Posts tagged ‘Medical Records’

A Useful Meaning for Meaningful Use?

Image via HealthITBlog

While the march towards universal EHR adoption continues, some resistance to implementation has emerged, including from inside the medical community. Some of the hesitation is based on safety issues and privacy concerns – people worry that the personal content of health documents could be viewed by anyone or that opportunistic hackers could easily gain access to our most intimate details. I’ve written about this argument before and concluded that, while I agree it’s important to proceed cautiously and intelligently, we must proceed nonetheless.

One of the biggest impediments to electronic health record adoption has been the lack of concrete definition of “meaningful use.” But let’s not get too far ahead of ourselves. In order to receive government funding/aid in the form of incentive payments from Medicare and Medicaid, facilities have to demonstrate that their electronic health record serves or provides “meaningful use” to the practice and physicians. The definition for meaningful use has been murky and vague; a subjective and fleeting characterization that made many physicians and health facilities reluctant to commit to any electronic solutions for fear of not being reimbursed or not qualifying as “meaningful use.” Luckily, this issue has been resolved – mostly – thanks to the definition put forth by the Office of Health and Human Services. So what is the definition and what does this mean for health information technology?


August 5, 2010 at 4:02 pm Leave a comment

Security in the Time of EHRs

You are online right now.  I don’t just mean that you are sitting in front of your computer or using your smartphone to read this post on the internet.  I mean the majority of your “vital” information about your identity – bank account, social security, address, etc. – can be found somewhere in cyberspace right now.  You exist in the internet; and not just you, but also various versions of you complete with your interests, past transactions and other personal information that you’ve added to your social networking sites or the online store where you buy things.  All of these pieces of you are captured online and are out there in the ether of the web if someone wanted to find them.

It’s a bit creepy, isn’t it?  The fact that so much of our lives these days exist online – and therefore so much of who we are is being captured or constructed on the net – leaves many feeling unsettled.  This is especially true if you’re a person who doesn’t know much about software security, who doesn’t follow how data is captured and stored, who isn’t sure how much of the web works but you are fairly certain it will be working against you.

Now add in the idea that soon some (if not most, if not ALL) of your personal medical information will be stored on a similar system – and you understand why people are apprehensive about the idea of an Electronic Health Record (EHR).  There are those who believe that web-based data storage will only lead to security breaches or identity theft issues.  And there’s definitely the potential for such shenanigans to abound with an EHR.  While these concerns are valid and need to addressed as new systems are created, they shouldn’t stop us from proceeding with developing portable EHR systems.


March 30, 2010 at 4:18 pm 1 comment

Introducing the OpNote Consultants – Dr. Seth Goldberg

While creating our surgical reporting product, the OpNote, we at mTuitive have been working with many highly skilled surgeons.  These surgeons are from a diverse group of specialties and backgrounds and help to shape the future and efficacy of the OpNote.  We’re introducing these consultants to all of you in the coming weeks.

After 27 years as an otolaryngologist/facial plastic surgeon in Rockville, MD, Dr. Seth Goldberg launched a new career as a health care consultant specializing in clinical information technology development, utilization management, continuous quality improvement, and risk management. He conducts accreditation surveys of outpatient medical facilities for the Accreditation Association for Ambulatory Health Care. Dr. Goldberg holds board certifications in Otolaryngology-Head & Neck Surgery, and Facial Plastic and Reconstructive Surgery.

He earned his B.S. degree in Molecular Biophysics and Biochemistry from Yale University, and his M.D. degree from Tufts University School of Medicine. He recently received his Masters of Medical Management degree from Carnegie Mellon University. Washingtonian Magazine and Washington Consumers Checkbook have included him in their list of Top Doctors.

In conjunction with his solo clinical practice, Dr. Goldberg was Chief of Otolaryngology at Holy Cross Hospital in Silver Spring, MD, and Shady Grove Adventist Hospital in Rockville, MD. He also served as a member of the Peer Review Committee of the Montgomery County Medical Society and as a peer review consultant with the Delmarva Foundation, Medical Mutual Liability Society of Maryland and the Medical Chirurgical Society of Maryland.

How did you get your interest in medicine?

I’m at the leading edge of the baby boom generation and my role model was – and we can joke about this – it was the TV show “Marcus Welby, MD.” He was a very respected individual and it was clear, back in the sixties, that physicians were highly respected members of and contributors to the well-being of  society.  So I think that’s what originally piqued my interest.

There were other factors, of course – I excelled at science and math.  I had an inquiring, experimental mind – I worked as a lab assistant for one of my biology teachers in addition to taking Advanced Biology as an elective in high school.  I taught tomato plants to say, “feed me, Seth.”


Once I got into college, I fast tracked into medicine – that seemed to be the thing to get into at the time.  So I did my pre-med and the process for getting into medical school was actually pretty easy.  I had an interview at Tufts that consisted of the interviewer informing me that they had already decided to admit me.

(Laughs) So then you clearly felt like “I nailed it!”

(Laughs) Basically, yeah – I felt like I had nailed it, right.  Also, at the time, there was this other little thing called the Vietnam War.  I had a high lottery number, or I guess it was actually a low lottery number.  So there was only one other choice and that was be cannon fodder.


March 17, 2010 at 10:25 am Leave a comment

HITECH – One Year Later

This Healthleaders Media article examines the efficacy of Health Information Technology for Economic and Clinical Health (HITECH) Act after its one year anniversary.  Built on other Health IT initiatives originating in 2004, HITECH Act incorporates monetary incentives to encourage health professionals to adopt electronic health records and to utilize more health information technology.

In the wording of the law, “eligible professionals” must demonstrate “meaningful use” of a certified EMR in 2011 in order to receive incentive payments of up to $44,000 from Medicare and $65,000 from Medicaid per individual physician – to help cover the cost of EMR adoption.

And while there are ongoing debates about privacy issues and the effectiveness of digitization, one of the main goals of the project seems to be portability: the ability to have a individual’s medical history readily available to any physician where ever/when ever that individual seeks treatment.  This is the ideal that Dr. H. Walter Kaess and Dr. Roger Chabra spoke of when I interviewed them recently.  GE has illustrated this idea dynamically in its recent commercials for EMRs that have been airing recently.

But what does this all mean for physicians?  How is the Health IT market working with physicians to deliver on the promise of portability without any cost to caring for patients or impeding the physician’s workflow?


March 12, 2010 at 9:01 am 1 comment

Introducing the OpNote Consultants: Dr. H. Walter Kaess

While creating our surgical reporting product, the OpNote, we at mTuitive have been working with many highly skilled surgeons.  These surgeons are from a diverse group of specialties and backgrounds and help to shape the future and efficacy of the OpNote.  We’re introducing these consultants to all of you in the coming weeks.

Dr. H. Walter Kaess attended medical school in Cologne, Germany, and Vienna, Austria, and graduated magna cum laude from the University of Cologne in 1970. He started his surgical residency at the University of Bonn and continued his training at Rhode Island Hospital, a Brown University Teaching Hospital, where he completed his residency in 1979 as Executive Chief Resident.

In 1979, he moved to Cape Cod and began his almost thirty year career at Cape Cod Hospital.  During that time he was actively involved in Medical Staff Quality Assurance committees, served as Chief of Surgery and two three-year terms on the Board of Trustees. Dr. Kaess practiced the wide range of Vascular and General Surgery, with a special interest in Breast Surgery.

How did you become interested in medicine?

You start out with a very difficult question!  But when I think about it, I think it had something to do with the fact that medicine was always familiar to me growing up because my mother was sick.  My mother spent a great deal of time in hospitals and eventually passed away.  When she got sick, I was less than 10 years old.  And when you are at that formative age, and you walk into hospitals and the smell of disinfectant becomes an everyday occurrence to you, then I think that sort of breeds a certain familiarity with medicine.

My high school advisors told me that I was good in natural sciences and that I should become a physicist – which I tried…for one semester.  But I found that much too dry.

I had always fought against going into medicine, because my father’s second wife was a medical general practitioner and everybody had expected me to go into medicine.  When you’re in that rebellious stage, you say “No Way!”  Nevertheless, at some point my interest in natural sciences and my familiarity with medicine became strong enough that I decided I wanted to go into that field.

And how did you decide to become a surgeon?

I did a mixed internship – 6 months of medicine, 6 months of surgery.  The first six months of medicine…I was bored to tears.  That was the worst rotation I’ve ever had in my life.  All people did was talk – they never did anything with the patient.  I’m not a desk person – I’m a doer!  So, all of a sudden, I went into surgery and said, “I like that!” You know, interacting with the patient, doing something.  So, I became a surgeon.


March 9, 2010 at 11:32 am 1 comment

Introducing the OpNote Consultants: Dr. John Mattson

While creating our surgical reporting product, the OpNote, we at mTuitive have been working with many highly skilled surgeons.  These surgeons are from a diverse group of specialties and backgrounds and help to shape the future and efficacy of the OpNote.  We’re introducing these consultants to all of you in the coming weeks.

Dr. John Mattson is an orthopedic surgeon who specializes in knee arthroscopy, ligament reconstruction and sports medicine.  Operating out of Berkeley, CA, Dr. Mattson is both a member of the staff of Alta Bates Summit Medical Center as well as working with his own private practice – the Berkeley Orthopaedic Medical Group, Inc.

Dr. Mattson graduated from Northwestern University in Evanston, Illinois and completed his medical and Orthopaedic training at the University of Michigan in Ann Arbor.  Dr. Mattson joined Berkeley Orthopaedics in 1983 and was Chairman of Orthopaedics at the Student Health Service of the University of California at Berkeley from 1990-2004. Dr. Mattson is a member of the clinical faculty at the University of California San Francisco Medical Center.

Dr. Mattson specializes in knee arthroscopy and Anterior Cruciate Ligament Reconstruction. He uses minimally invasive state-of-the-art arthroscopic allografts (donor grafts) for ACL Reconstructions. Dr. Mattson has one of the largest series of soft tissue allograft ACL Reconstructions in Northern California.

How did you get interested in medicine/surgery?  Why orthopedic surgery?

I became interested in a surgical career as both my father and uncle were surgeons and I strove to emulate them.

I was fortunate to be accepted to the University of Michigan medical school where I graduated in 1972. While in medical school, students rotate among various clinical services and are introduced to both the nature of the specialty and to the personalities who were attracted to that particular specialty.

I was immediately drawn to Orthopedic Surgery as I enjoyed both the nature of the specialty and the individuals who were residents. It seemed a comfortable fit.

I’m sure you’ve been approached by other Health IT organizations before.  What about mTuitive – or the OpNote product itself – did you find appealing?  What got you interested in working with us to develop the OpNote?

Number one – I’m sort of a computer nerd and drawn to innovative advances using technology.


And I like the idea of being able to create an operative report that is complete and comprehensive in a very rapid and efficient way.   I review a number of medical legal reports, both for the medical association and for various attorneys, and have been struck by the disorganization and deficiencies of non-standardized dictations.  Basic information about the procedures done are often missing or incomplete. In working with OpNote, it became apparent that a complete, standardized report could be generated in a rapid and intuitive manner.


February 23, 2010 at 9:36 am 2 comments

Introducing the OpNote Consultants: Dr. Deanna Attai Part 2 of 2

While creating our surgical reporting product, the OpNote, we at mTuitive have been working with many highly skilled surgeons.  These surgeons are from a diverse group of specialties and backgrounds and help to shape the future and efficacy of the OpNote.  We’re introducing these consultants to all of you in the coming weeks.

Dr. Deanna Attai is an accomplished breast surgeon certified in General Surgery by the American Board of Surgeons in 1997.  Dr. Attai is also a Fellow of the American College of Surgeons, certified in Breast Ultrasound and is an instructor in Breast Ultrasound Education for the American College of Surgeons.  She is affiliated with Providence St. Joseph Medical Center in Burbank, CA and runs the Center for Breast Care, Inc.  For more information on Dr. Attai, the Center for Breast Care, Inc. and breast health awareness, please visit her website.  Dr. Attai and I recently spoke over the phone regarding her background in surgery, interest in electronic reporting and why it is so important for surgeon to be aware of medical coding.

Click here for Part 1!

How much do you think could be gained from structured data?  I’m defining “structured data” as capturing a point of data that can be graphed or used for research later.  We at mTuitive put a lot of value into it – do you think a lot of other physicians do?

I’m not sure if a lot of other physicians would – but they should.  That’s how things are going: you need to pull out your cancer staging for some of the stuff that I’m doing with American Society of Breast Surgeons (ASBS) and we’ve got this quality initiative program where you’re entering in some of your data.  Everybody’s going towards quality reporting; it’s going to be part of board certification requirements; it’s going to eventually be part of Medicare and other insurance participation [programs].

Are they looking for quality or for data research purposes?  You can’t always anticipate how the data will be used in the future or what you’ll need.

People need to be told just how important it is.  You’re not just dictating your operative report so you have something in the hospital chart – everybody’s looking at this stuff now.  Whether it’s the insurance companies, patients, hospital billing, or [the Joint Commission] – everybody’s looking at it.

A lot of physicians don’t understand how important it is but they are going to be told very quickly.  Those that do understand will get it, and I think a lot of hospital administrators will understand – now it’s just getting the docs to buy into it, as we don’t like to change.


February 19, 2010 at 10:35 am 6 comments

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Disclosure Statement - The authors of this blog are paid employees of mTuitive Inc. and are compensated for their services.