Coastal ENT Medical Group

Coastal ENT Medical Group

We are a full-service ENT / Head and Neck medical and surgical office, located in La Jolla CA on the Scripps Memorial Hospital campus.

9834 Genesee Ave, Suite 128
La Jolla CA 92037
858-458-1287

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Wireless Health

Qualcomm and Don Jones are busy uniting the folks around wireless devices to improve data dn information flow.

See the West Foundation formation of West Wireless Health Institute and Wireless Life Sciences

Digital Consultations

Today's WSJ mentioned on-line consultations and secure messaging.

Along with insurance companies, this may be helpful in the future to reduce costs and increase access.

We are evaluating this option with our contracts, as well as a secure email system such as RelayHealth, Medfusion and Medem.

A new product from UHC called American Well may be one solution for some physicians and patients.

HSA's

Long a good choice for individuals and companies, the HSA and the older MSA are destined to be seriously changed if not eliminated. They require a high- deductible-perhaps $2400 to $4000 per individual. A paired HSA eligible health care insurance is necessary.
Perhaps your employer deposits an amount equal to the deductible into an HSA management company such as Healthequity. Your will have centralized management, a debit card etc.

Then, you use your insurance as a usual, paying for services with the card.

Monies accumulate in an account earning interest and can be invested in mutual funds, making this like an IRA. Contributions until age 65, but withdrawals can be for much longer.

Download HSA-62609

PHR's

Personbal Health Records (PHR) have existed for a while. Recent developments by Google and Microsoft helped promote concept.

Office of National Coordinator of Health Information Technology (ONCHIT) is developing a model and template.

www.gpoaccess.gov/fr/index.html

Meaningful Use

The term "meaningful use" is often mentioned about EMR's but it has NOT been defined as of 6/09.
Perhaps by the end of this year. The definition will allow vendors and providers to qualify fo economic stimulus dollars. Many groups are making their case to federal officials.

Per the MARKLE FOUNDATION,numerous representatives of 60 organizations call fo meaningful use to focus on medication reconciliation and coordination of care.

Several phases were discussed:
1. Clinical data display and CPOE
2. CPOE over 51% OF ORDERS
3. Data exchange using CCD, Continuity of Care Document

CHIME(College of Healthcare Management Executives
HIMSS(Healthcare Informatin Management and Systems Society
AMIA(American Medical Informatics Association)

EMR-Remote hosted vs local

When you decide to run an EMR, local and remotely hosted varieties are possible. Depending on you past history and support services, one may be better than other for you.

Small offices might try the ASP model since maintanence and support are easier. You do need a local machine, router and firewall but backup is taken care of by service. But you can avoid a server. Updates are handled by ASP supplier. Local workstation connect via a web browser. examples include athenahealth, Practisefusion.

Perhaps a hospital can be the host of remote systems.

Larger system might host applications locally with a required server, backup locally with NAS and off-site. Local workstations are clients on a client-server system.

Some companies offer both options using Citrix for remote hosting. Others use a web browser.

Your Body is Talking

Many areas of your body speak to you is some way. We deal mostly in Head and Neck/ENT anomalies but were interested in this article about general medicine.
Download Body is talking-62309

Healthy Family Trees

Most of you have studied genealogy for fun or on a serious level. Recently, a great article appeared in the WSj discussing the live-saving ability of family tree study concerning health topics.

At family picnics or yearly gatherings, it may be possible to study the family secrets and help better than fancy genomic research.

Colon polyps and cancer, diabetes, Alzheimer's disease, macular degeneration, cancer, heart disease, cholesterol and triglycerides all are worth study.

You can obtain a genetic profile from 23andme.

See the article:
Download Family tree-61109

Healthcare - 2009

Healthcare is a good 17% of our GDP. Is that because of insatiable demands, inefficacy, expensive tests and procedures, expensive drugs?

Probably all of these cause our high expense for healthcare.

Despite this, there is some form of rationing, but not as much as we are likely to have in the future.

Our system of stability is crumbling This might be thought of as classic Schumpeter creative destruction but I am not sure. Financial including banking, autos and suppliers and now healthcare is in for a fix.

I have included a few recent articles on ObamaCare as of June 2009.

Download CO-OP
Download Myth of prevention
Download Road to recovery
Download Wyden 3rd way
Download PUBLIC PLAN-61509
Download UNINSURED-62409

ACT Database System

For several years we have employed a contact manager database (ACT) redesigned for medical use.

We programed a receptionist view to allow entry of basic demographic fields. Then the nurse adds data about complaints and Vital Signs.

MD then begins his narrative and fills in blank fields. Several are templated.

Then, the data is mail-merged into ACT word processor which produces a referral letter which is faxed to MD.