Health Record Corporation (HRC) has completed development of its simple, easy-to-use MedKaz System and launched three pilot studies to demonstrate its efficacy to consumers and care providers alike.

The three pilots — one with consumers activating and using their MedKaz devices with their doctors, one where the doctor issues the MedKaz to patients, and one with a population of MedKaz-using consumers concentrated in one city – currently count more than 200 MedKaz users in 10 states and will last approximately four months.

The real-life use of the MedKaz has already led to several improvements that enhance the user experience and generated two upgraded versions of the software that MedKaz users have downloaded to their MedKaz devices.

As HRC responds to feedback from its pilot studies, it continues to enhance the capability of the MedKaz and expects to launch the next expansion of the system in the coming weeks: enabling one family member to have other family members’ medical records on their device. Whether a parent has copies of their children’s records on their MedKaz or an adult child has copies of their senior parents’ records on their MedKaz, this capability will be invaluable.

HRC welcomes additional physicians who would like to participate in a pilot study and be among the first in the country to offer the game-changing MedKaz to their patients. Patient participation is free. Physicians who participate receive a $1,000 honorarium plus a free copy of the MedKaz Patient Record Manager (PRM).

The PRM is the component of the MedKaz System for physicians and other providers. It enables those who keep paper charts to enjoy the advantages of electronic records without the hassle of installing an EMR system. It also enables all physicians to easily respond to public health initiatives that affect their practice such as instantly identifying all patients who are affected by a drug recall or disease alert. And it enables all physicians to quickly and easily meet 80% of Stage 1 Meaningful Use requirements.

For more information on the MedKaz, our pilot studies, or to participate in a pilot study, contact HRC President, Merle Bushkin, by phone at 802 484-0249, by e-mail at mbushkin@medkaz.com.

Merle Bushkin, Founder and CEO of Health Record Corporation, posted the following blog on The Health Care Blog.com. He suggests that people – especially those who want to remove profits from healthcare – should reconsider their position. He concludes that “the pursuit of profits just might solve our healthcare problems.”

To date, more than 166 comments have been posted, and more are added daily. The original blog follows. To read the informative comments, click here.

Let’s Stop Bashing Profits and Business In Healthcare

By MERLE J. BUSHKIN

I’m tired of profit-bashing and business-bashing in healthcare. And every American should be, too!

Well-run, profitable businesses, along with our sense of decency, democratic institutions, education and free enterprise systems, and adherence to the rule of law, have made the United States the most extraordinary nation in recorded history. Together they have unleashed the talents, creativity and productivity of our people, generated enormous sums of capital, and created unheard of social, economic, scientific and political advances.

Is there anything nobler than providing the environment and opportunity for people to fulfill their potential and achieve their dreams, and for providing the goods and services that enable people to raise their standard of living? Not even the practice of medicine can do so much good for so many people. But that’s precisely what businesses do. (That also may explain why far more Americans today are interested in job creation than restructuring healthcare.)

In our system, an individual has an idea, attracts capital, and hires people to build a product or provide a service. When they meet a need, they prosper – and attract more capital and hire more people. Everybody wins. If they fail, they alone suffer the consequences. That’s what capitalism is all about and that’s what has made America great.

Sure, there are ups and downs. Some caused by business cycles, some by global competition, some by excesses on the part of companies and individuals. Unfettered competition can be terribly harmful and that’s where government comes in. Government must ensure there is a level playing field so businesses and individuals have equal opportunity and can compete fairly. Additionally, government should protect against harmful excesses, and apply monetary and fiscal policies to moderate the ups and downs.

The last thing we should do, however, is abandon the very values and forces that have made America great. We should improve not destroy them, so let’s stop bashing businesses and profits.

For example, many think it crass and wrong for insurers, pharma or other healthcare vendors to earn a profit — so they want to get rid of profits. But where will capital to support these activities and innovation come from if investors (who include Wall Street and Main Street investors alike) can’t earn a return on their capital? From the government? Hardly. The government today doesn’t have reserves to fund the $37± trillion in future Medicare liabilities or our massive deficits. Our children and grandchildren will have to meet them. And how much in additional liabilities can our economy carry before our cost to borrow capital becomes prohibitive and we default on our debt? At least the insurance companies have reserves to back their obligations – so shouldn’t we force them to compete fairly rather than disband the concept of private insurance?

Similarly, many docs who consider the pursuit of their calling as noble and the pursuit of profit unseemly, apparently don’t understand that they are just as driven to earn a profit and return on their investment as profit-focused companies are – only they use different words to describe what they do. They claim they provide a noble service and therefore are entitled to large incomes because they have invested years of their lives and lots in tuition to develop their expertise. Described in other terms, isn’t their expertise their trade, and aren’t their practices really small businesses? In truth, aren’t they demanding a return on their investment – just like all businesses do? (If they don’t, their practices won’t survive.) And how much income does one have to earn before part of it is recognized as a return on investment?

Don’t misunderstand. I recognize that all businesses, like all doctors, aren’t noble, and I don’t support the power of insurers today to dictate what they will pay doctors for their services, or most of the other distortions in our healthcare system. But let’s stop the profit and business bashing. Properly directed, the pursuit of profits just might solve our healthcare problems.

Posted July 22, 2011 by Jane Sarasohn-Kahn

In a blog posted on The Health Care Blog.com,
Jane Sarasohn-Kahn, a health economist and management consultant in healthcare technology, discusses the findings of a study commissioned by Xerox. It reports “that 83% of people have concerns about digital medical records. The most concerning issue is that “my” personal health information could be hacked, cited by two-thirds of people. The second most common concern is that digital medical record files could be lost, damaged or corrupted (noted by 54%) and that personal health information could be misused (52%). Another worry is that a power outage or computer problem could prevent providers from accessing health information, cited by 52% of people surveyed.” She concludes that there is a “need for education and raising awareness of EHRs.”

Merle Bushkin, Founder and CEO of Health Record Corporation, posted several comments to this blog. He says these consumer concerns are well founded and shouldn’t be ignored, and that we’re not making progress (with the adoption of electronic health records, EHRs) because we’re defining the problem incorrectly. He writes “the problem isn’t how to make a patient’s records available over the Internet. The problem is two-fold and requires separate, independent solutions. One is how doctors should keep records. The other is how to make a patient’s records available to their care providers when and where they need them.”

He believes every doctor and hospital should keep electronic records but that the systems available today don’t work for care providers. He writes: “We need to encourage the development of new systems that actually help and benefit them (i.e., care providers).” Similarly, on the issue of how to make a patient’s lifetime health record available to their care providers, he suggests we need a different kind of system, one that doesn’t store patient records on the Internet-accessible servers. He says the system should be patient-focused and give the patient control of their aggregated lifetime medical record which they, in turn, can give to their care provider when they seek care. The MedKaz System works just that way. It avoids the problems cited by consumers in the Xerox study. It also could be the precursor of a new generation of EMR systems for providers.

Virtually no one puts the blame where it belongs. Simply put, Google Health didn’t meet the needs of the two most important groups in healthcare: consumers and providers. Neither have the many other previous attempts at launching a viable personal health record.

Google’s search engine disrupted the world because it met the needs of people to quickly and easily access information. Google did the work, the user got the information they wanted. Then Google met a need for advertisers, it gave them exposure to consumers. The result: incredible acceptance by both consumers and advertisers, growth and financial rewards!

With Google Health, Google did exactly the opposite. It created a system in which the user had to do all the work and the providers were taken for granted and all but ignored.

Patients want convenience and to know their records are secure, yet Google Health required that they become data entry clerks, and stored their records on breachable Internet-accessible servers! Providers don’t want to be bothered unless they benefit in a meaningful way, yet Google Health did nothing for them.

The lessons to be learned from the failure of Google Health are that providers must embrace a personal health record system or it will fail, that convenience, ease of use, and a sound business model are critical, and that despite one’s size/prominence, financial resources, or technical expertise, they will fail if they do not to meet these requirements.

Easier said than done!  A patient’s complete record isn’t available because care provider records are too varied and can’t be aggregated.   Most physicians and hospitals keep paper records and can’t share them easily.  And those relatively few who keep electronic records use systems that are incompatible and can’t exchange information either.

Established leaders in health information, including vendors, professional organizations, care providers and government agencies, have spent thousands of hours over many years plus millions of dollars trying to overcome this problem. But despite the endless conferences, committees, hoopla and hundreds of millions spent to date, they have made precious little progress.  Medical records still can’t be shared or—in the jargon of the industry—aren’t “interoperable!”  Why?

The simple answer is they have based their proposed solutions on at least a dozen bad assumptions, or “myths,” which have led them astray! They have pursued unnecessarily complex, elaborate and expensive strategies, and have little acceptance to show for it.

Myth #1: The best, most efficient and cheapest way to exchange patient records among care providers is to make them available over the Internet.   Reality: Storing patient records on Web servers is extraordinarily complex, expensive and creates more problems and issues than it solves.  They are trying to use a nuclear bomb when they need a fly swatter!  The MedKaz is a simpler, cheaper, less disruptive way to share records.

Myth #2: Complex, expensive, state-of-the-art networks linked across the country, such as RHIOs, HIEs, and an NHIN, are required to exchange patient records.   Reality: Complex networks are unnecessary and financially unsound.  They will take years to build, will cost hundreds of billions of dollars, are not sustainable financially, and don’t accommodate out-of-network encounters. This is another nuclear bomb!

Myth #3: When everyone agrees on the requisite standards and technology, the funding needed to implement and exchange interoperable patient health records will be available—as a last resort from non-profits, the Federal government, and/or state and local governments.   Reality: The money simply isn’t and for the foreseeable future won’t be there to fund financially unsound solutions.  We must adopt a solution like the MedKaz that we can afford, implement quickly and is financially self-sustaining.

Myth #4: It is acceptable to spend years developing and installing a Web-based network; there is little urgency.   Reality: The needs couldn’t be more urgent or the costs of delay greater.  People are dying while we dawdle.  Lives can be saved, pain and suffering avoided, and billions of dollars saved each year.

Myth #5: Web-based networks or services can guarantee that a patient’s medical records are safe, secure and private.   Reality: No one despite their claims and best intentions can guarantee security and privacy over the Internet.  Web servers, including the Defense Department’s, often are breached and data are stolen. Additionally, patient records too often are lost, misplaced and even published on the Internet.  Consumers know this which is why they resist Web-based systems.

Myth #6: Physicians don’t want to adopt electronic medical records.   Reality: Most would like to do so but the costs—both financial and operational—are greater than they can or will tolerate.  They want a simple system like the MedKaz that is cheap, easy to install, easy to use, and gives them the information they need without completely disrupting their workflow.

Myth #7: Sooner or later all care providers will adopt a comprehensive electronic medical record (EMR) system (which can cost as much as $50 thousand per physician to install and $10 thousand per year per physician to maintain).  If they refuse, they must be required to do so.   Reality: More than 80% of physicians and 70% of hospitals have not done so and refuse to do so because it is against their economic self-interest.  Forcing them would be draconian and is unnecessary. We need their support not their opposition.

Myth #8: Physicians and hospitals will install electronic medical records if they are subsidized.   Reality: Most paper-using care providers don’t want subsidies to install elaborate systems. They want a simple, manageable system like the MedKaz that fits into their workflow and helps—not hurts—them.

Myth #9: It isn’t necessary to give patients copies of their medical records.  It is sufficient for a care provider to make a patient’s records available to other care providers.   Reality: Increasingly, patients want to control their records, who accesses them and how they are used.  Moreover, one Meaningful Use requirement is that care providers must be able to give their patients electronic copies of their notes within 36 hours of a visit.

Myth #10: Patients don’t mind entering extensive information into a PHR and keeping it up to date.   Reality: They are put off by the burden and inconvenience which may explain why so few have embraced available PHR systems.  To be acceptable, a PHR system must be easy to use by patients and physicians alike.

Myth #11: Patient-provided information, claim reimbursement records and/or information from other third parties are acceptable substitutes for actual physician notes, test results, images, etc.   Reality: They are incomplete, may be inaccurate, and do not contain the clinical content care providers need.  They are poor substitutes for the real thing.

Myth #12: New online healthcare platforms like Microsoft’s HealthVault and Google Health are the solution.   Reality: They are not.  They are focused primarily on wellness and disease management, not personal health records.   Their PHR applications are incomplete, and require the patient to input extensive data (which may not be correct).

To qualify for reimbursement, physicians must install an EMR system and meet Meaningful Use criteria.  In return, the government will reimburse them up to $44 thousand per physician, to be paid over three years starting in 2011.  If they do not install an EMR system and meet the three stages of Meaningful Use requirements by 2015, their Medicare reimbursement rates will be reduced.

While HITECH is raising every physician’s awareness of the need to have electronic medical records by 2015, it also is provoking a growing rebellion. Paper-using physicians are very aware of the traumatic experiences many colleagues have had installing legacy EMR systems.  As a result, many are seriously considering not participating in the reimbursement program and—starting in 2015—opting out of Medicare.   Moreover, many practices that previously installed EMR systems are abandoning them as too costly and too cumbersome.

Such resistance may force the government to extend its adoption and reimbursement deadlines. And if enough docs drag their feet or refuse to adopt EMR systems, state and federal efforts to network care provider EMR systems will stall as well.

Despite these possible problems and in part because of them, we believe the massive infusion of government funding will have a very favorable impact on the patient-focused MedKaz.

Most docs would like to have a simple EMR system that is easy to use, saves them money and enables them to keep and access their patient records electronically.  That’s precisely what our Patient Record Manager (PRM) does.  The legacy systems the government is urging physicians to adopt, do not.

Even the simplest legacy systems typically cost far more than the mere cost of the EMR software. Their installation seriously disrupts the doc’s work flow and requires expensive additional hardware, software, and staff training.  Most importantly, while the docs and their staffs learn how to use the system, which typically takes six to nine months, they must reduce the number of patients they see each day by up to 50%.  One four-doc practice in VT paid $40,000 for their EMR system but estimates their all-in cost totaled $316,000.  Others have had similar experiences.

In contrast, the MedKaz System benefits paper-using physicians in three important ways. It actually increases their revenue. They are paid for uploading a patient’s records following an encounter.  It does not disrupt their work flow. And its PRM serves as an EMR-lite, meeting their desire to have a manageable, low cost, easy to use electronic system even while keeping paper charts.

A copy of the digitized paper records already loaded onto the patient’s MedKaz, is automatically downloaded onto his or her PRM.  So now the doc has a manageable digitized copy of the paper records he or she has created for each patient.  The next time the patient comes for an appointment, the doc can open his or her PRM and review the patient’s chart on their computer rather than having to pull the patient’s paper chart.

Additionally, the MedKaz makes it possible for docs to meet important Meaningful Use requirements.  For example, by loading a patient’s encounter record on the patient’s MedKaz, the doc satisfies the requirement that the physician must be able to give his or her patient an electronic copy of their encounter record.  In turn, the patient can access the record and share it with his or her other care providers.

The PRM also enables paper-using docs to meet certain public health needs.  If there is a drug recall, they can electronically identify which of their patients take the drug.  Or if they need to contact patients with a particular illness, they can easily do so.

Thus, the PRM satisfies the needs docs have for electronic records even if they keep paper records.  Adding to its appeal, it is free, easy to use, and doesn’t disrupt the doc’s work flow or force them to reduce the number of patients they see.

Once paper-using physicians learn how convenient it is to use electronic records, we believe and hope they will opt to install a more robust EMR system, though their choices may be quite different from today’s legacy systems.  And when they do, they will avoid the cost of having to scan and digitize their active patient records.  They’ll merely upload their records from their PRM to their new system.

Thus, the patient-focused MedKaz and physician-focused EMRs will live side by side-with each meeting the unique needs of its owner.  The MedKaz will continue to meet patients’ needs to own and control their medical records, make them immediately available to care providers when and where they need care, and facilitate the coordination of their care.  And EMR systems will meet the record-keeping, practice management and public health needs of physicians.