November 2, 2009

 
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National Health System Reform Moves Forward as Senate/House Leadership Announce Outline of Merged Bills

The focus on federal health care reform was on both the House and Senate last week, as the House leadership unveiled its bill representing a consolidation of drafts developed by three House Committees.  The merged bill will serve as the vehicle for a debate on the House floor this week.  The Senate leadership also finished its efforts to blend its two committee reports into a single bill.  Because the bill includes a so-called "public option", Senator Olympia Snowe announced that she would not vote for the bill on the Senate floor, at least not in its current form.

The health system reform debate in Washington, D.C. is moving closer to floor action in the Senate and House, as Democratic leaders last week announced the outline of the merger of two bills in the Senate and three bills in the House.  On October 26, 2009, Senate Majority Leader Harry Reid (D-NV) stated that the bill based upon reports from the Finance Committee and the Health, Education, Labor & Pensions (HELP) Committee would include a government option with the ability for states to opt out or to establish insurance cooperatives to compete with private carriers.  Republicans, including Maine's senior Senator Olympia J. Snowe, expressed disappointment with this decision, as did a number of moderate Democrats.  Last Thursday, October 29, 2009, the House Democratic leadership announced the outline of the merger of three House bills into a package that would cost $894 billion over ten years.  On the other hand, because of new tax revenue and Medicare savings, the bill is estimated to reduce the deficit by $104 billion over the next decade.  

It is expected that the House bill could cover 96% of all non-elderly residents and legal residents through expansion of the Medicaid program and new health insurance exchanges that may offer both private and public plan options.  The primary new tax revenue to fund the House bill is a surcharge on the portion of income above $1 million for couples and $500,000 for individuals.  The House bill defers the Medicare physician payment (SGR) issue to a separate bill.

The primary House reform bill is H.R. 3962, the Affordable Health Care for America Act.  The House bill dealing with the Medicare physician payment issue is H.R. 3961, the Medicare Physician Payment Reform Act.  You can find the text of both bills and summary documents on the web site of the House Ways & Means Committee at:  http://waysandmeans.house.gov/MoreInfo.asp?section=52 .

You can find the latest on the AMA's health system reform advocacy activity on the web at:  http://www.ama-assn.org/ama/pub/health-system-reform/blog.shtml.

FTC Again Delays Enforcement of Controversial "Red Flag" Rule - Now to June 1, 2010

According to the AMA, late last Friday afternoon the Federal Trade Commission announced that the Red Flags rule compliance deadline is delayed until June 1, 2010.  The AMA has been urging the FTC and Congress that physicians are not "creditors" and should not be subject to the rule.  We are pleased that the FTC has granted another delay.  For more information on the FTC's decision: http://www2.ftc.gov/opa/2009/10/redflags.shtm.

 The AMA's compliance guidance for the rule may be found on the web at:  http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/regulatory-compliance-topics/red-flag-rules.shtml. [return to top]

Medical Professional Health Program to Dedicate John C. Dalco House Dec. 4, 2009

All members of the MMA family are cordially invited to join the MMA leadership and the Medical Professional Health Program on Friday, Dec. 4th, 2009 at an open house at the newly renovated John C. Dalco, M.D. House in Manchester.  The ranch-style property,  located on the MMA campus in Manchester,  will be dedicated to and named for Dr. Dalco at an 11:30am ceremony, followed by a luncheon at the Augusta Country Club.  Additional tours of the property will take place in the afternoon.

John C. Dalco, M.D. was the first medical director of the Physician Health Program, beginning in 1987 and serving in that capacity for nearly fifteen years until his retirement.  Dr. Dalco died in Feb. of 2006.  His widow Clare and his son John C. Dalco, Jr. will be present at the dedication.

There is a $50 charge for the luncheon and any interested person may RSVP to Dee deHaas at ddehaas@mainemed.com or call Dee at 622-3374 ext. 215. [return to top]

AHRQ Announces Medical Liability Reform Grant Opportunity

Because of continuing advocacy in Washington D.C. related to the topic of medical liability reform, the HHS Agency for Healthcare Research and Quality (AHRQ) recently announced two grant opportunities for Medical Liability Reform and Patient Safety.  Both grant opportunities are available at the following links: http://www.ahrq.goc/fund/rfaHS1022.htm and http://www.ahrq.gov/fund/rfaHS1021.htm.

The first grant program funds $300,000 planning grants for one-year, to create plans for development, implementation and evaluation of approaches that focus on patient safety and MLR reform. The second program provides funding for up to $3 million for three-year demonstration projects to allow States and health systems that have existing plans to develop, implement, and evaluate medical liability models that focus on patient safety and reform the medical liability system.

State medical associations can join in a coalition effort and be considered a "component" of a health system and Maine Medical Association is considering applying for a grant. The language does not limit the type of reforms that may be considered applicants will have wide discretion and flexibility in designing their patient safety and medical liability innovations that meet specified criteria (i.e., health courts, early offer programs, and administrative-type programs may all be considered). AHRQ will hold a Technical Assistance call on November 12 from 1:00 to 2:00 EST. Details for registering are in the grant announcement. The grant application period opens December 27 and will close January 27. Funding decisions will be made within four months.

An Advisory Committee has been established to advise AHRQ on the review criteria in the announcement or clarify additional issues for applicants. Dr. William Hazel, AMA Trustee and an orthopedic surgeon, has been appointed to the Subcommittee, which is meeting next week. Other physician organizations, including the American College of Surgeons, American College of Obstetricians-Gynecologists, and American Society of Anesthesiologists are represented, as well. The first meeting of this advisory committee was held on October 26. The AMA will continue to work to shape this initiative.

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Anthem Alerts Physicians to Potential Nationwide Data Breach

If you are an Anthem Blue Cross Blue Shield provider, you probably received a letter last week concerning a potential data breach.  A laptop computer stolen from a Blue Cross employee contained names, addresses, taxpayer ID numbers and NPI numbers for every physician in the country contracted with a Blues-affiliated insurance plan.

While it is not yet known whether any identity theft has resulted from the breach, the AMA is working with the insurer on methods to help mitigate the risk of identity theft.   The insurer is offering credit monitoring services to physicians whose Social Security number was exposed.  However, the credit monitoring offer was limited to one year and some physicians have objected to that time frame, believing that monitoring for a longer time period is warranted. 

Anthem Blue Cross and Blue Shield mailed letters to physicians in Maine last week describing the problem. [return to top]

Physician Panel Presents to Health System Development Advisory Council on Payment Reform

MMA President David McDermott, M.D., MPH represented MMA members Friday afternoon as part of a panel presentation on payment reform at a meeting of the Health Systems Development Advisory Council.  Also participating on the panel were Michael Roy, M.D., acting Chief of Medicine at the Maine Medical Center and  Douglas Jorgensen, D.O., immediate past President of the Maine Osteopathic Association.  This presentation followed three earlier meetings focusing on the subject of payment reform.  At the previous sessions, the presentations were largely from employers, insurers and hospital providers. The Council recognized the importance of hearing from practicing physicians and scheduled this panel presentation focusing solely on physicians.  After being introduced by MMA EVP Gordon Smith, Esq., the panelists described their thoughts on expectations relative to how the payment system might be moved away from fee-for-service reimbursement. The alternative models discussed in previous discussions and in a primer prepared for Council members included Accountable Care Organizations (ACO), Global Budgets Episodic Treatment Groups, Pay for Performance, Gain-Sharing, Capitation and the Patient-Centered Medical Home.  Not surprisingly, a lot of the focus on Friday afternoon's session wason the increasing amount of physician employment and the concommitant decrease in the number of physicians who have an ownership interest in their practice. Dr. McDermott's prepared statement can be viewed on the MMA website at www.mainemed.com.  But in summary, his comments revolved around the following themes.

  • The current trend in Maine and elsewhere toward hospital-employment.
  • The activities of MMA related to payment reform, including the presentation in June, 2008 of Eliott Fisher, M.D. at the MMA/MHA/MOA Quality Symposium.
  • The history of the Maine Medical Assessment Foundation, recently featured in a series of broadcasts on National Public Radio.
  • The positioning of the healthcare marketplace in Maine toward the ability to model some new payment systems.
  • The need to bolster primary care, while recognizing that an effective health care system cannot survive on primary care alone.
  • The need for anti-trust reform if physicians are expected to more fully integrate their practices for the purposes of reimbursement and quality improvement.
  • The need to be aware of the role of medical liability and its significant impact on physician behavior.

Dr. McDermott noted that no single payment system was likely to solve the problems associated with inappropriate utilization of care or with variations in care delivery.  These issues need to be worked on independently, regardless of payment reform.  He also asked that the Council proceed slowly in the area of payment reform, as the law of unintended consequences is likely to apply.  Any new payment system should be piloted and modeled prior to widespread adoption.

Dr. Jorgensen spoke of the need to better educate residents and young physicians in how to operate a private practice and lamented the growing shortage of role models in this area.  He also advocated for improved reimbursement for primary care physicians.  He also noted that Maine was a leader in the development of quality metrics but that patients also needed to be part of this process.

 Dr. Roy spoke of the efforts in the Maine Health system to more fully integrate and noted the six month engagement with the Dartmouth Institute to do analytical research and to look at integration through some service lines including end-of-life care and spine surgery.   At least three workgroups have been organized at the Medical Center to develop a road map toward the goal of the Center and related practices becoming an ACO.

During the public participation, Mr. Smith noted the various factors that were causing physicians to flee private practice in favor of employment.  He also noted that Maine was not an anomaly, but that many other states, particularly small rural states, were seeing the same trend.  78% of Maine's primary care physicians are now employed by hospitals or hospital systems, with over two hundred more employed in rural health centers and large group practices.  Overall, it is estimated that 45% of physicians (both primary care and specialists) in Maine are employed by hospitals.

Following the panel presentation, the HSDAC's subgroup on payment reform met to discuss further its legislative mandate to report back to the legislature in January on payment models that would move reimbursement away from fee-for-service.  A robust discussion evolved regarding what state laws or rules needed to be changed in order to pilot or model some alternative payment schemes.

Further meetings on this topic are scheduled for Nov. 16 and Dec. 11.  The meeting in December will focus on review of the draft report being prepared for the Legislature which reconvenes in early January.   [return to top]

Dirigo Board Sets Hearing Date for Re-hearing on 4th Year SOP, Discusses Health System Reform, & Receives Financial Update

The Dirigo Health Agency Board of Directors held a regular meeting on Friday, October 30, 2009.  The Board began the meeting with an executive session in which AAG William Laubenstein provided advice regarding litigation over the Year 4 savings offset payment (SOP).  During the public discussion of the litigation, the Board set December 16, 2009 for a new hearing on the SOP following a remand order from the Superior Court and the Superintendent of Insurance.

GOHPF Executive Director Trish Riley  briefed the Board on her recent trip to Washington during which she had the opportunity for discussions in depth about the health system reform debate with Senators Snowe and Collins and their staffs.  Board members followed up her report with a discussion of the national debate.  Ms. Riley also provided an update on the payment reform work of the Advisory Council on Health System Development (ACHSD).  The Council's report to the legislature on payment reform is due in January.  Finally, Ms. Riley mentioned that her office will ask the legislature for authority to delay the next State Health Plan until June because of state and federal health system reform work.

Dirigo Health Agency Executive Director Karynlee Harrington mentioned that she has received several statements of intention to bid for the next DirigoChoice contract and that bids are due on November 16, 2009.  She also related stories of DirigoChoice subscribers affected adversely by eligibility changes made by the Board earlier this fall.  Will Kilbreth next provided an overview of the Dirigo Health Agency's finances which he described as "about where he expected."  

The Board scheduled its next regular meeting for Monday, November 16, 2009 at a time TBA. [return to top]

Several Most Common H1N1 Q &A and Weekly Availability of Vaccine

Several of the most common questions MeCDC is receiving currently are:

1.  Where can I get a flu shot?  The short answer is if you’re in a high priority group and cannot find it, keep trying with your health care provider.  The vaccine supply is increasing every week. 

Right now there are few if any public clinics since there is not sufficient vaccine.  This is the case in many other states as well.  Eventually there will be enough vaccine for anyone who wants it.  In the meantime, we are distributing vaccine to those who are in the high priority groups.  Right now there is a focus on pregnant women and children.  So, the vast majority of vaccine is currently being distributed to schools, pediatric, and obstetrical health care providers.  Early on some vaccine went to hospitals for health care workers with frequent direct contact with patients and infectious material, especially to those with contact with pediatric and obstetrical patients.  This past few days we also received a very tiny amount of some adult-only vaccine formulations for the first time, so we distributed that to some specialty practices (pulmonary, cardiac, dialysis, etc) and large internal medicine/family practices. 

  1. Why are healthy school children getting vaccine and I cannot find any?  The answer is threefold.  First, all children are disproportionately affected by H1N1 and are at risk.  Second, by vaccinating school children we also provide protection for the entire community since they are the major transmitters of flu.  Third, because about 40% of the H1N1 vaccine formulation we have received to date is the nasal spray, which is only licensed for otherwise healthy non-pregnant people ages 2 – 49, we could not offer this vaccine to many high priority categories of people because they have underlying conditions.  It therefore seemed most effective to use this vaccine with our healthy school and pre-school aged children, though we are also distributing some injectable vaccine into schools and pediatric practices for their children with underlying conditions.
  1. How are you deciding which schools are getting vaccine?  The first few schools that held clinics this past week were simply those that had ordered early and were ready to vaccinate right away.  Since then, we have received a surge of orders from schools across the state and not enough vaccine to fulfill these orders.  We are distributing vaccine to those schools indicating readiness to vaccinate and we are also assuring an even distribution across the state and within counties in proportion to the population. 
  1. Who are the overall priority groups for vaccine?   They are:
    1. Pregnant women
    2. All people ages 6 months – 25 years old
    3. People with underlying conditions who are 25 – 65 years old
    4. Caregivers and household contacts of those <6 months old
    5. Health care workers

However, it should be emphasized that these priority groups number ~700,000 in Maine, so with only 99,000 doses of vaccine in the state right now, we are asking that vaccine in state and not administered yet be prioritized for pregnant women and children. 

  1. Who are the priority groups for receiving antiviral medications (Tamiflu or Relenza) if they have symptoms of H1N1 or are heavily exposed to someone with H1N1 (eg is a household contact)?  They are:
    1. Pregnant women
    2. Children < 2 years old
    3. People >64 years of age
    4. People with underlying medical conditions, including children on chronic aspirin therapy
    5. Anyone with more severe H1N1 disease such as that involving a pneumonia or a hospitalization (which children at any age are more likely to encounter)
    6. People in certain outbreak situations involving many at high risk – prisons outbreaks, for instance
  1. Why are these two priority groups not the same, for instance, seniors?  Epidemiology of pandemic H1N1 indicates that seniors are at low risk for contracting H1N1 since they seem to have some underlying immunity.  However, if they do contract H1N1, they are at risk for complications and should receive antiviral medications.
  1. What are the details on how the H1N1 vaccine is distributed? 

As of today, 99,000 doses of pandemic H1N1 vaccine have been distributed to health care providers in Maine – just the tip of the iceberg of the total doses of vaccine that Maine expects to receive this flu season. This is not where we expected to be at this point, based on what we were initially told by the manufacturers and the federal government, and it creates a difficult and frustrating situation for everyone, especially those people at greatest risk of complications from the H1N1 flu.

These initial limited supplies have been prioritized for distribution to: schools as well as pediatric and obstetrical health care providers for their patients and students, including caregivers and household contacts of infants <6 months old.  Some very initial supplies (10,000 doses) were distributed to hospitals for highest priority health care workers - those with frequent direct contact with patients and infectious materials, especially with pediatric and obstetrical patients.  However, currently children and pregnant women are where we believe almost all of the very limited supply of vaccine should be targeted.  Last week we received some small amounts of adult-only vaccine that we have distributed to some specialty and large medical practices for high-risk adults. 

As vaccine supplies arrive in larger quantities, more and more health care providers will receive vaccine for their patients.  Vaccine will then be more available to young adults up to 25 years old and people 25-64 with chronic health problems.  Eventually, flu clinics for the general public will begin.  However, they won’t be scheduled until there are large enough quantities of vaccine available to support them. Based on current projections from the US CDC, these flu clinics will not likely be feasible until December. When they have been scheduled, you can find one near you at www.maineflu.gov.  It is important to note that no public H1N1 clinics are listed at this time because there is not enough vaccine to run them.

This vaccine supply and distribution situation is complex and confusing.  We continue to receive requests for further details on how vaccine arrives in the state, the role of Maine CDC in that process, and how we receive word on upcoming vaccine availability.  Here are some details on how the system works:

There are 9 different vaccine formulations approved for various age groups and populations. Vaccine comes as thimerisol-free prefilled syringes, multi-dose vials with thimerisol, and live, attenuated virus nasal spray (Flumist). So, the doses of vaccine are not interchangeable.  They can only be used for the groups they were made and approved for.  More detailed information is available on the chart below. 

Weekly Notice to Providers on Newly available Vaccine:

Several times each week, Maine CDC receives notice about newly available vaccine they can expect to receive and in which formulations. They use several pieces of information to determine where the vaccine should be shipped, based on the following: 

1.  Each week (late Friday or early Monday) Maine CDC receives the national estimates for vaccine availability for that week.  Maine CDC then develops a detailed plan for that week’s distribution.  The Maine CDC has not distributed this plan because it changes as the week progresses, since each week some vaccine formulations do not become available as estimated and other factors change unexpectedly. 

2.  That one-week plan is based on several pieces of information.  First, the Maine CDC uses the tables of estimated amounts of each vaccine formulation available in Maine for the week that they derive from the national estimates.  Secondly, they use details provided to their vaccine registration system by health care providers who have ordered vaccine to match the type of health care provider they are and the types of patients they have ordered for with the types of vaccine formulation available.  Thirdly, they use tables of information compiled by the Maine CDC Vaccine Coordinators in each DHHS District (from which health care providers have ordered for high priority settings such as schools and day cares, how many doses these settings need, and when these settings’ clinics are scheduled for or generally how ready they are to administer the vaccine).  Fourthly, the Maine CDC uses tables of information showing where vaccine has already been shipped in Maine and the population numbers for each area, in order to assure even distribution across the state related to the population. 

(i.e.,  pregnant women and people with underlying conditions cannot take the nasal spray.  So, if the only vaccine available to is nasal spray, the Maine CDC cannot send that new quantity to obstetricians.  It can however, be administered to healthy children, and would therefore likely be sent to pediatricians and schools.)   

There are about 600 health care providers in Maine who have signed up with Maine CDC to receive H1N1 vaccine this year.  The actual number of vaccination sites is higher, because some of the larger providers, such as some hospitals, will further distribute their allocations of vaccine to their affiliated health care provider locations and schools.  Almost all obstetrical and most pediatric practices that have registered with us and ordered vaccine have received some doses, but almost none has received all that they ordered. 

Unfortunately, the vaccine supply is unpredictable during these early days of distribution, and at this time, the state does not have enough vaccine for everyone in the highest priority groups. 

Maine has a total of 1.37 million people, with 700,000 people fitting into one of the 5 high priority groups.  As of November 1st, there are 99,000 total doses of vaccine distributed into Maine.  That’s 1 dose per 7 in the high priority groups, and 1 in 14 for the population as a whole.  600 health care providers have ordered close to 800,000 doses of vaccine.  Clearly, there will be a deficit of vaccine supply to meet the demand for a while.  But, eventually there will be sufficient vaccine for all health care providers who want to administer it and for all people who want it.

Maine CDC is frustrated, as many are, about the current situation. Regrettably, neither the states nor the federal government have the ability to speed vaccine production.  What we can do is pledge to distribute the vaccine to the appropriate providers as soon as it becomes available and to keep providing the most up to date information on the situation.

Manufacturer

Dose/ Presentation

Age Group

sanofi Pasteur

0.25 mL  prefilled syringe

0.5 mL prefilled syringe

0.5 mL vial single dose vial

5.0 mL multidose vial

6-35 mos

> 36 mos

> 36 mos

> 6 mos

Novartis                       

0.5 mL prefilled syringe

5.0 mL multidose vial

> 4 yrs

> 4 yrs

CSL Biotherapies

0.5 mL prefilled syringe

5.0 mL multidose vial

> 18 yrs

> 18 yrs

MedImmune

Nasal Spray

Healthy, non-pregnant 2 – 49 yrs

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Electronic Medical Records Give Early Warning of Domestic Abuse

(Excerpt from Elizabeth Cooney from “White Coat Notes,” News from the Boston-area medical community, provided by the Maine PSR) Boston researchers reported on a novel use for electronic medical records – using data in patient records, they say they were able to identify likely victims of domestic abuse an average of two years before a diagnosis was actually made.

Ben Reis, Dr. Isaac Kohane, and Dr. Kenneth Mandl of Children’s Hospital Boston and Harvard Medical School studied six years of hospital admissions and emergency visits for patients over 18 years old.  Based on the patient’s history, including injuries and assaults, they determined whether patients met a definition of domestic abuse.  Then they looked at actual diagnoses of domestic abuse.

The risk factors linked to a future domestic abuse diagnosis differed between men and women.  For women, the red flags were trips to the hospital to treat injuries, poisoning, and alcoholism.  For men, depression and psychosis were associated with the greatest risk.

The researchers developed a visual display that could become part of a patient’s electronic health record.  The work is not ready to be implemented, they said, but the model could form the basis for an early warning system that would help busy doctors decide which patients need further screening and perhaps intervention.  The researchers reiterated that this is not a diagnosis, but a screening support system.  Their hope is to bring the wealth of information about a patient to the forefront during a doctor-patient encounter encumbered by competing demands. 

As part of the ongoing effort to keep Maine health care providers involved in violence intervention, Physicians for Social Responsibility, Maine Chapter are inviting facilities to hold grand round sessions on responding to domestic abuse.  Over the past 5 years, PSR has trained over 1,200 clinicians and administration in Maine on how to identify, respond, and raise awareness pertaining to abuse their patients may be exposed to.  The Domestic Violence Response Initiative (DVRI) has presented to clinicians during grand rounds at York Hospital, Maine General’s Waterville and Augusta campuses, CMMC and MMC, as well as lunch and learns at numerous facilities throughout the state.  As Spring sessions are now being planned, please keep the free DVRI program in mind for 2010.  To hold a DVRI training at your medical facility, please call PSR Maine at 207-772-6714 or email Janey Morse at jmorse@psr.org [return to top]

New Report Urges Public Health Readiness Plans for Climate Change Impacts

Trust for America's Health (TFAH) released a new report this week that most states, including Maine, do not yet have a published plans for a public health response to climate change. This includes planning for health challenges and emergencies expected to develop from natural disasters, pollution, and infectious diseases as temperatures and sea levels rise. 

Currently, the Maine Department of Environmental Protection is drafting climate change adaptation recommendations that will include a public health component. The Maine Medical Association, along with the Maine PSR and others are contributing to those recommendations, which will be ready for release in early 2010.

The Health Problems Heat Up: Climate Change and the Public's Health report examines U.S. planning for changing health threats posed by climate change, such as heat-related sickness, respiratory infections, natural disasters, changes to the food supply, and infectious diseases carried by insects.  A full copy of this report is available by contacting Kellie Miller, Director of Public Health Policy, Maine Medical Association at kmiller@mainemed.com or by calling 207-622-3374, ext. 229.  [return to top]

New State Epidemiologist, Stephen Sears

Dr. Stephen Sears, Mercy Hospital vice president of medical administration, has accepted the position of epidemiologist for the state of Maine.  Dr. Sears' background and training is in infectious disease epidemiology, so when this position opened, he viewed it as an opportunity for which he has trained his whole professional life.  At Mercy he led the hospital’s preparation for the H1N1 pandemic.  His expertise and leadership significantly advanced Mercy quality reporting and quality outcomes, according to hospital CEO Eileen Skinner.  In addition, his efforts (with team collaboration) took the hospital successfully through its recent Joint Commission accreditation process.  Dr. Sears is also a key member of a team of executives which is responsible for the significant physician recruitment work of the last few years.  His last official day at Mercy will be on or around January 22, 2010.  The hospital is immediately forming a search committee and putting transition plans into place.  [return to top]

Free athenahealth Webinar: Cracking the Code of Successful EHR Design

Thursday, November 19, 2009, 12:00 PM ET

With all the buzz in Washington these days around the HITECH Act and the federal stimulus dollars available to doctors, one could get the impression that electronic health record (EHR) adoption is a no-brainer. It’s not.

The truth is that traditional EHRs consistently fail to help physicians make more money, do less work, or deliver better care. Cost is one factor: traditional EHRs have high up-front fees and revenue-draining maintenance and upgrade costs.

But the greatest problem with traditional EHRs is that they are designed without an understanding of the fundamental economics of a patient encounter.

There Is a Better Way. Join us for this live Webinar to learn more about:

  • The key economic drivers of a typical clinical encounter
  • The five critical failures of traditional EHRs
  • How a well-designed EHR can reduce costs where they are highest – client document management, patient orders, and results follow-up
  • How an informed EHR approach leverages all phases of the patient encounter for increased revenue and improved staff efficiency

Please join us for this presentation, and bring your own questions — we’ve set aside plenty of time for Q&As. Learn more and register now.

http://event.on24.com/r.htm?e=175163&s=1&k=5640457568CCD4F38AB0B733B895B884&partnerref=MMA [return to top]

Quality Improvement Symposium for Physicians, November 12

Quality Improvement Symposium for Physicians: Influencing the Direction of Healthcare, sponsored by Community Physicians of Maine, Maine Medical Partners, Maine Medical Center, MaineHealth Center for Quality & Safety, Mercy, and NovaHealth, will take place November 12, 8:15am-2:30pm at the Hilton Garden Inn in Freeport.  6 CME Credits are available.

For more information, or to register, click here [pdf] [return to top]

For more information or to contact us directly, please visit www.mainemed.com l ©2003, Maine Medical Association