerships with the school.”

The relationships that Dr. Green establishes in China assist researchers in the United States and at the School of Medicine by broadening relationships. Chinese researchers may be working on similar studies as their counterparts at the School of Medicine. Opening dialogs and sharing findings broadens the pool of research subjects as well as the wealth of discoveries.

While in China, Dr. Green conducts research at the nation’s largest neurological hospital, Tian Tan Hospital, which is entirely devoted to studies and treatment of the brain and neurology.

Prior to his current assignment, Dr. Green served as the executive director of the Emergent Technology Research Division in the Departments of Psychiatry and Behavioral Neurosciences, and Diagnostic Radiology, where he is an adjunct professor and Fellow in Clinical Neuroimaging.

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MSMS, AMA Team Up To Offer IT Help For Members

Michigan physicians are the first in the nation to gain increased access to health information technologies (HIT) through a new collaboration announced May 1 by the American Medical Association (AMA) and Michigan State Medical Society (MSMS) with Compuware’s Covisint. This collaboration builds on MSMS’s nation-leading “MSMS Connect” and comes just days after the AMA announced its agreement with Covisint to develop an AMA web-based portal.

The collaboration will increase the number of products and services available to Michigan physicians. MSMS Connect currently has a portfolio of services that help to improve patient care, facilitate efficient medical practice and ease the adoption of HIT. Later this year, through the AMA collaboration, MSMS members will be able to access even more secure tools and information in support of improved patient care and efficiency.

“Our collaboration with the AMA is very exciting for Michigan physicians because we are now able to pool our efforts to deliver a broader range of resources to help physicians in their practices,” said Gregory J. Forzley, MD, chair of MSMS board of directors and Medical Director of Informatics at Saint Mary’s Health Care in Grand Rapids, Mich. “Physicians can select the products and services they need to help increase their efficiency, quality of care, and patient safety through one online portal.”

Available offerings will include the latest and most useful tools and information for ePrescribing, electronic health records, and practice and revenue management to provide very practical and tangible help to practicing physicians. The new physician-friendly portal will allow for personalized content, search capabilities and learning and networking opportunities that will not require great technological expertise to implement.

“Through this collaboration with MSMS, Michigan physicians will provide feedback that will help improve the program for physicians nationwide,” said AMA Board Chair Joseph M. Heyman, MD. “By working together, we can develop a better portal with the products and services to help simplify physicians' day-to-day routines so they can focus on what they do best – caring for patients.”

The AMA platform will be launched nationally in 2010.

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