3rd in a series Risk analysis: Getting control of medical care

by • January 1, 2008 • UncategorizedComments Off on 3rd in a series Risk analysis: Getting control of medical care1421


By E. Patrick Moores, JD 

A very interesting column written by Bill Gates appeared in the Oct. 5, 2007, issue of the Wall Street Journal, titled “Health Care Needs an Internet Revolution.”

Gates, founder of software giant Microsoft, begins by noting that our healthcare system is dependant on information, but it is reaching a crisis in delivering medical care due to our systems being so isolated as to make it nearly impossible for the doctor to obtain sufficient information about the patient.

Gates cites a 1999 report published by the Institute of Medicine that as many as 98,000 Americans die annually as a result of preventable medical errors, making the healthcare system itself the fifth leading cause of death in the U.S. He comments, “At the heart of the problem is the fragmented nature of the way health information is created and collected.”

While every visit for medical care generates a large amount of data, every medical provider has its own system of storing records, which do not talk to other provider systems. Such information of “potentially lifesaving medical information” is “underutilized,” which limits “our ability to ensure that care is based on the best available scientific knowledge.”

Despite the fact that most records and data are now digitized, Gates notes that patients never see this data, and doctors generally are unable to share it. He proposes that “What we need is to place people at the very center of the healthcare system and put them in control of all their health information.”

Gates reports in his commentary that this issue has become an important priority at Microsoft, which is working with software and hardware companies, medical provider organizations, government agencies and consumer and patient advocacy groups for a solution to develop “a comprehensive, internet-based system that enables healthcare providers to automatically deliver personal health data to each patient in a form he can understand and use.”

Such a system would need to protect the patient’s privacy, and allow the patient the process for controlling whomever receives this information necessary for the patient’s care.

It is a grand vision, which needs support. Many in the healthcare system have recognized this need for years, and it is encouraging that someone such as Bill Gates is devoting his talents and assets to achieve this goal.

In my last two commentaries, I have expressed the problem of healthcare planning, to include the collection of data and planning options for the care and long-term illnesses of ourselves and our loved ones. Until the system envisioned by Bill Gates becomes available, lawyers and doctors need to encourage their clients to, on their own, undertake the collection and storage of this information for planning and care purposes.

The first issue must be the focus on collecting data. Most states have statutory provisions that allow an individual to obtain a free copy of his medical records. I have been recommending that my clients make an annual collection of their medical records and the records of the family for whom they are responsible. (I use Memorial Day as my target date for collection of all my personal records, while clients may also use the end of the year or tax time, while they are in the process of reviewing their personal and financial status.) This should not only include the provider’s notes of the patient’s visits to his or her doctor’s office, but also the discharge summary and operation report of any hospitalization. I also recommend collecting from the pharmacist a list of medications obtained during that year.

This process requires adopting a method for easy retrieval of this information. If my client lacks a computer system that provides for document scanning, I recommend that the information be stored in a notebook, arranged in an appropriate system of identification by health condition and identity of provider. What is important is a system that allows immediate access to the appropriate records.

The second focus should consist of analyzing the emerging trends in the individual’s healthcare needs, and planning the future care needs and potential options available. Information should be collected and placed in a file during the year relating to news reports on health conditions of concern and innovations and options in treatment, including alternative medical treatments.

Analysis should also include long term care needs, such as in-home and nursing home options, available financial resources, and access to insurance, including Medicare and Medicaid. Further, the client should be consulted concerning wills, his power of attorney, placement of financial assets in special needs trusts and other appropriate planning concerns.

Taking the time to initiate this process, and establishing an annual review system, will go a long way to achieving control over the future healthcare needs of the individual. This will boost awareness to all the immediate family members involved and give peace of mind to each individual. This in turn will promote comfort within the family and elevate concentration on the process of treatment and recovery.

Getting our healthcare planning under control, just as with the financial planning for our future needs, will make each individual acutely aware of the issues to be focused on and the appropriate questions to ask the healthcare provider concerning the care needed long before the situation reaches the critical care stage. •

E. Patrick Moores is an attorney in Lexington, Ky., and concentrates his practice in insurance coverage legal issues in addition to employment and healthcare law. He can be reached at patrick@epmooresattorney.com.

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