In my blog on March 15th , I talked about personal health records and how important they can be to the aging family.
What is a personal health care record ?
For the aging family, a personal health care record is information about an older family member’s health , compiled and maintained by a younger aging family member or friend. These are not medical records. Medical records and your personal health record (PHR) are not the same thing. Medical records contain information about your health compiled and maintained by each of your older family members healthcare providers
Personal health care records ,created and maintained by a family member on a computer are different than the paper version because - just that- instead of on paper , or unplugged- they are electronic. They can be printed from your computer onto paper but they are maintained in the computer.
As an aging family member, you can do this all yourself, on your own computer but a wiser choice would be to just purchase one of the many PHR products available.
There are about 100-200 PHR on the market right now, so you have a wide range of choices. Just google personal health care records and you will find many products , including Google’s own version.
What’s in a personal health care record maintained via computer?
– Most PHR products contain data similar to the binder ,unplugged,hard copy version I wrote about on March 15th. The product information can vary but in general they include :
– *
Identification Sheet –This may be a listing of the older family members demographic information: name, address, telephone number, insurance, and policy number.
Problem List – A list of significant illnesses and operations older family member has had
Medication Record – A list of medicines currently prescribed to the older family member .. including medication allergies
History and Physical – A list of any major illnesses and surgeries the older family member has had and what the physician found when older person went to each doctor’s appointment
Progress Notes – Notes made by the family caregiver who accompanied the older person to the medical appointment , including observations and treatment plans made by doctors, nurses, therapists, or social workers.
Consultation – An opinion about your older family member’s condition made by a physician other than older person’s primary care physician.
–
Physician's Orders – The older family members physician's directions to other members of the healthcare team regarding medications, tests, diets, and treatments.
Imaging and X-ray Reports – Findings of x-rays, mammograms, ultrasounds, and scans.
Lab Reports – Results of tests conducted on body fluids. Common examples include a throat culture, urinalysis, cholesterol level, and complete blood count (CBC).
Consent and Authorization Forms – Copies of consents for admission, treatment, surgery, and release of information.
–
Discharge Summary – A concise summary of a hospital stay, including the reason for admission, significant findings from tests, procedures performed, therapies provided, response to treatment, condition at discharge, and instructions for medications, activity, diet, and follow-up care.
What do you have to make sure of before you choose a personal health care record product for an older family members?
1. Is it a stable company-? You do not want to end up loosing all your personal health records if the company goes under ?
2. Does it have a secure server. If so, where is the data hosted. Many of the companies claim to have secure servers, but the data will be hosted at an shared server in some remote part of the world. .
3. What is the privacy policy regarding your health data-is it mined with personal identifying information .Many of the firms sell your personal health data. to make money
4. Does the company perform audit trails of data entry and retrieval-It is vital to know who enters and exists the database server
–
Personal Health Care records ,created and maintained electronically have many advantages over the paper version, put in a binder. In my next blog I will cover why an aging family might choose a computer generated personal health care record over paper.
Monday, March 23, 2009
Friday, March 20, 2009
Nine Reasons Why I Love Michele Obama
Nine Reasons Why I love Michele Obama
1.She’s a woman of color in the White House and that says it all
2.. She started a vegetable garden in the White House. Alice Waters said a while ago Kennedy stopped wearing hats and it changed men’s fashion forever . Michele is setting a model for organics that every mother and eater should love ( see link below)
2.She was on the cover of the New Yorker last week looking great.
3.She celebrated Women’s history month by going to schools in DC and telling her story that a girl of color can go to public school come from middle class parents and be first lady . It made me cry this morning. ( see link below)
4.She celebrated Black history month by inviting DC kids, mostly black, to the White House and touching them all as they walked in
5.She beautiful and black and I see so many women of color in advertisement these days- there has to be a connection.
6.She’s married to a very cute guy
7.She went to Harvard and Princeton and has chosen community service.
8.She is a great Mom and I love their kids making their beds in the White House
9.She has her Mom living in the White House which is an inspiration to all aging families
New York Times Article
1.She’s a woman of color in the White House and that says it all
2.. She started a vegetable garden in the White House. Alice Waters said a while ago Kennedy stopped wearing hats and it changed men’s fashion forever . Michele is setting a model for organics that every mother and eater should love ( see link below)
2.She was on the cover of the New Yorker last week looking great.
3.She celebrated Women’s history month by going to schools in DC and telling her story that a girl of color can go to public school come from middle class parents and be first lady . It made me cry this morning. ( see link below)
4.She celebrated Black history month by inviting DC kids, mostly black, to the White House and touching them all as they walked in
5.She beautiful and black and I see so many women of color in advertisement these days- there has to be a connection.
6.She’s married to a very cute guy
7.She went to Harvard and Princeton and has chosen community service.
8.She is a great Mom and I love their kids making their beds in the White House
9.She has her Mom living in the White House which is an inspiration to all aging families
New York Times Article
Sunday, March 15, 2009
Personal Health Records for the Aging Family
President Obama has proposed the change to electronic health records as part of his vast stimulus plans. There are pros and cons to this, one of them being privacy , as you can see in the recent New York Times article
In the meantime aging families can consider making their own personal health record for an older family member. Why? It gives the family members and caregivers up to date health and social support information . They can use this in medical emergencies, when attending a doctor’s appointment ,for caregiving directions and sharing information with other family members and the older relative.
A personal health record can be as simple as a piece of paper in a file folder or a binder with an older family members health and social support information. Or the family can transfer it can be health information to computer or a disc or a USB file.
If you don’t want to go electronic and want a physical binder with personal health and social information, here is a suggestion for the tabs you can put in your loved one’s binder.
• Tab - make a list of all the older family member’s emergency contacts- telephone number, e-mail, address- neighbors, friends
• Tab - complete information on name address telephone ,fax, e mail specialty of all older person’s physicians
• Tab- name of pharmacy and the address telephone number, fax and e mail
• Tab- exact meds, dosage, amount of med prescribed each time
• Tab- clergy contacts if they have spiritual connections
• Tab- local support agencies involved- names and contact info. Example Meals on wheels, home care agency
• Tab Neighbor’s name, address, phone number, e-mail
• Tab all family names involved with older person, address, phone number e-mail
• Tab - Health insurance information
• Tab- results of recent Dr. visits
• Tab- instructions to care providers
The trick here is you have to keep all this information updated. So when there is a new medication or dosage, you need to update and print out a whole new page for the binder. Crossing out and writing in ink will make a mess and you might as well just toss the binder.
You can also purchase a family caregiver planner. A good one can be purchased through the National Assoc of Geriatric Care Managers, GCM Store. It is called a Caregiver Planner, 2nd edition and it is a 3-ring 10" x 11.5" binder that holds 60 pages of all care information in one binder . You can also use this to document instructions for caregivers or family members and it includes worksheets for personal, medical, home, and emergency care.
• In my next blog I will talk about making the your older family member’s health and social support records electronic.
In the meantime aging families can consider making their own personal health record for an older family member. Why? It gives the family members and caregivers up to date health and social support information . They can use this in medical emergencies, when attending a doctor’s appointment ,for caregiving directions and sharing information with other family members and the older relative.
A personal health record can be as simple as a piece of paper in a file folder or a binder with an older family members health and social support information. Or the family can transfer it can be health information to computer or a disc or a USB file.
If you don’t want to go electronic and want a physical binder with personal health and social information, here is a suggestion for the tabs you can put in your loved one’s binder.
• Tab - make a list of all the older family member’s emergency contacts- telephone number, e-mail, address- neighbors, friends
• Tab - complete information on name address telephone ,fax, e mail specialty of all older person’s physicians
• Tab- name of pharmacy and the address telephone number, fax and e mail
• Tab- exact meds, dosage, amount of med prescribed each time
• Tab- clergy contacts if they have spiritual connections
• Tab- local support agencies involved- names and contact info. Example Meals on wheels, home care agency
• Tab Neighbor’s name, address, phone number, e-mail
• Tab all family names involved with older person, address, phone number e-mail
• Tab - Health insurance information
• Tab- results of recent Dr. visits
• Tab- instructions to care providers
The trick here is you have to keep all this information updated. So when there is a new medication or dosage, you need to update and print out a whole new page for the binder. Crossing out and writing in ink will make a mess and you might as well just toss the binder.
You can also purchase a family caregiver planner. A good one can be purchased through the National Assoc of Geriatric Care Managers, GCM Store. It is called a Caregiver Planner, 2nd edition and it is a 3-ring 10" x 11.5" binder that holds 60 pages of all care information in one binder . You can also use this to document instructions for caregivers or family members and it includes worksheets for personal, medical, home, and emergency care.
• In my next blog I will talk about making the your older family member’s health and social support records electronic.
Wednesday, March 4, 2009
Obama's Medicare Liposuction
The financial meltdown crushing the US - already triggered the stimulus package and bailing out of the banks, AIG and the auto companies. As we all know this will not be the end. Obama is calling from the tightening up of our collective fiscal belt, which must bring changes in Medicare and Social Security.
President Obama has no choice but to address Social Security and Medicare. Medicare does have many nasty problems and one was addressed in a New York Times story today
Physicians who take kickbacks from drug and device comprise are now being investigated by the feds. These doctors have had consulting agreements with device makers and Pharmas. These heavy hitter providers pay these doctors, (many of whom are surgeons) handsomely for using their products.
This looks and smells like kickbacks. The Department of Health and Human Services ‘s chief counsel is leading the investigation into these “ consulting agreements”. The point is not only are kickbacks but these “ consulting contracts” increase the cost of health care, and endanger patients This investigation into physicians who enter into these fraudulent contracts may end their participation in Medicare This will severely affect their practice since the elderly over 65 consume the bulk of our national health care dollar.
In order to deter health care fraud the story says, the feds are looking into criminal wrongdoing by doctors that may end in jail time and fines on top of losing all Medicare patients. This is an example of some of the liposuction that needs to be done on this huge entitlement.
Another recent Times stout on fatty Medicare tissue, (2/29/09) says Obama would also increase premiums charged to Medicare beneficiaries with higher incomes for prescription drug coverage.
Obama will make drug makers do what they do with the huge VA health care system, discount drugs. President Bush left this out of his prescription drug plan, helping create that disastrous donut hole. The result is taxpayers and the elderly pay more for drugs than VA recipients who get at a reasonable discount. The government knew how to low bid this contact. Bush just forgot that.
Mr. Obama said he would cut $176 billion over the next decade by cutting Medicare payments to health insurance companies that provide comprehensive care to more than 10 million of the 44 million Medicare beneficiaries.
Medicare pays private insurers an average of 14 percent more than it would cost to care for the same people in the traditional fee-for-service Medicare program. “It’s time to stop this waste,” the White House said, quoted I the New York Times story.
Our bulging Medicare budget would be lighter on the scale with another proposed cut. The president projected cutting Medicare payments to hospitals that re-admit a large proportion of patients within 30 days after they are discharged. Such re-admissions sometimes indicate that hospitals provided poor care or did not properly coordinate care.
Under the proposal, hospitals would receive “bundled payments” that cover not only their own services, but also any care provided by nursing homes and home health agencies in the month after patients left the hospital.
Geriatric patients now get out the hospital sicker and quicker. The are scooped into the trembling arms of unpaid family care providers who are made to be pseudo nurses and doctors for very ill relatives. These tremulous family members are asked to manage Hoyer lifts, give injections, transfer the non-ambulatory (talk about breaking your back) and a whole raft of medical jobs they have absolutely no training to do. This causes older patients to end up back in the hospital sicker and very quick.
Hospitals now do little training of family care providers and do not include them in plans for discharge. Discharge planners are so overwhelmed by their huge caseloads they barely have time to educate and train family care providers to care for these very ill older relatives. So older patient cycle quickly back through the ER before 30 days, costing the health care system and Medicare tons for this insane gap.
The White House said this proposal would save $26 billion over 10 years.
Mr. Obama also proposed squeezing $37 billion out of the payments to home health agencies over the next decade.
There is more to come but the patient is morbidly obese. That fat is mostly, high calorie physicians, insurance carriers, pharmas, device makers stuffing the Medicare body with cheap junk food that the tax payer and both Medicare patient and family, has to absorb .
President Obama has no choice but to address Social Security and Medicare. Medicare does have many nasty problems and one was addressed in a New York Times story today
Physicians who take kickbacks from drug and device comprise are now being investigated by the feds. These doctors have had consulting agreements with device makers and Pharmas. These heavy hitter providers pay these doctors, (many of whom are surgeons) handsomely for using their products.
This looks and smells like kickbacks. The Department of Health and Human Services ‘s chief counsel is leading the investigation into these “ consulting agreements”. The point is not only are kickbacks but these “ consulting contracts” increase the cost of health care, and endanger patients This investigation into physicians who enter into these fraudulent contracts may end their participation in Medicare This will severely affect their practice since the elderly over 65 consume the bulk of our national health care dollar.
In order to deter health care fraud the story says, the feds are looking into criminal wrongdoing by doctors that may end in jail time and fines on top of losing all Medicare patients. This is an example of some of the liposuction that needs to be done on this huge entitlement.
Another recent Times stout on fatty Medicare tissue, (2/29/09) says Obama would also increase premiums charged to Medicare beneficiaries with higher incomes for prescription drug coverage.
Obama will make drug makers do what they do with the huge VA health care system, discount drugs. President Bush left this out of his prescription drug plan, helping create that disastrous donut hole. The result is taxpayers and the elderly pay more for drugs than VA recipients who get at a reasonable discount. The government knew how to low bid this contact. Bush just forgot that.
Mr. Obama said he would cut $176 billion over the next decade by cutting Medicare payments to health insurance companies that provide comprehensive care to more than 10 million of the 44 million Medicare beneficiaries.
Medicare pays private insurers an average of 14 percent more than it would cost to care for the same people in the traditional fee-for-service Medicare program. “It’s time to stop this waste,” the White House said, quoted I the New York Times story.
Our bulging Medicare budget would be lighter on the scale with another proposed cut. The president projected cutting Medicare payments to hospitals that re-admit a large proportion of patients within 30 days after they are discharged. Such re-admissions sometimes indicate that hospitals provided poor care or did not properly coordinate care.
Under the proposal, hospitals would receive “bundled payments” that cover not only their own services, but also any care provided by nursing homes and home health agencies in the month after patients left the hospital.
Geriatric patients now get out the hospital sicker and quicker. The are scooped into the trembling arms of unpaid family care providers who are made to be pseudo nurses and doctors for very ill relatives. These tremulous family members are asked to manage Hoyer lifts, give injections, transfer the non-ambulatory (talk about breaking your back) and a whole raft of medical jobs they have absolutely no training to do. This causes older patients to end up back in the hospital sicker and very quick.
Hospitals now do little training of family care providers and do not include them in plans for discharge. Discharge planners are so overwhelmed by their huge caseloads they barely have time to educate and train family care providers to care for these very ill older relatives. So older patient cycle quickly back through the ER before 30 days, costing the health care system and Medicare tons for this insane gap.
The White House said this proposal would save $26 billion over 10 years.
Mr. Obama also proposed squeezing $37 billion out of the payments to home health agencies over the next decade.
There is more to come but the patient is morbidly obese. That fat is mostly, high calorie physicians, insurance carriers, pharmas, device makers stuffing the Medicare body with cheap junk food that the tax payer and both Medicare patient and family, has to absorb .
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