In Washington, the Obama administration is promising to spend billions to make health care more efficient, but Jennifer Brull, a family doctor in rural Kansas, is already a step or two ahead.

A year ago, she switched her 3,000 patients from paper charts to electronic health records, a core feature of most plans for healing the nation’s ailing health system. Now, working with computers and printouts, her staff of part-time nurses and shared front-office workers has more time to help her meet the needs of patients.

“I’ll never go back to the old system,” said Dr. Brull, 37, who runs a solo practice in Plainville, Kan. “I can always look at the records by Internet, whether I am seeing patients at the nursing home or a clinic or the hospital, or even when I’m as far away as Florida. The change has been tremendously beneficial for my productivity.”

Patients are appreciative, too. Kagay Wheatley brings her 97-year-old neighbor, Charlotte Hayes, to Dr. Brull for blood tests every few weeks. “We do not have to sit and wait while the nurses search for the records,” said Ms. Wheatley, a retired school board aide who is also a patient of Dr. Brull’s. “They find the information right there on the computer, and when we leave, we get a printout of what we did and what she said.”

About 42 percent of active family doctors have installed some type of electronic health records, according to surveys and estimates by the American Academy of Family Physicians, a professional and advocacy group. One in four said they did not plan to purchase an electronic system, and many said they could not afford the $30,000 to $50,000 in start-up costs. The academy has 94,600 members, including about 60,000 in active practice.

Medical centers like the new 24-bed critical-access hospital in Plainville, connected by a walkway to Dr. Brull’s office, are also rapidly adopting electronic records.

“The use of electronic health records and being able to transmit X-rays allows us to be in contact with the whole world,” said Chuck Comeau, a hospital board member who is chief executive of Dessin Fournir, a national furniture design company that moved its head office to Plainville from Los Angeles.

Even so, 8 in 10 of all American doctors still labor in a world of paper. And some doctors said they encountered upsetting setbacks when they tried to switch to electronic records.

Michael Ferris, a 33-year-old emergency medicine physician in Parsons, Kan., said he had to give up his solo practice after he had invested $38,000 in software for systems that kept crashing and thwarting his attempts to send out electronic bills. “I was spending as much time trying to fix the computer and the billing as actually seeing patients,” he said, “and neither process was generating any revenue for me.”

Now, as director of the emergency room at the Labette County hospital in Parsons, Dr. Ferris said, “I get paid by the hour and don’t have to worry if the software is down.” But he said he expected that some day he would have to help the hospital make the transition to electronic records. “I know it is coming.”
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Amid mounting concerns about the ethics and limitations of animal use in laboratories, the Physicians Committee for Responsible Medicine (PCRM) announced today that it has developed a diagnostic test used to measure insulin levels in diabetes patients. Linco Research, Inc., a leading manufacturer of testing supplies based in St. Charles, Missouri, is now marketing the test internationally. The announcement of the new test comes just weeks after European Union officials and industry groups issued a joint declaration pledging to reduce the use of animals in laboratories.

PCRM initiated development of the assay in 2002 after launching a clinical trial examining the effects of a low-fat vegan diet on diabetes. The only insulin test kits on the market at the time used two cruelly derived animal ingredients—fetal calf serum, a slaughterhouse byproduct that can harbor bacteria and viruses, and cells incubated in the abdomens of live mice, a painful procedure banned in several European countries but still legal in the United States. No one had ever manufactured an insulin assay kit without the animal serum, and numerous laboratories told PCRM it couldn’t be done.
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PATIENTS are now getting just what the doctor ordered and nothing else thanks to a new type of prescription which aims to save money lost through wasted medication.
GPs have been prescribing 28-day courses of treatments for the past year in order to stop expensive drugs from going to waste and are now introducing another type of prescription for repeat users.

The six-monthly prescription has a special bar code which patients can use once a month for up to six months.
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Va. program checking prescriptions breaks ground, expert says

BY TAMMIE SMITH
TIMES-DISPATCH STAFF WRITER

Jan 18, 2007

A state program that monitors narcotics prescriptions will start sending notices to doctors when it appears a patient of theirs may be “doctor shopping” to get additional narcotics.

Doctors and select others already are able to query the state’s Prescription Monitoring Program database to see if a patient has been prescribed narcotics by other practitioners.

In this new effort, Prescription Monitoring Program staff this month will begin sending unsolicited alerts.

The notices will be for information only, said Ralph A. Orr, program manager for the Prescription Monitoring Program, who spoke Jan. 5 at a Board of Medicine committee meeting.

“We are not making any judgments,” Orr said. “There is no requirement for them to report back.”

The information also will include options for substance-abuse treatment, pain-management guidelines and resources for evaluating and treating patients.

Orr said there are various circumstances that might trigger a letter being sent; for instance, if a patient has narcotics prescriptions from several doctors or has filled narcotics prescriptions at several pharmacies in a short period.
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Anne Krishnan, Staff Writer
http://www.newsobserver.com

They hang out in hallways, hoping to snatch just two minutes with a doctor. They stock supply closets with drug samples and know the latest medical research inside and out.

But pharmaceutical sales representatives, once welcomed by doctors as the bearers of golf outings and days at the spa, have been pushed by many physicians to the margins of their practices.

At Wilmington Health Associates, drug reps aren’t allowed to pitch their drugs to doctors who are signing for samples.

“Our rule is that if you want to sit down and chat with a doctor, you can do it at lunchtime when a doctor has time,” said Michelle Jones, a family doctor in the practice who sees five to 10 reps a day. “Surprisingly, they understand.”

Drug reps haven’t become any less attractive, intelligent or persuasive. But over the past five to 10 years, a changing health-care industry has disrupted the way they do their jobs.

That’s good news for critics who contend that any freebies from drug reps, no matter how small, affect the way doctors write prescriptions and potentially drive up the nation’s health-care costs.

To be sure, drug companies’ finances are still healthy, although they have recently faltered. The world’s five largest pharmaceutical companies generated $36 billion in profits last year. Drug reps still took home average compensation of $89,600 in 2005, according to Hay Group, a management consulting firm.

Their jobs are just tougher and less glamorous than they were.

Drug reps’ role is to know the latest research about their own products and their competitors’, to communicate that information to physicians and to encourage the use of their companies’ drugs. However, much of their daily grind can involve delivering drug samples, branded giveaways and food to doctors’ offices. (more…)