Monday, February 26, 2007

Getting Your Drugs Faster and More Easily with E-Prescrbing

Recently Blue Cross Blue Shield (BCBS) of Illinois announced an E-Prescribing collaborative program that would improve patient safety by spearheading an effort to encourage health plans, pharmacies and various business and patient advocacy groups in Illinois to work together to increase the use of E-prescribing in the State. Blue Cross Blue Shield is also supplying the initial seed funding to provide the digital technology for writing prescriptions to 500 physicians across the State.

The obvious advantage of E-Prescribing is the elimination of errors made by pharmacists in reading the doctors’ notoriously bad handwriting and filling the prescription with the wrong drug or the wrong dosage. E-Prescribing software has the capability to enter modify, review, and communicate drug prescriptions between the doctor or nurse practitioner and the pharmacist. The computer uses its built-in clinical decision support to check on what medications are covered by your health plan; what possible drug-drug interactions might occur among the medications you are currently taking; whether or not the dosage is appropriate; whether or not you might have an allergic reaction to the drug and any other factors that are relevant in the administration of your medication.

Access to this information on the doctor’s computer or PDA, enables your provider to prescribe the right medication, at the right dosage, at the right time, Alternative suggestions are built in, that inform the physician which drug to choose if the initial suggestion is rejected by the health insurer.

When E-Prescribing works correctly you could be sitting in your doctor’s office discussing your health issues while your prescription is on its way to the pharmacy. On your way home you stop at the pharmacy that has your filled prescription ready, along with detailed instructions on how to take the medication; what to look for if you have an adverse reaction; and what your co-payment will be.

Like everything else in healthcare, E-Prescribing does not come without a price tag,– one that most doctors cannot afford to absorb. Other Blues from Massachusetts, to Ohio, to Florida are taking the initiative for E-prescribing, as well they should. They, along with their subscribers, are the ones to realize the most gain in more cost efficient, safer, better prescription drug practice for everyone.

Thursday, February 15, 2007

Is Your Medical Information Safe?

Is Your Medical Information Safe?

Last summer the theft of a laptop containing the personal and medical records of over 24 million veterans caused a quite a stir. The theft occurred when a couple of teens broke into the home of a VA employee who had authorization to take the computer home. The incident ended happily for the Veterans. The data was recovered and had not been compromised, since the teens were more interested in the computer than what was stored on it.

Other incidents involving medical record privacy have not turned out so well.

Last summer confidential medical information belonging to hundreds of patients who subscribed to Prudential Financial Insurance was exposed when faxed to the wrong fax number by a third party. This incident was reported in Network World,

Recently the Akron Children’s hospital admitted that an intruder had gained access to patient and charitable donor information of over 200,000 patients.

During the past year, computer backup tapes and disks containing records of 365,000 home health patients were stolen from a car in Oregon; a hacker broke into a server and accessed 42,000 patient records in Colorado; Backup tapes containing information on 57,000 enrollees of Blue Cross Blue Shield of Arizona were taken.

The issue is not new. Two years ago the Kaiser Foundation Health Plan was fined by the State of California for unauthorized disclosure of patient health information resident on a web site over a four year period. This web portal included confidential patient information such as names, addresses, phone numbers and lab results. It was set up and available for public viewing without the prior consent of those affected, in direct violation of state law.

A story on the front page of the Wall Street Journal on December 26, 2006 told of a woman whose discussions with her psychologist were made public to an insurance company when she applied for disability benefits, after her psychologist verbally assured her that their discussions would remain confidential.

In 1996 the United States Congress passed the Health Insurance Portability and Accountability Act which was amended to include the Privacy Rule, in 2003. This law is intended to guard patient privacy, particularly in situations dealing with emotional and mental health. However, nothing on the books is able to prevent individuals with malicious intent from tampering with digital databases and trying to access confidential information.

As medical institutions, third party providers and insurers scramble to tighten their security, spending millions of dollars to bring some semblance of reliability to their computer systems, loopholes and limitations in technology and legislation enable unauthorized individuals to seek and peek at your data. For example, HIPAA allows providers to share data with healthcare-related businesses (third party sources). When you have a consolidated electronic medical record, all sorts of information about you can be out there.

On the other hand your paper records are not any safer. In April 2005, thousands of hospital bills issued by the Cleveland Clinic fell out of a delivery truck and blew through downtown Cleveland. In every hospital and doctor’s office, any healthcare worker can access a paper record that is lying on a desk unprotected.

There are some things that you can do to protect your medical record which belongs to you:

o Talk with your providers. Find out where your medical information is kept and how it is stored. Let them know that you expect them to keep your data confidential.

o Become more familiar with privacy laws which specifically prohibit your providers from disclosing your medication information to anyone, including your employers without your explicit permission.

o Be aware if your medical information is being posted on a “secure” web portal. Be sure that you have granted permission for that.

o Never assume that an email communication with medical providers is passing through secure channels.

Wednesday, February 14, 2007

How Personal Health Records Could Save Your Life

By Nancy B. Finn

Suppose you were in a car accident and arrived at the emergency room of the closest hospital alone and unconscious. Healthcare workers could search through your wallet and determine from your license and other identification cards just who you are and perhaps where you live. However, they would have a hard time figuring out your personal medical history; whether or not you have any allergies to drugs; whether or not you have chronic conditions for which you are being treated with medication; what is the best approach to treating you. That information could mean the difference between life and death. That is why a personal health record (PHR) is critical to your well being.

Your PHR is a comprehensive outline of all of your health information theoretically it could be a written synopsis of your medical heath and history on paper, but that is the old fashioned way. Today technology enables you to have an electronic record of your medical health and history residing on a web site, CD, a smart card or on a chip that you, your designee or a provider can access with a user name and password. There is also an implantable device that when scanned directs a physician to a web site where your PHR resides.

Essentially an online PHR is a form that you fill out that includes comprehensive data about your health history, including: all medical issues, surgeries, allergies, medications you have been and are currently taking; information about your health proxy; the names of your primary care physician and your insurance provider. This information resides on a secure website and is easy for you to update and access. You need to designate an individual besides yourself who has access to the information in the event that you are physically or mentally unable to communicate the location of the information.

All you need to carry around with you is the access information to the PHR in the format of a piece of paper with a URL on it and the name and contact information of the individual you have designated to relay your username and password that will provide access to the PHR.

Organizing a PHR online also enables you to carry with you a wallet size card that includes all of the medications your currently taking - information that is vital to the doctors who are trying to figure out what to do with you in the emergency room.

Consider a PHR. Do it today.

Health Insurance, A Quagmire

There’s been a lot of talk lately about expanding health insurance coverage to those who don’t have any. Last year Massachusetts enacted Commonwealth Care a program that connects eligible Massachusetts residents – those with incomes below the poverty level – with approved health insurance plans, and helps them pay for the plans.

Two weeks ago California Governor Arnold Schwarzenegger launched an even more aggressive plan that would expand coverage to the uninsured, and tax employers, doctors and hospitals small percentages to cover the increased costs. This week a coalition of business, medical, insurance, and consumer groups proposed a national version of a similar plan.

People without health insurance have health care needs that are currently met when they end up at a publicly supported clinic or a hospital emergency room. Their unpaid medical bills are shifted to those who have health insurance in the form of higher premiums.
The good news is that everyone agrees there are benefits to helping the uninsured. The bad news is that the current funding for these plans is not adequate to meet the promise and the model builds on a healthcare system that needs a complete overhaul and not a quick fix of just one problem.
Studies estimate that there are nearly 20 million people in America, ages 19-64, who are underinsured. Helping pay the medical expenses of the uninsured will fall on the shoulders of these individuals. In 2006 the average cost of a family insurance plan that workers obtained through their jobs rose over seven percent. Over the past seven years medical insurance for the same individuals doubled, while incomes did not rise nearly as much. The stark reality is that medical expenses of the underinsured are a major contributor to U.S. bankruptcy filings.
For every vehicle that General Motors sells, $1,500 of the purchase price goes to pay for medical care for their employees, according to GM’s chief executive Rick Wagoner. Medical care for Starbucks employees costs the company more than the cost of all of the coffee beans the company purchases to make its product.
No one would argue that we need to work on the issue of universal healthcare and that the new plans address worthwhile problems. However, the solution is not to be found by increasing the burden carried by the rest of us.

Thursday, February 1, 2007

Packing ICE in your Pocket

Terrorist bombings, natural disasters, avian flu epidemics -- if there is one thing that experience has shown us it is that there are no certainties regarding our ability to stay out of harm’s way.

That is why a group of paramedics in Great Britain conceived the idea of ICE, In Case of Emergency, after the terrorist bombings in London. The premise of ICE is that individuals carry the number of an emergency contact in their cell phone’s address book, label it ICE and store it. They should also carry an ICE identification card in their wallet, blackberry, PDA, with similar information.

Whether you are a victim of an auto or plane accident, a terrorist incident, or a tsunami, medical personnel treating you are limited in what they can do if they do not have your medical history. Reaching an ICE contact who can provide permission to access your medical record and outline your prescription drugs and allergies is often critical and time sensitive. Your emergency contact person needs to be appraised of the location of your medical record, as well as any unusual medical conditions and allergies to be able to convey that information

Emergency medical practitioners throughout the world have been trained to recognize the ICE acronym and search for it in a wallet or cell phone of an individual who may be comatose or too disoriented to remember who to call for information.

Although information about ICE is spreading virally via word of mouth, the media, email and the Internet, too few individuals have heard about it or have incorporated it. The Centers for Disease Control and Prevention reported in 2003 that 900,000 emergency room patients could not provide information because they were incapacitated. The ICE method is free of charge and available to everyone. Ice is not just something to put into a drink. An In Case of Emergency (ICE) contact should be in your cell phone, your blackberry, PDA and wallet. This action could save your life.