GetHealthHelp

n Friday, March 20, 2009, I attended the First Annual NYC Primary Care
Information Project/eClinicalWorks User Conference at the NY Academy of
Medicine. As part of a $27 million mayoral initiative to improve
quality and
efficiency of health care in NYC, the Primary Care Information Project
was established to support the adoption and use of prevention-oriented
Electronic Health Record systems. An exclusive software license for the
New York City version was given to eClinicalWorks EHR system, including
a practice management system, eRx, prevention-oriented support tools
and a patient portal. A Voice-over-Internet Protocol is included for
appointment reminders, normal lab results and changes the way patients
and physicians communicate. 

Last year, I attended the introductory meeting of PCIP/ECW, which was
held in Brooklyn’s Borough Hall. One other sponsor besides the city
addressed a hundred policy analysts about the need for more meaningful
health information.  This year’s conference filled four floors of
breakout sessions and sponsors to train over five hundred physicians
and health care administrators. The sponsors represented services and
products that were included or could be added to the eClinicalWorks
program. Vendors like Brooklyn’s Lenco Diagnostic Laboratory will
provide free online reports directly into the patient’s chart, which
can then be accessed by the patient or their other doctors.
Exit-Writer, a medical video program used in the doctors office can be
added to ECW for just $5 a month. All day, we were treated to fancy
pastries and exotic teas while being courted by Xerox, Fujitsu and
Dell. Besides the pens and hand sanitizers, I came away with two types
of flash drives, though I didn’t win any of the ten or more raffle
prizes. I wonder who won the $2000 computer or the wireless scanner.

A highlight of the day was hearing Dr. Salvator Volpe, M.D. of Staten
Island speak about managing a successful small practice. He addressed
the issue of the way health plans pay doctors according to the amount
of time spent with a patient. He used a picture to describe how doctors
are made to feel like a hamster on a treadmill. "The office visit
reimbursement rate for an in-network family practitioner in 1990 was
$45. It is about the same today. How many people would work for almost
20 years without a raise?" Dr. Volpe got a big laugh when he explained
how doctors are forced to cut the visit time to make up the loss of
income. "You go from twenty minutes with a patient, to fifteen, and on
and on until why even let them park the car." Dr. Volpe’s practice was
one of the first to use the ECW system and he shared some of the
benefits his patients get from it. "Patients want a courteous and
friendly staff, timely access to appointments, involvement in medical
decision making, access to their health information and they want to
feel connected to the office even after the visit." Dr. Volpe starts
the process off  with patients filling out update information, instead
of reading magazines in the waiting room and he can provide patients
with a visit summary that includes a list of medications. He might
suggest suppliers who provide additional free coaching for patients
with chronic conditions such as Neighborhood Diabetes Supplies, another
sponsor of the conference, who comes to patients homes to help them
learn to cope with the disease.  Dr. Volpe was joined later in the day
by Tom Frieden, Commissioner, NYC Department of Health and Mental
Hygiene. They both pointed to the current health care system’s main
problem being the shift of care and therefore also costs from primary
care physicians to specialists. 

Remember, Fight Against Cost Shifting!
Caryn Isaacs, Patient Advocate
patientadvocate@gethealthhelp.com