OBR Daily Commentary

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Less Than Two Percent of Hospitals Are Paperless As Medicare Penalties Loom

(Forbes) Jan 16, 2013 - With less than two years to go before penalties kick in from the government for hospitals that are not using electronic health records, new data shows less than 2% have operational systems.

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William McGivney, PhD (Posted: January 21, 2013)

quotesThe present article illustrates how the full implementation and realization of utility of electronic health record systems is difficult to achieve. There remain standardization issues that diminish the ability to communicate even within hospital systems and networks, the need for sophisticated staffing to apply and benefit from system functionalities, and the substantial cost of start-up and maintenance. In community oncology, these issues are only magnified. EHRs have been shown to improve practice workflow, effectiveness, and safety under study conditions. Progress is being made. However, clinicians can feel overwhelmed by the input and data requirements of installed systems. As one doctor wrote in an oped piece (10/23/12) in the Wall Street Journal, “Who’s got time to listen to patients when the government demands ‘meaningful’ data entry?” Clearly in this Era of Accountability in Medicine, with millions of patients, millions of patient encounters, and trillions of health care dollars expended, electronic systems are essential. The road to implementation will be challenging as new systems are implemented and change (e.g., ICD-10 coding) continues. quotes

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Cardinal Health Specialty Solutions, Blue Cross and Blue Shield of Louisiana Launch Quality Program for Cancer Treatment

(Dayton Business Journal) Oct 22, 2012 - Blue Cross and Blue Shield of Louisiana and Cardinal Health Specialty Solutions have launched a joint program designed to improve cancer treatment using clinical pathways.

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William McGivney, PhD (Posted: October 23, 2012)

quotesPathways are in the ascendancy in terms of becoming the policy or tool that directs cancer care. There is clearly the opportunity to achieve efficiencies in care and reduce variation while the “use of these pathways demonstrates clinical outcomes consistent with published evidence“ (Hoverman et al, JOP vol.7 issue 3S). Intriguingly, pathways, in some cases, for specific tumor types may offer fewer treatment options for patient subpopulations than payer coverage policies. The implications for the timely inclusion of new drugs, biologics, devices and techniques are significant for patients, clinicians and innovator companies. Further, as the number of sources of pathways grows, the clinician may be challenged in her/his practice setting with a number of differing coverage policies and precert criteria, topped off by a new layer of varied pathways recommendations. Enhanced efficiency and reduction in unwarranted variation in practice are clearly needed in cancer care. As we head down the “pathway” highway, it is incumbent upon clinicians to be proactive and to assert on behalf of patients, pathways and policies that have sufficient latitude to meet the needs of those patients. It is essential that provider organizations be directly involved in an active and collaborative way to represent the interests of their constituents. quotes

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Meet the Editorial Board

Community Oncology
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Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
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Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
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H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
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Howard S. Hochster, MD

Associate Cancer Center Director, Yale Cancer Center P...

Community Oncology
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Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
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Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Financial Sector
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Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
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Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

Editor-In-Chief
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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Health Policy
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Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
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Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
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William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
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William McGivney, PhD

National Health Policy Expert...

Payer
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Winston Wong, PharmD

President, W-Squared Group...