Wednesday, April 16, 2008

Government vs Market Reform - Summary of Six NEJM Reform Articles in April 17 Issue

1. R. Steinbrook, MD “Personally Controlled Health Data – The Next Big Thing in Medical Care?” Dr. Steinbrook is national Correspondent for the Journal - Reports 26% of patients use EMR and 60% to 91% desire to use some aspect of EME. Notes that Dossia(AT&T, Intel, Wal-Mart, and 5other large employers), Google Health, and Microsoft HealthVault have entered personal health record market.

2. Pamela; HrtzbandMD and Jerome Groopman, MD, “Off the Record – Avoiding the Pitfalls of Going Electronic, ”Drs. Hartzman and Groopman are Harvard Medical School faculty members. Express cautionary warning that electronic templates may constrain critical creative clinical thinking.

3. David Goodman, MD, and Eliot Fisher, MD, “Physician Workforce Crisis – Wrong Diagnosis, Wrong Prescription. Authors are with Center for Health Policy Research at Dartmouth. Believe problem with U.S. system is not shortage of doctors, but tremendous variations in practice. Cite variations between 5 leading academic centers – Johns Hopkins, Mayo Clinic, UCLAS, Cleveland Clinic, and Mass General.

4. Kenneth Mandl, MD, and Isaac Kohane, MD, “Tectonic Shifts in the Health Information Economy. Authors are academic medical information expects from Harvard. Talk of PCHRs (Personally Controlled Health Records0 and 5 hurdles blocking adoption – agreement on standard formants, lack of commitment from medical providers. Clinical laboratory rules that do not permit release of data to patients; too much data still store don paper, no patient identifier in U.S.

5. Rebecca Kush, PhD, and three PHD colleagues, “Electronic Health Recurs, Medical Research, and the Tower of Babel, Clinical Data Consortium, Authors assert uniform standards would result in innovative research that would enhance quality and safety of daily care.

6. John Iglehart ,”Grassroots Activism and the Pursuit of an Expanded Physician Supply, “Iglehart is national correspondent for Journal. Tracks downs and ups of various prestigious medical organizations on predicting physician workforce. Despite record numbers of physicians, physician shortage said to exist. American Academy of Medical Colleges now recommends 30% increase in medical student numbers and removal of cap on graduate medical education positions. Increase in physician supply will clash with desire to reduce growth of Medicare spending


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