Dr. Alex Jadad has his finger on the pulse of the hurdles to overcome in implementing an national Electronic Health Record.

Jadad has outlined the 4 key issues (CRAP).

Confidentiality of health information comes up, but banks are showing that information can be handled confidentially online and that it's not a deterrent.
Reduction in the quality of care is another one - people say technology is dehumanizing, but they don't have a relationship with a doctor who can only spend five minutes with a patient.
Absence of evidence about technology's ability to improve care - it takes years to
do clinical trials to get that evidence, and by the time they're done, the technology's obsolete.
Protection is the last issue: how to handle the legal issues if something goes wrong.

Removing my tongue from my cheek, it is very good to see this sort of messaging coming from the office of no less than a director at the University Health Network of Toronto.

I have two thoughts to add -

• What lessons can Canada Health Infoway (CHI) from the implementation challenges, cost overruns and results of Canada's Gun Registry?
  
• We need to harness the strength of Canada's employers by appealing to their interest in improving their employees health.

More than Employee Relationship building
In the US it is very simple, Employers want to keep employees healthy because healthy employees cost less in terms of expensive medical treatment (physicians, hospitals, etc.)

In Canada - it is not so simple. A result of our socialized medicine structure, the government (our taxes), pays for this large chunk of healthcare costs. We need to dig a little deeper, but we can find health related cost centers for employers. As a society & as an economy we have to uncover the costs of employee health for employers. Providing employers with tangible ROI in health and wellness programs, builds the case for the business decision to invest.


Technorati Tags: Dr. Alex Jadad, Electronic Health Record, EHR, University Health Network, UHN, Canada Health Inforway, CHI, ROI, Healthcare, Wellness

Watch Your Back! | Spine-Health

From spine-health.com

1. Move
2. Avoid hunching
3. Choose a good chair
4. Set up a back friendly office
5. Exercise

Five ways to turn back the clock on computer-related back issues:

1. Just move. Your body can only tolerate one position for about 20 minutes at a pop, 30 minutes max. Not only will you experience discomfort, over time the soft tissues in your back (muscles, ligaments, tendons) slowly lose their elasticity, causing unnatural postures, stress in the back and then pain. So, remind yourself that a prolonged static posture is the enemy! Change positions often. Stand, stretch, take a short (or long) walk. Learn the Reverse Arch Stretch exercise that can be done right in your office chair and literally takes just a few seconds to do.
2. Avoid hunching. Often computer users will sit at the front of their office chair and hunch forward to see the computer screen. This is exactly the WRONG way to use your chair. You actually want to sit back in your chair and have your computer screen at the right height so you don’t have to bend your neck. With a regular tennis ball, you can train yourself to sit back in your chair while sitting and working at the computer. Try the tennis ball technique for 30 days and see if you can “retrain” your posture.
3. Choose a good office chair. The key with your office chair is that it has the flexibility to adjust to your body and work needs in order to support your low back and create good posture. It doesn’t have to be expensive and it doesn’t have to have “ergonomic” in the description. What you do need to look for in a good office chair are the following, which are explained more in choosing the right ergonomic office chair:
• Adjustable seat height
• Enough seat width and depth
• Lumbar adjustment
• Adjustable back rest
• Padded seat material
• Adjustable arm rests
• Swivel
4. Set up a back-friendly office. There are some tried-and-true guidelines for setting up your office chair and workstation to make them right for your unique work needs. First, you should determine the proper height of your desk, and then you can adjust your office chair according to your unique physical proportions. Check out our top 6 guidelines for customizing your office chair.
5. Use exercise as the ultimate weapon against back problems. Really important for maintaining good posture as you age is having strong back and abdominal muscles – your core body muscles - to hold your trunk up and in proper alignment. Specific ab and back strengthening exercises are needed to build and maintain these core muscles. General aerobic and muscle fitness from walking, swimming, biking, pilates, dancing – whatever kind of movement you prefer – is an absolute must to get your blood circulating after a day of sitting in front of the computer, and frankly as smart prevention against back problems for anyone. As daunting as it seems, getting in some regular back-healthy exercise is in fact doable. Check out an easy exercise program for low back pain relief.

Any other tips? Please add them in the comments below. Now get back to work!

Technorati Tags: office health tip, back pain, desk excercise

Employers ready to listen about healthcare ROI

I have followed Seth for years.

Seth's Blog: Are they ready to listen struck a chord. He described precisely the challenge MedExtra has faced in marketing our services to corporations.

• Every employer has employees with medical issues (which MedExtra can resolve)
• Every employer wishes to increase profitability (which MedExtra does by resolving employee medical issues)

BUT until recently, we had to focus our attention on the Innovators and Early Adopters. (Even though we provide value to everyone along the curve).

In 2008, though the tides shifted, or rather, the Canadian market matured and employers are now seeking out health related solutions which deliver ROI.

I guess, in Seth's terms, they are now ready to listen.

Technorati Tags: Healthcare ROI, Employee Resources, health related solutions

Corporate Healthcare Investment: where is the ROI?

The recent Sanofi-Aventis healtcare survey uncovered an interesting enigma:
while 94% of respondents feel that health programs foster goodwill , the number of employers investing in health & wellness programs has been declining since 2004.

Could it be that the corporate drive towards tangible ROI has come to bear on the somewhat ephemeral value of employee health programs which are more likely to serve employee wants & needs than deliver a fiscal or productivity return for employers?

MedExtra looked at the measures of ROI, employee satisfaction & scope of use for health related initiatives in a recent white paper.

A smart Rx for employee health

A smart Rx for employee health -- OrlandoSentinel.com

Hotel magnate Harris Rosen has figured out where to invest in employee health, and has had it right for nearly a decade!

The key to employer investment in employee health is first identifying which employee health issues can save the employer money.

In the case of Rosen's Quality Inn International hotel, managing employees chronic medical conditions has delivered hard ROI. In the US, it is cost effective to manage someone's diabetes in order to avoid the expensive hospital costs associated with untreated disease.



While making sure an employee's diabetes is well managed is always a
good thing, and fosters employee satisfaction, the ROI in Canada is far
less, since the bill for the hospital costs falls to the government -
rather than the employer.

Canadian employers can also find ROI, they just have to look in the right place!

In Canada, the chief among the issues to look at are those which rob an employer of an employees' productivity. While most employers aren't set up to track health related productivity loss, the numbers (and potential ROI) is staggering.

Approx 1 in 27 or 3.68% of the US population (and likely a similar percentage in Canada) suffer from undiagnosed obstructive sleep apnea. Employees with this condition simply cannot sleep enough at nightime to be fully productive at work.

By putting in place simple screening programs (even as simple as an online questionnaire) an employer can identify and address problems like OSA which syphon thousands of dollars of productivity per employee annually.

Technorati Tags: Healthcare ROI, Investing in Healthcare

Trisha Torrey writes about an issue we see at MedExtra on a regular basis in her blog post:

Another Patient Advocate Request « Every Patient’s Advocate

We help people like Jane everyday. Our members turn to us with every kind of medical problem. Our Care Managers work with them to find the the information, answers and resources they require to arrive at an answer, and achieve peace of mind.

People come to us not only with their unsolved medical issues, but also with everyday issues which range from simple to complex. From arranging medical tests (bloodwork or diagnostic imaging) to confirming a diagnosis and treatment plan through a Remote Second Opinion. Further, though our provider network, we are able to lower the costs of tests and care!

What we have come to appreciate in cases like Jane's is that as a result of the case going on for years, the medical record can become quite extensive. This has both positive and negative consequences.

On the up side, clues to the answer can be found in the workup and analysis that have been done over time. On the downside, the size of the record makes it like finding a needle in a haystack.

For services similar to MedExtra outside of Canada, Jane should be in touch with Health Advocate.

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Healthcare Early Adopters - Dr. Krongrad

Dr. Krongrad was involved in one of the first cases I learned about when I joined MedExtra. He is a pioneer in his field in North America. I have known for a long time that the option for many men to have Laparoscopic Radical Prostatectomy, exists. Nontheless I am astounded to learn the potential impact only in the state of Florida of this proceduce can have on the population.

From a Miami Herald Article article I learned that a significant number of the 3500 men who undergo radical prostatectomies annually, the procedure that Dr. Krongrad has brought to America could save

• 7000 hospital days


• 7000 shots of morphine


• 7000 units of blood

WOW.

It has been written in this space before that the delay from early adoption to widespread acceptance of medical practices is greatly regretable.

Dr. Brock, MedExtra's CEO is fond of saying "Everyone likes innovation, but nobody wants change". For every innovator like Dr. Krongrad, there are many people who promote the status quo.

Too bad that revolutionary advancement in medicine don't gain popularity as quickly as Youtube!

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