Cost control

The full savings potential of electronic health records (EHR), or lack thereof, is not entirely clear. But there may be certain instances where EHR can lead to savings. A new article in Forbes examines a few such instances. Here is an excerpt:

The Milliman Group did two studies on so called “multi-payer” portals that work with multiple insurers and found that portals such as NaviNet save doctors an average of $20 per patient, per visit. The savings for an insurance plan covering 500,000 people is estimated between $14.5 million and $15 million a year.

Now extrapolate that out to the entire population of the United States. We’re talking more than $9 billion in annual savings.

8 thoughts on “Cost control

  1. You are quoting issues of the 1980s. Both of your points are pirmarily Republican talking points and do not speak to the functional inefficiencies within health care delivery. What about how conflicts of interest affect care and the accuracy of research? Companies extraordinary use of patent claims on gene assessment and other methodologies. Capitalism is totally running a socially driven system. Its ludicrous! Look at how the financial system collapsed in 2008. All the voluntary reporting mechanisms failed. Same issues exist in health care and the result is poor QA and outcomes.

  2. Something that few people talk about, Quality of the Health Care Provider. My spouse is a health care provider, many times I hear or see first hand the total disregard for human life. Poor procedure, unclean environments, lack of urgency the kind of things that lead to people dying an early death caused by a health care worker. There is little regulation until someone makes a mistake. Between poor health care coverages, poor providers and overwhelming increase in cost, its a wonder any of us are still alive. Lastly, I find is appalling that certain parties and politicians find it proper to waste lives, allow people to die in pain or otherwise when it is with-in their power to help or even save them. There is no difference between witnessing great suffering and causing it, when it comes to human life if you do not aid in the solution your the problem.

  3. EMRs depersonalize patients by presenting them as boxes to be checked and blanks to be filled in and, of course, make privacy of medical information even more of a joke than it is now. In addition, EMRs present the patient as nothing more than collection of data. My own doctor, whose office spent $500,000 for an EMR system, says when he looks at each EMR, it’s only clinical information – “I can’t tell who that person *is*. Yet, excellence in diagnoses and treatment includes far more than just clinical information. It includes knowledge (not just test results or boxes checked) of patients’ histories, family situations, current work and home situations, psychosocial stresses – all contemplated and processed in a cognitive fashion by a well-trained physician.

    Government medicine doesn’t allow for that. It’s goal is to reduce costs through standardization, reduction in services, and delegation of diagnoses and treatment to the less-trained. Patients, however, aren’t “standard” – and never will be.

    To see the future of socialized medicine in the U.S., look at what’s happening now with the British National Health Service (you won’t see this in any American media):

    Cash is king. It always will be. If patients paid physicians directly, as they did pre-Medicare, instead of paying thousands of government workers (and unnecessary workers in doctors offices to process claims) healthcosts would plummet. Doctors would be responsible to their patients, not to the government. There is no better watchdog of a patient’s wallet than the patient.

  4. @Marc Wilton, MD
    Marc, I like your comments. Here’s a few other thoughts:

    1. The depersonalization problem comes from giving IT folks too much leeway in designing EMR systems. No disrespect to IT folks meant here – their way of thinking works great in their own field but just doesn’t translate well to ours. I designed the templates for our EMR myself and avoided overuse of blanks and drop down menus, opting instead for “physician narratives”. That allows us to document well the human element to a patient’s background that you correctly point out is often missed.

    2. Because of CPT billing requirements EMR entries are often quite long and contain too much “white noise” – too much demographics, too many irrelevant details, etc. I have seen 5 pages EMR notes for a patient that came in with impacted ear wax!

    3. Docs MUST take the lead in EMR implementation. If we oppose EMR and CPOE because we dwell on its shortcomings then our history with managed care will repeat itself. We will allow non-physicians to create and force upon us a completely unworkable system.

  5. @Mike Koriwchak MD
    Dr. Koriwchak,
    I agree with your points 1 and 2. I am computer info systems major specializing in health informatics. I actually don’t see how “IT folks” such as myself can design a truly useful system without majority of the physicians input. Obviously you will know more than the couple of background health administration courses we are required to take. Our job should be to inform you of whether the feature you would like to include is technically feasible and that is all; not to take control as if we are health providers first.

  6. I see that Healthcare organizations throughout Europe are continuing to benefit from this offering. Smart Terminals at the Bedside is an uncooked solution here in the US. An All-in-One network monitor (terminal) on an arm/mount supported with customized software written for each Unit or Dept. within a Healthcare facility. To provide customized solutions to patients and medical staff at the bedside. EHR/EMR access, HIPPA required patient education videos, bar code scanning, card reader, Web Access, IPTV, VOIP, touch screen, and gaming. In turn, supplying Healthcare facilities patient-centric solutions which are efficient and effective, secure. Also, decentralization of care stations to decrease the spread of infectious diseases acquired during treatment.

    Smart Terminals offer much more than just patient entertainment. Real cost and time savings are possible through:
    • Immediate and secure EHR access
    • Real time patient information
    • Touch screen data entry
    • Increased patient interaction
    • Video consultation (telehealth)
    • Automated meal ordering
    • Patient education

    Terminal features for clinical access:
    • Barcode Scanner
    • Wireless Connectivity
    • Telephony
    • Biometric Security
    • Camera
    • Remote Control
    • Custom Buttons
    • TV Tuner

    Through bedside smart terminals, physicians and staff have the means to become more productive and efficient in achieving patient/hospital mission and goals supporting quality and efficient work. Bedside Smart Terminals are a new patient-centric environment for the US. Not for all Healthcare arenas but, customizable for some. Patient entertainment is possible now in dialysis centers, chemo therapy centers or any other arena where treatment cover hours of time. As I see it, Bedside Smart Terminals are not de-personalizing to the provider or nurse. The provider and nurse still need to do what they do currently with tablets, desktops at nurse stations, mobile desktop carts etc… so will them with a Bedside Smart Terminal, at the point of care, side by side with the patient. I believe this technology can increase patient satisfaction scores. Do you see hospitals, recovery centers, out-patient facilities, dialysis treatment centers or chemo therapy centers benefiting from Bedside Smart Terminal technology?

    To support the cost challenge, we offer Leasing options to help organizations focus their capital budgets and lines of credit on core business needs, while providing a means to refresh computing technologies that will help your partners grow on their cash flows at the same time.

    I know there’s a US Hospital, Holy Name Hospital, NJ (I believe it’s less than 1% in the US) that have adopted Bedside Smart Terminals. I’m interested to see if you have worked with this type of technology. If so, please share your experience or your interest in positioning this technology. I appreciate any feedback on this technology. Example links attached.

    Thank you.

  7. @Stephen Dolle
    I think your anti-capitalism is showning here Stephen. Really, you think the financial collapse was due to a lack of overseeing? come on, the problem is not that simple and you should know that. The real problem, and there is plenty of evidence if you don’t take CNN’s word for it, that the problems were mainly due to the practices put in place by our government. Politicians that have no training or real world experience make decisions that affect the markets negatively. Think about it, 2008 Barney Frank and Chris Dodd said that Fannie and Freddy were in good shape, then this whole small Banking issues became very large issues when all the risky loans that the government required of banks started failing. The real issue was why did the government require 46% of all loans be given out to minorities and high risky borrowers. Look it up, it’s true. I have been watching the stupidity of our government for years and I saw this coming and so did many other who warned of this.

    Capitalism is not the problem with our health care system. Come on Stephen, we are the best medical providers on the world. We lead the way in most medicines that hit the market, new innovations in medicine, and by far the most elaborate services at fairly affordable rates. Check out the rest of the world, they come here for treatments, except in cases were the government controlled agencies block certain drugs and treatments. We have WAY TO MUCH government intervention, check out the third world countries where the government decides what is best for you Stephen, and not the free market. I really hate this whole screwed up thinking of people like you that want the government to have a say in MY life. I trust the free market more than politicians who will sell out their grandmother for a vote.

    As far as this issue is concerned, I work in the IT industry and I can tell you beyond a shadow of a doubt that EHR is a very bad idea. Our records will not be safe, and it all will be giving the government to much access to our personal information. Hackers break into things all the time, there will be big money in it for them to break into this, I guarantee you it will happen.

    Please leave me and others alone, we don’t want your big government busy body I know better than you hands in our health care. If EHR is a good idea, then the markets will bring them about and in a better and safer version than some politician that is only trying to give themselves more votes and more power. Don’t be fooled.

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