csiblog

Electronic Medical Records: Google and Cleveland Clinic Pair Up

I remember when my wife Kim and I were first searching for a diagnosis for our daughter.  We went from doctor to doctor – Geneticists, Neurologists, Pediatricians, GI’s, etc.  Living in the Boston area we had broad access to a number of doctors who specialized in specific areas – which at first glance seemed great.   And, at some level it is.  However, the fragmentation of the healthcare system in Boston also created a big issue around sharing information between specialists, and accessing medical records.  I can’t even tell you how many times we had doctors cutting and pasting information out of their hospital systems into emails so we could share prior tests with professionals at other hospitals.  You would think that doctors have better things to do with their time.

We oscillated across three separate hospitals in search of a diagnosis -- Mass General, Boston Childrens, and Tufts New England Medical Center.  We found ourselves answering the same questions over and over again.  Finally, Kim put the family tree/ genetic map into a PowerPoint slide and started pulling it out-- the medical professionals looked at her like she was the next coming of Bill Gates.  It saved us about 10 - 15 minutes at the start of every meeting.

Today, we still use doctors at all three hospitals for our daughter.  The medical records are still spread across all of them.  We still spend time transferring information from one hospital to the other.   In fact, I find a bit of irony that with all the money spent on electronic medical records (EMRs) -- which figures into our healthcare costs -- the most comprehensive medical record we have on our daughter happens to be a three ring binder that sits in our home.  Every doctors’ letter is in it, every blood test, and much more – including Kim’s original PowerPoint slide.

For caregivers and patients, not having quick access to their records can be disastrous. For doctors and medical staff, it can be frustrating, time-consuming, and lead to major mistakes in care options.

So the focus these days is on management of electronic medical records, who owns them, where they reside, how to make them portable, how to protect privacy along the way. Both Google and Microsoft have pilot programs to house personal medical records in large databases so that any doctor anywhere can access information about any patient. Of course, there is controversy.

But for us, the larger issue is that there is movement away from the concept that individual hospitals own your information, and toward a more open architecture that favors the patient and not the hospital.

While the important debate about privacy and security goes on, Kim and I are thrilled to see that one hospital, the prestigious Cleveland Clinic, is engaging in a pilot program with Google to store medical records in a central database built by Google. We applaud the Cleveland Clinic’s efforts toward portability and accessibility, and look forward to the results of the pilot.

Brian Costello
carespace.com

For more on this:
techdirt.com
cnn.com
wsj health blog

Caregiving Military Moms Buck the System

I just finished reading a story in the New York Times about  three young military men, two of whom sustained major injuries in Iraq, one who injured himself in a motorcycle accident. Their lives are now filled with pain, suffering, and a constant need for comprehensive rehabilitative services. So the military mom's fought the Veteran's Administration to get their sons' into private care.

But along with this tragic and heartbreaking story is one of caring, courage, friendship, and hope. The injured men’s moms have become good friends, partners in care.

One is from the state of Washington, the other is from Arizona, and the third is from Virginia. And aside from bringing to light the disgraceful treatment their sons’ were receiving from the Veterans Administration, the story also sheds light on how strong we caregivers become when we work together, share experiences, and really connect with each other around our lives as caregivers.

Thomas Falconer
carespace.com

Challenging Denied Medical Claims

We all love to hate insurance companies. That's one of the reasons the Michael Moore film Sicko resonated -- those of us, especially caregivers, who are constantly in one sort of  battle or another with insurance company bureaucracies felt the pain.

Denials of benefits, like taxes and death, are so common these days that they are generally considered a routine component of the health insurance claims process. It’s expected that insurance providers will reject many claims—more often than not for no good reason. And to my view that borders on the scandalous.  In any case, denied claims are inevitable, especially for those with serious health issues, and their caregivers, who file the most claims.

For the caregiver, denied claims are a major aggravation and distraction. Just the amount of time spent on the phone can be completely infuriating, and exhausting.

As frustrating as it is, though, fighting your insurance provider can be worth the effort.  A surprising number of appeals succeed, though they take tenacity, time, and a zen-like sense of patience. As caregivers, we have plenty of courage, but very little time.

Denied claims are often due to simple administrative errors that can take hours to identify. Others denials are more complex. But you never know unless you take the first step—calling the customer-service number of your health plan or insurer.  And don't hold your breath when you get put on hold. Before you make the call, put Yo-Yo-Ma on softly in the background.

My strong advice -- before launching into the battle, take a look at these excellent, time-saving resources:

• The Consumers Union (publisher of Consumer Reports) provides a detailed step-by-step guide through each stage of a denied-claim challenge.
• CNNmoney .com  has ten tips to help challenge a denial of benefits.
• Bankrate.com provides some detail on the process of challenging an insurance company.

Thomas Falconer
carespace.com