St. Vincent's Hospital Manhattan

St. Vincent's Hospital Manhattan Expands PatientKeeper Relationship with Physician Portal
Publication: Business Wire
Date: Wednesday, February 14 2007

Leading Medical Center Enhances Care, Saves Time, Demonstrates 33% Increase in Collections with Physician Information System

NEW YORK & BOSTON -- St. Vincent's Hospital Manhattan, part of Saint Vincent Catholic Medical Centers, today announced it has expanded its relationship with
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PatientKeeper[R], a leading provider of physician information systems, to improve both its clinical workflows and financial performance. Under the terms of the expansion, PatientKeeper will provide St. Vincent's physicians with both the PatientKeeper Physician Portal and PatientKeeper Charge Capture applications, helping to enhance care, save time, and increase collections.

"PatientKeeper Physician Portal presents me with a comprehensive view of my patients," said Richard Roistacher, MD, Medical Director of the Faculty Practice for Internal Medicine at St. Vincent's Hospital Manhattan. "From any web browser, I can now access my patient's medical history, lab tests and results, insurance information and other relevant information, allowing me to deliver the most informed care possible. PatientKeeper saves me a tremendous amount of time and makes it easy for me to stay informed about my patients."

PatientKeeper is designed to support physicians throughout their entire day, across all settings of care. Applications allow physicians to access their patients' electronic records, write prescriptions, enter charges for services, document patient encounters, place orders, and securely send messages to other caregivers - all in a single integrated environment.

St. Vincent's, a major healthcare resource in the greater New York Metropolitan area, introduced PatientKeeper to its internists and inpatient physicians last year. Due to PatientKeeper's physician-intuitive design and personalization capability, additional physicians quickly expressed interest in using the system. Today, over 200 physicians at St. Vincent's Hospital Manhattan are using PatientKeeper software, including:

* PatientKeeper Physician Portal provides a comprehensive, longitudinal view of a patient's entire medical history from any Web browser

* PatientKeeper Charge Capture enables clinicians to quickly and easily record charges for services they deliver - at the point of care, in the office, or anywhere in between

* PatientKeeper Mobile Clinical Results delivers access to essential patient clinical information - anytime, anywhere with PDAs and Smartphones

A Hospital Is Offering Digital Records

April 6, 2009
A Hospital Is Offering Digital Records
By STEVE LOHR
http://www.nytimes.com/2009/04/06/technology/companies/06health.html?_r=1&hpw=&pagewanted=print
Online personal health records — controlled by patients themselves, not by hospitals, doctors, insurers or employers — have been available for years. Yet only a small percentage of Americans have digital personal health records today, analysts estimate.

A major obstacle to adoption has been getting useful medical and patient information into personal health records. Typing one’s personal health information into an online form is time-consuming, mind-numbing and error-prone.

To overcome that challenge, Microsoft and Google have announced partnerships in recent months with large health care providers like Cleveland Clinic, Mayo Clinic and Kaiser Permanente to explore transferring patient data automatically into personal health records.

NewYork-Presbyterian Hospital, whose centers and clinics provide about 20 percent of the health care in New York, is the first large institution to move beyond the pilot stage this week as it begins to offer consumer-controlled health records for patients, and its experience will be closely watched in the industry.

NewYork-Presbyterian has been working with Microsoft for more than a year, not only on technical matters but also ease-of-use concerns with patients. The introduction will be gradual, beginning with heart patients, who will be told of the potential benefits of personal health records when they visit a NewYork-Presbyterian hospital or outpatient clinics.

Initially, patients will be given on-site help signing on and setting up passwords, and access to the Web portal for personal health records, myNYP.org, will be controlled.

But the goal is to scale up the introduction over months. “We view this as widely applicable to all our patient population,” said Dr. Steven J. Corwin, chief operating officer of NewYork-Presbyterian.

NewYork-Presbyterian has had its own computerized records for patients for years, and Dr. Corwin says the use of electronic medical records to track care inside the hospital system has saved money and improved outcomes, for instance, reducing medication errors considerably.

Seeking similar gains across the health care system, the Obama administration plans to spend $19 billion over the next few years to accelerate the adoption of electronic health records in doctors’ offices and hospitals.

The government’s plan has no incentives for consumer-controlled health records. But Dr. Corwin says the personal health record is a “powerful additional tool for improving health care” and one that offers added benefits because “the data is controlled by the patient, not tethered to an institution.”

One significant benefit is the mobility of information and ease of access to an online personal health record, said Dr. Mehmet Oz, a heart surgeon at NewYork-Presbyterian.

Many of his patients are referrals from outside the NewYork-Presbyterian system. When they arrive, Dr. Oz said, they typically come in with incomplete paper records and patchy recollections of past care. When they leave the hospital, he added, they get paper records of their care and a check-list of reminders.

“The paper-based system is sort of ‘Here, and good luck,’ ” Dr. Oz said. “It’s cumbersome and dangerous.”

Nationally, 20 percent of heart-surgery patients are readmitted to the hospital within 30 days, often for preventable conditions like fluid buildup in the lungs, which can be easily monitored and prevented. The online personal health record makes efficient communication and continuity of care far easier, Dr. Oz said. It can be accessed by the patient and, with permission, relatives and a patient’s personal physician,

Personal health records, experts say, hold considerable promise, but much depends on how complete the information is in them. “Something like what NewYork-Presbyterian is doing is a great step, but it’s only part of the answer,” said Dr. David J. Brailer, former national health information technology coordinator in the Bush administration.

If a patient gets all or nearly all his or her care in one health system, then the personal health record will be rich in information, and very useful, Dr. Brailer said. But if some doctors or clinics put information in and others do not, it will be less useful. The ideal, he said, is for most patient information to be in digital form and, with safeguards for privacy, be collaboratively shared by health providers and patients.

Still, Patrice Daly Cohen, 50, who had heart-valve replacement surgery in February at NewYork-Presbyterian, is impressed by the benefits of the personal health record, which she has used in the pilot project. When she needed the report of her operation for her physician, she went online and printed it out.

When she was home recovering in West Caldwell, N.J., Ms. Cohen read over the daily reports from her hospital stay, which had been automatically dropped into her personal health record.

“It was almost too much information,” she said. “But I am someone who likes to be in control. I think it’s great.”

Defining ‘Health Care Reform’

Economix - New York Times Blog
March 27, 2009, 7:01 am
Defining ‘Health Care Reform’
By Uwe E. Reinhardt
Defining ‘Health Care Reform’
Uwe E. Reinhardt is an economics professor at Princeton.

In his news conference Tuesday night, President Obama stated that he was willing to be flexible on negotiating with Congress on the budget for the 2010 fiscal year, but that he would stand firmly by his commitment to “health care reform.” It sets off the question of what he and others mean by that term.

Here is a brief explanation of what he’s probably referring to.

As a horizontal economist lying in a hospital bed, I, like most patients, tend to think of health care as a caring human activity in which I repose my trust.

As a vertical economist, however, I naturally think of health care as just another economic sector with the following distinct facets:

1. a demand side (by which I mean patients or their agents, private and public health insurers, who procure health care and pay for that care)

2. a supply side (the providers of health care and of health care products)

3. a health-insurance system, intended to protect individuals and households from excessive financial loss due to medical bills, and also to help patients procure health care at negotiated prices

4. an information infrastructure supporting and linking patients, insurers and providers of care with one another, and

5. a regulatory infrastructure intended to keep transactions in this market honorable, fair to both sides, and oriented toward the ultimate social goals of a health system.

Ambitious as he is, the president would like to reform all of these facets of the health sector.

First, on the demand side, he would like to move the United States closer to the almost-century-old goal of attaining universal health-insurance coverage. The idea is to endow with adequate purchasing power the rapidly growing number of low-income Americans who cannot afford to pay for health care of a satisfactory quality. I shall explain in a next post what all that entails, especially how much it might cost in added public spending.

Next, also on the demand side, the president would like to reform the manner by which we pay the providers of health care. The general idea is to align payments with actual “performance” through what is now known as “pay-for-performance” or simply P4P. Ideally such a system would be based on so-called “bundled payments” for an entire medical case treated in accordance with evidence-based clinical practice guidelines.

Although an old idea, it has eluded implementation so far, because it is horrendously difficult to achieve in practice. For a taste of how difficult it is, the reader may wish to view this and this.

The ultimate objective of this demand-side policy, however, is to goad the supply side through financial incentives into delivering genuinely clinically integrated health care, in place of the traditionally fragmented care they now deliver. It would require a major realignment of professional and economic power on the supply side.

Third, on the health insurance facet, the president would like to develop a well-functioning market for individually purchased health insurance, as an alternative to the employment-based system which covers most insured non-elderly Americans.

There now is such a market, but it covers only a small fraction of non-elderly Americans, primarily because it is highly fragmented and, moreover, in most states pegs the individual’s insurance premiums to that individual’s health status. To reform this market, the president would establish a National Insurance Exchange.

This can be thought of as the analogue to a farmers’ market on which competing insurers offer their products, subject to a set of regulations that make transactions in the market transparent and honorable, and the competition among insurers fair.

A major contentious issue here is whether the insurers competing in this market should include a newly established public insurance plan like Medicare, but for the non-elderly.

Fourth, on the information facet supporting both sides of the market, the president and Congress jointly already have earmarked close to $50 billion for the development of an electronic health-information infrastructure.

That infrastructure would contain an electronic medical record, through which clinicians anywhere in the health system can have access to an individual patient’s medical record, intended to safeguards of the patient’s right to privacy.

Over the longer run, there would also be a so-called personal electronic health record that links individual patients electronically to their medical record and to their primary care physicians.

Such an information infrastructure would make available, to patients and other users, information on the quality of health care rendered by individual providers of health care — e.g., hospitals and physicians. This access would facilitate better cost- and quality-control emanating from the demand side of the system.

It would also disseminate information from what should be called “cost-effectiveness analysis,” but, as was discussed in earlier posts, has been constrained to be mere “comparative effectiveness analysis” (see this and this for more on this subject).

Finally, to make all of these pieces work harmoniously together — toward the social goals of improving the health status of Americans by providing all of them with access to timely care, and of protecting their budgets from undue inroads of medical bills — there would have to be a whole set of additional government regulations, mainly on the health insurance industry.

This is a challenging set of tasks, some of which warrant further discussion. I plan to trigger it with some subsequent posts.