Science & Society Blog

Researchers at Ben-Gurion University of the Negev (BGU) in Israel have developed a new hand gesture recognition system, tested at a Washington, D.C. hospital, that enables doctors to manipulate digital images during medical procedures by motioning instead of touching a screen, keyboard or mouse which compromises sterility and could spread infection, according to a just released article.

The June article,” A Gesture-based Tool for Sterile Browsing of Radiology Images” in the Journal of the American Medical Informatics Association (2008;15:321-323, DOI 10.1197/jamia.M24), reports on what the authors believe is the first time a hand gesture recognition system was successfully implemented in an actual “in vivo” neurosurgical brain biopsy. It was tested at the Washington Hospital Center in Washington, D.C.

According to lead researcher Juan P. Wachs, a recent Ph.D. recipient from the Department of Industrial Engineering and Management at BGU, “A sterile human-machine interface is of supreme importance because it is the means by which the surgeon controls medical information, avoiding patient contamination, the operating room (OR) and the other surgeons.” This could replace touch screens now used in many hospital operating rooms which must be sealed to prevent accumulation or spreading of contaminants and requires smooth surfaces that must be thoroughly cleaned after each procedure – but sometimes aren’t. With infection rates at U.S. hospitals now at unacceptably high rates, our system offers a possible alternative.”

Helman Stern, a principal investigator on the project and a professor in the Department of Industrial Engineering and Management, explains how Gestix functions in two stages: “[There is] an initial calibration stage where the machine recognizes the surgeons’ hand gestures, and a second stage where surgeons must learn and implement eight navigation gestures, rapidly moving the hand away from a “neutral area” and back again. Gestix users even have the option of zooming in and out by moving the hand clockwise or counterclockwise.”

To avoid sending unintended signals, users may enter a “sleep” mode by dropping the hand. The gestures for sterile gesture interface are captured by a Canon VC-C4 camera, positioned above a large flat screen monitor, using an Intel Pentium and a Matrox Standard II video-capturing device.

The project lasted for two years; in the first year Juan Wachs spent a year working at IMI (Washington D.C.) as an informatics fellow on the development of the system. During the second year, there was a contract which ended between BGU and WHC (Washington Hospital Center) where Wachs continued working at BGU with Professors Helman Stern and Yael Edan, the project’s principle investigators.

At BGU, several M.Sc theses, supervised by Prof. Helman Stern and Yael Edan, have used hand gesture recognition as part of an interface to evaluate different aspects of interface design on performance in a variety of tele-robotic and tele-operated systems. Ongoing research is aiming at expanding this work to include additional control modes (e.g., voice) so as to create a multimodal telerobotic control system.

In addition, Dr. Tal Oron and her students are currently using the gesture system to evaluate human performance measures. Further research, based on video motion capture, is being conducted by Prof. Helman Stern and Dr. Tal Oren of the Dept. of Industrial Engineering and Management and Dr. Amir Shapiro of the Dept. of Mechanical Engineering. This system, combined with a tactile body display, is intended to help the vision impaired sense their surroundings.

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About Ben-Gurion University of the Negev and American Associates

Ben-Gurion University of the Negev is a world-renowned institute of research and higher learning with campuses in Beer-Sheva, Sede Boqer and Eilat in Israel’s southern desert. It is a university with a conscience, where the highest academic standards are integrated with community involvement, and where the pioneering spirit of discovery flourishes, fulfilling David Ben-Gurion’s dream to make the desert bloom. Founded in 1972, this year marks American Associates, Ben-Gurion University of the Negev’s 36th year of support, helping BGU develop the bold new vision for the Negev: the focus of the future of Israel and the world.

Source: Andrew Lavin

Ben-Gurion University of the Negev

The Austalian Medical Association believes the Rudd Government must reform the Medicare Benefit Schedule (MBS) to better rebate patient’s access to GPs. The MBS must also be properly indexed, aligned with increasing costs.

As part of General Practice Week, the peak medical body is highlighting the difficulties GPs face every day in ensuring that patients get the highest quality of care and then obtain an appropriate Medicare rebate.

AMA President, Dr Rosanna Capolingua, said the current Medicare Benefits Schedule was complex, and needed to be modernised to meet changing patient needs. Over the past 15 years, the number of GP consultation items had increased four-fold; the demand is higher and more complex.

“Patients need a rebate system that supports them when they see a doctor for acute care, and also for more chronic or complex problems, and for preventative medicine. GP are needing to spend more time with their patients,” she said.

“Studies show that patients who have access to longer consultations with their GPs use other areas of the health system less often – saving the health system and the community money.”

Dr Capolingua said GPs were best placed to deliver holistic care.

“GPs are able to assess the patient’s total needs, coordinate care and meet these needs. General Practice best preserves the privacy and dignity of patients in the primary care setting.

“We need a modern Medicare Benefits Schedule that supports the patient’s access to the clinically effective and cost effective high-quality care that is delivered in General Practice.

“The MBS should support patients spending more time with their local doctor so GPs can focus more on tackling chronic disease and delivering preventative health care,” she said.

Eighty per cent of Australians visit a GP at least once a year and spend more time with their GP than people in many other countries.

Recent Australian Institute of Health and Welfare (AIHW) data showed that GPs are playing a key role in the fight against chronic disease – including high blood pressure, diabetes, osteoporosis, skin conditions and cardiovascular disease.

The AIHW said the number of encounters for chronic disease rose from 46.5 per 100 encounters in 1998/99 to 52.1 per 100 encounters in 2006/07.

General Practice Week (15-21 June) highlights the importance of general practice in our healthcare system and shows that GPs are leading the way to better health.

Australian Medical Association

The Royal College of Physicians and Surgeons of Canada is pleased to present the Teasdale-Corti Humanitarian Award for the first time ever to
Dr. Paul Thistle, FRCSC, who has built his life around serving the people of rural Zimbabwe.

“Where health is concerned, globalization is a reality – disease and illness know no boundaries and we are increasingly interdependent in our approach to solutions.” says Dr. Louise Samson, FRCPC, Royal College President. “The Royal College has a global reach with Fellows practising in 88 countries worldwide. Their contributions are valued and deserve to be honoured.”

The Royal College launches the Teasdale-Corti Humanitarian Award in 2008 to recognize the work of Canadian physicians who go beyond normal expectations to deliver health care worldwide.

Dr. Thistle has been the chief medical officer of The Salvation Army Howard Hospital in Glendale, Zimbabwe since 1995. In his time there, Zimbabwe’s life expectancy dropped to the lowest in the world. Faced with monumental challenges, Dr. Thistle has kept his hospital’s doors open providing a high level of health care to a population suffering from poverty and HIV/AIDS.

“As part of the Teasdale-Corti Humanitarian Award, the Royal College is proud to offer $5,000. on Dr. Thistle’s behalf to The Salvation Army World Missions.” says Dr. Andrew Padmos, FRCPC, Royal College CEO. “This money is expected to go along way in supporting Dr. Thistle’s continued work at Howard Hospital.”

The Royal College of Physicians and Surgeons of Canada is the national, not-for-profit organization that oversees the medical education of specialists in Canada by setting high standards for postgraduate medical education and continuing professional development. In collaboration with health organizations and government agencies, the Royal College also plays a role in developing sound health policy in Canada.

Royal College Of Physicians And Surgeons Of Canada
rcpsc.edu

Backgrounder

Paul Thistle: Multi-faceted physician excelling under pressure

Dr. Paul Thistle, FRCSC, is graduate of the University of Toronto and a specialist in obstetrics and gynecology. In 1995, he accepted a posting at The Salvation Army Howard Hospital in rural Zimbabwe – a country characterized by the World Health Organization as one “plagued by food insecurity, economic crisis and one of the world’s highest HIV/AIDS prevalence rates.”

Dr. Thistle is a dedicated clinician. Of the three physicians at Howard Hospital who attend to its 2,500 deliveries per year, he is the only specialist. As a result, he is on call day and night to offer his expert support. Dr. Thistle has been instrumental in bringing a number of critical programs to the region. Among them, he secured USAID and Ministry of Health funding in 2003 to start and maintain an antiretroviral program that currently treats close to 1,200 patients.

Dr. Thistle is a teacher and a researcher. He has taught and mentored many students and residents whether from Zimbabwe, Canada or elsewhere. He has 20 publications to his credit on topics ranging from perinatal HIV transmission to antiretroviral therapy and rural maternal health issues in developing nations.

Dr. Thistle is an advocate. He and his wife Pedrinah, a nurse and midwifery instructor, facilitate funding for the education of 300 AIDS orphans, also helping to mentor them. His “Hockey Night in Zimbabwe” is a small example of an important outlet for play and social development for many of these children. Dr. Thistle works 16-hour days and yet a holiday back to Canada usually involves speaking engagements, educational events and advocacy for international health, his hospital and his work.

In June 2008, Dr. Thistle is receiving both the Royal College Teasdale-Corti Humanitarian Award and an Honorary Doctorate of Law from the University of Windsor, Ontario.

Doctors Teasdale and Corti: A legacy of service in the developing world

The Royal College’s Teasdale-Corti Humanitarian Award is named in honour of Dr. Lucille Teasdale, FRCSC, and Dr. Piero Corti, a physician couple who devoted their professional careers to healing, teaching and improving the condition of the population residing in the poverty-stricken Gulu region of Uganda. For 35 years the couple served in this region, characterized by frequent outbreaks of infectious diseases, and provided medical care throughout nearly 25 years of Ugandan civil war and unrest. Their medical and surgical skills saved thousands of lives; their teachings instilled hope for a better future in many; and their perseverance transformed a small missionary dispensary into the St. Mary’s-Lacor Hospital, which is now a modern teaching hospital and medical centre almost entirely staffed by Ugandan health care professionals.

The American Medical Association (AMA), the nation’s largest physician group, voted at its Annual Meeting to adopt the following new policy.

Six trials, involving more than 95,000 adult men and women, have shown aspirin may be effective in reducing the risk of heart attack and stroke. The AMA today passed policy to increase education among physicians on the importance of appropriate aspirin counseling for the prevention of heart disease and stroke.

“Heart disease continues to be the number one cause of death in the United States, and the treatment of cardiovascular disease costs the health care system $403 billion a year,” said AMA Board Member William Hazel, M.D. “Encouraging physicians to incorporate aspirin counseling into patient care when appropriate, may help reduce the prevalence of heart disease and stroke among Americans.”

American Medical Association
ama-assn

Senate Finance Committee Chair Max Baucus (D-Mont.) on Tuesday said that legislation that would prevent a 10.6% reduction to Medicare physician fees will be ready by the Fourth of July recess, CQ HealthBeat reports. Baucus introduced in early June a bill (S 3101) that would block the fee reduction, which is scheduled to go into effect on July 1, but the measure on Thursday failed to receive enough votes for debate (Armstrong/Carey, CQ HealthBeat, 6/17). Baucus did not reveal what his plans were but said that there were several options. Lobbyists said that Baucus might attempt another cloture vote on his bill, which failed 54-39. However, Senate Majority Leader Harry Reid (D-Nev.) voted against cloture to retain the ability to bring the legislation up again, according to CongressDaily.

CongressDaily reports that Democrats likely would have the 60 votes required to end debate if they added the five Democrats who missed the vote because they were campaigning or sick (Edney, CongressDaily, 6/18). CQ HealthBeat reports that Baucus is “eventually expected to reach a compromise” with Finance Committee ranking member Chuck Grassley (R-Iowa). Grassley introduced a competing bill (S 3118) that would make fewer cuts to Medicare Advantage, among other differences (CQ HealthBeat, 6/17). Before the cloture vote, Reid denied a request by Republicans for a similar vote on Grassley’s measure (Kaiser Daily Health Policy Report, 6/13).

Baucus is scheduled to meet with House leadership on Wednesday to discuss the legislation. He said that a bill could be on the floor this week, although it is “somewhat doubtful.”

Baucus, Grassley Introduce Competitive Bidding Program Delay Bill
In related news, Baucus and Grassley on Tuesday introduced a measure that would delay the first two rounds of a Medicare competitive bidding program for durable medical equipment, CQ HealthBeat reports (CQ HealthBeat, 6/17). Under the competitive bidding program, which is scheduled to begin July 1, CMS will select DME suppliers to participate in Medicare based on bids they submit. The 2003 Medicare law mandated the program as part of a larger effort to implement competitive bidding.

In 2008, the program will operate in 10 of the largest Metropolitan Statistical Areas and will apply to 10 of the top DME, prosthetics, orthotics and supplies product categories. In 2009, the program will expand to an additional 70 MSAs and will continue to expand in future years. The program also will apply to additional product categories in future years. The program likely will result in an average 26% decrease in the prices of medical equipment in the 10 MSAs, according to CMS (Kaiser Daily Health Policy Report, 6/12).

Both Baucus and Grassley had added language to delay the DME program in their Medicare bills. The measure would terminate contracts that were already awarded for the first round of the program and restart the bidding process for those areas. The measure’s cost would be offset by cutting the annual inflationary adjustment for 2009 on DME covered under the first round of the competitive bidding program and reducing payments for those products by 9.5% nationwide. The DME suppliers subject to the cut would receive a 2% increase in 2014, except in areas where the bidding program is in effect or where CMS has adjusted rates (CQ HealthBeat, 6/17).

House Ways and Means Health Subcommittee leaders last week proposed an identical measure, according to CongressDaily. On Monday, bipartisan support for the legislation “eroded a bit” after the Republican Study Committee said in a policy statement it does not want Congress legislating “the minutia of fee schedules,” according to CongressDaily (CongressDaily, 6/18).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Few treatments for Parkinson’s disease (PD) restore function for extended periods. In a new study published in the inaugural issue of the Journal of Parkinson’s Disease, an international group of researchers report that platelet-derived growth factor-BB (PDGF-BB) restored function in rodents and shows promise as a clinical candidate drug for treatment of PD.

Parkinson’s disease is the second most common neurodegenerative disorder, affecting 1 – 2% of the population over the age of 65. It is characterized by loss of brain cells (neurons) from the mid-brain which use the neurotransmitter dopamine to help control voluntary movements. Investigators from NeuroNova AB, Stockholm, Sweden, the Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden, The Parkinson’s Institute, Sunnyvale, CA, USA, and Motac Neuroscience Ltd, Manchester, UK, found that behavioral, tissue and biochemical changes in experimental models of Parkinson’s disease in rodents could be counteracted by infusion of PDGF-BB. This could offer an alternative strategy to restore function in PD.

“In animal models of nigrostriatal injury, a two weeks treatment with platelet-derived growth factor-BB resulted in long-lasting restoration of striatal dopamine transporter binding sites and expression of nigral tyrosine hydroxylase,” commented Anders Haegerstrand, MD, PhD, Chief Scientific Officer, NeuroNova AB, Stockholm, Sweden.”It also normalized amphetamine-induced rotational behavior in 6-hydroxydopamine lesioned rats. Platelet-derived growth factor-BB promoted proliferation of neural progenitor cells in the subventricular zone. The effects on dopaminergic neurons and functional recovery could be blocked by co-infusion with a proliferation inhibitor, indicating a link between the proliferative and anti-parkinsonian effects. Based on the current data, we consider platelet-derived growth factor-BB a clinical candidate drug for treatment of Parkinson’s disease.”

The study demonstrated for the first time a functional relevance of a PDGF-induced cell proliferation in a model of CNS disease. In the rats studied, normalization of behavior after PDGF-BB treatment lasted for 10 weeks. PDGF-BB is already in clinical trial at NeuroNova.

Sources: IOS Press BV, AlphaGalileo Foundation.

The Australian Medical Association believes that the Rudd Government’s centrepiece GP Super Clinics policy may only benefit a limited number of Australians and, in fact, do damage to many existing general practices that currently provide valuable patient care.

As part of General Practice Week, the Australian Medical Association has called on the Rudd Government to move beyond its restrictive policy framework.

AMA President, Dr Rosanna Capolingua, said the Government should use the $275 million set aside for GP Super Clinics to develop measures to enhance GP services across the country.

“Super Clinic money can be invested in existing practices – effectively improving access to services for all Australians,” she said.

The AMA believes that if the Government is serious about improving primary care, it should work with the peak medical body on the broad measures needed to improve access to GP services for all Australians. Such measures include:

- Significantly expanding training places in general practice;

- Simplifying the Medicare Benefits Schedule – allowing GPs to focus on preventative care and the effective management of chronic disease, as well as manage acute presentations;

- Creating initiatives to support the use of practice nurses – for and on behalf of GPs;

- Appropriately indexing patient rebates to keep pace with the rising costs of service delivery;

- Supporting the extension of IT infrastructure across health service delivery to improve the coordination of patient care; and

- Reducing red tape and unnecessary compliance costs.

The AMA acknowledges that the Government is trying to improve the delivery of primary health care services.

If the Rudd Government is intent on implementing the Super Clinic policy, the AMA believes that:

- GP Super Clinics should only be located in areas where there are identified gaps in the delivery of local health services and clear evidence of significant GP shortage; and

- GP Super Clinic funding should be directed towards supporting existing practices to improve infrastructure and expand their services.

General Practice Week (15-21 June) highlights the importance of general practice in our healthcare system and shows that GPs are leading the way to better health.

Australian Medical Association

The Australian Medical Association today said that unnecessary paperwork was severely affecting the amount of time GPs are able to spend with their patients.

As part of General Practice Week, the peak medical body is highlighting the importance of general practice in our health care system and the restrictions GPs face in trying to deliver high-quality patient care.

AMA President, Dr Rosanna Capolingua, said that young doctors were turned off general practice because of all the paperwork!

“Red tape is a burden on the good work of GPs,” she said.

“Up to a quarter of a GP’s time is spent on paperwork. Doctors rank administrative problems in their top five difficulties in running a GP practice.

The AMA is calling for paperwork requirements in a raft of government programs to be drastically cut – such as Practice Incentive Programs, service incentives, chronic disease items, and authority prescriptions.

Dr Capolingua said that successive governments had ignored repeated recommendations to cut red tape in general practice.

“Government turned a blind eye to the Productivity Commission’s findings in 2002 and more recently, largely disregarded recommendations put forward by the Regulation Review Taskforce.

“The Government is investing millions of dollars to recruit doctors from overseas. Clearly, if we could ease some of the pressures on our GPs – by cutting red tape and using this precious resource more wisely – we could better retain and attract more locally-trained GPs” she said.

General Practice Week runs from 15-21 June. The week highlights the fact that GPs are leading the way to better health.

Australian Medical Association

Medicine has moved a little bit closer to the era of tailor-made treatments, based on the unique genetic profiles of individual patients, according to recent research conducted by Dr Rima Rozen of the Research Institute of the McGill University Health Centre (RI MUHC) at the Montreal Children’s Hospital and McGill University. Her study, published June 18 in the journal Pharmacogenetics and Genomics, shows how minor genetic differences between individuals alter the way a common drug affects the body.

Rozen has measured the impact of Methotrexate — a drug that inhibits the metabolism of folate — on mice with an altered MTHFR gene, which is a gene crucial for folate metabolism. The results were striking: after treatment with Methotrexate, mice with the altered gene had approximately 20 per cent less hemoglobin and red blood cells than their counterparts with non-altered genes. The altered mice also showed increased susceptibility to liver and kidney damage following treatment.

“We know that these results are applicable to humans because a parallel mutation in the human MTHFR gene affects human folate metabolism similarly. The results demonstrate that medication affects subjects differently according to individual genetic traits,” Dr. Rozen explained. “And tests exist to detect this mutation.” Genetic testing would allow physicians the modify treatment based on each patient’s personal genetic makeup, limiting potential side effects.

In earlier studies, Rozen’s laboratory cloned the MTHFR gene and identified the common variant which interferes in folate metabolism in human populations. Between 10 and 15 per cent of the total caucasian population have two copies of the variant in MTHFR. Folate, a form of water-soluble Vitamin B2, is essential to the production of red blood cells and provides protection against spina bifida, other birth defects, and heart disease. Patients with cancer or auto-immune diseases are often treated with medications that affect folate metabolism, but physicians are not trained to verify how patients naturally metabolize folate, even though this could be an important factor in effective treatment.

“This is a first step towards personalized medicine that is based not only on symptoms but also on the patient’s own genetic ‘baggage,’” Rozen said. “This trend definitely represents the medicine of the future.”

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This release is available in French.

Dr. Rima Rozen is a Scientist in the Medical Genetics and Genomics Axis of the RI MUHC at the Montreal Children’s Hospital. At McGill University, she holds the positions of Associate Vice-Principal (Research and International Relations) and Professor in the Human Genetics, Pediatrics and Biology Departments.

This study was funded by the Canadian Institutes of Health Research (CIHR) and the U.S. National Institutes of Health (NIH). Students working on Dr. Rozen’s study also received scholarships, such as a Turkish Higher Education Council-Hacettepe University Hospital scholarship, a Cole Foundation Award, and a Studentship Award from the Montreal Children’s Hospital Research Institute.

The Montreal Children’s Hospital (MCH) is the pediatric teaching hospital of the McGill University Health Centre (MUHC) and is affiliated with McGill University. The MCH is a leader in providing a broad spectrum of highly specialized care to newborns, children, and adolescents from across Quebec. Our areas of medical expertise include programs in brain development/behaviour, cardiovascular sciences, critical care, medical genetics and oncology, tertiary medical and surgical services, and trauma care. Fully bilingual, the hospital also promotes multiculturalism and serves an increasingly diverse community in more than 50 languages. The Montreal Children’s Hospital sets itself apart with its team approach to innovative patient care. Our health professionals and staff are dedicated to ensuring children and their families receive exceptional health care in a friendly and supportive environment.

The Research Institute of the McGill University Health Centre (RI MUHC) is a world-renowned biomedical and health-care hospital research centre. Located in Montreal, Quebec, the institute is the research arm of the MUHC, the university health center affiliated with the Faculty of Medicine at McGill University. The institute supports over 600 researchers, nearly 1200 graduate and post-doctoral students and operates more than 300 laboratories devoted to a broad spectrum of fundamental and clinical research. The Research Institute operates at the forefront of knowledge, innovation and technology and is inextricably linked to the clinical programs of the MUHC, ensuring that patients benefit directly from the latest research-based knowledge.

The Research Institute of the MUHC is supported in part by the Fonds de la recherche en santГ© du QuГ©bec.

For further details visit: muhc/research.

Source: Isabelle Kling

McGill University Health Centre

The cost of switching from a paper-based health records system to an electronic version for patients is a key obstacle for many primary care physicians in the U.S., according to a study published on Wednesday in the New England Journal of Medicine, USA Today reports. For the study, co-authors Catherine DesRoches and David Blumenthal of Massachusetts General Hospital in Boston surveyed 2,758 physicians nationwide (Davis, USA Today, 6/19).

According to the New York Times, the study — funded by HHS and a grant from the Robert Wood Johnson Foundation — found that the “slow adoption of the technology is mainly economic” as “especially those in the small practices lack the financial incentive to invest in computerized records.” According to the study, fewer than 9% of practices with one to three physicians — which account for nearly 50% of all physician practices nationwide — use an EHR system (Lohr, New York Times, 6/19).

The study, titled “Electronic Health Record Adoption in the Ambulatory Setting: Findings from a National Survey of Physicians,” also found that 4% of all respondents had converted to a “fully functional” EHR system, which records patient information and demographics, allows physicians to view and manage laboratory results, manage orders such as prescriptions and assist with clinical decisions. Thirteen percent of respondents had adopted a basic system, which might not have specific entry capabilities or the ability to offer clinical decision support, according to CQ HealthBeat (Wyckoff, CQ HealthBeat, 6/18).

According to the study, among physicians who already had “fully functional” EHR systems, 82% said the technology had improved the quality of medical decisions in their practices, 86% said they had averted prescription errors and 85% said that it had enhanced their delivery of preventive care to patients. However, 54% of the respondents said that difficulty finding an EHR system that met their needs was a “major barrier” in their ability to adopt the technology (New York Times, 6/19).

Drawbacks
The Times reports that many physicians “lack the financial incentive” to invest in EHR systems. Although private and government insurers can reduce costs through less paper, lower administration expenses and fewer unnecessary lab tests, the initial investment in EHR systems typically falls to the physicians, according to the Times. In addition, the “time-consuming conversion” to an EHR system could reduce the number of patients a physician could see, “perhaps doubling the cost” (New York Times, 6/19).

Philadelphia-based physician Richard Baron, who in conjunction with the release of the study participated in a conference call sponsored by the Robert Wood Johnson Foundation and the Massachusetts General Hospital’s Institute for Health Policy, said that setting up an EHR system was “the most difficult thing we have ever done in our practice.” Baron said, “It disrupted every system we had in the office” and “made us dependent on a tech we did not understand and could not maintain ourselves” (Goldstein, “Health Blog,” Wall Street Journal, 6/18).

According to Baron, it cost each physician in his practice $40,000 to implement an EHR system and another $60,000 annually for technical support. Baron recommended financial incentives as a way to encourage a wider adoption of the technology. “I really think new financing strategies are desperately needed” (CQ HealthBeat, 6/18).

More Implementation Could Come Soon
The study found that 42% of the physicians reported that they currently are setting up an EHR system or plan to do so in the next two years. According to DesRoches, the announcement last week by federal officials of a $150 million Medicare pilot program to assist hundreds of physicians in converting to an EHR system will encourage a widespread change in the U.S. health care system. “The physicians who now use these systems like them,” DesRoches said (USA Today, 6/19).

Efforts to develop a national EHR system have received the support of President Bush and both the Republican and Democratic presidential candidates, according to Blumenthal and DesRoches. However, the authors note that widespread adoption of EHRs could cost tens or hundreds of billions of dollars, much of which would come through government incentives. “[W]hether any future federal administration will find the resources is uncertain,” they wrote (“Health Blog,” Wall Street Journal, 6/18).

Karen Bell, director of the Office of Health IT Adoption at HHS, said she is “heartened” by the growing response among physicians to adopt EHR systems, noting, however, that the study shows “we are a long way from universal adoption” (USA Today, 6/19).


An abstract of the study is available online.

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.