【优质】HealthcareReformandtheImpactonthePracticeofMedicine.pptVIP

* Potential Medical-Liability Risks of EMRs (Cont’d) As systems mature Email advice: Facilitates response without thorough investigation and examination of the patient Multiplies the number of clinical encounters that can give rise to claims Temptation to copy and paste Risks missing new information and perpetuates previous mistakes Bright audit trail Information overload may cause clinicians to miss important pieces of information Departures from clinical-decision support guidelines are obvious Source: NEJM – Medical Malpractice Liability in the Age of Electronic Health Records, 363:21 November 18, 2010 * 2005 RAND Study: Impact of National EHR Annual savings of $80 billion Is this still true today? Can Electronic Medical Records Transform Health Care? Potential Health Benefits, Savings and Costs, Health Affairs, v.24, no. 5, 2005 * Observation “… The one truly scary thing about health reform: Far from being a government takeover, it counts on local communities and clinicians for success. We are the ones to determine whether costs are controlled and healthcare improves…” Atul Gawande M.D. * Another Observation “Relatively little of healthcare reform will make our nation healthier. The bigger impact will still come from addressing the underlying physical, social, and behavioral determinants of health.” Dr. Stephen Shortell * Conclusion The next decade of medical practice will see a collision of massive economic interests, social concerns, and unintended consequences. This will occur in an extraordinarily polarized nation with inadequate resources and limited vision. It will not be smooth, and it is unlikely to be pretty * Distribution of Total Educational Debt for Medical Students in the United States at Graduation, 2004-2008. Debt figures include premedical or college education debt. In 2008, 38% of graduates had debt from premedical education (median amount, $20,000). The distribution of the 23% of students with total de