Advocacy Project: Letter to Public Official

April 28, 2009
Senator Amy Klobuchar
U.S. Senate
302 Hart Senate Office Building
Washington, DC 20510

Senator Klobuchar,

The proposed bill H.R. 1309 that encourages the adoption and implementation of interoperability into the health technology systems will provide the United States with improved health care quality, reduced medical errors, and increase in the efficiency of care. With your help on passing this bill not only will it improve our health systems by the actions stated above but it will also allow for greater communication between doctors, patients, nurses, and health office representatives. Improved communication can allow for improved work flow, optimal care, and a decrease in duplicated medical records caused by the standard technology systems. For future insight, the passage of this bill will enable students in college working towards a health care administrating degree's to enter their job with the confidence and assurance that they have the precise technology provided to them to advance the way hospitals operate. Not only will this bill affect the future prospects in the health care field but will affect the present citizens looking for the best possible care from their local hospitals. Because interoperability connects all systems and records into a network it will allow patients to access online medical portfolios that may contain information regarding treatments, status,and future appointments. Interoperability will aid everyone young and old is not forgotten about when it comes to health. With your help by voting "yes" to House Bill# 1309 we can revolutionize the United States health system by simply turning data into intelligence.

Thank you Senator Amy Klobuchar!

-Noah Funk

Share and Voice: Do The Green Thing

Hey Everybody!

So I came across this sort of whacky/funny site that delivers short films representing ways to be greener. Some of the ideas they have are pretty clever and others are like HUH?....either way it provided me with some entertainment about being green. There are different sections to the site with a variety of videos on each section so be sure to do some searching. Check it out! Do The Green Thing

HERES MY FAVORITE! (I don't need to explain what its about)


Plug Out Boy feat. Green Monday from Green Thing on Vimeo.

Hope you guys enjoyed it!

Advocacy Project: Issue Overview

My Issue:

The issue that I am concerned about deals with Health Informational Technology or Health IT. This issue focuses on how the United States health system could be operating more efficiently and effectively if we are to change the current Health IT systems by implementation of an interoperable infrastructure that results in EMR (Electronic Medical Records).

What is interoperability in Health IT?
Interoperability is the ability to have a hospitals computer system connected with other hospital's systems so that the final outcome will be a nationwide network of Health IT systems connected to one another.
Current Legislation:
Representative Sam Johnson of Texas has already started this process to a more effective and efficient health system by introducing bill number H.R. 1309. This bill's title is to encourage and enhance the adoption of interoperable health information technology to improve health care quality, reduce medical errors, and increase the efficiency of care. It was introduced to the House on February 12, 2009.
Who is affected by my issue?:
Being that my issue is correlated with one of the largest cost expenditures in the United States it is surely to affect a number of people. The one's who will be affect the most by a change to Health IT would be doctors, patient, and health care providers.

Gains: Affected the most by this issue would have to be the doctors. With interoperability doctors will have the power to access specific patient data that without interoperability would have possibly been locked in a database or put into hiding in a file drawer. Doctors like to have patient information at their fingertips whenever possible and having a network system that can simply connect a patients records directly to him/her would benefit the doctors accuracy on patients, overall work flow, and hospital recognition. The gains sort of connect like a chain, if you have the doctors benefiting from this Health IT system the next ones down are the patients that work with those doctors. The patients will have the acknowledgment that the doctor has the most up to date records and can administer him/her the best quality care possible. Eventually everything adds up to an efficient and reliable communication tool within the hospital. Doctors will be able to communicate better with their patients, other clinics, other doctors, and administrative staff on ways to further improve there infrastructure. The greatest gain is to the United States health system as a whole. With an update to interoperability systems, we can rely on there to be less flawed processes, more efficient work flow, and top of the line quality medical care. Loses: Those who many suffer the brunt edge of this transformation to interoperability infrastructure is a bit limited. The people and loses coming from interoperability systems can be somewhat questionable. If some doctors can not grasp the way the new Health IT system functions then it would cause them to lose the reliability of patients, patient information, downgrade in work flow, and the worst lose; their jobs. As for the patients, they may inquire loses with insurance companies if their companies gain hold on health records that can make all the difference in being qualified for health insurance, that's if insurance companies have the rights to access the same medical files that doctors can. However, I feel the greatest loss would be our health. An IT system like interoperability has the chance to advance the way the U.S. handles its health care by providing doctors with the information necessary to provide top notch quality care to those patients.

Consequences:
By improving the way technology is used in health care systems it doesn't seem like there should be any consequences to individuals, families or society but begin that technology is not always the most reliable tool we are bound to develop some repercussion with this issue. The consequences of interoperability IT to society would breach mainly the lines of confidentiality. Living in a world that is centered around technology and when things don't go as planned with technology people become impatient, upset, and blame it on the system not working. If there would happen to be a malfunction with the interoperability IT system it would cause much unsatisfactory with the new IT system, decrease patient satisfaction with there doctors, and a burden for families who are unhappy with the new IT.

Issue's Economic Impact:

If there is a nationwide push towards having an interoperability IT system then costs would be weighed upon the government which more than likely would be eventually paid for by tax payers dollars. However if we have certain hospitals designating that they are switching over to an interoperability system the cost would be weighed upon the administration. These costs are countered weight with the future benefit that will come from having an inter connected medical network. Economically this system would greatly benefit the consumer. Interoperability would allow individuals to access information about their health status, eliminate hesitation about switching between clinics now being that they will not have to fear about losing medical records, and benefit from the economic efficiency of less medical error, duplication of records, and increased work flow.
Issue's Social Impact:

The social impact of interoperability would fall upon the tax payers if the government were to make this a nationwide change to the Health IT system. This of course wouldn't be very fond by some while others will not mind and feel that overall wellness should not be decided by a price. Relating back to healthcare providers, this may also impact the group of people who are worried that their insurance providers may view records resulting in a denial for medical coverage and this includes all those who are trying or have been denied coverage that feel it is wrong to have medical records inter connected in a way that allows insurance companies a full detailed report of their medical history. However the social gaining impact will be that ever increase group of people who applaud the use of have medical records inter connected that allows for the most efficient, effective, and grade A doctors that will be able to provide them with the right care. This issue will have a positive impact on the groups of doctors who feel that with an interoperable system they will be able to complete their job better than before by simply having the right medical records in front of them with a click of the mouse.

The Barriers:

The barriers addressing this issue is that of safety for the patient. Having a system that connects every medical records in a network may results in some unexpected problems. Example, a doctor wants to bring up a medical records for Jane Doe. The doc pulls up her records to write out the correct medication prescription. However he did not notice that the record he pulled up was for a Jane E. Doe and thus providing her with the wrong a medication that she may possibly be allergic to. Because the electronic medical records will be entered in by name it will be possible to run into the slightest mix-up with identities. It seems simple to overcome this issue, the IT system will have to be upgraded as to where instead of locating the patient by name they may be located by say a phone number, or address, or even a specific patient number id. The mix up in identities with Jane Doe and Jane E. Doe may also cause there to be billing problems. If Jane Doe's insurance company is looking to bill her for the medication prescribed but by accident confused Jane Doe for Jane E. Doe, then there is going to be a conflicting with payments and result in administrative costs to resolve the error. These two barriers to the issue could be resolved in the same way.
What are the resources?

I would have to say that the most important resource that may come into play on this issue is the Health Insurance Portability and Accountability Act or HIPPA. HIPPA aims to improve the effectiveness and efficiency of the health care system, portability and continuity of health insurance coverage in the group and individual markets, and to provide consequences to those that do not apply with the regulations stated within the act. As well to address this issue I will need up to date information about certain interoperability software being developed and how they expect each one to be a success. Most of my resources can been found with in depth internet searches, library references, and magazine articles.
History of the Issue:

This issue has been on the rise since 2005. The NHS (National Health Service) is hoping to have 60,000,000 patients with electronic medical records by 2010. The progression of switching to electronic medical records is increasing at a slow rate. This rate may be increasing very slowly due to the limited EMR systems that will be used to inter connect all records. In 2005, to push towards the production of EMR systems that will connect medical records within a networks the U.S. Department of Health and Human Services made a non-profit organization designated specifically to develop EMR systems called Certification Commission for Healthcare Information Technology (CCHIT). This new organization provided great results in 2006, CCHIT released a list of 20 certified EMR products.

Allies & Opponents:
Allies of this issue would be patients who are encourage by the benefits that interoperability will bring to health care quality, doctors, CCHIT, computer engineers installing these programs, software trainers, health insurance companies, and hospital administrators. Opponents of introducing an nationwide interoperability system would be tax payers, hospital administrators not interested in the costs, and health insurance companies that have to change their record systems.

My Recommendation:

I would recommend that my representative votes yes for bill H.R. 1309 to encourage and enhance the adoption of interoperable health information technology to improve health care quality, reduce medical errors, and increase the efficiency of care. Voting yes would result in a more efficient and effective medical system that allows doctors to provide the absolute best care they can deliver to the patient by having up-to-date medical records at the tips of there fingers.

Reflection: Week 11 & 12

Okay, so I am absolutely ready for summer time. I think we should have our class time outside when its glorious days like today. Any seconds? Another two weeks of environmental health have been erased from the calendar and just a few remain.

Week 11

We got back into the swings of things this week after having week ten off due to the AAPHERD convention. We watched our last documentary film for class titled "Unnatural Causes." The film consisted of multiple short flicks and the one we watched was "In Sickness and in Wealth." This film was about how the wealth of someone can simply be a main factor in determining there health. Wealthier people live longer and poorer people die sooner. I thought it was a very interesting documentary. I've never really thought about how wealthy people have an advantage in life over poorer people. Second part of the week we had blog assignment to explore a health issue that grabs your interest. A busy week it was.

Week 12

This week was a little more relaxing but gave us an insight into the busy weeks coming up. We went over ways to fully understand an issue, so that we can get the most out of our advocacy project.

I'm looking forward to the coming weeks. Especially next weeks venture outside.

Advocacy Project: Healthy People/THOMAS

Healthy People 2010 Goal #23 - Public Health Infrastructure

Goal: Ensure that Federal, Tribal, State, and local agencies are provided with an infrastructure that allows them to provide essential public health services effectively.

There are four focus points that the Department of Health & Human Services hope to address in order to achieve progress towards the goal; data and information systems, workforce, public health organizations, prevention research. I am going to focus on data and information systems.

• Goal objective 23-3: Increase the proportion of major national health data systems that use geocoding to promote nationwide use of geographic information systems
• Target: 100 percent
• Baseline: 50 percent of major national health data systems geocoded records to street address or latitude and longitude in 2000
• Sources: CDC, NCHS
  

Progress: As of now the Progress Quotient Chart for area 23: Use of geocoding in major health data systems, has shown a 0% increase towards its 2010 goal. The use of geocoding has remained constant, 50% of major health systems using geocoding in 2000 and 2004.

• What is Geocoding? - Many current health systems rely on address to base there business decisions off of. Geocoding is a form of location filing by using longitude and latitude. Geocoding can target exact world locations and match that with how it relates to health disparities in race/ethnicity. The process of determining these coordinates and linking this intelligence to a street address is known as geocoding. (What is Geocoding? Business Geographics)

Disparities: Public Health Infrastructure objective 23-3 is not population based, therefore, a disparity study was not conducted. PHI objectives work to eliminate disparities in access to care and health outcomes for vulnerable populations by addressing the capacity and resources of the public health infrastructure and educational training for persons working within it.

Opportunities and Challenges: IT (Information Technology) systems, the core element in public health infrastructure is the focus for opportunities directed to benefit the targeted geocoding objective. There has been three major efforts directed towards development and coordinate public health data.

1. Office of the National Coordinator for Health Information Technology (ONC) - ONC helps by providing leadership for the development and nationwide installment of IT infrastructure. Including exchange of information between different operating systems. This type of infrastructure is designed to improve quality and efficiency of health care and capability for consumers to access their care and safety.
   
2. Public Health Information Network (PHIN) - PHIN is managed by the CDC to improve the electronic communication within the public health community.
   
3. National Environmental Public Health Tracking Network - The goal for this network is to collect, integrate, analyze, and interpret data from monitoring environmental hazards, humans exposure to those hazards, and human health effects correlated to environmental hazards in order to protect communities from adverse health effects.

Emerging Issues: The most urgent issue that Public Health Infrastructure's have to deal with is the unexpected outbreak of an infectious disease or natural disasters. These unexpected events bring stress upon the pubic health system that focus on responding to these situations. The newest issues that require attention are bioterrorism and emergency preparedness. After all in any situation its hard to prepare for the unexpected. Success in the Public Health Infrastructure rest on the ability to change and overcome these new threats.

H.R. 1039 Promoting Health Information Technology Act 2009 (Introduced to House)

Title: To encourage and enhance the adoption of interoperable health information technology to improve health care quality, reduce medical errors, and increase the efficiency of care.

Sponsor: Rep Johnson, Sam [TX-3] (introduced 2/12/2009)

Cosponsors: 26 Cosponsors (Click Here for list)

Latest Major Action: 2/12/2009 Referred to House committee. Status: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

My Political Representatives: U.S. Senator Amy Klobuchar

I am a student majoring in Health Care Administration and an issue involving the way major health systems will use information technology will more than likely affect me in the rest of my career. Being that health care consumes a large chunk of U.S. spending it seems only right that we take action to make sure health systems top priority is communication within and outside the health infrastructure. I believe that you should vote YES to the Promoting Health Information Technology Act 2009.

Share and Voice: A Unique Way To Reuse Plastic

In America we are very fortunate to have access to practically any good or need that we want. Unfortunately it isn't the same for other countries. However, these people find other ways to obtain the goods or needs they so dearly want. Ways that many Americans don't think about using because we just simply don't need to, we have other means of acquiring that good or need. So it made me think about how some kids in the poorest countries reuses plastic to acquire the on certain good that he/she wants.

For The Love Of The Game



I have played soccer all my life and still do so it's kind of a bummer for kids that want to play the game but can't because they lack the ball. I did this post because it's a different and neat way that plastic bags have been reused. I'm glad to say that I have donated soccer balls to kids in Africa so that they can enjoy the same luxury as I can...to have a real soccer ball at their feet.

Links:
Worldvision - a site designated for helping out the poorest kids to keep there soccer dreams alive. Just in case any of you are soccer fans.

Share and Voice: Cleaning The Heights

Apa Sherpa has to be one of the most ambitious trash cleaners in the world. I don't think many of us will be able to say we've gone to such heights to keep the world a little cleaner. It's good to see that people do what they can to make our planet a little greener. Check out the short article.

Climber to break record with Mt. Everest Clean-up Climb