ElectronicHealthcare 4(4) March 2006 : 100-100


The ehealthrecord.info is designed to provide the latest news, best practices, policy and ideas about electronic health records. The ehealthrecord.info is short and to the point. The subject is salient to advancing the quality of care; our objective is to provide you with clarity and to keep you current. Think of it as a supplement to the journal ElectronicHealthcare. It is updated every two weeks. To view the entire eletter, please visit: www.ehealthrecord.info

Consumer Reports: EMRs Have Potential for Misuse

An investigation in the March 2006 issue of Consumer Reports found potential for abuse in the drive to create a national system of electronic health records. Although EMRs could save lives and billions of dollars in healthcare spending, it could also compromise the security of personal healthcare information, the report found.

Data Mapping

One essential component of health IT interoperability, and the improved care and efficiency it offers, is data mapping. Data mapping involves "matching" between a source and a target, such as between two databases that contain the same data elements but call them by different names. This matching enables software and systems to meaningfully exchange patient information, reimbursement claims, outcomes reporting, and other data.

Modern Healthcare Lists Some Predictions for 2006:

  • At least some hospitals and health systems will benefit from availability of financing and credit. "Executives [in both for-profit and not-for-profit hospital sectors] will be taking advantage of that to shore up their balance sheets, fund growth, and acquire new properties."
  • "Growing ranks of uninsured patients, shrinking Medicaid rolls, and an overextended federal budget will only compound stress on not-for-profit hospitals, a sector under pressure to widen and further promote its aid for those who cannot afford to pay."
  • Industry observers predict that large, established investor-owned hospital chains like HCA and Triad will "prune their portfolios," continuing a trend to sell off hospitals.
  • Physicians face ever-increasing expenses and flat revenues. According to one executive of the American Academy of Family Physicians (AAFP), "The next year is going to be economically challenging, particularly for people who are in primary-care specialties who operate on low margins to begin with and who do not have the ability to increase volume."
  • The construction boom will continue.
  • For the managed-care industry, 2006 will bring continued prosperity, including increased revenue from Medicare Part D, steadily increasing adoption of consumer-directed health plans, more industry consolidation and a return to more participation in Medicare.
  • On the IT front, "both the federal government and the private sector will be major players in healthcare information technology in 2006, but privacy could be a point of contention." Two industry watchers comment about the remaining need for money, either from public-sector or private-sector subsidies, to spur adoption. This is obviously one area to watch.
  • Ongoing studies about admission criteria for long-term care and the "much debated 75 percent rule for inpatient rehabilitation hospitals" will yield results and changes in 2006.
  • Physician joint ventures will continue to thrive, "sapping revenues" from hospitals in ambulatory surgery and diagnostic imaging in particular. Medical liability will remain a "front-burner issue," and one industry observer predicts more litigation between hospitals and managed-care plans. According to the president and CEO of the Federation of American Hospitals, as Medicare and private insurers integrate pay-for-performance incentives into contracts, hospitals and physicians will risk running a foul of the Stark physician-referral law.
  • For GPOs, 2006 could bring an end to the years-long investigation of business practices.

Biggest Concern for CEOs

For the third year, U.S. hospital CEOs have listed financial issues as the top concern, with Medicaid, Medicare and Bad Debt as their three biggest special financial worries in the American College of Healthcare Executives (ACHE) annual survey. Rankings were as follows (CEOs ranked their top three):
  • Financial challenges (67%)
  • Personnel shortages (35%)
  • Physician-hospital relations (33%)
  • Quality (23%)
  • Patient safety (20%)
  • Patient satisfaction (18%)
  • Capacity (17%)
  • Technology (17%)
  • Governmental mandates (16%)
  • Malpractice insurance (11%)
Quality and patient safety continued to rise up the ranks of the priority list. Last year they were top issues for 18% and 16%, respectively. Nursing shortages were the top personnel shortage for 85%, with imaging technicians second (58%) and pharmacists third (57%).


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