Re: Re: Proposing a paradigm shift

[Guest guest]

Lou: You are right on target, but why should you have to use such energy on all these activities. We need to go one step higher in our thinking at providing this service to physicians who want to use it to see patients. Could we somehow start a company for providing all these services cost effectively so all the physician had to do was see the patient, document visit, and leave the room. When this is possible, waves of physicains will adopt IT and move away from traditional practice. P.S. I agree with your topics. We will need to transform medicine in stages.l_spikol wrote: I would certainly agree with these articles, but I think they need to be much more concrete. Quite honestly, I love when we talk about pay-for-performance, Institute of medicine, yada yada yada..., however I believe this type of stuff makes the rank and file physicians eyes glaze over.Not only do I believe that most of the external medical system is sick, but I believe many offices are sick. Just as when you see in the office someone who is taking care of their elderly parents who have Alzheimer's disease and that someone is becoming ill herself by giving this care. It is impossible for offices that are sick to provide adequate patient care and do this new model. I believe strongly that the idea is to heal the

caregivers and the patient care will follow. (Obviously many of you believe this also as you have left dysfunctional situations). So, I suggest some of the topics below as well that could be integrated into articles/podcasts and eventually a "how-to" book:Some suggestions for articles/podcasts:How to survive in a low overhead/solo practice model-Putting your patient's to work and they will love you for it:1. How to have patients make their own appointments2. Communication with patients that does not involve the telephone3. How to set up and use patient entered information, both in the office and on the Internet.4. How to synchronize your patient entered information with your electronic health record5. How to put together all of your communication with patients into electronic format. What tools does it take and how should it be done?Help me, I'm scared-how do I bill for my services and make

sure I get paid?1. How to efficiently bill for your services when you are the only one doing it.2. How do I use electronic billing?3. How do I bill Medicare?4. How do I effectively opt out of private insurance?5. How do I opt out of Medicare and what are the consequences?Help me to put together a useful and low cost health information technology solution for my office.1. Please tell me some low-cost, effective electronic health records that I can use.2. How do I connect these low-cost records with other electronic forms of information such as billing system, laboratory systems and hospital information systems?3. How do I make my electronic health information technology system seamless from one end to the other and bring in all necessary information in digital format?4. Do I need help in setting up my computers/network/system? If I need help, who should I ask for help?Help

me do efficient workflow?1. What do you mean by continuous common efficient office workflow and where can I find out more about this?2. Why does advanced access scheduling work so well with this continuous workflow.?3. I read that the Toyota production system can actually help medical office workflow. Is anyone doing this stuff? Can anyone give me more information?regardslou spikol>> Hi folks> Here's what I'm proposing as a series of articles about our work:> > The IMP project is moving ahead and continuing to gather steam.> I'd like to propose the following:> > A) Why this Series of Articles> 1. There is a need for better care. My example was "IMP". My example > shows that many are

willing/able/needing to change.> > 2. The following series of articles will provide info from several > perspectives about IMP as an innovative, replicable and realistic > change model. Because the IMP change model is a win for clinicians, > we build each article around the perspective/experience of the > physician. But physicians are not the only winners. IMP has great > potential for patients so we will illustrate each article with info > from patients (we have lots of patient verbatims we can use). IMP > also has great potential for those who pay for care so each article > will include a commentary or example from the business community.> > 3. IMP is not an innovative model for solo clinicians only. Large > practices need to recognize how valuable IMP innovations are to all > types of practice. For this reason, each article also includes a > commentary

about the implications for workforce within various types > of practice.> > 4. Finally, we recognize that transitions from the current financial > and practice model is not going to happen over night. "There is the > old joke that when you are up to your neck in alligators it is hard > to recall how to drain the swamp." So we conclude each article with > some frequently asked questions.> > The Origins and Direction of IMPs and IMP relationship to > Consensus Statements about Health Care Change.> > IOM> CCM> Patient-centered, collaborative care> P4P> > C) Brief Summary and topics for the series> 24/7 access> Screening all patients> Measuring office practice and using the measurement to steer improvement> Getting paid for innovative modes of care delivery (e.g. Virtual > Office Visits, group visits)>

> I'd also like to suggest some position papers on office measurement > and changing the nature of how we finance health care (esp. primary > care) in the U.S.> > I have a number of the articles in draft form (close to completion), > a cadre of other docs starting some companion pieces, and business > folks from the National Business Coalition on Health ready and > willing to provide their input.> > Gordon> __________________________________________________