2005mayjun

May/June 2005

The Paperless Future In this issue A Vision for the Future •

Advancing Patient Care with EHR Systems •

AAFP’s Center for Health Information Technology

M. Obinna Nwaneri, m.d.

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CLINICS Burnsville 952.892.7190 Edina 952.928.2900 Maplewood 651.779.7978

Minneapolis Saint Paul Waconia Woodbury

612.863.8585 651.602.5200 952.442.6006 651.735.7414 An Affiliate of US Oncology

0HYSICIAN #O EDITOR 9 2ALPH #HU - $ 0HYSICIAN #O EDITOR 4HOMAS " $UNKEL - $ 0HYSICIAN #O EDITOR 0ETER * $EHNEL - $ 0HYSICIAN #O EDITOR #HARLES ' 4ERZIAN - $ -ANAGING %DITOR .ANCY + "AUER !SSISTANT %DITOR $OREEN - (INES (-3 #%/ *ACK ' $AVIS 2-3 #%/ 2OGER + *OHNSON 0RODUCTION -ANAGER 3HEILA ! (ATCHER !DVERTISING 2EPRESENTATIVE "ETSY 0IERRE #OVER $ESIGN BY 3USAN 2EED -ETRO$OCTORS )33. IS PUBLISHED BI MONTHLY BY THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES 'ODWARD 3TREET .% "ROADWAY 0LACE 7EST 3UITE -INNEAPOLIS -.

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)N YOUR EXPERIENCE WHAT HAS BEEN THE BIGGEST CHALLENGE IN IMPLEMENTING AN ELECTRONIC MEDICAL RECORD 4HE IMPLEMENTATION OF THE ELECTRONIC MEDICAL RECORD WAS NOT NEARLY SO DIFlCULT AS ONE MIGHT EXPECT 4HE PROGRAM WAS MANDATED BY THE 6ETERANS !FFAIRS #ENTRAL /FlCE AND THEREFORE THERE WAS LITTLE CHOICE /NCE A START DATE WAS ADOPTED THERE WAS LITTLE TO DO BUT TO GO FORWARD AND TAKE THE APPROPRIATE TRAINING FOR THE h#023 3YSTEMv #OMPUTERIZED 0ATIENT 2ECORD 3YSTEM !FTER UNDERSTANDING THE INTRICACIES AND PROBLEMS ASSOCIATED WITH #023 WE DECIDED TO CREATE A NUMBER OF TEMPLATES TO BE USED IN CLINIC "ECAUSE THERE WAS A LIMITED AMOUNT OF TRANSCRIPTION AVAILABILITY THE TEMPLATES BECAME EXTREMELY USEFUL FOR ROUTINE FOLLOW UP VISITS 4HEY ARE NOT AS HELPFUL FOR COMPLEX PRIMARY CONSULTS AND

THEREFORE SOME OF THE COMPLEX CONSULTS ARE DICTATED /VER TIME WE HAVE RElNED THE TEMPLATES AND ARE CONTINUING TO RElNE THEM TO MAKE THEM MORE USER FRIENDLY AND QUICKER TO USE 4HEY ARE MOST USEFUL FOR FOLLOW UP CARE OF ROUTINE PROBLEMS )T WAS ALSO NECESSARY TO REDUCE THE VOLUME OF PATIENTS COMING THROUGH THE CLINIC IN ORDER TO ACCOMMODATE THE LENGTH OF TIME REQUIRED TO ENTER NOTES ENCOUNTER FORMS AND ORDERS INTO THE ELECTRONIC MEDICAL RECORD

7HAT EFlCIENCIES OR INEFlCIENCIES DO YOU SEE WITH THE 6! S %-2 5NFORTUNATELY IT IS EASIER TO TALK ABOUT THE INEFlCIENCIES CREATED BY THE COMPUTERIZED PATIENT RECORD SYSTEM RATHER THAN THE EFlCIENCIES 4HE #023 SYSTEM AT THE 6! IS VERY PHYSICIAN INTENSIVE )T REQUIRES THAT NOTES MUST BE ENTERED INTO THE MEDICAL RECORD WITH LIMITED USE OF DICTATION -AY *UNE

AND CLERICAL SUPPORT !S IN ANY MEDICAL OFlCE THERE ARE THREE ELEMENTS THAT NEED TO BE ENTERED INTO THE MEDICAL RECORD TO MAKE IT COMPLETE 4HE lRST IS THE PROGRESS NOTE OR CLINIC NOTE 4HIS IS FOLLOWED BY THE ENCOUNTER FORM AND THEN THE ORDERS !S NOTED THE PHYSICIANS MUST ENTER ALL OF THIS DATA INTO THE #023 MEDICAL RECORD SYSTEM !S A RESULT

WE HAVE FOUND THAT PHYSICIANS WERE INITIALLY ABLE TO SEE APPROXIMATELY PERCENT FEWER PATIENTS IN A CLINIC /BVIOUSLY THIS WAS A SIGNIlCANT CHANGE IN CLINIC EFlCIENCY !S TIME HAS GONE ON AND THE #023 MEDICAL RECORD HAS BECOME A PART OF OUR LIVES THE PROCESS HAS IMPROVED BUT IT APPEARS THAT WE WILL NEVER BE ABLE TO SEE THE NUMBERS OF PATIENTS THAT WE DID PRIOR TO THE IMPLEMENTATION UNLESS THERE IS MORE CLERICAL SUPPORT GIVEN TO PHYSICIANS 4HE GOOD NEWS ABOUT AN ELECTRONIC MEDICAL RECORD IS THAT THE CHARTS ARE READABLE AND IMMEDIATELY AVAILABLE 4HERE IS ALSO NO WAITING FOR ACCESS TO A MEDICAL RECORD 4HIS IS A TIME SAVING FEATURE AS WELL AS BEING ABLE TO SEARCH THE RECORD IN A MORE ORGANIZED AND METHODICAL WAY

)S STAFF PHYSICIAN TRAINING ON %-2 A DIFlCULT PROCESS OR IS THE SYSTEM INTUITIVE 7HILE ) HAVE LITTLE EXPERIENCE WITH OTHER ELECTRONIC MEDICAL RECORDS IT IS MY UNDERSTANDING THAT THE 6! RECORD IS A VERY SATISFACTORY SYSTEM AND IS UNDERGOING CONTINUAL REVISIONS TO IMPROVE ITS PERFORMANCE 5NFOR TUNATELY ) lND THAT THE SYSTEM IS NOT PARTICULARLY INTUITIVE BUT AS WITH MOST COMPUTER PROGRAMS ONCE ONE BECOMES FAMILIAR WITH IT THE SYSTEM BECOMES VERY FUNCTIONAL )T OFFERS A COMPLETE RECORD INCLUDING ALL OF THE OPERATIVE REPORTS X RAY REPORTS AND LABORATORY REPORTS IN ONE SYSTEM ) AM HOPEFUL THAT THE DEVELOPERS OF ELECTRONIC MEDICAL RECORD SOFTWARE WILL CREATE PRODUCTS THAT ARE INTUITIVE AND HAVE ENOUGH SIMILARITIES SO THAT A PHYSICIAN WORKING AT MULTIPLE HOSPITALS WILL FEEL COMFORTABLE WITH THE VARIOUS BRANDS OF ELECTRONIC MEDICAL RECORDS $ESPITE ALL THE TRAINING THAT IS GIVEN TO LEARN THESE SYSTEMS IT SEEMS THAT ONE OF THE BEST WAYS TO LEARN IS TO SIMPLY ASK A COLLEAGUE WHEN ONE IS STUMPED AND UNABLE TO COMPLETE A TASK !LMOST ALWAYS ONE WILL lND A QUICK AND EASY WAY TO ACCOMPLISH WHAT ONE WAS lNDING IMPOSSIBLE -ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

(OW HAS THE %-2 IMPACTED TEACHING FOR RESIDENTS AND STUDENTS ) lND THAT THERE HAS BEEN LITTLE IMPACT ON THE TEACHING OF RESIDENTS 3U PERVISION HAS BEEN MADE EASIER BECAUSE THE CHART IS ALWAYS AVAILABLE AND IN AN INSTANT CAN BE REVIEWED BY THE ATTENDING PHYSICIAN /NE SIMPLY HAS TO SIGN ON TO A COMPUTER AND PULL UP A GIVEN PATIENT S MEDICAL RECORD

7HAT ROLE WILL THE 6! SYSTEM PLAY IF ANY IN THE STANDARDIZATION OF %-2S IN THE PRIVATE HOSPITALS 7ITH FORWARD THINKING THE 6! HAS LED THE WAY IN CREATING AN ELECTRONIC MEDICAL RECORD AND THEN PUT IT INTO ACTION BY MANDATING THAT IT BE USED IN ALL OF THE 6! HOSPITALS 4HEY HAVE DEMONSTRATED IN THE LARGEST HOSPITAL SYSTEM IN THE 5NITED 3TATES THAT AN ELECTRONIC MEDICAL RECORD CAN WORK EFFECTIVELY "Y SO DOING ) BELIEVE THEY HAVE ESTABLISHED THE ELECTRONIC MEDICAL RECORD AS A NATIONAL STANDARD "Y VIRTUE OF THE SIZE OF THE 6! MEDICAL SYSTEM ) BELIEVE THEY WILL BE A COLLABORATOR IN DEVELOPING STANDARDS FOR ELECTRONIC MEDICAL RECORDS 4O ME IT SEEMS LIKELY THAT AN INNOVATIVE DEVELOPER WILL COME UP WITH THE MOST INVENTIVE AND INTUITIVE WAY TO ELECTRONICALLY STORE MEDICAL RECORDS AND INFORMATION 4HE 6! WILL UNDOUBTEDLY PLAY A SIGNIlCANT ROLE DUE TO THEIR SIZE AND EXPERIENCE

7HAT DO YOU SEE AS THE GREATEST BENElT TO THE PATIENT AND THE PHYSICIAN WHEN USING AN %-2 !ND HOW DID YOU GET PHYSICIANS TO BUY IN 4HE BENElT FOR THE PHYSICIANS AND PATIENTS IS THE RAPID ACCESS TO MEDICAL INFORMATION WITH THE RECORDS BEING AVAILABLE ALMOST INSTANTLY AND IN A READABLE FORM "ECAUSE NONE OF US LIKE CHANGE IT IS DIFlCULT TO GET PHYSI CIANS TO ADOPT THE ELECTRONIC MEDICAL RECORD /NE PROBABLY NEEDS TO BE COERCED AND POSSIBLY FORCED INTO ITS USE $ESPITE THE DRAWBACKS OF SOME INEFlCIENCIES ) SUSPECT THAT MOST PHYSICIANS WHO HAVE USED AN %-2 ON A REGULAR BASIS WOULD NOT CHOOSE TO GO BACK TO A PAPER MEDICAL RECORD

7HAT ADVICE WOULD YOU GIVE PHYSICIANS WHO ARE FACING THE IMPLEMENTATION OF AN %-2 FOR THE lRST TIME 4HERE IS NO EASY OR QUICK ADVICE FOR THOSE WHO MUST ADAPT TO AN ELECTRONIC MEDICAL RECORD /NCE IT BECOMES INEVITABLE THAT YOU WILL BE USING ONE MY ADVICE IS TO LEARN THE SYSTEM WITH WHICH YOU WILL BE WORKING /NCE THE BASIC SYSTEM IS UNDERSTOOD WE HAVE FOUND IT USEFUL TO CREATE TEMPLATES FOR ROUTINE NOTES AND ORDER SETS IN THE ELECTRONIC MEDICAL RECORD WHICH WILL SAVE SIGNIlCANT TIME OVER INDIVIDUALLY ENTERING THE ITEMS WHETHER IN CLINIC OR IN THE HOSPITAL

(OW HAS THE REGIONALIZATION OF CARE IN THE 6! SYSTEM AFFECTED ACCESS AND QUALITY ) HAVE WORKED IN THE 6! SYSTEM FOR NEARLY YEARS AND THE 6! HAS CHANGED DRAMATICALLY OVER THAT PERIOD OF TIME 4HIS APPLIES TO THE NATIONAL 6! AS WELL AS THE 6! IN -INNEAPOLIS 4HE NATIONAL LEADERSHIP OF THE 6!

HAS ESTABLISHED PRIORITIES AND METHODS TO ASSURE ACCESS AS WELL AS QUALITY -ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

)T IS MY OPINION THAT THE NATIONAL 6! ADMINISTRATION IS RESPONSIBLE FOR MANY OF THESE CHANGES 4HEY HAVE DEMANDED THAT QUALITY BE REVIEWED AND SCRUTINIZED AND THAT ALL OF THE INSTITUTIONS WITHIN THE 6! LIVE UP TO THESE STANDARDS !S A RESULT THE 6! HAS BECOME A LEADER AND IN MANY AREAS IS PERFORMING BETTER THAN THE PRIVATE SECTOR 2ECENTLY THE 6! HAS DEMANDED THAT PATIENTS BE SEEN WITHIN A LIMITED PERIOD OF TIME RATHER THAN BEING PLACED ON WAITING LISTS 4HIS CREATED MANY DIFlCULTIES AND HAS NOT BEEN EASY TO ACCOMPLISH )T HAS REQUIRED HIRING TEMPORARY AND PERMANENT PHYSICIANS AND PERSONNEL !S A RESULT THE WAITING LISTS HAVE DIMINISHED TO A POINT WHERE CLINIC ACCESS IS SIMILAR TO THAT IN THE COM MUNITY !LSO IN REORGANIZING THE SYSTEM THE 6! HAS CREATED REGIONAL NETWORKS OF HOSPITALS AND CLINICS AND PLACED THE BURDEN OF CARRYING OUT THE NATIONAL OBJECTIVES ON THESE 6)3.S 6ETERANS )NTEGRATED 3ERVICE .ETWORKS 7HILE THE FRONTLINE PHYSICIAN MAY NOT BE GREATLY IMPACTED

BY THIS REGIONALIZATION IT APPEARS TO ME THAT THE 6)3.S ARE BEGINNING TO REALIZE SOME COLLABORATIVE EFlCIENCIES AND COST SAVINGS AS INTENDED

!RE THE ORTHOPEDIC INJURIES COMING TO THE -INNEAPOLIS 6!

FROM THE )RAQ CONmICT IN ANY WAY DIFFERENT THAN WHAT S BEEN SEEN IN THE PAST 4HE INJURIES FROM THE )RAQ WAR CAUSED A REAL ANXIETY WITHIN THE 6! )T IS VERY OBVIOUS THAT THE MILITARY AND THE FEDERAL GOVERNMENT WANT THESE PATIENTS TREATED WITH THE UTMOST RESPECT AND GIVEN THE VERY BEST CARE $ESPITE ALL OF THE PUBLICITY WE HAVE SEEN LIMITED NUMBERS OF PATIENTS FROM THE )RAQ WAR 4HE BODY ARMOR SEEMS TO BE PROTECTING THE INDIVIDU ALS TO A SIGNIlCANT DEGREE AND SAVING LIVES (OWEVER THEY ARRIVE WITH SERIOUS EXTREMITY INJURIES AND TRAUMATIC BRAIN INJURIES 7HEN THEY ARRIVE AT A 6! HOSPITAL THEIR ORTHOPEDIC INJURIES HAVE GENERALLY BEEN VERY WELL TREATED 4HEIR DElNITIVE CARE HAS OFTEN BEEN DONE IN 'ERMANY 4HEY ARE IN A STATE OF HEALING AND PRIMARILY NEED FOLLOW UP CARE WITH A LIMITED AMOUNT OF ACTIVE TREATMENT 4HE EXTREMITY INJURIES MAY BE SERIOUS BUT HAVE A HIGH SALVAGE RATE 0ATIENTS WITH AMPUTATIONS ARE OFTEN TREATED BY THE MILITARY AND ARE SEEN BY ORTHOPEDICS IF THEIR STUMP IS NOT HEALED )F THEY HAVE NOT BEEN lT WITH A LIMB THEY ARE SEEN IN 0HYSICAL -EDICINE AND 2EHABILITATION FOR PROSTHETIC lTTING 4RAUMATIC BRAIN INJURY 4")

HOWEVER IS ANOTHER STORY 0- 2 HAS SEEN NUMEROUS TRAUMATIC BRAIN INJURIES OF ALL DEGREES OF SEVERITY AND THESE ARE OFTEN DEVASTATING TO THESE INDIVIDUALS AND THEIR FAMILIES 4HE -INNEAPOLIS 6! IS ONE OF THE NATIONAL 6! CENTERS FOR TRAUMATIC BRAIN INJURY TREATMENT 4") PATIENTS REQUIRE INTENSIVE SERVICES AND ARE LONG TERM COMMITMENTS TO THE 6!

7HAT CHALLENGES DO YOU FACE IN HELPING 6! PATIENTS 4HE PATIENTS COMING TO THE -INNEAPOLIS 6! RECEIVE EXTREMELY COMPETENT CARE 4HERE SEEMS TO BE VERY FEW BARRIERS TO DELIVERING EXCELLENT CARE TO OUR PATIENTS 4HE ADMINISTRATION HAS A VERY HANDS OFF APPROACH TO THOSE MAKING MEDICAL DECISIONS 4HE GREATEST BARRIER HOWEVER IS THE BUDGET PROCESS USED BY THE 6! 4RYING TO lND FUNDING FOR ALL THAT IS DEMANDED IS A GREAT CHALLENGE AND CAUSES CONSTANT ANXIETY TO ALL INVOLVED

#ONTINUED ON PAGE

-AY *UNE

Colleague Interview (Continued from page 3)

in a competitive environment and pay them a market wage. Congress has passed a VA physician’s pay bill, the results of which will not be known until it actually goes into effect in 2006 but, hopefully, this will help correct some of the inequities and make the VA a more desired place to work.

What benefits do you see working within the VA system?

The benefit of working in the VA is having a challenging and interesting group of patients to treat. They come with numerous problems that one often does not see elsewhere, and each day becomes a learning experience. The ability to train residents, learn as they learn, participate in research and work with a highly skilled group of physicians makes it very worthwhile. The VA provides great autonomy in terms of patient care, and is currently striving to provide quality care in excellent facilities. There are no more problems working in a VA Medical Center than in a private practice. However, one must learn that the VA is a political and a bureaucratic system and it is important to understand how such a system operates in order to be comfortable. Your ultimate boss is the Congress and the President. The rules are the laws of the country.

What are some of the major changes you have seen in the practice of medicine/surgery/orthopedic surgery in your career?

I started practice approximately 30 years ago and at the time life seemed quite simple. There was fee-for-service medicine. Everyone was hospitalized. There were a limited number of operations, a limited number of medications and no computers. Obviously, that has all changed. One could probably pick any of these changes and write a whole book. However, what strikes me as an orthopedic surgeon are changes in payment in the health care system. We are now driven by health plans and Medicare.

All physicians are still well paid, but are working harder and looking for other ways to create income. In orthopedic surgery it seems that everything has changed. There are now total joint replacements and not only hip and knee, but also multiple other joints. Not only are we doing hip and knee replacement, but also doing them through miniaturized incisions with computer assistance. Arthroscopy was just in its infancy when I began practicing. It has now streamlined surgery of the shoulder and the knee and is extending into other joints. The “scope” is used in 1 almost every other area of our body. The materials that we use in surgery

What challenges do you see for the VA Hospital as you look ahead for the next five years?

The VA will face a number of challenges over the next five years. It appears that their patient population will actually be growing and not diminishing in the near future. The VA will find great difficulty in providing expensive technology in face of a very tight budget. Also, as the VA demands more and more quality and strives to perform better than PM Page 2:12physicians 4/8/2005 Half-Page MetroDoctors the community standard, it hasBW.qxd become difficult to recruit

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May/June 2005

May-June 2005 Final.indd 4

MetroDoctors

Phone (612) 373-0400

The Journal of the Hennepin and Ramsey Medical Societies

4/25/05 1:23:09 PM

HAVE CONTINUED TO CHANGE AND WE ARE SEEING THE USE OF BIOLOGIC IMPLANTS AS WELL AS ARTIlCIAL PARTS AND MATERIALS 7ITH EACH OF THESE CHANGES IT SEEMS THAT WE MAKE MAJOR ADVANCES BUT EACH TIME WE NEED TO CREATE A NEW SURGICAL SUBSPECIALTY TO PROVIDE THE TECHNICAL PROlCIENCY REQUIRED BY EACH OF THESE PROCEDURES #OMPUTERS AND THE DIGITAL AGE HAVE ALSO ENTERED OUR LIVES ,ITTLE DID ) KNOW THAT THE lRST !TARI COMPUTER THAT MY FAMILY OWNED WOULD SOON BECOME A POWERFUL INFORMATION TOOL AND ALSO ENTER MEDICAL PRACTICE IN THE FORM OF ELECTRONIC MEDICAL RECORDS AND DIGITAL IMAGING SYSTEMS ) WISH ) WERE SMART ENOUGH TO PREDICT WHERE ALL OF THIS IS HEADED BUT ) DO KNOW IT WILL CONTINUE TO CHANGE RAPIDLY

7HAT ADVANTAGES DO YOU EXPERIENCE AS BEING A MEMBER OF THE LOCAL MEDICAL SOCIETY (ENNEPIN -EDICAL 3OCIETY ) HAVE ALWAYS BEEN A JOINER AND A BELIEVER THAT ORGANIZATIONS SERVE A PURPOSE 4HEREFORE ) HAVE BELONGED TO THE (ENNEPIN -EDICAL 3OCIETY

!MERICAN !CADEMY OF /RTHOPAEDIC 3URGERY AND MULTIPLE OTHER ORGA NIZATIONS 7HILE COMMITMENTS TO ORGANIZATIONS HAVE WANED WITH BUSY LIFE SCHEDULES THEY ARE STILL THE WAY TO COLLECTIVELY MAKE AN IMPACT ON A BROADER SCALE ! GREAT EXAMPLE IS THE CLEAN AIR LEGISLATION THAT HAS BEEN PROMOTED BY OUR MEDICAL SOCIETIES AND OTHER MEDICAL ORGANIZA TIONS %ACH TIME ) HAVE PARTICIPATED IN AN ORGANIZATION ) HAVE FOUND SIGNIlCANT VALUE ) HAVE ALWAYS DEVELOPED NEW FRIENDSHIPS ENJOYED THE COLLEGIAL RELATIONSHIPS LEARNED NEW SKILLS AND BECOME MORE EDUCATED ) STILL lND THIS TRUE

7HAT ADVICE WOULD YOU GIVE TO A NEW PHYSI CIAN JUST COMPLETING RESIDENCY TRAINING AS THEY START THEIR CAREER IN MEDICINE SURGERY %ACH NEW PHYSICIAN LEAVING A RESIDENCY AND EN TERING PRACTICE COMES WITH THE LATEST AND GREATEST KNOWLEDGE THE NEWEST TECHNICAL INNOVATIONS AND GREAT SKILL (OWEVER THE BEST PART OF MEDICAL PRACTICE IS LEARNING TO ENJOY THE PATIENTS APPRE CIATE WHO THEY ARE UNDERSTAND WHAT THEY NEED AND THEN PROVIDE WHAT IS IN THEIR BEST INTEREST 4HE BETTER ONE KNOWS THEIR PATIENTS AND THEIR NEEDS THE EASIER AND LESS BURDENSOME PRACTICE BECOMES )N OTHER WORDS THE JOY OF MEDICINE IS THE PATIENT PHYSICIAN RELATIONSHIP

HOSPITAL COMMITTEE WORK EVENTUALLY BEING #HIEF OF 3TAFF AT TWO DIFFERENT HOSPITALS ) HAVE BEEN INVOLVED WITH RESIDENT TEACHING AND HAVE PARTICI PATED IN AND BEEN CHAIRMAN OF COMMITTEES FOR THE !MERICAN !CADEMY OF /RTHOPAEDIC 3URGERY 4HROUGH ALL OF THESE EXPERIENCES ) HAVE ALWAYS GAINED MORE THAN ) HAVE GIVEN AND ) BELIEVE THAT ) BECAME A BETTER PHYSICIAN BY DOING SO %VEN PARTICIPATION IN BUSINESS AND MANAGEMENT OF A PHYSICIAN GROUP CAN BE CHALLENGING AND A LEARNING EXPERIENCE !

HIGHLIGHT FOR ME WAS AS A BOARD MEMBER OF -IDWEST -EDICAL )NSURANCE #OMPANY AND CHAIRMAN OF THE 2ISK -ANAGEMENT #OMMITTEE .OT ONLY DID ) LEARN TO PRACTICE BETTER MEDICINE DO IT MORE SAFELY AND EFlCIENTLY

BUT ALSO HAD FUN DOING SO 4HROUGH --)# ) LEARNED A GREAT DEAL ABOUT BUSINESS THE INSURANCE INDUSTRY ORGANIZATION AND RISK MANAGEMENT ) STILL USE THE KNOWLEDGE THAT ) GAINED ON A FREQUENT BASIS AND EVEN FOLLOW THE MEDICAL MALPRACTICE INDUSTRY AT A DISTANCE ) HAD A GREAT ASSOCIATION WITH THIS EXCELLENT ORGANIZATION AND HAVE VALUED THE EXPERIENCE

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7E LL HAVE COMPUTERS ON HOURS PER DAY SO ) LL TAKE CARE OF THE PRE WORK FOR THE DAY BY LOGGING INTO MY PATIENTS FROM HOME

7

7(),% ! ")4 /& ! $2%!- STILL ) BELIEVE THAT ANYONE PRACTICING IN THE -ETRO AREA FOR THE NEXT YEARS IS LIKELY TO EXPERIENCE THE SCENARIO AS LAID OUT BELOW !T A M MY ALARM CLOCK GOES OFF AND ) GET READY TO START MY PRACTICE WEEK ) VE STARTED COVERING THE INPATIENT TEACHING SERVICE WHERE ) LL BE ROUNDING AT A M AND ) HAVE CLINIC SCHEDULED FOR THE AFTERNOON 7E LL HAVE COMPUTERS ON HOURS PER DAY SO ) CAN CLEAN UP AND MAKE SOME COFFEE AND CHECK THE DRIVE TIME TO THE CITIES ) LL TAKE CARE OF THE PRE WORK FOR THE DAY BY LOGGING INTO MY PATIENTS FROM HOME ) CAN SEE MY TEAM CENSUS CLINIC SCHEDULE AND STAFF COM MUNICATIONS FROM A SINGLE LAUNCHING POINT THAT ) CAN CONlGURE 4HE INPATIENTS CAN BE REVIEWED BY SELECTING THEIR NAME OR )$ AND THEN PAGING THROUGH THEIR CLINICAL INFORMATION %ACH PATIENT S PAGE STARTS WITH A SUMMARY OF THEIR CURRENT CONDITION RESULTS AND NOTES INCLUDING VOICE ANNOTATIONS FROM THE PARTNER SIGNING OUT TO ME %ACH PATIENT HAS AN OUTLINE OF THEIR PROGRESS IN THE HOSPITALIZATION BASED ON THEIR DIAGNOSIS OR SYMPTOMOTOLOGY AND WORKUP %XPECTED EVENTS FOR THE COMING DAYS ARE OUTLINED IN A TIMELINE 4HERE IS A SUMMARY OF AUTOMATED ACTIONS THAT HAVE OCCURRED BASED ON APPROVED DEPARTMENTAL PROTOCOL A PATIENT HAS BEEN FEVER FREE FOR HOURS SO THERE IS AN AUTOMATIC SUBSTITUTION OF THE ANTIBIOTIC FROM THE )6 TO ORAL FORM !ND THERE ARE RECOMMENDED CHANGES THAT ARE PROTOCOL DRIVEN BUT REQUIRE MY lNAL APPROVAL PRIOR TO IMPLEMENTATION A PATIENT IS ON HOSPITAL DAY THREE OF A #(& ADMISSION WOULD IT BE O K FOR CARDIAC REHABILITATION TO BEGIN TO WALK THE PATIENT LATER IN THIS DAY .EXT ) AM ABLE TO REVIEW NOTES FROM THE CLINIC NURSES DIRECTLY OR NOTES FORWARDED ON FROM PATIENTS AND ) CLEAR OUT MY INBOX BEFORE EVER LEAVING FOR THE HOSPITAL )N ADDI TION TO THE REGULAR COMMUNICATIONS ) SEE THAT A MONTHLY REPORT OF PATIENT HEALTH CARE PREVENTIVE INTERVENTIONS IS AVAILABLE /N A MONTHLY BASIS THE SYSTEMS RUN AN APPROVED ALGORITHM COMPARING EVIDENCE BASED HEALTH MAINTENANCE RECOMMENDATIONS AGAINST MY PATIENT POPULATION !FTER REVIEW ) FORWARD THE LIST TO THE OFlCE STAFF FOR PROCESSING 3OME OF THE PATIENTS WILL BE E MAILED WITH APPOINTMENT REMINDERS AND ALL WILL RECEIVE A HARD COPY LETTER TO FOLLOW IN THE COMING WEEKS ) SEE THAT A NEW PATIENT HAS BEEN ADDED TO THE SERVICE FROM THE %MERGENCY $EPART MENT WHILE ) WAS WORKING THIS MORNING 4HE PATIENT IS FROM OUT OF TOWN BUT WITH THE DEVELOPMENT OF A STANDARD DATA EXCHANGE PROCEDURE AND PATIENT IDENTIlCATION PROTOCOLS

) AM ABLE TO REVIEW MEDICAL RECORD INFORMATION FROM THE PATIENT S PRIMARY HEALTH CARE SYSTEM IN NORTHERN -INNESOTA 4HE DATA EXCHANGE SERVICES REQUIRES THAT ) ENTER MY PERSONAL IDENTIlCATION AND THE REASON THAT ) AM REQUESTING THE MEDICAL RECORD INFORMATION BUT ONCE THAT IS ENTERED ) CAN SEE A LIST OF THE PATIENT S CURRENT ACTIVE PRESCRIPTIONS A RECENT DISCHARGE SUMMARY FROM ANOTHER HOSPITAL AND THE MOST RECENT %+' "9 2!9 '%.3).'%2 *2 - $

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-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

2OUNDS AT THE HOSPITAL ARE FACILITATED BY LIGHTWEIGHT TABLET LIKE DEVICES THAT INTERACT WIRELESSLY WITH THE HOSPITAL S INFORMATION SYSTEMS .OT ONLY CAN THE DEVICE BRING INFOR MATION FORWARD BY IDENTIFYING ME BUT IT ALSO CAN USE RADIO FREQUENCY IDENTIlCATION TO hSEEv THE PATIENT THAT ) AM PHYSICALLY NEAREST AND BRING THAT INFORMATION TO THE FRONT 4HE DEVICE ALSO KNOWS THE IDENTITY OF THE RESIDENTS AND NURSES ) AM ROUNDING WITH AND OTHER PATIENTS IN THE IMMEDIATE VICINITY BUT IT WON T BRING UP THE OTHER PATIENT INFORMATION UNLESS ) DEVELOP A RELATIONSHIP WITH THEM WITHIN THE SYSTEM !FTER ROUNDS BUT BEFORE CLINIC ) GO TO LUNCH WITH THE RESIDENTS ) AM GETTING SEVERAL QUESTIONS ABOUT THE PATIENTS WE VE SEEN 4HE lRST AND THIRD YEAR RESIDENTS ARE ARGUING OVER WHETHER THE CELLULITIS IN ONE OF OUR PATIENTS HAD REGRESSED OR ADVANCED &ORTUNATELY ) HAVE THE DIGITAL PHOTO TAKEN BY MY PARTNER THE DAY BEFORE STORED ON MY CELL PHONE 0$! 7E AGREE TO GO BACK AFTER LUNCH AND COMPARE THE IMAGE WITH THE PATIENT S CURRENT CONDITION AS WELL AS IMPORT THE IMAGE INTO THE PATIENT S RECORD FOR FUTURE REFERENCE ! TEXT MESSAGE ARRIVES LETTING ME KNOW THAT THE lRST PATIENT HAS CHECKED INTO CLINIC

SO ) AM OFF AGAIN ) SEE THAT A COUPLE OF MESSAGES HAVE COME IN AS WELL AND ) AM ABLE TO RESPOND TO THEM USING MY PHONE S TEXT MESSAGING OPTIONS PRIOR TO HEADING BACK TO THE CLINIC )N CLINIC ) HAVE SIMILAR ELECTRONIC ACCESS TO THE PATIENT RECORD INFORMATION BUT IT IS TAILORED FOR THE AMBULATORY WORKmOW THAT DIFFERS FROM THE HOSPITAL 4HERE IS A COMPUTER AND PANEL DISPLAY IN EACH ROOM 4HIS ALLOWS FOR ME TO DO CHART REVIEW DOCUMENTATION

AND BEGIN PATIENT EDUCATION PRIOR TO LEAVING THE ROOM !DDITIONALLY THE DEVICES CAN SERVE TO ENTERTAIN OR EDUCATE THE PATIENTS WHILE THEY ARE AWAITING MY ARRIVAL 4HE EDUCATION MATERIALS ARE EQUALLY AVAILABLE FOR MY PATIENTS AT HOME SO THEY CAN BE INTRODUCED TO THEM IN THE OFlCE HAVE A PAPER COPY IN HAND AS THEY LEAVE BUT CAN ALWAYS GET BACK TO THEM VIA THE 7EB FROM HOME IF NECESSARY ! PATIENT CANCELS FOR P M BUT SEVERAL PATIENTS HAVE REQUESTED SAME DAY ACCESS SO THE lRST PATIENT ON THE LIST IS NOTIlED OF THE NOW OPEN SLOT AND IS SCHEDULED TO BE SEEN 4HE DAY HAS BEEN BUSY AND MY DAUGHTER HAS A BASKETBALL GAME AT P M ) M NOT QUITE DONE WITH MY FOLLOW UP MATERIALS BUT ) KNOW ) CAN LEAVE TO CATCH THE GAME BECAUSE ) CAN ALWAYS GET BACK INTO THE RECORDS FROM HOME AFTER THE KIDS ARE DOWN FOR THE NIGHT ) DON T LIKE BRINGING MY WORK HOME BUT AT LEAST NOW ) HAVE THE OPTION TO GET HOME EARLY YET lNISH MY WORK FROM THERE AT A LATER TIME )T S MIDNIGHT WHEN THE PHONE RINGS )T IS ONE OF THE %$ STAFF (E HAS ONE OF MY PATIENTS THERE BUT WANTS TO MAKE SURE ) AGREE THAT IT IS O K FOR THEM TO GO HOME AND BE SEEN THE NEXT DAY IN CLINIC RATHER THAN BE ADMITTED TO THE HOSPITAL OVERNIGHT ) WALK OVER TO THE COMPUTER TO LOOK AT THE CHEST RADIOGRAPH THE %$ PHYSICIAN HAS CONCERNS ABOUTx

) BELIEVE THAT MOST PHYSICIANS ARE AWARE OF THE BENElTS OF TECHNOLOGY BUT ARE UNWILLING TO ACCEPT THE RISK ASSOCIATED WITH INVESTING IN ELECTRONIC HEALTH RECORDS IN THEIR PRACTICE

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&EATURE #ONTINUED FROM PAGE

) AM SURE THAT EACH OF US HAS HEARD THE DREAM BEFORE 3OME MIGHT REFER TO IT AS A NIGHTMARE 7E EACH HAVE RATIONAL REASONS FOR OUR BELIEFS ) AM SURE THAT WE ARE GOING TO BE EXPERIENCING MANY OF THOSE EVENTS AS LISTED ABOVE .OT BECAUSE ) HAVE BOUGHT INTO ANY ONE VENDOR S VISIONS OF THE HEALTH CARE FUTURE BUT BECAUSE ) HAVE COMMITTED TO BEING A PART OF THE CHANGES THAT NEED TO HAPPEN TO THE PRACTICE OF MEDICINE )N &EBRUARY ) WAS ABLE TO SEE THE #ISCO VIEW OF THE HEALTH CARE VISION OF THE FUTURE AS PRESENTED BY #ISCO #%/ *OHN #HAMBERS /F COURSE THE ONLY SUCCESSFUL HEALTH CARE EVOLUTION WAS THE ONE THAT RE QUIRED EVER INCREASINGLY COMPLEX NETWORK SWITCHES AND BROADBAND MODALITIES (IS SHOWCASE CLIMAXED WITH A ROBOT MAKING ROUNDS USING VIDEOCONFERENCING SOFTWARE WHILE THE PHYSICIAN SAT BEHIND A VERY LARGE DESK OF A WELL APPOINTED OFlCE 4HIS IS THE DIRECTION MEDICAL TECHNOLOGY WILL TAKE IF

IT IS DESIGNED BY CORPORATE #%/S AND NOT PHYSICIANS ) VE BEEN PRACTICING INTERNAL MEDICINE FOR YEARS AND CAN T IMAGINE BEING ABLE TO DO NEARLY ANY ASPECT OF MY JOB WITHOUT THE ASSISTANCE OF A PIECE OF TECHNOLOGY ) M PROBABLY A LUCKY PHYSICIAN 4ECHNOL OGY AND COMPUTING HAVE BEEN A PART OF MY PRACTICE SINCE MEDICAL SCHOOL AND SO ) HAVE ALWAYS BEEN LOOKING FOR A WAY TO MAKE THEM WORK FOR ME ,ET S LOOK AT A COUPLE OF COMPLEX QUES TIONS THAT ARE NOT UNREASONABLE FOR US TO ANSWER s (OW LONG WOULD IT TAKE TO IDENTIFY EVERY PATIENT IN YOUR PRACTICE ON #E LEBREXÚ PRESCRIBED BY YOU s (OW LONG WOULD IT TAKE FOR YOU TO IDEN TIFY EVERY YEAR OLD WOMAN IN YOUR PRACTICE WHO HASN T HAD A MAMMOGRAM THIS YEAR s 7HAT IS THE CURRENT COMMUNITY SENSITIVITY OF % COLI TO TRIMETHOPRIM SULFAMETHOXAZOLE

s )S IT REALLY TIME TO START -R *ONES ON

,EVITRAä )F SO WHAT IS THE MOST EFl CIENT WORK UP FOR HIM PRIOR TO INITIATING THERAPY 'OT %(2 ) BELIEVE THAT MOST PHYSICIANS ARE AWARE OF THE BENElTS OF TECHNOLOGY BUT AT THE SAME TIME ARE UNWILLING TO ACCEPT THE RISK ASSOCIATED WITH INVESTING IN ELECTRONIC HEALTH RECORDS IN THEIR PRACTICE 4HEY EACH UNDERSTAND THE CAPITAL COSTS OF THE EQUIP MENT AND SOFTWARE THE LOST PRODUCTIVITY DURING THE IMPLEMENTATION PROCESS AND THE CHANCE THAT THE SOLUTION THEY INVEST IN WILL BE INCOMPATIBLE WITH THE OTHER SYSTEMS AND PROVIDERS ! RECENT ARTICLE IN -EDICAL %CONOMICS WWW MEMAG COM MEMAG ARTICLE ARTICLE $ETAIL JSP ID BY +EN 4ERRY

*ANUARY FOUND THAT IN A SURVEY OF PHYSICIANS ONLY PERCENT OF THOSE WITH AN %LECTRONIC (EALTH 2ECORD

%(2 WERE ABLE TO CONNECT THAT TO ANOTHER

"

"

" ! " ! " ! !

# # #

-AY *UNE

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

SYSTEM )N THAT SAME SURVEY ONE IN THREE PROVIDERS FELT THEIR %(2 SLOWED THEM DOWN WHILE ONLY PERCENT FELT THEY HAD SPED UP 5NFORTUNATELY THERE WAS NO REPORT ON ANY QUALITATIVE MEASURES /NE IN FOUR PHYSICIANS WERE USING AN %(2 THAT GATHERS MEDICAL RECORD INFORMATION AT A GRANULAR LEVEL SO THAT IT CAN LATER BE SEARCHED FOR EASIER RETRIEVAL 4HIS LEVEL OF DETAILED DATA CAPTURE IS THE lRST STEP THAT SUPPORTS THE ABILITY TO ANSWER ANY OF THE QUESTIONS THAT WERE LISTED ABOVE 4HE STRONGEST ARGUMENT ) RECEIVE AGAINST THE USE OF %(2S IS h7HY ARE YOU TRYING TO MAKE ME INTO A SECRETARY -Y TIME IS TOO VALUABLE TO BE DOING CLERICAL WORK v ) HAVE TWO MAJOR THOUGHTS ABOUT THIS RESPONSE -Y lRST THOUGHT IS THAT WHEN THIS POINT IS ARGUED TO NON CLINICIANS WE COME ACROSS AS ARROGANT AND THEREFORE IM MEDIATELY WEAKENED IN OUR POSITION -Y SECOND THOUGHT IS THAT THE ARGUMENT HAS VALIDITY AT LEAST IN THE VERY SHORT TERM 4HIS REINFORCES THE LOGIC THAT AS PROVIDERS WE ARE MUCH BETTER OFF BECOMING INVOLVED IN AUTOMATION INITIATIVES AND HELPING FRAME THE PROCESS OF CHANGE RATHER THAN BY DIG GING IN OUR HEELS AND RESISTING CHANGE AT ALL COST ,ET S LOOK AT A COUPLE OF EXAMPLES $OCUMENTATION OF A NEW PATIENT HIS TORY AND PHYSICAL EXAMINATION AT THE TIME OF A HOSPITAL ADMISSION IS A TIME CONSUMING PROCESS EVEN WHEN THE PROVIDER CAN DICTATE ALL OF THE lNDINGS 2EALISTICALLY THOUGH BY THE TIME THE PROVIDER GETS TO THE HOSPITAL TO SEE THE PATIENT CONSIDERABLE DOCUMENTATION MAY ALREADY BE COMPLETED BY EMERGENCY ROOM NURSING AND PHYSICIAN STAFF AS WELL AS mOOR NURSES AND ANY TRAINEES IF THEY ARE PRESENT !T THIS POINT DOCUMENTATION SHOULD BE NO MORE THAN AN ACKNOWLEDGE MENT OF OTHERS DOCUMENTED INFORMATION AND THEN YOUR SPECIlC ADDED CONTRIBU TIONS "UILDING ON THE WORK OF OTHERS IS REFERRED TO AS COLLABORATIVE CHARTING !T A RECENT *OINT #OMMISSION -OCK 3URVEY WE WERE INFORMED THAT THIS WAS THE PREFERRED DOCUMENTATION METHODOLOGY %ACH DAY THEREAFTER DOCUMENTATION SHOULD FOCUS ON THE INFORMATION THAT IS CHANGING AND

#ELLULAR 0HONE

3UBSCRIPTIONS

REFERENCE DOCUMENTATION THAT IS ALREADY RECORDED YET UNCHANGED ! SECOND EXAMPLE RELATES TO FEARS ASSOCIATED WITH THE WORK OF PHYSICIAN ORDER ENTRY 0/% 0HYSICIAN REVOLT AS DOCUMENTED AT #EDARS 3INAI IN ,!

AND RECENT REPORTS OF 0/% INCREASING ERRORS ARE BOTH PRIME EXAMPLES OF THE RESULTS OF INSTITUTIONAL TECHNOLOGY IMPLEMENTATION WITHOUT THE CONTRIBUTIONS OF EXPERIENCED CLINICIANS 7ORKING WITH THE HOSPITAL TO DEVELOP STANDARDIZED ORDER SETS AND CARE PLANS WILL FACILITATE ORDER WRITING IN TWO IMMEDIATE WAYS !DMISSION ORDERS NOW ARE PRIMARILY A SERIES OF CHECK BOXES OR RADIO BUTTONS REQUIRING LITTLE MORE DOCUMENTA TION THAN PROCEDURE INDICATIONS AND EX CEPTION REPORTING 3ECOND ELIMINATION OF LEGIBILITY ISSUES WILL CERTAINLY SAVE THE TIME NECESSARY FOR ALL INVOLVED IN THE PAGE AND RESPONSE DANCE THAT FOLLOWS ANY COMPLEX ADMISSION 4HE 0OWER OF THE (ANDHELD $EVICE 4HE 5 3 $EPARTMENT OF #OMMERCE .ATIONAL 4ELECOMMUNICATIONS AND )NFOR MATION !DMINISTRATION AND THE #ELLULAR 4ELECOMMUNICATIONS AND )NTERNET !S SOCIATION HAS REPORTED THAT THE NUMBER OF ACTIVE CELLULAR PHONES HAD GROWN FROM JUST OVER MILLION IN TO MIL LION IN 4HIS GROWTH SUPPORTS THE NOTION OF VALUE IN MOBILE COMMUNICATION BUT THE FORM FACTOR AND ADDED DATA STORAGE CAPA BILITIES ALLOW A CELLULAR PHONE TO BE SO MUCH MORE TO A PHYSICIAN )F YOU HAVEN T MADE THE INVESTMENT YET GO AND GET A SMART PHONE WITH EITHER THE 0ALM OR 7INDOWS #% /3 INSTALLED !S AN EXAMPLE LOOK AT THE 4REO FROM 0A M/NE 4HIS DEVICE CAN IMMEDIATELY RE PLACE YOUR CELL PHONE PAGER AND WHATEVER PERSONAL ORGANIZER YOU USE ON A DAILY BASIS

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

4HE DEVICE COMES WITH A BUILT IN CAMERA AND A MEMORY CARD SLOT AND USES A MINI KEYBOARD FOR ANY ESSENTIAL DATA ENTRY THAT YOU MAY NEED TO DO ON THE mY )F YOU WANT A MORE ERGONOMIC DATA ENTRY TOOL YOU CAN ADD ON A PORTABLE KEYBOARD AS WELL 7ITH THE ADDITION OF A COUPLE OF PIECES OF SOFT WARE YOU HAVE NEARLY ENDLESS mEXIBILITY IN WHAT YOU ARE CAPABLE OF ACHIEVING -Y TWO ESSENTIAL PIECES OF SOFTWARE ARE E0OCRATES AND $OCUMENTS TO 'O )F YOU ARE NOT FAMILIAR WITH E0OCRATES YOU CAN GET THE FULL SCOOP AT WWW EPOCRATES COM

BUT ) LL SUMMARIZE HERE 4HIS PIECE OF SOFTWARE TAKES OVER THE HIGHEST LEVEL FUNC TIONS OF THE 0HYSICIAN S $ESK 2EFERENCE WHILE ADDING THE CAPABILITIES OF MULTIPLE DRUG INTERACTIONS AND ANTIBIOTIC THERAPIES BASED ON A KNOWN ORGANISM OR PRESUMED ORGANISMS BY BODY SITE )F YOU SYNCHRONIZE YOUR DEVICE ON A DAILY BASIS YOU ARE ALWAYS GUARANTEED TO HAVE THE LATEST INFORMATION IN THE PALM OF YOUR HAND &OR GOOD MEA SURE THEY THROW IN ABOUT TABLES OF INFORMATION THAT ARE SURE TO MEET SOME OF YOUR PERSONAL PRACTICE NEEDS 4HE $OCUMENTS TO 'O APPLICATION ALLOWS YOU TO SYNCHRONIZE AND CARRY IN YOUR DEVICE DOCUMENTS THAT COME FROM A VARIETY OF -ICROSOFT APPLICATIONS PORTABLE DOCUMENT FORMATS PDF lLES AND IMAGES ) USE IT TO KEEP COPIES OF ARTICLES ) REFER TO FREQUENTLY MY HOSPITAL S BYLAWS DON T ASK AND ASSORTED SPREADSHEETS WHERE ) KEEP TRACK OF MISCELLANEOUS REFERENCE DATA "ECAUSE PART OF MY RESPONSIBILITIES ARE TO TEACH RESIDENTS AND STUDENTS ) ALSO KEEP A LARGE NUMBER OF IMAGES OF RASHES AND MICROSCOPE SLIDES THAT ) CAN QUICKLY PULL OUT TO USE TO EDUCATE OUR RESIDENTS OR PATIENTS

#ONTINUED ON PAGE

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&EATURE #ONTINUED FROM PAGE

)F YOU HAVE A COMPREHENSIVE SERVICE PLAN FROM YOUR WIRELESS PROVIDER THEN YOU CAN HAVE 7EB ACCESS FOR APPROPRIATE 7EB MATERIAL RETRIEVAL AS WELL AS HAVE THE DEVICE FUNCTION AS A TEXT MESSAGING SYSTEM BETWEEN YOU AND YOUR STAFF OR EVEN CERTAIN PATIENTS IF YOU FEEL SO INCLINED 7HILE THIS MIGHT SEEM A BIT FRIGHTENING THERE ARE SEVERAL DEMONSTRATIONS WHERE CLINICIANS ARE BEING REIMBURSED FOR USING E MAIL AND TEXT MESSAGING TO COMMUNICATE WITH PA TIENTS #ALIFORNIA (EALTHCARE &OUNDATION .EW 'UIDELINES (ELP 0HYSICIANS #HOOSE AMONG /NLINE 0ATIENT #OMMUNICATIONS /PTIONS HTTP WWW CHCF ORG PRESS VIEW CFM ITEM)$ .OVEMBER

4HE CAMERA FEATURE IS LIKELY TO KEEP YOU BANNED FROM THE LOCKER ROOM AT THE LOCAL HEALTH CLUB FACILITY BUT DOES HAVE SOME PRACTICAL BENElT 9OU CAN EASILY TAKE PICTURES OF THE CURRENT PROGRESSION OF ERY

THEMA AROUND A WOUND SITE DOCUMENT A RASH OR TAKE A QUICK PHOTO OF PAPER DOCU MENTATION THAT HAS SOME PRACTICAL VALUE IN THE COURSE OF YOUR DAY TO DAY TRAVELS 7HILE IN NO WAY DOES THIS MATCH THE DETAIL OF A DIGITAL CAMERA IT SERVES AS ONE LESS DEVICE YOU NEED TO CARRY AROUND WITH YOU PROVIDES FOR RAPID DOCUMENTATION OF A SITUATION AND IF YOU ARE LIKE ME WILL SERVE AS A FAR MORE MEANINGFUL REPRESENTATION OF WHAT IS GOING ON THAN ANY PICTURE ) MIGHT BE ABLE TO DRAW ESPECIALLY IF ) AM TRYING TO COMMUNICATE WITH ANYONE OTHER THAN MYSELF ! NEGATIVE MUST BE KEPT IN MIND RE GARDING THESE DEVICES 4HERE ARE STILL SOME HOSPITALS AND HOSPITAL UNITS THAT HAVE BANNED THE USE OF CELL PHONES IN PROXIMITY TO PATIENT MONITORING DEVICES #ELL PHONES TODAY STILL CAN GENERATE A VERY STRONG TRANS MISSION SIGNAL THAT OCCURS WHEN THE PHONE IS lRST TURNED ON OR IF THE SIGNAL BETWEEN THE PHONE AND THE TOWER IS VERY WEAK )T IS DURING THESE hHIGH ENERGYv STATES THAT

( "%% )&* ) '!,)" " % )* "% ) (+" )' " #"-"% "% $ ( % , &&$ #"%" % ( %* ( &+ ( &( "%% )&* #*! ( "#"*" ) * 1'- + #"& )- $",1 +, "& /",! (!1+" " &+ ' ,! !" ! +, $" * /!' * * * & . *" " & '%%",, ,' '%($ ,"'& ' & ++" &% &, * 1'- + #"& '%( ,",". + $ *1 . *" ,1 ' (* ," + ,,"& + & % $(* ," '. * -, '-* 0( *" & & * +'-* + ,' /'*# '* 1'- $$ -+ ,' 1

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-AY *UNE

CELL PHONES WERE IMPLICATED IN AFFECTING MEDICAL DEVICES ABILITY TO ACCURATELY RECORD PATIENT DATA 4HE MOST RECENT STUDIES HAVE DEMONSTRATED INTERFERENCE WITH CELL PHONES WHEN THEY ARE LITERALLY HELD UP AGAINST A VENTILATOR (AYES $, -AYO #LIN 0ROC

OR WITH WIRELESS 0$!S NO INTERFERENCE AT ALL 4RI -, ET AL -AYO #LIN 0ROC

4ECHNOLOGY IS ALWAYS IMPROVING FRE QUENTLY AT A lXED COST POINT SO DON T GO OUT AND REPLACE WHAT YOU CURRENTLY HAVE IF IT MEETS YOUR NEEDS /N THE OTHER HAND

IF YOU ARE OUT LOOKING FOR A NEW DEVICE

THE MULTIPURPOSE OFFERINGS AVAILABLE ARE WORTH THE INVESTMENT !SK YOUR FRIENDS AND PARTNERS PUT THE DEVICE THROUGH THE PACES IN THE STORE AND TAKE THE TIME TO DO SOME ONLINE REVIEW 6IRTUAL ,IBRARY )F YOU HAVEN T HAD THE OPPORTUNITY IT WOULD BE WORTHY READING TO REVIEW h 4HE &UTURE OF -EDICAL ,IBRARIESv ,INDBERG

$! (UMPHREY ", 4ITLE . %NGL * -ED PP ! MEDICAL LIBRARY IS LIKELY TO BECOME LITTLE MORE THAN A LOCA TION WHERE ELECTRONIC INFORMATION CAN BE GATHERED AND WHERE WE CAN ESCAPE TO FOR A BIT OF QUIET TIME WHILE TRYING TO GET SOME READING DONE 4HE IDEA OF HAVING TO GO THROUGH STACKS OF JOURNALS IS QUICKLY BE COMING A PROCESS OF THE PAST -Y MEDICAL LIBRARY IS lVE mOORS DOWN AND YARDS TO THE WEST BUT ) HAVEN T BEEN THERE IN OVER THREE YEARS 4HE LIBRARIANS ARE AVAILABLE VIA E MAIL AND WILL ACCEPT ANY REQUESTS THAT ) SEND TO THEM ELECTRONICALLY 4HEY PREFER THAT WE SEND DOWN ELECTRONIC REQUESTS AS IT SIMPLIlES THE hPAPERv TRAIL FOR THEM )F YOU HAVEN T BOOKMARKED THIS FOR YOURSELF

BE SURE TO GO TO WWW PUBMED ORG ) JUST CREATED A NEW FREE ACCOUNT AND SEARCHED FOR MY PUBLISHED ARTICLES AND COMPLETED BOTH TASKS IN LESS THAN SECONDS 4HE .ATIONAL ,IBRARY OF -EDICINE IS ATTEMPTING TO CREATE AN ENTIRELY DIGITAL RECORD OF RECORDED MEDICAL LITERATURE 4HE HISTORIC INFORMATION IS BEING SCANNED AND

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

STORED AS IMAGES AND WHERE POSSIBLE HAS THE IMAGES CONVERTED TO TEXT -ATERIALS THAT ARE AVAILABLE CURRENTLY AS DIGITAL DATA ARE LINKED AND STORED DIRECTLY 4HE LIMITATION WITH 0UBMED IS THAT THE AVAILABLE ONLINE INFORMATION IS LIMITED BY THE PUBLISHER S WILLINGNESS TO DONATE THEIR MATERIALS TO THE .,- )MPACT OF THE )NTERNET 4HE )NTERNET PROVIDES A LIMITLESS RESOURCE POOL TO THOSE INTERESTED IN GATHERING DATA ON SPECIlC DISEASES AND SYMPTOM COM PLEXES AND THERE IS NO QUESTION THAT PATIENTS ARE ACCESSING BOTH HIGH QUALITY AND HEAVILY BIASED DOCUMENTS &OR SOME THE ABILITY TO DIFFERENTIATE BETWEEN THE TWO IS NOT ACHIEV ABLE 7HERE DOES THIS LEAVE CLINICIANS 7E ARE EXPECTED TO BE EVEN MORE KNOWLEDGE ABLE THAN EVER BEFORE 7E HAVE TO HAVE A lRM GRASP ON THE CURRENT KNOWLEDGE OF OUR PROFESSION !.$ THE LATEST BUZZ AND FADS DESCRIBED ON THE 7EB AND IN OTHER POPULAR MEDIA %ACH PROVIDER NEEDS TO BE PREPARED TO RESPOND TO THE PATIENT PRESENTING WITH A SHEAF OF PAPERS ON THE LATEST TREATMENTS FOR SYMPTOM X AND DISEASE Y /UR BEST DEFENSE IS EVIDENCE FROM THE MEDICAL LITERATURE 4HE $EVELOPMENT OF "EST 0RACTICES AND %VIDENCE "ASED -EDICINE ) BELIEVE IT IS TIME FOR THE PRACTICE OF MEDI CINE TO COMPLETELY EMBRACE EVIDENCE BASED MEDICINE AND THE NATURAL PROGRESSION OF THE EVIDENCE INTO BEST PRACTICE GUIDELINES

ORDER SETS AND AUTOMATED CLINICAL DECISION SUPPORT 2ATHER THAN RESISTING THE DEVEL OPMENT OF GUIDELINES EACH PRACTITIONER SHOULD PARTICIPATE IN THE ESTABLISHMENT OF GUIDELINES THAT ARE MOST MEANINGFUL TO THEM 7HY &IRST AND FOREMOST BECAUSE IT WILL MAKE YOU A BETTER EDUCATED PROVIDER IN BOTH THE AREA YOU ARE REVIEWING AND IN UNDERSTANDING THE VALUE OF GUIDELINES PRODUCED BY OTHER REVIEW TEAMS /NCE PHYSICIANS HAVE EMBRACED THE VALUE OF PRACTICE GUIDELINES THE NEXT LOGICAL STEP IS TO AUTOMATE AS MUCH OF THOSE GUIDELINES AS IS TECHNICALLY POSSIBLE !DOPTION AND

AUTOMATION OF GUIDELINES IS MEANT TO HELP PHYSICIANS TAKE THE RIGHT ACTIONS AT THE RIGHT TIMES !NYONE WHO IS NOT FAMILIAR WITH )#3)

THE )NSTITUTE FOR #LINICAL 3YSTEMS )MPROVE MENT NEEDS TO REVIEW THEIR 7EB SITE

WWW ICSI ORG .OTE THE DEPTH OF EXPERIENCE OF THE DEVELOPER REVIEWERS THE COMPLEXITY OF THE SOLUTIONS BEING PROPOSED AND THE VOLUME OF LITERATURE NECESSARY TO ARRIVE AT A BEST PRACTICES APPROACH ) DON T BELIEVE THIS WOULD BE AN ACHIEVABLE OBJECTIVE FOR A SINGLE PRACTITIONER TO ACCOMPLISH ON THEIR OWN /NCE WE ARE PAST THE ACCEPTANCE OF GUIDELINES THEY CAN BE USED AS INVALUABLE TOOLS IN DISPENSING CARE TO OUR PATIENTS IN THE CLINICS AND IN THE HOSPITALS ) BELIEVE THAT ONE OF THE REASONS FOR THE GROWTH IN STRENGTH OF HOSPITALISTS COMES FROM THEIR MASTERY OF PRACTICE EFlCIENCY WITHIN THE HOSPITAL WALLS 4HE AVAILABILITY OF GUIDE LINES ALLOWS EACH OF US TO MAKE THE RIGHT CHOICES AT THE RIGHT TIMES 4HE PRACTICE OF MEDICINE IS GOING TO CHANGE AND TECHNOLOGY IS GOING TO BE THE FOUNDATION OF THE CHANGE 4HE FRUSTRATION FOR EACH OF US IS THAT THE TECHNOLOGY HAS NO AVENUE TO MATURE AND DEVELOP OUTSIDE OF OUR DAILY PRACTICE 3OME BAD DECISIONS ARE GOING TO BE MADE AND SOME TECHNOLOGY IS LIKELY TO SLOW US DOWN IN SOME OF OUR ACTIVITIES ) BELIEVE THAT WE CAN OVERCOME THE SHORTCOMINGS BY BECOMING ACTIVE IN THE TRANSFORMATION OF OUR PRACTICE 4HE MORE EACH OF US BECOMES INVOLVED THE MORE WE WILL UNDERSTAND THE PROCESS OF TRANSFORMATION AND THE MORE LIKELY THAT THE TRANSFORMATIONS WILL BE SUITED TO THE WAY WE DO OUR WORK $ON T BE AFRAID TO THINK ABOUT HOW WE CAN DO THE WORK BETTER AND MORE EFlCIENTLY THAN WE DO NOW 4HE WORLD IS A CHANGING PLACE ˆ BE A LEADER 2AY 'ENSINGER *R - $ &()-33 #0()-33

IS DEPUTY MEDICAL DIRECTOR (ENNEPIN #OUNTY -EDICAL #ENTER (E IS BOARD CERTIlED IN INTERNAL MEDICINE AND HAS ADVANCED TRAINING IN MEDICAL INFORMATICS

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

-AY *UNE )NDEX TO !DVERTISERS #LASSIlED !DS #OLDWELL "ANKER "URNETˆ "RUCE "IRKELAND )NSIDE "ACK #OVER #RUTCHlELD $ERMATOLOGY (ANSEN #ONSTRUCTION OF %DINA )NC

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" 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

A === 9+0=)8@=1331)49 +64 -ETRO$OCTORS

/VERVIEW OF THE !!&0 S #ENTER FOR (EALTH )NFORMATION 4ECHNOLOGY

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).&/2-!4)/. 4%#(./,/'9 HAS REVO LUTIONIZED MANY INDUSTRIES IN THE WORLD BUT ADOPTION OF THIS TECHNOLOGY IN THE HEALTH CARE SYSTEM HAS LAGGED BEHIND )N THERE WAS A COLLABORATIVE PROJECT OF THE FAMILY MEDICINE COMMUNITY LOOKING AT THE FUTURE OF FAM ILY MEDICINE !S PART OF THIS PROJECT A NEW MODEL OF CARE WAS CONSTRUCTED TO MEET THE POTENTIAL NEEDS OF PATIENTS IN THE FUTURE 4HIS MODEL NECESSITATES THE USE OF HEALTH INFORMA TION TECHNOLOGY TO IMPROVE QUALITY ENHANCE PATIENT SAFETY AND INCREASE EFlCIENCY 4HE ELECTRONIC HEALTH RECORD %(2 BECOMES THE hCENTRAL NERVOUS SYSTEMv OF THIS NEW MODEL 4HE &EDERAL 'OVERNMENT ALSO BELIEVES THE FUTURE OF THE HEALTH CARE SYSTEM NEEDS %(2 ADOPTION

AS DOES INDUSTRY 7ITH THIS CRITICAL NEED FOR ADOPTION OF %(2S AND THE MANY BARRIERS TO THEIR ADOPTION

BY FAMILY PHYSICIANS THE !MERICAN !CADEMY OF &AMILY 0HYSICIANS !!&0 ESTABLISHED A #ENTER FOR (EALTH )NFORMATION 4ECHNOLOGY #(I4 IN /CTOBER 4HE #(I4 S MISSION IS TO PROMOTE AND FACILITATE HEALTH INFORMATION TECHNOLOGY E G %(2 ADOPTION AND OPTIMAL USE BY !!&0 MEMBERS AND OTHER OFlCE BASED PHYSICIANS 4HERE ARE THREE MAIN TACTICS THE #(I4 UTILIZES TO ACHIEVE THIS MISSION PHYSI CIAN EDUCATION VENDOR COLLABORATION AND PARTICIPATION IN NATIONAL INITIATIVES

0HYSICIAN %DUCATION -AKING THE DECISION TO PURCHASE AND IMPLE MENT AN %(2 IN ONE S OFFICE IS DAUNTING )MPLEMENTING AN %(2 TAKES SIGNIFICANT RESOURCES Â&#x2C6; BOTH IN TIME AND MONEY Â&#x2C6; TO MAKE THE IMPLEMENTATION SUCCESSFUL 0LUS

THERE IS SPARSE DATA ABOUT %(2S AND VENDORS

INCLUDING PRICING USABILITY lNANCIAL STABILITY

"9 34%6%. % 7!,$%.

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ETC TO MAKE AN INFORMED DECISION $UE TO THESE CIRCUMSTANCES THE #(I4 HAS DEVELOPED RESOURCES TO HELP PHYSICIANS NAVIGATE THIS COMPLEX DECISION AND TO PROVIDE ADDITIONAL INFORMATION ABOUT PRODUCTS AND VENDORS THAT IS DIFlCULT TO OBTAIN ELSEWHERE 4HESE RESOURCES ARE AVAILABLE ON THE #(I4 S 7EB SITE HTTP WWW CENTERFORHIT ORG 4HE SITE OUTLINES THE %(2 ADOPTION LIFE CYCLE Â&#x2C6; PREPARING THE PRACTICE SELECTING AN %(2 IMPLEMENTATION

AND MAINTENANCE Â&#x2C6; AND PROVIDES RESOURCES FOR ALL STAGES OF THE CYCLE 4WO OF THE GREATEST RESOURCES ON THE 7EB SITE ARE THE 0HYSICIAN 0RODUCT 2EVIEWER AND THE !!&0 %-2 E MAIL DISCUSSION LIST 4HE 0HYSICIAN 0RODUCT 2EVIEWER ALLOWS FAMILY PHYSICIANS TO GIVE REVIEWS OF %(2S THAT THEY USE IN THEIR PRACTICE 4HIS PROVIDES hIN THE TRENCHESv EX PERIENCE WITH A PARTICULAR %(2 4HEY RATE THE %(2 ON USABILITY SUPPORT PRODUCTIVITY AND PRICE AS WELL AS THE PROS AND CONS OF THE %(2 AND THEIR IMPLEMENTATION 4HE E MAIL DISCUSSION LIST CONTAINS ALMOST FAMILY PHYSICIANS THAT HAVE ADOPTED AN %(2 OR ARE IN THE DECISION MAKING PROCESS 4HE REAL VALUE OF THIS LIST IS BRINGING PEERS TOGETHER TO DISCUSS THE ISSUES AND TO EXCHANGE SUCCESSES AND FAIL URES 4HIS PEER LEARNING CAN DECREASE THE RISK OF IMPLEMENTATION FAILURE 6ENDOR #OLLABORATION 4HE lRST INITIATIVE OF THE #(I4 WAS THE 0ARTNERS FOR 0ATIENTS )NITIATIVE 4HIS INITIATIVE BROUGHT TOGETHER THE !!&0 AND HEALTH INFORMATION TECHNOLOGY VENDORS AROUND FOUR PRINCIPLES !FFORDABILITY #OMPATIBILITY )NTEROPERABILITY

AND $ATA 3TEWARDSHIP 4HESE PRINCIPLES PRO VIDE THE FRAMEWORK FOR THE COLLABORATION 4HE lRST COLLABORATION WAS THE SIGNING OF 0RINCIPLED 'ROUP 0URCHASING !GREEMENTS WITH VENDORS

WHICH PROVIDED DISCOUNTED PRICING FOR !!&0

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

MEMBERS 4HE NEXT COLLABORATION WAS THE FOR MATION OF THE %(2 0ILOT 0ROJECT WITH THE GOALS TO BETTER UNDERSTAND THE BARRIERS AND KEYS TO SUCCESS OF %(2 ADOPTION IN SMALL PRACTICES AND TO TEST THE APPLICATION SERVICE PROVIDER !30 HOSTING MODEL FOR SMALL PRACTICES 4HIS PILOT GAVE MANY KEY lNDINGS ONE OF WHICH IS THAT THE !30 MODEL DOES WORK FOR SMALL PRACTICES ! BRIEF REPORT OF THE lNDINGS IS AVAILABLE ON THE #(I4 7EB SITE /NE OF THE LATEST COLLABORA TIONS WAS THE 0ARTNERS FOR 0ATIENTS %(2 -ARKET 3URVEY WHICH GATHERED PRICING AND USER BASE INFORMATION FROM %(2 VENDORS 4HE DATA WILL ALLOW FAMILY PHYSICIANS TO MAKE A MORE INFORMED PURCHASING DECISION /UTSIDE OF THIS SURVEY AND EXPENSIVE CONSULTANT REPORTS THIS DATA IS VERY HARD FOR PHYSICIANS TO OBTAIN 4HIS TYPE OF TRANSPARENCY IN THE MARKET IS NEEDED FOR IT TO CONTINUE TO GROW 0ARTICIPATION IN .ATIONAL )NITIATIVES AND 3TANDARDS 4HERE ARE NUMEROUS NATIONAL INITIATIVES DRIVING %(2 ADOPTION COMING FROM MULTIPLE STAKE HOLDERS GOVERNMENT INDUSTRY HEALTH PLANS

VENDORS ACADEMIA AND PHYSICIANS 0HYSICIAN INPUT INTO THESE INITIATIVES RANGE FROM NONE TO INPUT AT EVERY DECISION 4HE #(I4 S GOAL IS TO PROVIDE A PHYSICIAN VOICE INTO THESE INITIATIVES

ESPECIALLY THE VOICE OF PHYSICIANS IN SMALL AND MEDIUM SIZED PRACTICES /NE OF THE MOST EXCITING NATIONAL INITIATIVES IS THE 0HYSICIANS %(2 #OALITION 0%(2# OF WHICH THE !!&0 WAS ONE OF THE FOUNDING MEMBERS 4HE 0%(2# IS A COALITION OF PHYSICIAN ASSOCIATIONS AROUND THE ISSUE OF HEALTH INFORMATION TECHNOLOGY #UR RENTLY THERE ARE MEDICAL ASSOCIATIONS THAT ARE PART OF THE COALITION REPRESENTING MORE THAN #ONTINUED ON PAGE

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!!&0 S #ENTER FOR (EALTH )NFORMATION 4ECHNOLOGY #ONTINUED FROM PAGE

PHYSICIANS 4HE 0%(2# MISSION IS SIMILAR TO THAT OF THE #(I4 TO EDUCATE PHYSI CIANS ON HEALTH INFORMATION TECHNOLOGY AND TO SPEAK WITH A UNIlED PHYSICIAN VOICE ON HEALTH INFORMATION TECHNOLOGY )NTEROPERABILITY IS A KEY TO WIDE SCALE ADOPTION OF %(2S AND THE E (EALTH )NITIATIVE E() IS WORKING TOWARD THAT END 4HE #(I4 S $IRECTOR $AVID +IBBE - $ IS A CO CHAIR OF THE E() 7ORKING 'ROUP FOR (EALTH )NFOR MATION 4ECHNOLOGY FOR 3MALL AND -EDIUM 0RACTICES /NE AGENDA ITEM FOR THIS GROUP IS LABORATORY %(2 CONNECTIVITY 7ORK IS UNDER WAY ON A REFERENCE IMPLEMENTATION THAT WOULD HELP STANDARDIZE THIS TYPE OF INTEROPERABILITY

WHICH IS OF GREAT IMPORTANCE FOR PHYSICIAN PRACTICES !NOTHER FACET OF INTEROPERABILITY WORK IS THE !!&0 SPONSORSHIP OF THE !34- #ONTINUITY OF #ARE 2ECORD ##2 3TANDARD 4HIS STANDARD WHICH IS CURRENTLY UNDER BALLOT

REPRESENTS A NEEDED INTEROPERABILITY OF PATIENT HEALTH SUMMARY DATA 4HIS CORE DATA SET IS SOME

OF THE MOST CLINICALLY RELEVANT PATIENT DATA IN CLUDING MEDICATIONS ALLERGIES PROCEDURES AND ADVANCED DIRECTIVES 3AID ANOTHER WAY IF AN UNCONSCIOUS PATIENT ARRIVES AT AN EMERGENCY ROOM THIS IS THE DATA THE PHYSICIAN WOULD WANT 0RACTICING PHYSICIANS INPUT INTO HEALTH INFORMATION TECHNOLOGY STANDARDS IS NEEDED MORE NOW THAN EVER IN THE PAST 4HIS IS ESPE CIALLY TRUE AS CLINICAL CONTENT AND KNOWLEDGE IS STANDARDIZED 4HE #(I4 PLANS TO BECOME EVEN MORE INVOLVED IN HEALTH INFORMATION STANDARDS IN THE NEAR FUTURE 4HE &UTURE (EALTH INFORMATION TECHNOLOGY IS THE FUTURE OF MEDICINE AND IT IS THE #(I4 S RESPONSIBILITY TO GIVE FAMILY PHYSICIANS THE TOOLS AND RESOURCES TO ACHIEVE THAT FUTURE AND TO HELP MOLD IT 4HE #(I4 WILL CONTINUE TO COLLABORATE WITH OTHER PHYSICIAN ASSOCIATIONS VENDORS GOVERNMENT

HEALTH PLANS AND PATIENTS TO DRIVE %(2 ADOP TION TO IMPROVE QUALITY PATIENT SAFETY PRACTICE EFlCIENCY AND PATIENT CONVENIENCE

3TEVEN % 7ALDEN - $ IS ASSISTANT DIRECTOR FOR THE #ENTER FOR (EALTH )NFORMATION 4ECHNOLOGY

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-AY *UNE

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

+UBLER 2OSS AND #OMPUTERS

)

h) (!6% 0!33%$ 4(2/5'( THE DENIAL AND

ANGER PHASE AND AM NOW IN THE ACCEPTANCE PHASE v 3O SAID A GOOD NATURED OBSTETRICIAN WHO RECENTLY WENT LIVE ON THE COMPUTER SYSTEM AT ONE OF &AIRVIEW S OUT STATE CLINICS 3HE PERHAPS DIDN T REALIZE IT BUT MADE A BRIEF STOP IN THE BARGAINING PHASE AS WELL INITIALLY SAYING SHE WOULD USE THE SYSTEM BUT WOULDN T PLACE ORDERS HERSELF .OW LESS THAN TWO WEEKS AFTER BEING DEPRESSED AT THE PROSPECT OF USING COMPUTERS IN EXAM ROOMS SHE HAS BEEN TALKING UP THE SYSTEM TO THE %.4 SPECIALISTS OFFERING TO HELP THEM BUILD DOCUMENTATION TEMPLATES h"ECAUSE

THIS IS WAY COOL AND NOT NEARLY AS HARD AS ) THOUGHT v )T SEEMS THAT PHYSICIANS HAVE lNALLY REAL IZED THAT COMPUTERS ARE COMING TO MEDICINE !FTER YEARS OF ASSUMING IT WOULD NEVER HAPPEN

THEY ARE SEEING THE BENElTS AND STARTING TO FEAR BEING LEFT BEHIND IF THEY DON T JOIN THE BANDWAGON !S PHYSICIAN CHAMPION FOR THE COMPUTERIZED HEALTH RECORD AT &AIRVIEW &6 ) AM OFTEN ASKED HOW WE MADE THE DECISION AND WHAT VENDOR WOULD ) RECOMMEND FOR THEM (OW DID &AIRVIEW $ECIDE TO -OVE TO AN %-2 )N THE S A SERIES OF ARTICLES STARTED TO AP PEAR REGARDING QUALITY AND ERRORS IN MEDICINE

WHICH CULMINATED IN THE LANDMARK )/- PUB LICATION #ROSSING THE 1UALITY #HASM IN 4HESE MADE A CASE FOR THE ADVANTAGES OF #OM PUTERIZED 0HYSICIAN /RDER %NTRY 4HE INmUENCE OF THESE STUDIES TOGETHER WITH A DESIRED ABILITY TO STUDY REPORT ON AND IMPROVE PROCESSES LED TO A DECISION TO TRY OUT AN %-2

"9 "!229 "%23(/7 - $

)N A COMMITTEE AT &AIRVIEW 0HYSI CIAN !SSOCIATES MET RESEARCHED AND SENT OUT 2&0S TO VARIOUS VENDORS !FTER SORTING THROUGH THE RETURNS THEY PICKED %PIC "ECAUSE THE SYS TEM WAS QUITE PRICEY AND %PIC WASN T AS WELL ESTABLISHED NATIONALLY LOW NUMBER OF INSTALLA TIONS THE COMMITTEE WAS ASKED TO RECONSIDER !FTER FURTHER REVIEW THEY PICKED %PIC AGAIN !

CONTRACT WAS SIGNED IN FOR A PILOT PROJECT

WHICH WAS DONE AT "URNSVILLE &AMILY 0HYSI CIANS "&0 WITH A GO LIVE IN EARLY !FTER ESTABLISHING THE SUCCESS AT THE PILOT SITE CLINI CAL QUALITY IMPROVEMENT STAFF PHYSICIAN AND PATIENT SATISFACTION AS WELL AS THE ECONOMIC ARGUMENT FOR IT &4%S SAVED AT THE END OF ONE YEAR AND THE ELIMINATION OF THE LEGACY BILLING SOFTWARE WHICH BALANCED OUT THE COST OF THE PRODUCT THE &6 "OARD MADE THE FORWARD LOOKING DECISION TO START ROLLING THIS OUT TO CLINICS STAFFED WITH &6 EMPLOYED PHYSICIANS &OR VARIOUS REASONS THE SYSTEM WAS NOT ROLLED OUT TO AFlLIATED CLINICS AT THAT TIME AND WHEN IT WAS OFFERED A FEW YEARS LATER THERE WAS STILL HESITANCY TO SIGN UP DUE TO COST CONCERNS AND LACK OF UNDERSTANDING OF THE BENElTS 3OME OF THOSE CLINICS ARE NOW APPROACHING &6 AGAIN

ASKING TO TAG ONTO THE SYSTEM 7HY $ID 9OU #HOOSE %0)# AS 9OUR 3YSTEM 4HERE IS A NATIONALLY RECOGNIZED RATING AGENCY

+,!3 IN 5TAH WWW HEALTHCOMPUTING COM %VERY YEAR +,!3 RATES MEDICAL SOFTWARE VEN DORS BASED ON EXTENSIVE INTERVIEWS WITH END USERS PHYSICIANS NURSES LAB SCHEDULERS

ETC SUPPORT STAFF )3 AND #)/S AROUND THE COUNTRY 4HEY COMPILE THE RESULTS AND MAKE AVAILABLE THESE h#ONSUMER 2EPORTSv TYPE RE VIEWS AND COMPARISONS OF VENDORS IN THE 5 3 %PIC HAS NOW COME IN lRST ON STRAIGHT REPORTS AND BY GENERAL CONSENSUS IS THE PRE

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

MIER QUALITY %-2 SYSTEM IN THE 5 3 )T HAS THE WIDEST RANGE OF CONlGURABILITY FUNCTIONALITY

AND IS TOP RATED IN SUCH IMPORTANT CATEGORIES AS h7OULD "UY IT !GAINv AND h#LIENT S "EST #ONSULTANT %XPERIENCE v %PIC DOES HAVE A FEW DOWNSIDES )T IS MORE EXPENSIVE THAN PLATINUM AND BY STRATE GIC DECISION OF %PIC IS ONLY AVAILABLE TO LARGE SYSTEMS 4HUS SMALL INDEPENDENT GROUPS CAN NOT IMPLEMENT %PIC UNLESS THEY CAN TAG ONTO A LARGE SYSTEM 4HIS IS HOW "URNSVILLE &AMILY 0HYSICIANS IS CONTINUING TO USE THE APPLICATION AS PART OF &6 &0!

7HAT HAS THE !CCEPTANCE "EEN BY THE -EDICAL 3TAFF !CCEPTANCE IS A FUNNY WORD 7E lND THAT EASE OF USE AND THEREFORE ACCEPTANCE IS VIRTUALLY ALWAYS DUE TO ATTITUDE )NTUITIVELY ONE WOULD THINK THAT AGE IS THE MOST IMPORTANT FACTOR IN COMPUTER COMFORT )N FACT ONE PHYSICIAN LAST YEAR WAS THREE MONTHS AWAY FROM RETIREMENT WHEN HIS CLINIC WENT LIVE (E WAS OFFERED THE OPTION OF STAYING ON PAPER UNTIL RETIREMENT BUT SAID h)F THOSE YOUNG WHIPPERSNAPPERS CAN LEARN THIS SO CAN ) v OR SLIGHTLY SALTIER WORDS TO THAT EFFECT !T &AIRVIEW WE HAVE PHYSICIANS RUNNING THE GAMUT FROM h,OVE IT CAN T EVER IMAGINE GOING BACK TO PAPER v TO h v )N SOME OF THESE CLINICS PHYSICIANS ARE STILL NOT USING ITS FULL CAPABILITIES AND OCCASIONALLY TRY TO SABOTAGE GO LIVES TO PROVE IT WILL NOT WORK 3URVEYS DONE DURING THE PILOT AT "&0 SHOWED THAT PHYSICIAN SATISFACTION WITH THE SYSTEM STARTED HIGH DIPPED DURING THE INEVITABLE LEARNING FATIGUE AT THE TWO THREE MONTH PERIOD THEN ROSE TO HIGHER LEVELS THAN RECORDED INITIALLY BY SIX MONTHS -Y FORMER

#ONTINUED ON PAGE

-AY *UNE

+UBLER 2OSS AND #OMPUTERS #ONTINUED FROM PAGE

PARTNER *OHN 2HOADES WAS QUOTED AS SAYING

h) LL GIVE UP MY COMPUTER WHEN THEY RIP THE MOUSE FROM MY COLD DEAD HAND v (E SEES A PACKED SCHEDULE EVERY DAY AND WALKS OUT THE DOOR WITH HIS DOCUMENTATION DONE CHARTS CODED AND CLOSED TEN MINUTES AFTER HIS LAST PATIENT LEAVES THE CLINIC .O ONE THOUGH WANTS TO GIVE IT UP !T "&0 AFTER THE PILOT THEY HAD THE OPTION OF HAVING &AIRVIEW COME IN PRINT OUT EVERYTHING IN THE DATA BASE REASSEMBLE PATIENT CHARTS PAY US A FEE FOR THE INCONVENIENCE AND HAVE US RESUME LIFE ON PAPER "&0 TOLD THEM NO THEY WANTED TO KEEP IT AND CONTRACTED WITH &6 TO PAY MAINTENANCE AND LICENSING FEES ON AN ONGOING BASIS 4HEY COULDN T IMAGINE LIVING WITHOUT AN %-2 7HAT 2ESULTS HAVE WE .OTED 3INCE )NSTALLING AN %-2 2EGARDING #ARE #OST

%FlCIENCY #ARE #ONTINUITY ETC /N THE lNANCIAL SIDE WE HAVE SEEN &4% RE DUCTIONS OUR PILOT CLINIC REDUCED STAFF &4%S IN THE lRST YEAR AFTER GO LIVE 7E HAVE ALSO EXPERIENCED IMPROVED CHARGE CAPTURE AND MORE ACCURATE DETAIL IN THE DEPTH OF CODING

ALLOWING FOR ACCURACY IN BILLING /N THE CLINICAL SIDE WE HAVE DRUG INTER ACTION CHECKING ALLERGY WARNINGS IMPROVED OUTCOMES ON OUR CLINICAL INITIATIVES IMPROVED SPEED OF lNDING PERTINENT CLINICAL DATA IN THE PATIENT S ROOM ACCESS FROM THE HOSPITAL OR HOME AND THE ABILITY TO INITIATE hE CAREv THROUGH THE -Y#HART THE %PIC PATIENT PORTAL CAPABILITIES 4HE OUTCOMES HAVE BEEN IMPROVED THROUGH THE USE OF h"EST 0RACTICE !LERTSv WHICH CAN HELP WITH CLINICAL DECISION MAKING E G BETA BLOCKER USE IN APPROPRIATE PERI OP ERATIVE PATIENTS OR REMINDERS TO INTERVENE IN A PATIENT S FORGOTTEN PROBLEM DURING A BUSY DAY 7E HAVE SEEN OUR OVERALL DIABETES OUTCOMES DOUBLE DURING A TWO YEAR PERIOD SINCE WE STARTED BROAD ROLLOUT IN THE &6 CLINICS 7ITH %PIC WE HAVE THE CAPABILITY TO PULL UP AND PRINT PATIENT EDUCATION MATERIAL IN BOTH %NGLISH AND 3PANISH FOR OVER ILL NESSES 4HIS INCLUDES DIAGRAMS OF ANATOMY AND PHYSIOLOGY EXERCISE INSTRUCTIONS ETC )N PRI

-AY *UNE

MARY CARE ) ALWAYS SEEMED TO HAVE THE WRONG ILLUSTRATION UP ON THE WALL )F ) WAS SEEING AN EAR PAIN THERE WAS A SKELETON DIAGRAM ON THE WALL IF IT WAS A FRACTURE CARE PATIENT A COLON POLYP DIAGRAM WAS AVAILABLE AND IN THE INEVITABLE RECTAL BLEEDING PATIENT THERE WAS THE EAR DIA GRAM .OW NO MATTER WHICH ROOM ) AM IN ) ALWAYS HAVE THE CORRECT EDUCATION MATERIAL AND WE HAVE LESS TROUBLE STOCKING THE RIGHT NUMBER OF PAMPHLETS !NY INSTRUCTIONS WE SEND HOME CAN BE PRINTED hREAL TIME v TOGETHER WITH THE PATIENT S VITAL SIGNS NEWLY DIAGNOSED PROBLEMS AND ASSOCIATED MEDICATIONS 4HE PHYSICIAN PORTAL ALLOWS US ALSO TO LEAVE THE OFlCE FOR A CHILD S SOCCER GAME AND THEN lNISH UP DOCUMENTATION AT HOME )T AL LOWS A MORE mEXIBLE LIFESTYLE THAN BEING LOCKED INTO HAVING CHARTS RESULTS ONLY AVAILABLE AT THE CLINIC SITE 4HE -Y#HART PORTAL ALLOWS OUR PATIENTS TO VIEW THEIR CHARTS LOOKING AT PROBLEM LISTS

MEDICATIONS LABS AND THE PHYSICIAN S COM MENTS ABOUT THOSE RESULTS 0RESCRIPTION RElLL REQUESTS CAN BE MADE ONLINE AND APPOINT MENTS BOOKED DIRECTLY WITHOUT HAVING TO WAIT ON HOLD TO SPEAK TO THE RECEPTIONIST 4HE ASYNCHRONIS COMMUNICATION AVOIDS THE WASTE FUL TELEPHONE TAG ON BOTH ENDS 4HIS PROGRAM HAS HAD TREMENDOUS PATIENT ENTHUSIASM AROUND THE COUNTRY ESPECIALLY THE ABILITY TO QUERY YOUR PROVIDER ON MEDICAL ISSUES RECEIVE ADVICE AND HAVE PRESCRIPTIONS SENT ELECTRONICALLY TO YOUR PHARMACY OF CHOICE 7HAT )MPACT HAS -EDICARE AND THE 'OVERNOR S 0LAN HAD 4HIS IS A DIFlCULT AREA ) DON T HAVE TO TELL READ ERS OF THIS JOURNAL HOW STRETCHED lNANCIALLY PHYSICIANS AND HOSPITAL SYSTEMS ARE RIGHT NOW ) THINK THE TIPPING POINT HAS BEEN REACHED IN UNDERSTANDING THE NEED FOR %-2S AND THE OBVIOUS BENElTS 4HE MAIN BARRIER RIGHT NOW IS INITIAL COST 4HIS INCLUDES THE HARDWARE

THE SOFTWARE LICENSING AS WELL AS THE UPFRONT COSTS OF THE PRODUCTION HIT WHEN LEARNING THE SYSTEM WORK UNTIL P M OR SEE FEWER PATIENTS 7ITH THE -EDICARE REDUCTIONS AND THE 'OVERNOR S CUTS IN REIMBURSEMENT BOTH 7ASHINGTON AND OUR STATE ARE STARVING THE ROOTS OF THE SYSTEM THEY ARE HOPING WILL IMPROVE THE HEALTH IN ITS COMMUNITIES 3OMETHING WILL NEED TO BE DONE TO REVERSE THIS COURSE

/N THE POSITIVE SIDE THE GOVERNMENT

WORKING THROUGH THE !GENCY FOR (EALTHCARE 2ESEARCH 1UALITY !(21 HAS FUNDED A PLANNING GRANT FOR THE THREE MAJOR DELIVERY SYSTEMS IN THE STATE &6 (EALTH0ARTNERS AND !LLINA TO WORK ON A JOINT EMERGENCY RECORD ABSTRACT )F WE RECEIVE THE IMPLEMENTATION GRANT AS WELL IT WOULD MEAN ANY PATIENT EXPERIENCING A DECOMPENSATION OF A STABLE CONDITION AND MOVING IN TRANSITION FROM ONE SYSTEM TO ANOTHER WOULD HAVE HIS HER IMPOR TANT MEDICAL RECORD ELEMENTS AVAILABLE FOR VIEW AT THE NEW SITE &OR EXAMPLE A PATIENT SEEN AT A &6 CLINIC WHO BECAUSE OF PROXIMITY IS BROUGHT TO AN !LLINA SYSTEM HOSPITAL WOULD HAVE HIS PROBLEM LIST MEDICATIONS ALLERGIES LAST #82 AND %+' AVAILABLE TO THE %$ PHYSICIAN 4HIS HAS THE POTENTIAL TO IMPROVE AND SPEED DECI SION MAKING AND PERHAPS AVOID THE PROSPECT OF DUPLICATE UNNECESSARY TESTS BEING DONE 4HIS CAPABILITY WOULD NOT EVEN BE A FANTASY WITHOUT HAVING %(2 AS A DATABASE FROM WHICH TO PULL THE DATA )T IS A HINT OF WHERE WE WILL BE GOING IN THE FUTURE WITH h#ARE !NYWHERE v PORTABLE

ACCURATE HEALTH RECORDS THAT CAN FOLLOW THE PA TIENT ANY PLACE IN THE WORLD WHERE THERE IS AN INTERNET HOOKUP 4HAT IS OUR STORY TO DATE 7E ARE NOW LAUNCHING INTO A VERY EXCITING PHASE WHERE OUR DATA COLLECTION ABILITY ALLOWS US TO MONITOR OUTCOMES AND REPORT RESULTS TO OUR PHYSICIANS &OR THE lRST TIME WE WILL HAVE A REALLY GOOD IDEA OF WHETHER WHAT WE ARE DOING IS HAVING THE DESIRED CLINICAL EFFECTS ON OUR PATIENTS (OTLINKS TO THE LATEST UP TO DATE GUIDELINES SHOULD IMPROVE OUR CARE AS WELL )DENTIlCA TION OF hBEST PRACTICES v AND SPREAD OF THAT KNOWLEDGE INTERNALLY SHOULD HELP US MEET OUR MISSION STATEMENT OF hIMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE v AND OUR VISION OF hRESPONSIVENESS AND SETTING NATIONAL STANDARDS FOR CLINICAL EXCELLENCE INNOVATION AND SAFETY v

"ARRY ! "ERSHOW - $ IS A CO FOUNDER OF "URNSVILLE &AMILY 0HYSICIANS 0 ! AND IS THE MEDICAL DIRECTOR OF QUALITY AND INFORMATICS AT &AIRVIEW (EALTH 3ERVICES &OOTNOTE 4HE #OMPUTER "ASED 0ATIENT 2ECORD !N %SSENTIAL 4ECHNOLOGY FOR (EALTH #ARE 2EVISED %DITION 3TATEMENT ON 1UALITY OF #ARE .ATIONAL 2OUNDTABLE ON (EALTH #ARE 1UALITYÂ&#x2C6;4HE 5RGENT .EED TO )MPROVE (EALTH #ARE 1UALITY

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PLACING THE FAMILIAR PATIENT MEDICAL CHARTS AND PRESCRIPTION PADS WITH ELECTRONIC HEALTH RECORD SYSTEMS %(2S WHICH TRACK A PATIENT S MEDICAL HISTORY AS HE SHE MOVES AND CHANGES DOCTORS )NSTEAD OF CALLING THE CLINIC FOR TEST RESULTS OR A PRESCRIPTION RElLL PATIENTS AND THEIR HEALTH CARE PROVIDERS WILL HAVE ACCESS TO THEIR MEDICAL RECORDS THROUGH AN ELECTRONIC PERSONAL HEALTH RECORD Â&#x2C6; FROM ANYWHERE IN THE WORLD 4HERE ARE COUNTLESS BENElTS TO THE %(2 SYSTEM 4HE PROBLEMS OF SKYROCKETING HEALTH CARE COSTS AND DETERIORATING QUALITY OF CARE HAVE BEEN WELL DOCUMENTED 4O ADDRESS THESE ISSUES

0RESIDENT "USH IN HIS %XECUTIVE /RDER ON !PRIL

ESTABLISHED A VISION OF A NATIONWIDE HEALTH CARE SYSTEM THAT hIMPROVES HEALTH CARE QUALITY REDUCES MEDICAL ERRORS AND ADVANCES THE DELIVERY OF APPROPRIATE EVIDENCE BASED MEDICAL CARExv /N THE STATE LEVEL 'OVERNOR 0AWLENTY S h3MART "UY !LLIANCEv USES MARKET FORCES TO ADDRESS THE SAME PROBLEMS 4HE -INNESOTA LEGISLATURE DIRECTED THE FORMATION OF THE -INNESOTA E (EALTH )NITIATIVE 3TEERING #OMMITTEE TO lND WAYS TO USE TECHNOLOGY TO ADDRESS THE SAME ISSUES 7E VE SEEN THE LARGEST HEALTH CARE ORGANI ZATIONS IN -INNESOTA n -AYO !LLINA (EALTH 0ARTNERS &AIRVIEW TO NAME A FEW INVEST IN %(2 SYSTEMS AND OTHER TECHNOLOGIES AND IN TEGRATE THEM INTO THEIR OPERATIONS 7E VE SEEN A GROWING NUMBER OF SMALLER ORGANIZATIONS FOLLOW SUIT 4HE %(2 MOVEMENT IS GAINING MOMENTUM AND COULD LEAVE MANY PROVIDERS STANDING AT THE DEPOT WONDERING HOW THEY MISSED THE TRAIN 3O WHY SHOULD THE AVERAGE HEALTH CARE PROVIDER GROUP CARE

(ERE S THE BOTTOM LINE ! PROPERLY DE PLOYED ELECTRONIC HEALTH RECORD SYSTEM CAN DELIVER SUBSTANTIAL BENElTS TO BOTH THE PATIENT AND THE PROVIDER ORGANIZATION 3PECIlCALLY THE %(2 WILL !DVANCE PATIENT CARE 3TRENGTHEN THE BOTTOM LINE %NHANCE CLINIC EFlCIENCY !DVANCES 0ATIENT #ARE )N VIRTUALLY EVERY GOOD %(2 THE PHYSICIAN WILL USE AN ELECTRONIC MEDICATION PRESCRIBING SYSTEM 4HIS SYSTEM WILL AUTOMATICALLY CHECK TO SEE IF THE MEDICATION BEING PRESCRIBED MIGHT CAUSE A PROBLEM WITH OTHER MEDICATIONS THE PATIENT IS TAKING OR CAUSE AN ALLERGIC REACTION &URTHER THE SYSTEM WILL MAKE SURE THE PAR TICULAR MEDICATION BEING PRESCRIBED IS ON THE PATIENT S HEALTH PLAN S APPROVED LIST OF DRUGS !LSO THE PRESCRIPTION CAN BE SENT ELECTRONICALLY TO THE PATIENT S PHARMACY OF CHOICE SO THAT IT IS READY WHEN THE PATIENT ARRIVES AT THE PHARMACY )N ADDITION THE PHARMACY CAN ELECTRONICALLY SEND BACK PRESCRIPTION USAGE INFORMATION SO THE PHYSICIAN KNOWS THE PATIENT S ENTIRE HISTORY OF RElLL USAGE 4HE DOCTOR WILL HAVE INSTANT ACCESS TO THE PATIENT S %(2 WHENEVER AND WHEREVER IT IS NEEDED &OR INSTANCE WHEN THE PATIENT CALLS THE CLINIC S EMERGENCY NUMBER AT NIGHT

THE ON CALL PHYSICIAN WILL BE ABLE TO ACCESS THE APPROPRIATE %(2 FROM HOME TO DELIVER CARE 3TRENGTHENS THE "OTTOM ,INE 4HE MOST OBVIOUS WAY THAT AN %(2 SYSTEM CAN STRENGTHEN THE BOTTOM LINE FOR A CLINIC IS THROUGH IMPROVED % - CODING 4HIS IS NOT TO SAY THAT THE %(2 WILL ENCOURAGE hUP CODINGv OF VISITS BUT RATHER IT WILL ENSURE hRIGHT CODING v -OST %(2S WILL GENERATE A SUGGESTED LEVEL OF CODING THAT THE %(2 DOCUMENTATION WILL SUP

"9 4(/-!3 ( ,%%

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

PORT 4HE PHYSICIAN CAN ALTER THIS SUGGESTED LEVEL OF CODING AS NEEDED -EDICAL %CONOMICS MAGAZINE ESTIMATES THAT hDOWN CODINGv ONE % - LEVEL COSTS A PHYSICIAN AT LEAST

ANNUALLY ! SECOND EXAMPLE OF AN IMPROVED BOTTOM LINE USING AN %(2 INVOLVES LOST REVENUE FROM MISSED APPOINTMENTS -OST %(2S WILL CONTAIN SOME TYPE OF HEALTH MAINTENANCE ALERT 4HIS IS A SYSTEM FEATURE THAT DElNES WHEN A HEALTH CARE PROVIDER RECOMMENDS SCHEDULING FUTURE ACTIVITIES FOR THE PATIENT FOR EXAMPLE AN AN NUAL BREAST EXAMINATION A TETANUS BOOSTER SHOT

OR A WELL BABY APPOINTMENT 4HE SYSTEM WILL ALSO IDENTIFY PATIENTS WHO NEED SPECIlC FOLLOW UP SERVICES AND WILL GENERATE A CALL LIST SO THAT OFlCE STAFF CAN SCHEDULE THE VISIT /R WHEN A PATIENT CALLS FOR AN APPOINTMENT THE APPOINT MENT SCHEDULER WILL REMIND THE PATIENT THAT THEY ARE DUE FOR A TEST OR INOCULATION AND WILL SCHEDULE IT WITH ANOTHER VISIT 4HIS PROACTIVE APPROACH TO APPOINTMENT SCHEDULING WILL NOT ONLY MAKE IT MORE CONVENIENT FOR THE PATIENT AND THE SCHEDULER BUT IT WILL DRIVE REVENUE AND STRENGTHEN THE BOTTOM LINE !N ADDED BENElT IS IMPROVED PATIENT CARE %NHANCES #LINIC %FlCIENCY /NE EXAMPLE OF A MORE EFlCIENT CLINIC OPERA TION IS HOW THE %(2 MANAGES PRESCRIPTION RE lLLS )N TODAY S PAPER CHART WORLD A PRESCRIPTION RElLL WILL USUALLY FOLLOW THESE STEPS 4HE RElLL REQUEST IS RECEIVED VIA A PHONE CALL OR FAX AND A REQUEST FOR THE PAPER CHART IS MADE /NCE LOCATED THE PAPER CHART ALONG WITH A NOTE REQUESTING THE RElLL IS PLACED ON THE PHYSICIAN S DESK 4HE PHYSICIAN WILL REVIEW THE CHART AND APPROVE THE RElLL #ONTINUED ON PAGE

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Incredible Setting on Lake Superior

Built into a ledgerock formation, this Mulfinger designed home takes in all the power of Lake Superior. Custom built with care and quality, this home features a stone fireplace, 2 bedrooms, 2 baths, rich woodwork and lots of windows to capture the view. Located on a private road near Grand Marais, the densely wooded 8.38-acre lot has 250 feet of dramatic but accessible shoreline. A true North Shore gem. $1,195,000.

RED PINE R E A L T Y

Gail Englund, Realtor P.O. Box 938 Grand Marais, MN 55604 e-mail: Info@RedPineRealty.com 800/387-9599 / 218/387/9599 www.RedPineRealty.com

-AY *UNE

4HE PHYSICIAN S ASSISTANT OR NURSE WILL RE TRIEVE THE CHART AND CALL THE PHARMACY TO AUTHORIZE THE RElLL 4HE PAPER CHART IS RETURNED TO THE lLE ROOM )N THE %(2 WORLD THE FOLLOWING WORK mOW STEPS WOULD BE FOLLOWED 4HE RElLL PHONE CALL IS RECEIVED AND A RElLL REQUEST IS PLACED IN THE PHYSICIAN S E MAIL IN BASKET 4HE PHYSICIAN CHECKS THE E MAIL IN BASKET AND REVIEWS THE %(2 FOR THE PATIENT RE QUESTING THE RElLL AND APPROVES THE RElLL 4HE RElLL AUTHORIZATION IS ELECTRONICALLY SENT TO THE PATIENT S PHARMACY AND THE ORDER IS lLLED 4HE ENTIRE MOVEMENT OF PAPER CHARTS IS REMOVED FROM THE SYSTEM !UTOMATION HAS HELPED SIMPLIFY AN ACTIVITY FOR WHICH THE PHY SICIAN RECEIVES NO COMPENSATION 4WO POPULAR VENDORS USE AND RESPECTIVELY FOR THE COST OF A CHART PULL )T S EASY TO CALCULATE WHAT PRESCRIP TION RElLLS IS REALLY COSTING THE ORGANIZATION ! SECOND EXAMPLE OF ENHANCED CLINIC EFlCIENCY IS TIED TO THE ELIMINATION OF PAPER CHARTS -EDICAL %CONOMICS $ECEMBER HAS ESTIMATED THE COST OF CREATING TRACKING

STORING AND MAINTAINING PAPER CHARTS TO BE PER CHART PER YEAR -AINTAINING AN ELECTRONIC CHART HAS BEEN ESTIMATED TO BE IN THE RANGE OF TO PER YEAR 4HE SAVINGS FROM USING AN %(2 ARE OBVIOUS 'LOBAL "ENElT OF %(2S ! MAJOR BENElT OF THE %(2 WORLD IS THAT SYSTEMS SHOULD BE ABLE TO SHARE INFORMATION ELECTRONICALLY )N THE TRADE PRESS THIS IS CALLED SYSTEM INTER OPERABILITY 4HIS RESULTS IN &EWER MEDICAL TESTS BEING PERFORMED SINCE ONE DOCTOR CAN REVIEW THE RESULTS FROM THE SAME TEST PERFORMED BY ANOTHER DOCTOR ! PHYSICIAN CAN KNOW THE MEDICATIONS BE ING PRESCRIBED BY OTHER PHYSICIANS AS WELL AS WHETHER OR NOT PRESCRIPTIONS HAVE ACTUALLY BEEN lLLED AND THE RElLL HISTORY ! PATIENT S COMPLETE MEDICAL HISTORY CAN BE DELIVERED ELECTRONICALLY TO THE POINT OF CARE

E G A HOSPITAL EMERGENCY ROOM IN MINUTES 4HE RESULT CAN BE A MORE EFlCIENT AND COST EFFECTIVE HEALTH CARE SYSTEM WHILE IT DELIV ERS IMPROVED PATIENT CARE 4HAT S SOMETHING WORTH PURSUING

(OW DO WE 0AY FOR IT 4HE COST TO IMPLEMENT AN %(2 CAN VARY CON SIDERABLY /NE LOCAL VENDOR OF A WELL KNOWN SYSTEM HAS ESTIMATED THAT FOR A SIX PHYSICIAN

PRIMARY CARE GROUP THE COST FOR NEW SOFTWARE

TRAINING AND IMPLEMENTATION WOULD BE IN THE RANGE OF n PER PHYSICIAN 4HIS WOULD INCLUDE FULLY INTEGRATED SCHEDULING BILL ING AND %(2 SOFTWARE WITH IMPLEMENTATION AND TRAINING 4HIS CAN BE A SIZABLE INVESTMENT FOR MANY GROUPS 4HERE IS A NATIONAL PROGRAM CALLED "RIDGES 4O %XCELLENCE "4% THAT IS FOCUSED ON LARGE

SELF INSURED EMPLOYERS 4HE IDEA BEHIND THIS PROGRAM IS THAT THE ORGANIZATION BEARING THE RISK FOR THE COST OF HEALTH CARE THE EMPLOYER WOULD PAY INCENTIVES TO GROUPS THAT DEMON STRATE IMPROVED PERFORMANCE 4WO OF THESE INCENTIVES FOCUS ON IMPROVEMENTS IN DIABETES AND CORONARY CARE 4HE THIRD IS CALLED 0RO VIDER /FlCE ,INK 4HIS IS A TECHNOLOGY BASED INCENTIVE )T IS BASED ON A SET OF NINE STANDARDS ESTABLISHED BY .#1! )F A CLINIC MEETS THE NINE STANDARDS THE GROUP CAN RECEIVE ANNUAL INCENTIVES OF UP TO PER PATIENT EMPLOYED

BY THE GROUPS SPONSORING THE "4% PROGRAM )N -INNESOTA THE PRIMARY PAYERS ALREADY HAVE PAY FOR PERFORMANCE PROGRAMS 'ENER ALLY THESE ARE CENTERED AROUND THE COMMU NITY MEASUREMENT INITIATIVES 0ERHAPS THESE PROGRAMS COULD BE EXPANDED TO INCLUDE AN .#1! TYPE TECHNOLOGY AWARD )N SUMMARY %(2S WILL MORE THAN PAY FOR THEMSELVES IN THE LONG RUN IN COST AND TIME EFlCIENCIES 4HE BENElTS IN IMPROVING PATIENT CARE AND CLINIC EFlCIENCIES WHILE STRENGTHEN ING THE BOTTOM LINE WILL DELIVER A RETURN ON INVESTMENT THAT WILL FAR EXCEED MOST PROVIDERS EXPECTATIONS 4HE %(2 IS MORE THAN A TOOL TO IMPROVE HOW BUSINESS IS DONE IT REALLY IS A WAY TO IMPROVE HOW CARE IS DELIVERED )T IS PART OF WHAT IS GOING TO IMPROVE THE FUTURE OF OUR HEALTH CARE SYSTEM

4HOMAS ( ,EE IS VICE PRESIDENT --)# 4ECH NOLOGY 3OLUTIONS --)# 4ECHNOLOGY 3OLUTIONS IS A FULL SERVICE PROVIDER OF HEALTH CARE TECHNOL OGY SOLUTIONS AND CONSULTING SERVICES AND IS AN EXCLUSIVE PROVIDER OF .EXT'EN THE INDUSTRY S ONLY INTEGRATED ELECTRONIC HEALTH RECORD AND ELECTRONIC PRACTICE MANAGEMENT SYSTEM --)# 4ECHNOLOGY 3OLUTIONS IS HEADQUARTERED IN 0LYMOUTH -INN

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

)DEALS TO !CTION ,OBBY $AY IN 7ASHINGTON $ #

4

4(%2% !2% 4().'3 THAT WE AS PHYSICIANS

AND MEDICAL STUDENTS ALL CARE ABOUT -AYBE YOUR PASSION IS THE KIDS THAT DON T HAVE HEALTH INSURANCE OR THE RISING COST OF MEDICAL EDUCA TION OR THAT SENIORS ARE LOSING ACCESS TO HEALTH CARE BECAUSE -EDICARE REIMBURSEMENTS TO PHY SICIANS ARE BEING CUT OR THAT WOMEN WITH HIGH RISK PREGNANCIES HAVE TO DRIVE HOURS TO lND A DOCTOR THAT CAN CARE FOR THEM 7E WANT TO DO SOMETHING TO CHANGE THESE INJUSTICES WE SEE "UT WHAT CAN WE DO TO MAKE A DIFFERENCE 7HAT CAN ) DO AS A MEDICAL STUDENT WHO DOES NOT HAVE LARGE AMOUNTS OF MONEY TO CONTRIB UTE TO CAMPAIGNS 7HAT CAN YOU DO AS A BUSY PHYSICIAN WHO DOES NOT HAVE TIME TO RUN FOR CITY COUNCIL 7E CAN SPEAK WITH OUR LEGISLATORS /UR LEADERS ARE WORKING AT THE STATE AND NATIONAL LEVEL TO REPRESENT OUR CONCERNS AND ISSUES !ND THEY NEED TO KNOW WHAT IT IS THAT THEIR CONSTITUENTS ARE CONCERNED ABOUT ,OBBY DAY IN 7ASHINGTON $ # IS A YEARLY EVENT ORGANIZED BY THE POLITICAL ARM !-0!# OF THE !MERICAN -EDICAL !SSOCIATION !-!

AND PROVIDES MEDICAL STUDENTS AND PHYSICIANS AN INCREDIBLE OPPORTUNITY TO HAVE OUR VOICES HEARD )T IS USUALLY HELD IN -ARCH AND THE DAY BEGINS WITH LEGISLATIVE BRIElNGS BY !-! STAFF AND EDUCATIONAL SESSIONS ON EFFECTIVE WAYS TO LOBBY AND GRASSROOTS ADVOCACY 4HEY ORGANIZE MEETINGS ON #APITOL (ILL WITH RESPECTIVE LEGISLATORS OR THEIR STAFFERS AND PROVIDE THE IN FRASTRUCTURE TO MAKE IT A SMOOTH ORGANIZED

EFFECTIVE DAY AT THE NATION S CAPITOL !SSISTED WITH THE GENEROUS SUPPORT OF (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES AND THE -INNESOTA -EDICAL !SSOCIATION THIS YEAR

-INNESOTA WAS FULLY REPRESENTED WITH MEDICAL STUDENTS FROM YEARS TWO TO FOUR RESIDENTS

"9 -/.)#! 2!.)

AND PHYSICIANS FROM VARIOUS PLACES IN -INNESOTA !ND ALL AGREED THAT IT WAS AN INCREDIBLE AND EMPOWERING EXPERIENCE 4HE $AY 4HE DAY BEGAN WITH REGISTRATION AND BREAKFAST AND WAS FOLLOWED BY A WELCOME FROM $R $AVID 3ELBY

-EDICAL 3TUDENTS REPRESENTING 2EGION IN 7ASHING THE CHAIR OF THE !MERICAN -EDICAL TON $ # FROM LEFT ,ISA -C'INNIS -ONICA 2ANI -ANISH !SSOCIATION 0OLITICAL !CTION #OM #HAMPANERIA #HAIR !-! -33 -INORITY )SSUES #OM MITTEE !-0!# 7E THEN HEARD MITTEE 3TEPHANIE 3TANTON !-! -33 6ICE 3PEAKER , 3HANE (OPKINS !-! -33 3TUDENT #OUNCILOR ON THE FROM 3TEVE "URDINE THE 'OVERN 0HYSICIAN #OUNCIL ON 3CIENTIlC !FFAIRS *ANET 7EST 2E MENT 2ELATIONS !DVOCACY &ELLOW GION 6ICE #HAIR .AOMI 3LUTZKI AND 3ARAH ,EE ABOUT OPPORTUNITIES TO WORK AT THE !-! OFlCE IN $# DURING MEDICAL SCHOOL

AND PASSIONATE ABOUT THE (IGHER %DUCATION AND RECEIVED LEGISLATIVE BRIElNGS FROM *ULIUS !UTHORIZATION (EALTH #ARE #OVERAGE FOR (OBSON THE DIRECTOR OF #ONGRESSIONAL !FFAIRS

5NINSURED #HILDREN AND -EDICAL ,IABILITY ABOUT HEALTH CARE ISSUES AND HOW TO PRESENT 2EFORM 4HE 5NIVERSITY OF -INNESOTA -EDICAL THEM IN AN EFFECTIVE MANNER DURING OUR MEET 3CHOOL n 4WIN #ITIES RECENTLY HIT THE NUMBER INGS ON THE HILL 4HE DAY WAS SUPERBLY ORGA ONE POSITION FOR THE HIGHEST TUITION FOR A PUBLIC NIZED WITH MEETING TIMES SCHEDULED MAPS OF MEDICAL SCHOOL IN THE 5NITED 3TATES -EDICAL THE CAPITOL AND BUILDINGS PACKETS OF LITERATURE STUDENT DEBT IS RISING AT AN UNSUSTAINABLE PACE PREPARED FOR US TO HAND TO OUR LEGISLATORS TALK AND SERIOUSLY AFFECTING STUDENTS DECISIONS ING POINTS ON ISSUES AND BUSES TO THE CAPITOL ON THE TYPE OF MEDICINE THEY WOULD LIKE TO ! SEEMINGLY COMPLICATED AND INTIMIDATING PRACTICE IN THE FUTURE 3TUDENTS INTERESTED IN PROCESS WAS MADE VERY FRIENDLY AND EASY TO DOING VOLUNTEER WORK AFTER MEDICAL SCHOOL FOR NAVIGATE ORGANIZATIONS SUCH AS $OCTORS WITHOUT "ORDERS ARE GROWING INCREASINGLY CONCERNED ABOUT THE #ONCERNS OF -INNESOTA 3TUDENTS FEASIBILITY OF FOLLOWING THEIR DREAMS GIVEN !S A STATE WE DECIDED TO FOCUS ON THREE MAIN IS THE AMOUNT OF MONEY THEY WILL NEED TO START SUES THAT WE AS STUDENTS WERE MOST CONCERNED PAYING BACK AFTER SCHOOL -ANY ARE WORRIED ABOUT MANAGING THE lNANCES OF PRACTICING FAMILY MEDICINE IN RURAL -INNESOTA PAYING BACK LOANS AND STARTING A FAMILY 7E SPOKE WITH LEGISLATIVE ASSISTANTS FROM OUR LEGISLATORS OFlCES ABOUT THE URGENCY OF CONTROLLING THE RISING RATE OF HIGHER EDUCATION /UR NEXT ISSUE WAS REGARDING THE NUMBER OF UNINSURED CHILDREN IN !MERICA "ETWEEN

-EDICAL 3TUDENT

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

#ONTINUED ON PAGE

-AY *UNE

,OBBY $AY #ONTINUED FROM PAGE

MILLION KIDS ARE UNINSURED IN OUR COUNTRY 2ESEARCH SHOWS THAT CHILDREN WHO LACK HEALTH INSURANCE ARE LESS LIKELY TO SEE A PHYSICIAN TAKE PRESCRIPTION MEDICATION AND MORE LIKELY TO VISIT THE %MERGENCY $EPARTMENT FOR THEIR CARE 7ITH THE CURRENT BUDGET DElCIT THE -EDICAID AND 3TATE #HILDREN S (EALTH )NSURANCE BUDGETS ARE IN DANGER OF BEING CUT 7E SPOKE WITH THE LEGISLATIVE OFlCES TO EDUCATE OUR LEADERS ON THE HEALTH CONSEQUENCES OF CUTTING HEALTH CARE COVERAGE AND THE FACT THAT IN THE LONG TERM IT WOULD COST THE COUNTRY MORE MONEY TO CUT THESE PROGRAMS NOW 4HE CURRENT AND GROWING MEDICAL LIABILITY CRISIS WAS ALSO ADDRESSED 7HILE -INNESOTA IS NOT CURRENTLY A CRISIS STATE IT IS RAPIDLY MOVING TO WARD THIS STATUS &OR STUDENTS TRYING TO DECIDE WHAT SPECIALTIES MIGHT BE A GOOD lT lELDS SUCH AS OBSTETRICS AND GYNECOLOGY SEEM DAUNTING IN THE FACE OF SKY HIGH MALPRACTICE INSURANCE RATES 4HE VERY REAL INmUENCE THESE RATES HAVE ON THE lELD OF MEDICINE THAT STUDENTS WILL CHOOSE AND ITS CONSEQUENCES IN TERMS OF CARE AVAILABLE FOR PA TIENTS IN HIGH RISK SPECIALTIES WERE ADDRESSED

!N %MPOWERING %XPERIENCE -ANY TIMES AS STUDENTS WE FEEL FRUSTRATED AND HELPLESS ABOUT THE STATE OF HEALTH CARE AND MEDICAL EDUCATION POLICIES ,OBBY DAY WAS AN INCREDIBLE OPPORTUNITY TO TAKE THOSE FRUSTRA TIONS AND USE THEM TO CREATE AND BRING A CON STRUCTIVE MESSAGE TO OUR LEADERS 4HE LEGISLATIVE ASSISTANTS WHO ARE THE EARS OF THE LEGISLATORS

WERE INTERESTED IN OUR OPINIONS AND CONCERNS 4HEY ASKED FOR OUR INPUT ON WHAT POLICIES WE WOULD LIKE THE LEGISLATORS TO SUPPORT AND THE REASONS FOR THEM 4HEY REQUESTED LITERATURE AND ASKED US TO FOLLOW UP WITH THEM ON ISSUES WE WERE REALLY CONCERNED ABOUT ,OBBYING %DUCATING WITH A 'OAL !S STUDENTS WE WERE SURPRISED TO lND THAT MANY LEGISLATORS WERE UNEDUCATED ABOUT OUR CONCERNS 7ITH HUNDREDS OF BILLS AND LEGISLA TIONS THAT THEY NEED TO CONSIDER MANY JUST DON T HAVE THE TIME TO EDUCATE THEMSELVES ABOUT ALL THE ISSUES THAT THEY ARE PRESENTED AND NEED TO MAKE A DECISION ABOUT 7E ARE THEIR GREATEST RESOURCE IN RAISING THEIR AWARENESS AND INFORMING THEM ABOUT THE CONCERNS OF AN ISSUE THE IMPACT IT WOULD HAVE ON A POPULA

TION AND WHAT IS A REASONABLE AND JUST WAY TO TACKLE THE PROBLEM 4HE OFlCES REPEATEDLY ASKED US FOR MORE LITERATURE ON ISSUES AND OUR PERSPECTIVES -AKING A #ONNECTION -EDICAL STUDENTS AND PHYSICIANS TALKING ABOUT THEIR CONCERNS WITH THE CURRENT HEALTH CARE SYSTEM AND ITS EFFECT ON THEIR PATIENTS PUTS A HUMAN TOUCH TO LEGISLATION )T GIVES A FACE AND A NAME TO POLICY )T SHOWS OUR LEADERS THAT WE

AS A COMMUNITY ARE DEDICATED TO MAKING A POSITIVE DIFFERENCE IN THE LIVES OF PEOPLE AND SO THEY LISTEN !N )NSPIRING %XPERIENCE ,OBBY DAY ALLOWED US THE OPPORTUNITY TO TAKE OUR PASSIONS AND IDEAS AND SHARE IT WITH A LARGER COMMUNITY )T GAVE US AN AVENUE TO MOVE DISCUSSIONS FROM THE BACK OF A CLASS ROOM TO THE OFlCES OF PEOPLE WHO ARE MAKING IMPORTANT DECISIONS ABOUT THEM /UR VISIONS SHIFTED FROM BEING INTANGIBLE AND TENUOUS TO SOMETHING STRONGER AND CONCRETE )T S NOT JUST IDEALS ANYMORE IT S ACTION

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; )".$&3 "2& 4)"4 9/5 "2& 4// #539 /2 4// *.'2&15&.4 " #59&2 4/ .&(/4*"4& %*3$/5.43 /. /6&2)&"% 2&,"4&% &80&.3&3 35$) "3 /''*$& 3500,*&3 ".% &15*0-&.4 /6&2.*()4 %&,*6&29 $&,, 0)/.&3 0"92/,, 02/$&33*.( ,/.( %*34".$& ".% ,/$", 4&,&0)/.& 2"4&3 53*.&33 %6".4 %(& $". $)".(& ",, 4)"4 !/ ,&"2. -/2& 6*3*4 4)&*2 7&#3*4& "4 777 #53*.&33 &%(& .&4 /2 $",, 4)&- "4

-AY *UNE

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

3TATEWIDE #ONSORTIUM &ORMED TO !DVOCATE FOR THE "ENElTS OF !MBULATORY (EALTH #ARE +ENT 3 7ILSON - $

3T 0AUL OTOLARYNGOLO GIST ANNOUNCED THE FORMATION OF A STATE WIDE CONSORTIUM OF PHYSICIAN GROUPS TO ADVOCATE FOR THE BENElTS OF AMBULATORY HEALTH CARE 4HE -IN +ENT 3 7ILSON - $ NESOTA !MBULATORY (EALTH #ARE #ONSOR TIUM -!(## INCLUDES PHYSICIAN OWNED FACILITIES THAT OPERATE AS CERTIlED AMBULATORY SURGICAL AND IMAGING CENTERS 4HE -!(## MISSION IS TO PROTECT AND PROMOTE THE PRACTICE OF HIGH QUALITY COST EFFEC TIVE READILY ACCESSIBLE AMBULATORY HEALTH CARE PROVIDED BY INDEPENDENT AMBULATORY SURGICAL AND IMAGING CENTERS

)N ANNOUNCING THE FORMATION OF THE #ENTERS FOR $IAGNOSTIC )MAGING 3T ,OUIS -!(## $R 7ILSON STATED h/UR GOALS ARE 0ARK BOARD MEMBER TO MAINTAIN THE HIGHEST QUALITY OF CARE AND THE 4HE (ENNEPIN AND 2AMSEY -EDICAL 3O HIGHEST STANDARD OF PATIENT SAFETY WHILE WORK CIETIES WILL SERVE AS THE ADMINISTRATORS OF THE ING TO PRESERVE THE MAXIMUM LEVEL OF PATIENT #ONSORTIUM AND THE ,OCKRIDGE 'RINDAL AND CHOICE AND THE MOST REASONABLE COST FOR OUR .AUEN LAW lRM OF -INNEAPOLIS WILL REPRESENT PATIENTS AND THEIR INSURERS v THE #ONSORTIUM 4HE OFlCERS AND BOARD MEM BERS OF THE -!(## ARE $R +ENT 3 7ILSON -IDWEST 3URGERY #EN TER 3T 0AUL CHAIRMAN PRESIDENT $R 0ETER * $ALY ,ANDMARK 3UR GERY #ENTER 3T 0AUL SECRETARY $R $AVID 3 (ANSON -INNESOTA 'AS TROENTEROLOGY 3T 0AUL TREASURER -ARK +LEINSCHMIDT ADMINISTRATOR OF 3AINT 0AUL 2ADIOLOGY 3T 0AUL

4HE OFlCERS AND BOARD MEMBERS OF THE -!(## FROM BOARD MEMBER AND ,IZ 1UAM LEFT -ARK +LEINSCHMIDT 0ETER * $ALY - $ $AVID 3 (ANSON - $ ,IZ 1UAM AND +ENT 3 7ILSON - $

*OINT (-3 2-3 "OARD -EETING 4HE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES HELD THEIR *OINT "OARD OF $IRECTORS MEETING ON 4HURSDAY -ARCH 4HE MEETING WAS WELL AT TENDED BY BOARD MEMBERS FROM BOTH SOCIETIES AND INCLUDED THOUGHTFUL DISCUSSION FROM TWO FRIENDS TO HEALTH CARE Â&#x2C6; 3ENATOR 3COTT $IBBLE

AND 2EPRESENTATIVE *IM !BELER 3ENATOR $IBBLE AUTHORED THE &REEDOM TO "REATHE !CT WHICH WOULD HAVE BANNED SMOKING IN BARS AND RESTAU RANTS THROUGHOUT THE ENTIRE STATE 4HE BILL PASSED THROUGH THE 3EN ATE COMMITTEES

BUT DID NOT PASS OUT OF THE (OUSE 3ENATOR $IBBLE ALSO DISCUSSED 3ENATOR 3COTT $IBBLE $ ADDRESSES THE *OINT "OARD OF $IRECTORS AND DISCUSSES THE &REEDOM TO "REATHE LEGISLA TION WHICH HE INTRODUCED

#LASSIlED !DS 2EPRESENTATIVE *IM !BELER 2 TALKS WITH THE "OARD ABOUT VARIOUS HEALTH CARE RELATED ISSUES FACING THE (OUSE OF 2EPRESENTATIVES IN

MANY OTHER HEALTH CARE RELATED TOPICS THAT ARE BEING CONSIDERED IN THE 3ENATE THIS SESSION 2EPRESENTATIVE !BELER PROVIDED THE BOARD MEMBERS WITH A BROAD PERSPECTIVE OF THE VARIOUS ISSUES THAT ARE FACING THE (OUSE OF 2EPRESENTATIVES THIS YEAR (E AUTHORED THE 4RANSLATOR "ILL WHICH WOULD ESSENTIALLY REQUIRE HEALTH PLANS TO PAY FOR SERVICES RENDERED BY TRANSLATORS 2EPRESENTATIVE !BELER ALSO PROVIDED INFORMATION AND INSIGHT ON MANY OTHER ISSUES FACING THE (OUSE THIS SESSION

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

./7 !6!),!",% -%$)#!, /&&)#% 30!#%

3& SUITE INCLUDING lVE EXAM ROOMS

SURGERY SUITE AND LAB LOCATED IN MEDICAL DENTAL BUILDING DIRECTLY ACROSS FROM 3T *OHN S (OSPITAL IN -APLEWOOD 0LEASE CALL 0AT 7OLF #2%3 )NC ).6%34 ). 3!&% 3%#52%$ 2%!, %34!4% 7E DO ALL THE WORK YOU GET GREAT RETURNS 0ERSONAL "USINESS OR 2ETIREMENT FUNDS K B 3%0 )2!

ETC 3MALL MINIMUM NO MAXIMUM INVESTMENT WWW )NVEST-Y-ONEY.OW COM

-AY *UNE

7INTER -EDICAL #ONFERENCE

4

4(% 2!-3%9 -%$)#!, 3OCIETY &OUNDATION 7INTER -EDICAL #ONFERENCE ENDORSED

BY THE 2AMSEY -EDICAL 3OCIETY AND (ENNEPIN -EDICAL 3OCIETY WAS HELD &EBRUARY !P PROXIMATELY PHYSICIANS FAMILY AND FRIENDS SPENT AN ENJOYABLE WEEK ABOARD THE 2OYAL #A RIBBEAN h2ADIANCE OF THE 3EASv CRUISE SHIP 4HE SHIP PROVIDED A WONDERFUL VENUE FOR PHYSICIANS TO ENJOY COLLEGIALITY WHILE HEARING THE LATEST INFORMATION ON HYPERTENSION AND CHOLESTEROL BY $R 4ONY &ERRARA PSYCHIATRY BY $R %RIC 'OAD SLEEP DISORDERS BY $R #ARLOS 3CHENCK ASTHMA AND #/0$ MANAGEMENT BY $R #HARLENE -C%VOY ERECTILE DYSFUNCTION AND MALE INFERTILITY BY $R $OUGLAS 3CHOW

AND PAIN MANAGEMENT BY $R *EEVAN 0AUL )N ADDITION TO THE WONDERFUL LECTURES PROVIDED ABOVE $R 2ON (ANSEN AMAZED ATTENDEES WITH HIS POWER POINT PRESENTATIONS ON 4HE &UTURE OF )MAGING %VENING DINNERS TOGETHER PROVIDED AN ADDITIONAL OPPORTUNITY TO EXPAND ON THE LECTURES 7HEN NOT IN CONFERENCE EVERYONE ENJOYED TIME ABOARD THE SHIP AND IN THE PORTS OF ,ABADEE (ISPANOLIA /CHO 2IOS *AMAICA

'EORGETOWN 'RAND #AYMAN AND #OZUMEL

-EXICO 3EVERAL PEOPLE CLIMBED $UNNS 2IVER &ALLS IN *AMAICA SWAM WITH THE STINGRAYS IN 'RAND #AYMAN AND SWAM WITH THE DOLPHINS IN #OZUMEL %ACH DAY PROVIDED MANY OPPOR TUNITIES FOR ADVENTURE OR RELAXING ON THE SHIP OR A BEACH

4HE PHYSICIANS ENJOYING ONE OF THE LECTURES

-AY *UNE

&ROM LEFT *ACQUELINE AND 4ERRANCE #APISTRANT

- $ $OUGLAS 3CHOW

- $ AND $ENISE 3CHOW

- $ AND ,EE!NN AND 4HOMAS %DWARDS - $ ENJOYING AN EVENING RE CEPTION HOSTED BY (OBBIT 4RAVEL

7INTER -EDICAL #ONFERENCE &ACULTY FROM LEFT *EEVAN 0AUL - $ &!#0 $OUGLAS 3CHOW

- $ #ARLOS 3CHENCK - $ 2ONNELL (ANSEN - $ %RIC 'OAD - $ 4ONY &ERRARA - $

AND #HARLENE -C%VOY - $ -0(

&ROM LEFT 0AULA AND "ERT &INKELSTEIN - $ $AVID 0LOCHER - $ AND 2ONNELL (ANSEN - $ SOCIALIZING ON THE SHIP

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

02%3)$%.4 3 -%33!'% #(!2,%3 ' 4%2:)!.

- $

#ONTACT 9OUR ,EGISLATORS !BOUT %(2S .OW 2-3 /FlCERS

2-3 "OARD -EMBERS

4ODD $ "RANDT - $ !T ,ARGE $IRECTOR 6ICTOR 3 #OX - $ 3PECIALTY $IRECTOR ,AURA ! $EAN - $ 3PECIALTY $IRECTOR *EREMY #ARLSON -EDICAL 3TUDENT !NDREW 3 &INK - $ !T ,ARGE $IRECTOR 2ONNELL ! (ANSEN - $ 3PECIALTY $IRECTOR "RADLEY # ,INDEN - $ 2ESIDENT 0HYSICIAN 4HOMAS * ,OSASSO - $ !T ,ARGE $IRECTOR 2OBERT # -ORAVEC - $ !T ,ARGE $IRECTOR *ANE # 0EDERSON - $ - 3 3PECIALTY $IRECTOR ,ON " 0ETERSON - $ !T ,ARGE $IRECTOR 4HOMAS $ 3IEFFERMAN - $ 3PECIALTY $IRECTOR *ACQUES 0 3TASSART - $ !T ,ARGE $IRECTOR $AVID # 4HORSON - $ 3PECIALTY $IRECTOR 0ETER " 7ILTON - $ !T ,ARGE $IRECTOR 2-3 %X /FlCIO "OARD -EMBERS #OUNCIL #HAIRS

"LANTON "ESSINGER - $ !-! !LTERNATE $ELEGATE 6ICTOR 3 #OX - $ #OMMUNICATIONS #OUNCIL #HAIR +ENNETH 7 #RABB - $ !-! $ELEGATE 2OBERT 7 'EIST - $ %THICS 0ROFESSIONALISM #OUNCIL #HAIR &RANK * )NDIHAR - $ !-! $ELEGATE .EAL 2 (OLTAN - $ #OMMUNITY (EALTH #OUNCIL #HAIR -ARK +LEINSCHMIDT #LINIC !DMINISTRATOR !NTHONY /RECCHIA - $ %DUCATION 2ESOURCE #OUNCIL #HAIR 3TEPHANIE $ 3TANTON 6ICE 3PEAKER

!-! -EDICAL 3TUDENT 3ECTION ,YLE * 3WENSON - $ 0UBLIC 0OLICY #OUNCIL #HAIR 7AYNE ( 4HALHUBER - $ 3R 0HYSICIANS !SSOCIATION 0RESIDENT 2-3 %XECUTIVE 3TAFF

2OGER + *OHNSON #!% #HIEF %XECUTIVE /FlCER +ATIE !NDERSON %XECUTIVE !SSISTANT $OREEN - (INES -EMBERSHIP 7EB 3ITE #OORDINATOR

)

). 4(% ,!34 &%7 -/.4(3 ) HAVE SPENT TIME EITHER MEETING WITH LEGISLATORS OR SENDING THEM E MAILS )N MY LOBBYING EFFORTS ) HAVE REP RESENTED THE 2-3 AND ALL PHYSICIANS PRACTICING IN OUR AREA /NE OF THE MAIN TOPICS OF CONVERSA TION IS ELECTRONIC HEALTH RECORDS %(2S 4HERE ARE LEGISLATIVE MOVES ON THE NATIONAL AND STATE LEVEL TO PROMOTE AND ENCOURAGE PHYSICIANS AND HEALTH CARE ENTITIES TO MOVE TOWARD AN ELECTRONIC HEALTH RECORD (OWEVER AS CLEARLY STATED IN THE LITERATURE AND BY COLLEAGUES THERE EXIST MANY ECONOMIC REGULATORY AND LOGISTIC BARRIERS THAT WILL INmUENCE OR PREVENT WIDESPREAD ADOPTION AND IMPLEMENTATION OF %(2S

4HE RATIONALE BEHIND THE IMPETUS FOR A NATIONWIDE ADOPTION AND USE OF %(2S INVOLVES MEDICAL ERROR PATIENT SAFETY AND QUALITY IS SUES THE CURRENT FRACTURED HEALTH CARE DELIVERY SYSTEM PHYSICIANS AND HEALTH CARE PROVIDERS HAVING INCOMPLETE KNOWLEDGE OF THEIR PATIENTS AND AN UNSOPHISTICATED SYSTEM OF TRANSMIS SION OF HEALTH INFORMATION WHICH COULD BE CALLED hUNWIRED v

5NFORTUNATELY THE COSTS OF IMPLEMENTING AND MAINTAINING A SYSTEM %(2 FOR ANY PRACTICE WHETHER A LARGE HEALTH SYSTEM GROUP PRACTICE OR INDIVIDUAL PHYSICIANS ARE VERY PROHIBITIVE !NY LEGISLATION MANDATING %(2 SHOULD INCLUDE lNAN CIAL INCENTIVES %XAMPLES OF lNANCIAL INCENTIVES MIGHT BE TAX BENElTS OR INCREASED REIMBURSE MENT 4HE -EDICARE 0AYMENT !DVISORY #OM MITTEE -ED0!# REALIZED THIS AND EMPHASIZED IN THEIR RECENT REPORT TO #ONGRESS THAT THERE BE FINANCIAL INCENTIVES TO PROMOTE ADOPTION OF %(2S %SPECIALLY IF -EDICARE IS LEADING THE WAY IN DEMONSTRATION PROJECTS TO PROMOTE 0AY FOR 0ERFORMANCE !N %(2 SYSTEM IS ESSENTIAL TO REPORTING ACCURATE HEALTH INFORMATION TO ASSESS QUALITY OF CARE

&URTHERMORE THERE NEEDS TO BE REGULATORY RELIEF IN THE FORM OF ALLOWING LARGE HEALTH SYS TEMS TO SHARE THEIR %(2S WITH AFlLIATED PROVIDER GROUPS 7E NEED TO FACILITATE THE EXCHANGE OF IN FORMATION BETWEEN PHYSICIANS !T THE MOMENT

IF A LARGE HEALTH ENTITY CHOSE TO SHARE THEIR %(2 SYSTEM WITH PHYSICIANS WHO WERE NOT EMPLOYEES OF THE ENTITY THIS COULD BE CONSTRUED AS GAIN SHAR ING AND FALL UNDER THE JURISDICTION OF THE 3TARK 2ULES ) PERSONALLY WOULD LIKE TO SEE AN /FlCE

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

OF )NSPECTOR 'ENERAL !DVISORY /PINION ON THIS TOPIC 4HE IDEA THAT THESE HEALTH CARE ENTITIES HAVE TO SELL ACCESS TO THEIR SYSTEMS CONTRIBUTES TO lNANCIAL DIS INCENTIVES TO ACQUIRING AND UTILIZ ING THESE SYSTEMS !NY LEGISLATION THAT TRIES TO MOVE FORWARD INTEGRATION OF %(2 INTO OUR CUR RENT HEALTH CARE DELIVERY SYSTEM SHOULD INCLUDE REGULATORY RELIEF OF HEALTH CARE ENTITIES THAT SHARE THESE SYSTEMS WITH AFlLIATED PROVIDERS WITHOUT SUBJECTING THEM TO UNNECESSARY OVERSIGHT AND lNES

&INALLY ANY LEGISLATION SHOULD PROMOTE USE OF %(2S WITH STANDARDIZED TECHNOLOGY THAT ALLOWS DIFFERENT SYSTEMS TO COMMUNICATE WITH EACH OTHER 4HIS COMMUNICATION SHOULD ENSURE PRIVACY WHILE ALLOWING THE TRANSMISSION OF PERTI NENT PATIENT INFORMATION TO FACILITATE CONTINUITY AND QUALITY CARE BETWEEN HEALTH CARE PROVIDERS .ON STANDARDIZED INFORMATION SYSTEMS EVERY HEALTH CARE SYSTEM DEVISING THEIR OWN ELECTRONIC FORMAT ARE NOT A GOOD INVESTMENT BECAUSE THEY ARE EXPENSIVE AND NECESSITATE THE DUPLICATION OF INFORMATION (OWEVER ) REALIZE THAT PATIENTS ARE CUSTOMERS AND THIS MIGHT NOT BE GOOD FROM AN ECONOMIC PERSPECTIVE FOR CERTAIN HEALTH CARE BUSI NESS ENTITIES "UT ARE WE EMPHASIZING %(2S TO PROMOTE QUALITY INSTEAD OF PROMOTING MARKET ADVANTAGE ECONOMICS OR THE RETENTION OF PA TIENTS

)N 'ERMANY WHICH DOES NOT HAVE AN ENTIRELY SOCIALIZED HEALTH CARE SYSTEM THEY ARE EXPERIMENTING WITH 3MART #ARDS FOR PATIENTS !LL OF THE DIFFERENT VENDORS HAVE AGREED TO A SYSTEM WHERE THE CARDS ARE ENCODED AT LOCATIONS SUCH AS CLINICS OR HOSPITALS WITH CLINICAL INFORMATION !CCESS TO THE INFORMATION ON THE CARDS IS VARI ABLE BASED ON NEED %ACH ENTITY CAN HAVE ITS OWN ELECTRONIC SYSTEM BUT THE INFORMATION ENCODED ON THE CARD IS STANDARDIZED AND SO ARE THE READ ERS 4HIS ISN T SUCH A NOVEL IDEA BUT ) THINK AN EXCELLENT SOLUTION TO THE PROBLEMS WE HAVE IN OUR STATE AND OUR COUNTRY OF IMPLEMENTING A TRULY UNIVERSAL AND APPLICABLE %(2 SYSTEM

7HILE ) ANXIOUSLY LOOK FORWARD TO THE RESULTS OF THIS PILOT PROGRAM IN 'ERMANY ) ENCOURAGE ALL OF YOU TO WRITE OR CALL YOUR LEGISLATORS AND VOICE YOUR CONCERNS ABOUT %(2S 4HEY NEED TO HEAR FROM YOU

-AY *UNE

2AMSEY -EDICAL 3OCIETY

0RESIDENT #HARLES ' 4ERZIAN - $ 0RESIDENT %LECT *AMES * *ORDAN - $ 0AST 0RESIDENT 0ETER * $ALY - $ 3ECRETARY 'RETCHEN 3 #RARY - $ 4REASURER #HARLES % #RUTCHlELD ))) --" - $

2-3 50$!4%

.EW -EMBERS 2-3 WELCOMES THESE NEW MEMBERS TO THE 3OCIETY 3CHOOLS LISTED INDICATE THE INSTITUTION WHERE THE MEDICAL DEGREE WAS RECEIVED

!CTIVE 2OBERT $ !CTON - $ 5NIVERSITY OF #INCINNATI #OLLEGE OF -EDICINE 'ENERAL 3URGERY 5NIVERSITY OF -INNESOTA 0HYSICIANS 2OBERT / !NDERSON - $ 5NIVERSITY OF -INNESOTA /RTHOPAEDIC 3URGERY -ETROPOLITAN (AND 3URGERY !SSOC 0 ! $EANNA , "ASS - $ -EDICAL #OLLEGE OF 7ISC -ILWAUKEE 0SYCHIATRY 5NIVERSITY OF -INNESOTA 0HYSICIANS .ANCY -AYER "ENEGAS - $ 5NIVERSITY OF -INNESOTA /PHTHALMOLOGY 5NIVERSITY OF -INNESOTA 0HYSICIANS ,OURDES 2 "ORGES - $ 5NIVERSITY OF 0ENNSYLVANIA 3CHOOL OF -EDICINE &AMILY -EDICINE 5NIVERSITY OF -INNESOTA 0HYSICIANS %RNESTO "RAUER - $ &ACULTAD DE -EDICINA DE LA 5NIVERSI DAD .ACIONAL !UTONOMA DE -EXICO 0ULMONARY $ISEASE 0ULMONARY #RITICAL #ARE !SSOC 0 !

2ICHARD $ "RUNNING - $ -C'ILL 5NIVERSITY &ACULTY OF -EDICINE -ONTREAL #LINICAL 0ATHOLOGY 5NIVERSITY OF -INNESOTA 0HYSICIANS *ORY - "URROUGHS - $ 5NIVERSITY OF -INNESOTA /BSTETRICS 'YNECOLOGY #OMPREHENSIVE (EALTH #ARE FOR 7OMEN ,YDIA " #AROS $ / 5NIVERSITY OF /STEOPATHIC -EDICINE (EALTH 3CIENCES $ES -OINES 0EDIATRICS 5NIVERSITY OF -INNESOTA 0HYSICIANS

-AY *UNE

6INCENT 0 #ASINGAL - $ 'ENERAL 3URGERY 5NIVERSITY OF -INNESOTA 0HYSICIANS 0ETER - #ERMAK - $ 5NIVERSITY OF -INNESOTA &AMILY -EDICINE 5NIVERSITY OF -INNESOTA 0HYSICIANS $ENIS 2 #LOHISY - $ .ORTHWESTERN 5NIVERSITY -EDICAL 3CHOOL #HICAGO /RTHOPAEDIC 3URGERY 5NIVERSITY OF -INNESOTA 0HYSICIANS 0ETER 3 $AHLBERG - $ 5NIVERSITY OF -INNESOTA 4HORACIC 3URGERY 5NIVERSITY OF -INNESOTA 0HYSICIANS 3UNDEEP $EV - $ "OSTON 5NIVERSITY 3CHOOL OF -EDICINE /PHTHALMOLOGY 5NIVERSITY OF -INNESOTA 0HYSICIANS $AVID * $RIES - $ -3% 'ENERAL 3URGERY 5NIVERSITY OF -INNESOTA 0HYSICIANS !RKADIUSZ :BIGNIEW $UDEK - $ !KADEMIA -EDYCZNA 7YDZIAL ,EKARSKI 7ARSZAWA )NTERNAL -EDICINE 5NIVERSITY OF -INNESOTA 0HYSICIANS 3 % %NGLARD &ALCONER - $ !LBERT %INSTEIN #OLLEGE OF -EDICINE /PHTHALMOLOGY 3HOSHANA % %NGLARD - $ 0 !

"RETT 4 'EMLO - $ (ARVARD -EDICAL 3CHOOL #OLON 2ECTAL 3URGERY 5NIVERSITY OF -INNESOTA 0HYSICIANS $WENDA + 'JERDINGEN - $ 5NIVERSITY OF -INNESOTA &AMILY -EDICINE 5NIVERSITY OF -INNESOTA 0HYSICIANS 2AJESH 'OGIA -" "3 2ADIOLOGY 5NIVERSITY OF -INNESOTA 0HYSICIANS

3TEVEN (ERMANN !NDERSON - $ 5NIVERSITY OF -INNESOTA 0SYCHIATRY 5NIVERSITY OF -INNESOTA 0HYSICIANS 4ODD ! +ELLOGG - $ 5NIVERSITY OF -INNESOTA 'ENERAL 3URGERY 5NIVERSITY OF -INNESOTA 0HYSICIANS *ANE - +ILIAN - $ 5NIVERSITY OF -INNESOTA -INN(EALTH &AMILY 0HYSICIANS 0 ! ,ARPENTEUR (YUN *OD +IM - $ 5NIVERSITY OF +ANSAS 3CHOOL OF -EDICINE 0ULMONARY #RITICAL #ARE -EDICINE 5NIVERSITY OF -INNESOTA 0HYSICIANS !MY , 3POLLAR +RAUS - $ 5NIVERSITY OF -INNESOTA &AMILY -EDICINE -INN(EALTH &AMILY 0HYSICIANS 0 !

-APLEWOOD !SHISH 2AJINDER +UMAR - $ ,OKMANYUA 4ILAK -UN -EDICAL #OLLEGE "OMBAY 0EDIATRICS 5NIVERSITY OF -INNESOTA 0HYSICIANS

3HANTHI 3IVANANDAM - $ 0EDIATRIC #ARDIOLOGY 5NIVERSITY OF -INNESOTA 0HYSICIANS !NGELA * 7 3MITHSON - $ -0( 5NIVERSITY OF -INNESOTA &AMILY -EDICINE -INN(EALTH &AMILY 0HYSICIANS

0 ! "ANNING #AROL # 3TEENSON - $ 2ADIOLOGY 5NIVERSITY OF -INNESOTA 0HYSICIANS 4IMOTHY . 4HOMPSON - $ %MERGENCY -EDICINE 3T *OSEPH S (OSPITAL

ST 9EAR IN 0RACTICE %RIC 4 "ECKEN - $ 5NIVERSITY OF -INNESOTA /TOLARYNGOLOGY /TOLARYNGOLOGY (EAD .ECK 3URGERY 0 !

-ICHAEL * $ !MATO - $ /RTHOPAEDIC 3URGERY 3UMMIT /RTHOPEDICS ,TD %RIC ! 3TEFFEN - $ /PHTHALMOLOGY 3T 0AUL %YE #LINIC 0 !

+AMAKSHI ,AKSHMINARAYAN - $ .EUROLOGY 5NIVERSITY OF -INNESOTA 0HYSICIANS

3UZETTE % 3UTHERLAND - $ 5ROLOGY -ETRO 5ROLOGY 0 !

"RUCE ! ,EVY - $ /RTHOPAEDIC 3URGERY 5NIVERSITY OF -INNESOTA 0HYSICIANS

ND 9EAR IN 0RACTICE

'ERALD , -ORIARTY *R - $ #ASE 7ESTERN 2ESERVE 5NIVERSITY 3CHOOL OF -EDICINE .EUROLOGY 5NIVERSITY OF -INNESOTA 0HYSICIANS 3URAJ ! -ULEY - $ -" "3 5NIVERSITY OF "OMBAY .EUROLOGY 5NIVERSITY OF -INNESOTA 0HYSICIANS

+ATHRYN (ANSON 'ORALSKI - $ /BSTETRICS 'YNECOLOGY 0ARTNERS /B 'YN 0 !

2OBERT " 2OCK - $ 5NIVERSITY OF -INNESOTA )NTERNAL -EDICINE 5NIVERSITY OF -INNESOTA 0HYSICIANS

'WEN 7 (ALAAS - $ (ARVARD -EDICAL 3CHOOL &AMILY -EDICINE 5NIVERSITY OF -INNESOTA 0HYSICIANS

$ANIEL ! 3ALTZMAN - $ 0H $ 5NIVERSITY OF -INNESOTA 0EDIATRICS 5NIVERSITY OF -INNESOTA 0HYSICIANS

*EFFREY ! (ANSON - $ 5NIVERSITY OF -INNESOTA &AMILY -EDICINE 5NIVERSITY OF -INNESOTA 0HYSICIANS

9OAV 3EGAL - $ .EPHROLOGY 5NIVERSITY OF -INNESOTA 0HYSICIANS

*EROME * 0ERRA - $ 5NIVERSITY OF -INNESOTA /RTHOPAEDIC 3URGERY 3UMMIT /RTHOPEDICS ,TD

0RACTICE 0ART 4IME #HRISTINA * 4EMPLETON - $ 5NIVERSITY OF ,ONDON &ACULTY OF -EDICINE 0SYCHIATRY (AMM -EMORIAL 0SYCHIATRIC #LINIC

2ESIDENT 0HYSICIANS "RETT 7 !DAMS - $ 5NIVERSITY OF -INNESOTA &AMILY -EDICINE 5 OF -. 'RADUATE 3CHOOL -UDASSAR !HMED - $ 5 OF -. 'RADUATE 3CHOOL 3YED 3OHAIL !LI - $ 5 OF -. 'RADUATE 3CHOOL "RIAN * !LLEN - $ !NESTHESIOLOGY 5 OF -. 'RADUATE 3CHOOL

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

-ARIAM !LSHARIF - $ 5 OF -. 'RADUATE 3CHOOL

%LMER $ #ALICA - $ 5 OF -. 'RADUATE 3CHOOL

-ICHELLE # %THUN - $ 5 OF -. 'RADUATE 3CHOOL

0ADMAJARANI 'OTTIPOLU - $ 5 OF -. 'RADUATE 3CHOOL

3ULEIMMAN !HMAD !L 3WEEDAN - $ 5 OF -. 'RADUATE 3CHOOL

!NNAMARIE , #ARLEY - $ 0ATHOLOGYn!NATOMIC #LINICAL 5 OF -. 'RADUATE 3CHOOL

3TELLA ! %VANS - $ 5 OF -. 'RADUATE 3CHOOL

#HRISTINE 3 'OUDGE - $ 5 OF -. 'RADUATE 3CHOOL

*OEL - #ARLSON - $ 5 OF -. 'RADUATE 3CHOOL

*ULIE - &AULKNER - $ 0EDIATRICS 5 OF -. 'RADUATE 3CHOOL

9VONNE - 'RIERSON - $ /RTHOPAEDIC 3URGERY 5 OF -. 'RADUATE 3CHOOL

,AURA + !NDERSON - $ 5 OF -. 'RADUATE 3CHOOL

!DAM & #ARPENTER - $ 5 OF -. 'RADUATE 3CHOOL

-ICHAEL 0 &INCH - $ 5 OF -. 'RADUATE 3CHOOL

-USTAFA !TIQ !RAIN - $ 5 OF -. 'RADUATE 3CHOOL

#HANDRA * #ASTRO - $ 5 OF -. 'RADUATE 3CHOOL

2OGER % &LANIGAN - $ 5 OF -. 'RADUATE 3CHOOL

+ARIN ! (AGEN - $ )NTERNAL -EDICINE 5 OF -. 'RADUATE 3CHOOL

-ICHAEL 4 !RMSTRONG - $ 0HYSICAL -EDICINE 2EHABILITATION 5 OF -. 'RADUATE 3CHOOL

%RIC #HIH 9U #HEN - $ 5 OF -. 'RADUATE 3CHOOL

0ATRICK # &OY - $ 5 OF -. 'RADUATE 3CHOOL

'EORGE ! #HEN *R - $ 5 OF -. 'RADUATE 3CHOOL

"RIGETTE ) &ROHNERT - $ 5 OF -. 'RADUATE 3CHOOL

*OHN :ONGYU #HEN - $ 5 OF -. 'RADUATE 3CHOOL

+URT ! 'ASNER - $ 5 OF -. 'RADUATE 3CHOOL

%RIC * #HOU - $ 5 OF -. 'RADUATE 3CHOOL

-ELISSA ! 'ELLER - $ #HICAGO -EDICAL 3CHOOL 5 OF -. 'RADUATE 3CHOOL

'HIYATH !L 4ABBAL - $ 'ENERAL 3URGERY 5 OF -. 'RADUATE 3CHOOL

(OLLY 4 !SHLEY - $ /BSTETRICS 'YNECOLOGY 5 OF -. 'RADUATE 3CHOOL "ARBARA !NN "ACKER - $ 5 OF -. 'RADUATE 3CHOOL *ENNIFER 0 "ALDWIN - $ 5NIVERSITY OF -INNESOTA "RETT "ALOUN - $ 5 OF -. 'RADUATE 3CHOOL +AYSIE , "ANTON - $ 'ENERAL 3URGERY 5 OF -. 'RADUATE 3CHOOL

+IRBY $ #LARK - $ &AMILY -EDICINE 5 OF -. 'RADUATE 3CHOOL 3ARAH ! #OOLEY - $ 5 OF -. 'RADUATE 3CHOOL

!SHRAF !NWAR 'OHAR - $ 5 OF -. 'RADUATE 3CHOOL

3EVDALINA $ABOVA -ISSOVA - $ 5 OF -. 'RADUATE 3CHOOL

*EANNE -ACKENZIE 'OODSPEED - $ 5 OF -. 'RADUATE 3CHOOL

0AUL 2 $AMBOWY - $ 5 OF -. 'RADUATE 3CHOOL

#HANDRA 3 'OTTIPATI - $ 5 OF -. 'RADUATE 3CHOOL

!NDREW 2 "ARKSDALE - $ 5 OF -. 'RADUATE 3CHOOL

*OHN " $ARLING - $ 5 OF -. 'RADUATE 3CHOOL

3EAN * "ARNETT - $ 'ENERAL 3URGERY 5 OF -. 'RADUATE 3CHOOL

*OSEPH # $ENOR - $ )NTERNAL -EDICINE 5 OF -. 'RADUATE 3CHOOL

4ESSIE , "ARRETT - $ 5 OF -. 'RADUATE 3CHOOL

-ELANIE !NDROS $IXON - $ 5NIVERSITY OF -INNESOTA &AMILY -EDICINE 5NITED &AMILY -EDICAL 2ESIDENCY

*ANET - "ELLINGHAM - $ 'ENERAL 3URGERY 5 OF -. 'RADUATE 3CHOOL "RIAN # "ERG - $ 5 OF -. 'RADUATE 3CHOOL *ARED $ "ERNARD - $ 5 OF -. 'RADUATE 3CHOOL *OSHUA ! "ODIE - $ 5 OF -. 'RADUATE 3CHOOL .ATHAN 2 "RAKKE - $ 5 OF -. 'RADUATE 3CHOOL *ENNIFER , "UDD $ / &AMILY -EDICINE 5 OF -. 'RADUATE 3CHOOL 2YNN "URKE - $ 5 OF -. 'RADUATE 3CHOOL

*OHN $ 'HERMAN - $ 5 OF -. 'RADUATE 3CHOOL

.AOMI . $UKE - $ (ARVARD -EDICAL 3CHOOL 0EDIATRICS )NTERNAL -EDICINE 5 OF -. 'RADUATE 3CHOOL +EITH % %IDMAN $ / #HICAGO #OLLEGE OF /STEOPATHIC -EDICINE )NTERNAL -EDICINE 5 OF -. 'RADUATE 3CHOOL -ARCINE 0 %LLWEIN - $ 5 OF -. 'RADUATE 3CHOOL 7OEI 9 %NG - $ 5 OF -. 'RADUATE 3CHOOL 2OBIN # %NGBERG - $ 5 OF -. 'RADUATE 3CHOOL

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

"ILAL (AMEED - $ 5 OF -. 'RADUATE 3CHOOL 8INQUIANG (AN - $ 5 OF -. 'RADUATE 3CHOOL $EBORAH - (ANS - $ 0EDIATRICS 5 OF -. 'RADUATE 3CHOOL +IMBERLY ! -ARK - $ 5NIVERSITY OF 3OUTH $AKOTA 3CHOOL OF -EDICINE /BSTETRICS 'YNECOLOGY 5 OF -. 'RADUATE 3CHOOL -ARIE 4 7ANG - $ 0SYCHIATRY 5 OF -. 'RADUATE 3CHOOL #ONTINUED ON PAGE

#!,, &/2 2%3/,54)/.3 0LEASE HELP US TO ASSURE THAT YOUR INTERESTS ARE ACCURATELY CONVEYED BY CONTACTING 2-3 STAFF TO SUBMIT RESOLUTIONS PHONE FAX OR E MAIL RJOHNSON METRODOCTORS COM $EADLINE 2ESOLUTIONS DUE BY -AY

2-3 #AUCUS P M n 4HURSDAY -AY

3T *OSEPH S 2OOM 3T *OSEPH S (OSPITAL P M n 7EDNESDAY *UNE

#ONFERENCE 2OOM " # 5NITED (OSPITAL --! !NNUAL -EETING 3EPTEMBER n -ARRIOTT #ITY #ENTER (OTEL

-INNEAPOLIS -.

)F YOU ARE INTERESTED IN SERVING AS AN !LTERNATE $ELEGATE PLEASE CONTACT 2-3

-AY *UNE

2AMSEY -EDICAL 3OCIETY

!MANDA + !RRINGTON - $ 5 OF -. 'RADUATE 3CHOOL

#YNTHIA , (ALL - $ 5 OF -. 'RADUATE 3CHOOL

2-3 .EW -EMBERS #ONTINUED FROM PAGE

-IN 7ANG - $ !NESTHESIOLOGY 5 OF -. 'RADUATE 3CHOOL * $AVID 7ATTS - $ /RTHOPAEDIC 3URGERY 5 OF -. 'RADUATE 3CHOOL *ENNIFER ) 7EISER - $ 0EDIATRICS 5 OF -. 'RADUATE 3CHOOL %LLEN 7ENBERG - $ 5 OF -. 'RADUATE 3CHOOL "RYAN ! 7HITSON - $ 'ENERAL 3URGERY 5 OF -. 'RADUATE 3CHOOL %LIZABETH + 7ILLIAMS - $ 5 OF -. 'RADUATE 3CHOOL (YNATU , 7ILLIAMSON - $ 5 OF -. 'RADUATE 3CHOOL .ICHOLAS * 7ILLS - $ 5 OF -. 'RADUATE 3CHOOL ,AURA % 7ILLSON - $ 5 OF -. 'RADUATE 3CHOOL +IRK $ 7ILSON - $ 5 OF -. 'RADUATE 3CHOOL #HRISTOPHER - 7OLFRAM - $ 5 OF -. 'RADUATE 3CHOOL (EATHER ,IA 7OLLER - $ 5 OF -. 'RADUATE 3CHOOL #AROLYN 3U 9ING 7OON - $ 5 OF -. 'RADUATE 3CHOOL !MANDA * 7YCOFF - $ 5NIVERSITY OF .EBRASKA #OLLEGE OF -EDICINE /BSTETRICS 'YNECOLOGY 5 OF -. 'RADUATE 3CHOOL 0A &OUA 9ANG - $ 5 OF -. 'RADUATE 3CHOOL 9OUA 0A 3 9ANG - $ &AMILY -EDICINE 5 OF -. 'RADUATE 3CHOOL !ISIMA 9ASIN - $ 5 OF -. 'RADUATE 3CHOOL *IANLING 9UAN - $ 5 OF -. 'RADUATE 3CHOOL

-EDICAL 3TUDENTS 5NIVERSITY OF -INNESOTA

(ARSH 2 !GGARWAL .ITI !GGARWAL +AIS ) !L 3HARIF !IMEE 2 !LEXANDER

-AY *UNE

!NTHONY 7 !NDERSON &RANKLIN / !NDERSON 2EBECCA + !NDERSON +AREN 2 !RMBRUST %LIZABETH ! "ALDWIN 'ENIE - "ANG -AISHA . "ARNES 3ARAH % "ERINI +ATHERINE ! "IEBL 0AUL 2 "OWLIN 4ONYA & "RAKEY *ESSE , "REHMER +RISTEN - "UZZELL "RENT $ #ARLSON -ARK $ #ONNELLY 3UJATA 2AO #OSTELLO 2OBERT , #ZECH %LENA 3 $IAZ %RIN & $RASLER #RAIG % %CKFELDT #HRISTOPHER - %RICKSON "ABARINDE / &ADIREPO +ENNETH - &ECHNER (EIDI + &LASHINSKI 'ARETH + &ORDE *ASON $ &OWLER ,AURA ! &REEMAN 3ARAH ! &ROMMER !NGELA + &RYER 3HANNON - 'ABRIEL +RISTIN - 'EHRKING *ESSICA ! 'ERWING !NN % 'IESE #AROLYN * 'ONTER (ANS 3 'RINAGER .ATHAN * 'ROEBNER 3ARAH % 'UNDALE -ATTHEW # (AGEN -ELISSA + (ART ,UKE ( (INTERMEISTER %LIZABETH , (OEL *ULIE % (ORBUL *UAN 0 *AMES *OAN - *ASIEN (ANS # *EPPESEN $AVID * *EWISON %LIZABETH " *OHNSON 3ARA ( *OHNSON 6ALERIE % *OHNSON *AMES 7 +ECK 4ARA # +ENDALL 0AUL - +IETZMANN %RIC % +IRKSSON #OLLEEN # +NIFlN %RIN - +NUDTSON *OSHUA 2 +NUDTSON 3ARAH * +OTTKE 0AO & +UE *OSHUA % ,ACKNER 0AMELA ( ,AI

!MANDA * ,AMBERT !NDREW 0 ,AUDENBACH *OSEPH ) ,EVINE -ELANIE 2 ,IND !YRES -ICHAEL ! ,INDEN -ARA , ,ISS 3TACY - ,ONGNECKER 3ETTY - -AGANA !TTIAS )SAAC 4 -ARSOLEK 3EAN % -C2OBERTS $ANIEL $ -ILLER 3ARA -OASSESFAR !BIGAIL 4 -OCH *OHANNA # -OORE *EFFREY 3 -ORRIS $ARLA -OTAMEDI -AI 3EE -OUA "ENJAMIN -UELLER +ATHARINE * .ELSON +INSEY " .ELSON 3AMEER .EVILE 'RETCHEN - .IEMIOJA -ARGARET . .JONJO +ARLA * .OCKLEBY #HRISTINA , /EHRLEIN *EREMY $ /LSEN 8ILMA 2 /RTIZ 'ONZALEZ -ATTHEW * / 3HAUGHNESSY 2ACHEL . /TTO "RIAN 3 0ERSHING

%LIZABETH + 0LOCHER $AVID . 0RALL +EVIN + , 1UINN ,ANE 2 *APP *R 3COTT 4 2EARDON 3COTT ! 2EULE 4HEODORE 2 2UZANIC "RETT * 3ALEK #YNTHIA 4 3CHANDORF !NDREW 0 3CHIPPEL !NNA - 3CHMID $OUGLAS + 3IGFORD 3ARA - 3KRLIN %RIC 2 3TEVENS ,UKE $ 3TOLTZFUS 0HILLIP 4 3UWAN .OLAWIT 4ESFAYE #HRISTOPHER * 4HOMPSON 3TEVEN - 6ANDERWERF 3HARY 6ANG !DAM 0 6OSSEN 3USAN % 7ALGRAVE *EFFREY ! 7ALLHOFF !MANDA - 7ALZ !NITA - 7ARFA +ATIE - 7EATHERHOGG 4RINA *O 7EIK -ATTHEW % 7IISANEN 9ER - 8IONG 2EBECCA - :IEGLER

)N -EMORIAM "%.*!-). &5,,%2 - $ DIED &EBRUARY AT THE AGE OF (E GRADU ATED FROM THE 5NIVERSITY OF -INNESOTA -EDICAL 3CHOOL AND SERVED IN THE !RMY !IR #ORPS AT THE END OF 7ORLD 7AR )) (E WAS A RESIDENT AT -AYO #LINIC $R &ULLER PRACTICED INTERNAL MEDICINE IN DOWNTOWN 3T 0AUL UNTIL WHEN HE JOINED THE 5 OF - MEDICAL SCHOOL STAFF FULL TIME TO WORK IN THE #OMPREHENSIVE #LINIC A PROGRAM THAT EMPHASIZED COORDINATION AND MANAGEMENT IN HEALTH CARE (E RETURNED TO PRIVATE PRACTICE IN IN 7HITE "EAR ,AKE $R &ULLER WAS A RECIPIENT OF 5NITED (OSPITAL S h3ERVICE TO (UMANITY !WARDv AND WAS THE AUTHOR OF TWO BOOKS ON PATIENT CARE (E JOINED 2-3 IN *%2/-% ! h*%229v (),'%2 - $ AGE DIED ON &EBRUARY $R (ILGER GRADUATED FROM THE 5NIVERSITY OF -INNESOTA IN (E SERVED IN 7ORLD 7AR )) AS A ,T #OLONEL WHERE HE SALVAGED METAL PARTS TO FASHION SURGICAL INSTRUMENTS AND HOLD TOGETHER THE FRACTURED FACES AFTER PERFORMING RECONSTRUCTIVE SURGERIES &OR HIS EFFORTS HE WAS AWARDED THE "RONZE 3TAR $R (ILGER WENT ON TO BECOME A MAJOR lGURE IN THE SPECIALTY OF OTOLARYNGOLOGY !S A FACULTY MEMBER AT THE 5NIVERSITY OF -INNESOTA -EDICAL 3CHOOL HE ORGANIZED THE SCHOOL S HEAD AND NECK CANCER PROGRAM WHICH ALSO INCLUDED RECONSTRUCTIVE SURGERY (E BUILT HIS PRACTICE INTO THE BIGGEST HEAD NECK CANCER GROUP IN THIS PART OF THE COUNTRY BECAME A PROFESSOR AND ORGANIZED THE GRADUATE SCHOOL AT THE 5 4HOUGH TECHNICALLY RETIRED HE WENT ON TO BECOME ENTREPRENEUR OF "IO -EDICAL #OMPUTING #OMPANIES WHICH WAS ESTABLISHED TO COMPUTERIZE MEDICAL RECORDS $R (ILGER JOINED 2-3 IN -ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

#(!)2 3 2%0/24 -)#(!%, " "%,:%2 - $

!DVOCACY AND 3ECONDHAND 3MOKE (-3 /FlCERS

(-3 "OARD -EMBERS

-ARY !NDERSON #O 0RESIDING #HAIR (-3 !LLIANCE #ARL % "URKLAND - $ %MMETT & #ARPEL - $ %RIC ' #HRISTIANSON - $ 0ETER * $EHNEL - $ -ARLENE %LLIS #O 0RESIDING #HAIR (-3 !LLIANCE 2AYMOND ! 'ENSINGER *R - $ ,ISA -C'INNIS -EDICAL 3TUDENT 2ONALD $ /SBORN $ / &RANK 3 2HAME - $ $AVID & 2UEBECK - $ 2ICHARD $ 3CHMIDT - $ *AN ( 3TRATHY - $ 4HOMAS # 4UNBERG - $ 0ETER ! 7ALLSKOG - $ (-3 %X /FlCIO "OARD -EMBERS

,EE ( "EECHER - $ --! 4RUSTEE +AREN + $ICKSON - $ --! 4RUSTEE $AVID , %STRIN - $ !-! !LTERNATE $ELEGATE +ENNETH " (EITHOFF - $ --! 4RUSTEE $ONALD - *ACOBS - $ --! 4RUSTEE +ARIN - 4ANSEK - $ --! 4RUSTEE "ENJAMIN ( 7HITTEN - $ !-! !LTERNATE $ELEGATE "ARBARA $AIKER --'-! 2EP (-3 %XECUTIVE 3TAFF

*ACK ' $AVIS #HIEF %XECUTIVE /FlCER +ATHY 2 $ITTMER %XECUTIVE !SSISTANT 3UE 3CHETTLE $IRECTOR -ARKETING -EMBER 3ERVICES

)

) (!6% 35--!2):%$ BELOW THE TWO MAJOR FOCI FOR THE LEADERSHIP AND STAFF OF THE (ENNEPIN -EDICAL 3OCIETY ADVOCACY AND SECONDHAND SMOKE IN THE WORKPLACE !DVOCACY 3EVERAL YEARS AGO THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES WERE INSTRUMENTAL IN ESTABLISH ING THE -INNESOTA &AIR #ONTRACTING #OALITION )N TOTAL OTHER PROVIDER ORGANIZATIONS JOINED US IN PURSUING A MORE EQUITABLE MANAGED CARE CONTRACTING ENVIRONMENT FOR PHYSICIANS 4HE #OALITION WAS SUCCESSFUL IN ITS MISSION ,AST FALL THE GROUP FELT THAT WE COULD CONTINUE TO JOIN FORCES TO PURSUE ISSUES AT THE ,EGISLATURE THAT WENT ACROSS VARIOUS PROVIDER CATEGORIES 9OUR (-3 LEADERSHIP AGREED THAT OUR MEMBERS ARE WELL SERVED BY STAYING ACTIVE IN THE LEGISLATIVE ARENA 4HE GROUP WAS RENAMED THE -INNESOTA 0ROVIDER #OALITION -0#

4HE (ENNEPIN -EDICAL 3OCIETY AND THE -0# WITH THE HELP OF LOBBYING GROUP ,OCKRIDGE

'RINDAL .AUEN HAVE MONITORED SEVERAL PIECES OF LEGISLATION THIS SESSION 4HEY INCLUDE LEGISLA TION THAT WOULD ALLOW MANAGED CARE STRATEGIES AND PRACTICE PARAMETER IN THE MEDICAL COMPONENT FOR REIMBURSEMENT OF WORKER S COMPENSATION CLAIMS DEFEATED ELIMINATION OR SEVERE MODIlCA TION IN THE MEDICAL COMPONENT OF NO FAULT AUTO DEFEATED SUPPORT FOR LEGISLATION THAT WOULD REQUIRE HEALTH PLANS TO PAY FOR REQUIRED TRANSLATOR SERVICES CHANGED TO A STUDY SUPPORT FOR LEGISLATION THAT WOULD ALLOW PHYSICIANS TO ITEMIZE THE PROVIDER TAX ON PATIENT STATEMENTS HEAR ING 3UPPORT FOR THE -INNESOTA &REEDOM TO "REATHE !CT WHICH WOULD PREVENT EXPOSURE TO SECONDHAND SMOKE IN ALL WORK PLACES INCLUDING BARS AND RESTAURANTS -ULTIPLE HEARINGS PROBABLY HELD OVER TO NEXT YEAR 3UPPORT FOR PER PACK TAX INCREASE FOR CIGARETTES SUPPORT THE TAX

BUT OPPOSE THE EXCHANGE FOR PREMIUM TAX &AVOR USING THE FUNDS FOR STATE PROGRAM ELIGIBILITY AND 3UPPORT FOR MANY ASPECTS OF LEGISLATION BASED ON THE --! (EALTH 2EFORM 4ASK &ORCE 2EPORT AND SEVERAL DOZEN OTHER PIECES OF LEGISLATION IN VARIOUS STAGES OF INTRODUCTION 3ECONDHAND 3MOKE 0REVENTION 3MOKING BANS WENT INTO EFFECT METRO WIDE -ARCH

"ELOW IS A SUMMARY OF SOME OF THE ACTIVITIES WHERE (-3 WAS INVOLVED

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

-INNEAPOLIS (-3 SERVED A CENTRAL ROLE IN THE EFFORTS FOR -INNEAPOLIS TO GO SMOKE FREE -ANY OF THE PHYSICIANS OF (-3 WERE INVOLVED WITH THIS PROJECT (-3 SERVED A PIVOTAL ROLE IN THE h-INNEAPOLIS n $ONE SMOKIN n 3TILL HOTv CAM PAIGN 0ART OF THE CAMPAIGN INCLUDED AN AGGRESSIVE MARKETING AND PUBLIC RELATIONS PLAN THAT WORKED TO PROMOTE -INNEAPOLIS AS A GREAT PLACE TO VISIT 4HE PLAN IS MULTI FACETED AND INCLUDES BILLBOARDS

MEDIA EVENTS NEWSPAPER ARTICLES AND TELEVISION COMMERCIALS 4HE CAMPAIGN ALSO UTILIZES THE 7EB SITE THAT (-3 HAD DEVELOPED FOR OUR -INNEAPOLIS PROJECT WWW CLEANAIRMINNEAPOLIS ORG

(ENNEPIN #OUNTY (-3 WAS ASKED TO TAKE AN ACTIVE ROLE IN (ENNEPIN #OUNTY BY HAVING DISCUSSIONS WITH ELECTED OFlCIALS AND MEMBERS OF VARIOUS REGULATORY AGENCIES 7E WERE ALSO ASKED TO HELP IDENTIFY PHYSICIANS WHO WOULD BE WILL ING TO TESTIFY AT A PUBLIC HEARING 3IMILAR TO OUR EXPERIENCE IN -INNEAPOLIS PHYSICIANS WERE VERY WILLING PARTICIPANTS AND EFFECTIVELY SPOKE OUT ON THE DANGERS OF SECONDHAND SMOKE

/THER #OMMUNITIES (-3 HAS BEEN INVOLVED WITH SMOKE FREE EFFORTS IN 'OLDEN 6AL LEY %DINA AND "LOOMINGTON AS WELL 0HYSICIANS PLAYED ACTIVE ROLES IN THOSE EFFORTS AND HELPED TO MAKE SURE THAT THE HEALTH MESSAGE RELATED TO THE DANGERS OF PROLONGED EXPOSURE TO SECONDHAND SMOKE REMAINED CONSISTENT

0OST )MPLEMENTATION 0OLLING (-3 WAS AWARDED A MONTH GRANT FROM THE -INNESOTA 0ARTNERSHIP FOR !CTION !GAINST 4OBACCO -0!!4 TO CONDUCT A POST ORDINANCE IMPLEMENTATION POLL IN (ENNEPIN #OUNTY

&REEDOM TO "REATHE 4HE (OUSE AND 3ENATE RECENTLY HEARD PUBLIC TESTIMONY FROM OPPONENTS AND PROPONENTS TO ENACTING LEGISLATION TO REQUIRE BARS AND RESTAURANTS TO GO SMOKE FREE (-3 WORKED WITH THE -INNESOTA -EDICAL !SSOCIA TION TO IDENTIFY PHYSICIANS TO TESTIFY ON BEHALF OF OUR ORGANIZATIONS 4HE &REEDOM TO "REATHE BILL WENT THROUGH THE VARIOUS COMMITTEES OF THE 3ENATE BUT FAILED IN A (OUSE VOTE OF THE #OM MERCE #OMMITTEE !T THIS POINT THE BILL COULD BE BROUGHT UP ON THE (OUSE mOOR BUT NO DECISIONS HAVE BEEN MADE WHETHER TO DO THAT OR WAIT UNTIL NEXT SESSION

-AY *UNE

(ENNEPIN -EDICAL 3OCIETY

#HAIR -ICHAEL " "ELZER - $ 0RESIDENT *AMES ! 2OHDE - $ 0RESIDENT ELECT 0AUL ! +ETTLER - $ 3ECRETARY %DWARD 0 %HLINGER - $ 4REASURER !NNE - -URRAY - $ )MMEDIATE 0AST #HAIR -ICHAEL " !INSLIE - $

(-3 .%73

"RIAN ( 2ANK - $ (EMATOLOGY /NCOLOGY (EALTH0ARTNERSn2IVERSIDE %VE 2ENEE 2OGERS - $ .EUROLOGY 4HE -INNEAPOLIS #LINIC OF .EUROLOGY ,TD

.EW -EMBERS (-3 WELCOMES THESE NEW MEMBERS TO THE 3OCIETY

ST 9EAR IN 0RACTICE *ADE ' !NDERSON - $ (EMATOLOGY /NCOLOGY (UBERT ( (UMPHREY #ANCER #ENTERn5NITY #AMPUS +EFENG 'U - $ &AMILY -EDICINE 3ILVER ,AKE #LINIC 0 ! +ARLA ! ,ARSON 7ADD - $ !NESTHESIOLOGY 2EGIONS (OSPITAL

ST 9EAR IN 3TATE #ARY (ERBERT -IELKE - $ 0EDIATRIC /RTHOPAEDIC 3URGERY 3HRINERS (OSPITAL FOR #HILDREN "ENJAMIN . 0OFAHL - $ &AMILY -EDICINE #AMDEN 0HYSICIANS ,TD ,ANCE -ICHAEL 3ILVERMAN - $ /RTHOPAEDIC 3URGERY /RTHOPAEDIC #ONSULTANTS 0 ! n "URNSVILLE $AVID " 6AN 3CHYNDEL - $ )NTERNAL -EDICINE !LLINA -EDICAL #LINIC .ICOLLET -ALL

!CTIVE #HARLES * "ILLINGTON - $ )NTERNAL -EDICINE 6ETERANS !FFAIRS -EDICAL #ENTER 0ETER # #ONKLIN - $ $IAGNOSTIC 2ADIOLOGY 3UBURBAN 2ADIOLOGIC #ONSULTANTS

,TD * +EVIN #ROSTON - $ 'ENERAL 3URGERY 3PECIALISTS IN 'ENERAL 3URGERY ,TD *ULIE + ,ESSER - $ 0SYCHIATRY *ULIE + ,ESSER - $ *EFFREY ! ,UKENS - $ $IAGNOSTIC 2ADIOLOGY 3UBURBAN 2ADIOLOGIC #ONSULTANTS

,TD

-AY *UNE

#ARY 2OSE - $ #ARDIOLOGY -ETROPOLITAN #ARDIOLOGY #ONSULTANTS 0 ! ,ELAND * # 3COTT - $ 0H $ .EUROLOGY 4HE -INNEAPOLIS #LINIC OF .EUROLOGY ,TD *OHN # 5ECKER - $ 0SYCHIATRY 9ELENA 6ICTOROVNA 5SMANOVA - $ .EUROLOGY 4HE -INNEAPOLIS #LINIC OF .EUROLOGY ,TD *EFFREY , 7ILSON $ / 2HEUMATOLOGY !RTHRITIS 2HEUMATOLOGY #ONSULTANTS 0 !

2ESIDENT 0HYSICIANS 2OLF *ON 3IMONSON - $ &AMILY -EDICINE #REEKSIDE &AMILY 0HYSICIANS #LINIC -ICHAELA ,ONG 4SAI - $ 'ENERAL 0REVENTIVE -EDICINE 5NIVERSITY OF -INNESOTA %RIC # 7ALTER - $ 5NIVERSITY OF -INNESOTA

-EDICAL 3TUDENTS 5NIVERSITY OF -INNESOTA .AA !DJELEY $ !BLORH #RISTINA 3 2 !LBOTT !BNET ! !LEMU #ARRIE ! !LME #HRISTOPHER - !NTOLAK "ILAL !NWER *AVARIAH ) !SGHAR .OELLE % "ACH "ENJAMIN *OHN "AECHLER 4YLER * "AILEY 9AN ' "AKMAN .ILES * "ATDORF *OAN $ "ECKMAN .ICOLAS 4 "EFERA *EREMY 3 "ENNETT $OUGLAS $ "ENSON :ACHARY * "ERBOS $ANIELLE - # "ERGE +ATHRYN % "ERKSETH "RYAN 0 "ERRY

.ATHAN 3 "ERTELSEN %MILY - "EZEK %MILY 3 "IRKHOLZ ,AURA * "LAISDELL *OSHUA 2 "LOMBERG !DAM +EITH "OETTCHER !LISON ,EE "ONOW *AMES ( "OYUM +EVIN * "RODER 6ICTORIA , "ROWN 'ILLIAN "URKHARDT 4ERENCE # "URNS +EVIN $ #AMPBELL +IMBERLY . #ANlELD "RETT - #ARLSON *ONATHAN # 4 #ARLSON "ENJAMIN #ASILLAS +ELLY * #ASPERSON +ELLY ! #AWCUTT "O ( #HAO *OSHUA $ #HAPMAN .ATHAN * #HARLES !NHTUNG 4 #HAU %LEANOR 9 #HEN $ANIEL . #OHEN -ICHAEL " #OLGAN *EREMY 7 #OOK +RISTOPHER ' #UNNINGHAM 2YAN 7 $AILEY -ATTHEW * $AMMEYER $AVID * $ANIELS /PEYEMI / $ARAMOLA 3TEPHANIE ! $AVISON 3ARAH , $EAMER *ASON & $EEN -ELISSA % ( $EER 0ARISSA $ELAVARI -EGAN * $ELL $ANIELLE # / $EMPSEY #HRISTOPHER # $E.UCCI 3HAILLY $HAM *AY 2 $IAZ 0ARLET +ELLY 2 $IETZ 4IM 3 $UENAS 4YLER * - $UNPHY *ONATHAN # %DEL !IMEE * %DWIN 3ARA % %HRLICH 3ARAH ,IV %LFERING !MY * %NGEBRETSON 3EAN # %NGEL #ESAR % %RCOLE !MBER ) %RICKSON *ONATHAN 0 %RICKSON ,AURA # %VAVOLD &ARID &ARZANEHKIA -ITRA - &ATOURECHI *USTIN 7 &INCH -ATTHEW * &ITZPATRICK 3IOBHAN - &LANAGAN %RINE / - &ONG *AMIE ,EE &ORT

6ANESSA . &RANCOIS "ONGARCON 3ARAH - &RENNING )LVY ( &RIEBE *OSEPH - &ULLMER $ANIEL 0 &ULTON ,AURA - &URDA !NDREA ' 'AETZ *ERALD - 'ARCIA ,AUREL % 'ARRETT +ATHRYN ! 'EHRIG *AMES # 'EKAS -ELISSA 2 'ERHART !DAM * 'ESS 4ATE ! 'ISSLEN +IMARA , 'LASER +IRSCHENBAUM 7ADI 3 'OMERO #URE .OELLE % 'RAY !NNE ' 'REGERSON 2YAN 4 'ROESCHL %RIN ( 'RUND 4ENNER * 'UILLAUME *ESSICA ! 'UIROY 4HOMAS 0 'USTAFSON +URT ! (ABBEN *ASON - (ABECK #ASEY , (ALL (EATHER 2 (AMERNICK -ICHELLE 9 (AMLINE :ACHARY 0 (ANDLER 2YAN -ARK (ARDEN .ATHAN 0 (ARRIS $EBORAH ! (ATANPA *ASON - (ATAYE 3RADDHA 0 (ELFRICH +RISTEN % (ELVIG 3ARAH % (ENNING 3HANNON 2 (ERRERA "ENJAMIN !NDREW (ESS +URT ! (ESSEN #HARLES $ (IGHTOWER !MY -ARIE (ILL 3HANA - (ILL *ACOB 2 (ODGE *ASON 3 (OLM $ANAH - (OLMAN 3COTT - (OLTHUSEN *OHN ( (OODY *ENNIFER % (RABE *EONG 3 (YUN -OHAMED ! )BRAHIM 0ATRICK 3 )NVEEN !NN , )SAKSEN .ICHOLAS ! )TZIN "ARTON # )VERSON 5ROGHUPATEI 0 )YEGHA *OHN 2 *ALAS ,ISA + *ASPERSON #RISTY 2 *ENSEN 4ANNER - *OHANNS !DAM # *OHNSON *EFFREY 2 *OHNSON -ATTHEW 3 *OHNSON

-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

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-ETRO$OCTORS 4HE *OURNAL OF THE (ENNEPIN AND 2AMSEY -EDICAL 3OCIETIES

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Sophisticated Estate

Prestigious Fremont Avenue

Charming Nantucket

Stunning Modern Romantic

Sophisticated Contemporary

Beautiful home set on private Bass Lake with nearly 1 acre of lake shore. Featuring all the amenities you can imagine including a state of the art home theater, gourmet kitchen with granite and cherry cabinets, and more. 4 bedrooms, 6 baths.

Set on a double lot, and just steps to Lake Harriet, this graceful 19th Century architecture offers classic old world charm and character throughout.

Includes attractive public and private spaces, spacious eat-in kitchen, master suite with dressing room and bath.

A wonderful home with fantastic potential. 5 bedrooms, 4 baths.

Attractive home set on a absolutely glorious lot. Features include a beautiful gourmet kitchen with granite countertops and tumbled limestone backsplash, main floor family room, enchanting bonus room and more. Absolutely move in condition! 4 bedrooms, 3 baths.

An impressive International Modern style home featuring, a rare sense of warmth, romance, mystery and drama. The home also affords a captivating and inviting open floor plan, a wonderful use of woods creating an intimate texture, and many graceful curves and crisp spaces. This fine home is a genuine work of art. 4 bedrooms, 4 baths.

Beautiful home set on a private lot with abundant wildlife and captivating views. Features spacious sun-filled public rooms, loads of windows, large eat-in kitchen with adjoining family room, dramatic master suite with loft/ office space, and lower level recreation room. 4 bedrooms, 5 baths.

Lowry Hill Mansion Meticulously maintained home overlooking Thomas Lowry Park. Features fantastic downtown views, impeccable fit and finishes, beautiful old world details. Mint condition! 6 bedrooms, 5 baths.

Go West Young Family We saved the best for last! Build the home of your dreams on a choice cut of the last piece of Prime Edina Real Estate. This is no East Edina, this is the West. These are the homes where the open spaces roam, and the lofty and soaring vaults tray. Don’t tell us about the Old World Charm. Heck, we built that, too. “Your investment will be significant in your next home, it may as well be on a home that you custom design!” There are 23 lots now available to turn your dreams into reality.

Call Scott Card John Shaw

612.209.6455

or visit us on the web at

612.720.4678

www.ParkwoodKnolls.com

Call

Bruce Birkeland 612-925-8405 www.brucebirkeland.com

Continuing Medical Education SPRING & FALL 2005

PRIMARY CARE FOCUS

SURGERY FOCUS

Family Medicine Review: Update 2005 May 23-27, 2005

Pediatric Esophageal Disorders Phoenix, Arizona May 27-28, 2005

Topics and Advances in Pediatrics June 9-10, 2005 Vascular Diseases: A Primary Care Perspective September 16-17, 2005

Advances in Gastrointestinal and GI Laparoscopic Surgery (69th Annual Surgery Course) June 15-18, 2005

Annual Psychiatry Review: An Eclectic Presentation of Psychiatric Erudition September 19, 2005

Endorectal Ultrasonography Workshop September 7, 2005

Twin Cities Marathon Sports Medicine Conference September 30 - October 1, 2005

Colon & Rectal Surgery: Conundrums and Controversies September 8-10, 2005

Annual Autumn Seminar: Obstetrics, Gynecology and Womenâ&#x20AC;&#x2122;s Health October 10-11, 2005

Transplant Immunosuppression 2005: Improving Recipient Outcomes September 28 - October 1, 2005

Internal Medicine Review: Update 2005 October 19-21, 2005

ALSO OFFERED Pediatric Dermatology May 20, 2005

This reflects our current listing.

All courses listed take place in the Twin Cities Metro Area unless noted.

For more information contact: Continuing Medical Education 612.626.7600 or 1.800.776.8636 www.cme.umn.edu / cmereg@umn.edu

Workshops in Clinical Hypnosis June 2-4, 2005 Novel Therapies in Thoracic Oncology July 15, 2005