Santa Cruz may find itself on the forefront of the health IT effort

Late last month, Santa Cruz County applied to be a Beacon Community in the federal government’s efforts to improve health internet technology. The Beacon Community program will distribute funds from the American Recovery and Reinvestment Act (the stimulus) to fifteen communities that already have invested in a high level of health IT infrastructure.Wired for Health Information Technology in Santa Cruz County

In Santa Cruz County, some 70% of physicians are already using electronic health records (EHRs), accounting for over half of the counties residents. Santa Cruz County health clinics, Sutter/Palo Alto Medical Foundation, Physicians Medical Group and Dominican Hospital make up the majority of doctors using EHRs in their practices, making care coordination between doctors within these systems more streamlined. Rama Khalsa, Santa Cruz County Health Services Director and author of the SCC grant, says the funds from the Beacon Community program would be used to make sharing across the various EHR programs being used easier and more secure.

Santa Cruz County started making the switch to EHRs early. Beginning in the mid-1990s, Dominican Hospital worked with a local software company to develop an early physician messaging system. In 2003, SCC Health Services Agency adopted EHRs in their clinics.

EHRs are essentially digital medical charts. They take the place of paper charts, but also offer added functionality. Khalsa says that the increased functionality and digitized medical records can lead to:

• Improved quality of care by allowing ambulatory, emergency and urgent care givers to make more informed decisions for patients who are unable to provide a medical history and complete list of medicines they take.
• Increased patient engagement in their own care. Because patients can see their records, they can see improvements or deterioration in health. EHR systems allow doctors to graph and track health outcomes to help patients better understand their care.
• Reduced human error by automatically checking for contra-indicated medicines and by built-in reminders for doctors to do things like checking diabetics’ feet or following up on lab results from previous visits.
• Smoother transitions between care facilities like hospitals, nursing homes and home health care organizations. These transitions represent the most risk for a patient’s health.
• Improved ability for analysis of community health. Because EHR systems also function like databases, it makes it easier to track disease vectors and analyze health outcomes for specific treatments. It also allows health agencies to contact patients at risk in the case of drug recalls.

Federal regulations mandate a high level of encryption be installed into HER systems to keep patient medical information secure. They also mandate that patient billing information be separated from health information. Khalsa says that EHRs actually makes patient information safer than paper records ever could.

While the Beacon Community program grant that Santa Cruz County’s Health Services Agency has applied for is a targeted grant that aims to improve inter-system electronic record exchanges, Rama Khalsa says that improving health IT infrastructure makes it possible to change the way that health care is done in this country.

Interviews with Sam Farr on the health care bills and their importance in the Monterey Bay area

Sam Far on hopes for a fix to low Medicare reimbursement in Monterey Bay area

Sam Farr discusses tradeoffs in the health care bills

Sam Farr reviews the State of the Union address and hopes for a health care overhaul

The Health Effects of State Budget Cuts

September 2009 Health Dialogues

www.HealthDialogues.org

As Congress considers a major overhaul of the U.S. health care system, Health Dialogues examines how the new state budget will affect health care closer to home. Will kids in low income families be able to get basic services? What about drug treatment programs mandated by Proposition 36? And how may where you live affect the care you’ll get?

The Value of Community Health Clinics

Many unemployed Californians and the working poor often turn to the nearly 800 community health centers throughout the state when they need medical attention. Host Scott Shafer visits the Russian River Health Center in Guerneville, in rural Sonoma County, to see how the state budget cuts have affected staff and patients.

Proposition 36 Coping With Significant Cuts

California’s landmark Proposition 36 was intended to send drug users into treatment, rather than prison. The current budget slashed Prop. 36 funding almost in half. That complicates things for the Superior Court in Santa Clara County, where Judge Stephen Manley oversees Proposition 36 cases. Guest: Honorable Judge Stephen Manley, Santa Clara County Superior Court judge.

Map of Rural Health Clinics

For more information, visit www.HealthDialogues.org

Severe cuts to children’s health coverage

After months of wrangling, California’s legislature finally approved a budget. The governor is expected to sign it next week. Among the many severe cuts in the budget is about a third of Health Families, a program that provides health insurance for children whose families can’t afford private insurance, but who don’t qualify for Medi-Cal. KUSP’s Robert Pollie has this report.

Health care overhaul

On Your Call right now Anthony Iton, director of the Alameda County Public Health Department: even with universal coverage there’s not enough primary care.

Are we ready for universal health coverage?

Are we ready for universal health coverage? On the next Your Call we discuss the status of the health care reform effort. President Obama’s Wednesday evening press conference is his attempt to reinvigorate a wavering Congress. But what happens if everyone gets a health insurance card? Are there enough primary care doctors? Would more healthcare mean better outcomes for patients? We’ll speak with Anthony Iton, director of the Alameda County Public Health Department, and take your calls. Send us an email at feedback@yourcallradio.org or join us live at 11 a.m. How do we get from better healthcare to better health? It’s Your Call with Rose Aguilar and you.

The State Budget and the Safety Net

Safety net nonprofits, the organizations that provide food, clothing, medicine, health and mental health care for central coast resident have caught a dual edged attack over the past couple years. Climbing unemployment, food and energy costs meant more clients for food and other direct assistance just as the state legislature halted nonessential checks last summer for a period of weeks. Many of these organizations contract with the state or with state programs through local governments. All indications are that this squeeze between increased demand and uncertain state funding has intensified in the proceeding 12 months.

In health and mental health care nonprofits, these challenges build complexity as the state chooses to opt out of programs with generous federal funding and release prisoners early from jails and prisons. In Santa Cruz and Monterey counties, patients receiving state subsidized addiction treatment
will see fewer effective options. In particular, residential rehabilitation may fall well out of reach. The potential loss of assisted day programs like Salud Para la Gente’s Elderday may leave families with few options for care for family members who need some nursing help during the day. As Sarah Clarenbach noted in her post on this blog, the loss of the state portion of adult dental care under Medicaid probably means people who need treatment for cavities will go without.

Each of these are cases that illustrate the strategic effort on the part of safety net nonprofits to provide subsidized services that help people with limited resources avoid devastating outcomes like imprisonment, hospitalization or placement in an assisted living facility. Outcomes that end up costing society more in moral terms and probably in fiscal terms.

April topic: cuts to Medi-Cal optionals – J.D. Hillard

According to the current state budget, cuts to Medi-Cal optionals would take place in June. State funding for psychological, podiatric, dental and other services for indigent patients would be eliminated. Recent reporting differs as to whether the federal stimulus may contain funds that will make up some of this funding.

How does the uncertainty around this funding affect staffing and services? What direct effects of a cut would you expect in your agency? How would patients experience these effects? Who are the patients who benefit from this funding – can you describe the conditions the need help with, the circumstances that lead them to need government assistance? When patients seek services that have been defunded what will they encounter? If defunding leads to emergency room visits, what outcomes are likely for patients and for hospital resources?

J.D. Hillard

Talk and Information Producer KUSP

Using this blog – J.D. Hillard

The goal of KUSP’s online health issues discussions is to collect the thoughts of leaders in health services throughout the Monterey Bay area in a format that can become both a public resource and a resource for reporters seeking to cover health topics that deserve to be in the public eye.

Part of my goal in using a blog is to save everybody time, so please do not spend more than a few minutes per day participating.

Each discussion will begin with a summary of news on a particular topic and some questions. You are invited to add your own opinions, questions, stories, interview suggestions… whatever you feel would add to the discussion. Do this by clicking the “Comments” or “No comments” link adjacent to the initial statement. The Comments page will appear with a submission form below all the comments to date. Please identify yourself and your title in the “Name” field. Add your email address in the email field [this will not be made public]. Add your comment in the “Comment” field and click the submit button.

Lastly please continue to monitor this discussion and contribute when you have something to add.

I will email all invitees daily with updates on the progress of the discussion. Please call me at 831-476-2800 or email me at jd at kusp dot org [pardon the spam avoidance email format] with any questions.

Thanks for participating in KUSP’s online health issues discussions.

–J.D. Hillard

Talk and Information Producer

Central Coast Public Radio KUSP