Pula resor

It was once associated with shady doctors and unsafe conditions, but medical tourism has become a booming multi-billion dollar industry.

And more Americans are travelling abroad than ever for cut-price health care, in a bid to avert the astronomical costs of undergoing treatment at home.

From a nip-and-tuck to dental work or a heart bypass, hospitals around the world treat millions of foreign patients a year – and most of them fly in from the U.S., experts say.

A recent report from Reuters showed than Americans can typically expect to save 40-50 per cent depending on the procedure.

However, in some cases, the savings could be much more. According to the Medical Tourism Association, savings could be as much as 90 per cent.

The cost of a heart bypass in the U.S., averages $144,000, according to the MTA, compared to a cut-price $14,802 in Colombia, or an astounding  $5,200 in India; while a patient seeking a less-invasive procedure, such as Lasik, can pay as little as $500 in India for both eyes, compared to over $4,000 stateside.

For those seeking a nip-tuck, the prices show similar shocking variance. Liposuction, averaging $9,000 in the U.S., is cut to $2,500 in Colombia and $3,900 in Costa Rica, and American patients can save as much as $11,000 on a face lift in a foreign country.

Lured by more affordable medical care and modern facilities, places like Medical Tourism Malaysia, India and Turkey, have also become hot-spots for patients seeking procedures abroad, according to experts.

Medscape News web site has forecast medical tourism in Asia could generate $4.4billion by 2012.’

According to the Korea Health Industry Development Institute, the number of tourists coming to South Korea ballooned last year to nearly 82,000, generating about $700million in revenues.

By next year, Singapore aims to treat a million foreign patients a year, generating about $3billion for the economy, the Singapore Straits Times has reported; while neighbouring Malaysia, attracted nearly 400,000 medical tourists last year, and aims to increase that number to 1.9million by 2020.

The Philippines also sees itself as a cut-price destination, and is projecting the number of medical tourists to hit one million by 2015, generating at least $1billion in revenue.

Dr Glen Stream, president of the American Academy of Family Physicians, explained that many of the patients are middle-class workers who simply can’t afford medical care at home.

He told the New York Daily News: ‘Historically, wealthy people have travelled to the U.S. for treatments. What we’re seeing now is American citizens going in the other direction.’

In the report, titled “Telemedicine: An Essential Technology for Reformed Healthcare,” Freddy Lykke, managing director of CSC Scandihealth in Denmark, and colleagues identified healthcare practices and reform programs in several countries, evaluating the benefits and challenges of telemedicine across the globe.

Telemedicine is defined in the report as a provision of healthcare delivered via information and communications technology, supporting a goal of overcoming a geographical separation of patient and provider. Lykke et al argued that the implementation of telemedicine in hospitals enables widespread delivery of cost-effective healthcare, resource-efficient and high-quality care.

Telemedicine is an enabler for combating the rising cost of healthcare, providing high-quality care, meeting care demands, overcoming provider shortages and achieving patient satisfaction, according to the report.

“Even though telemedicine pilots did not develop into large-scale initiatives, they have provided evidence that these solutions can be implemented and help to address the broad array of healthcare challenges,” the authors wrote. “Telemedicine has been successful in many aspects of care delivery and health management, ranging from the most intensive care setting in the hospital to health and wellness monitoring at home.”

In all levels of care—from intensivist coverage to aged care monitoring and support—researchers found that in the vast majority of the challenges presented, telemedicine either positively or significantly addressed challenges. For example, authors cited a study at the Uniersity of Massachusetts Memorial Medical Center in Worcester, Mass., which reported a 20 percent decline in patient deaths during its trial period of tele-ICU, and a 36 percent decrease in the severity-adjusted mortality rate at a community hospital also participating in the trial.

Some of the significant challenges to implementing telemedicine are regulatory in nature, while others relate to technology and cost, Lykke and colleagues found.

“The barriers preventing widespread use of telemedicine are coming down, thanks to health reform initiatives, changes to legislation and advances in healthcare technology. However, these are long-term changes which take time, making it necessary to address current barriers by developing strategies and tactics for eliminating or mitigating their impact,” the authors wrote. “This is no simple task. Taken singularly, barriers, such as legacy healthcare delivery models, regulatory restrictions, payment policies and technical issues, are complex. … Yet, the collective experiences provide a learning resource to those earlier in the journey.”

A significant traditional barrier to telemedicine, the authors noted, is reimbursement. Some European countries are providing standard reimbursement to telemedicine services, according to the report, and more are starting to follow their lead. Other barriers include legacy care models and regulatory restrictions. Among the technological barriers to implementing telemedicine, are connectivity, systems implementation and interoperability, costs and end-user adoption.

www.cmio.net(Source)

By Dr. JudyAnn Bigby and Rick Shoup

In doctors’ offices across Massachusetts, endless rows of filing cabinets are being replaced by electronic health records that give our physicians easy, secure access to lab results and other critical patient information.

With complete medical information at their fingertips, physicians are able to provide better care with fewer errors at a lower cost. Data, unlike bulky paper files, is portable. It can follow you if you change health plans or start a new job. That means medical records from your doctor in Eastern Massachusetts would be available at the touch of a button in a Western Massachusetts emergency room, should the need arise.

Strengthening the technology that supports our health care has the power to save lives, reduce costs and create thousands of new healthcare jobs. Massachusetts, because of our highly skilled workforce and history of health care leadership, is uniquely positioned to lead the nation to a high-tech health care future.

That’s why we are inviting physicians, entrepreneurs and experts from around the Northeast to a Health Care Information Technology Conference at the DCU Center in Worcester May 9-10.

Worcester, the home of the world-class University of Massachusetts Medical School and the proving ground for many life sciences startups, is the perfect host for this event, now in its second year. This year’s event will bring together the leadership of the Patrick-Murray administration with some of the smartest minds in the industry to explore new opportunities, exchange ideas and develop solutions to challenges in health care.

Thanks to programs such as Gov. Deval Patrick’s Life Sciences Initiative, Massachusetts leads the nation in medical innovation and the advancement of technology that reduces costs while improving care. The Massachusetts eHealth Institute works with 2,500 physicians across the state to accelerate the adoption of electronic health record systems — a greater market penetration than almost anywhere else in the nation.

Through the eHealth Institute, physicians have access to financing opportunities and resources to ensure they can fully utilize their electronic health record system to get their patients the best care possible.

The Obama administration has been a full partner in these efforts, making major investments through the Recovery Act to help 100,000 primary care doctors move to electronic health record systems by 2014.

Health care providers who have made the switch to electronic health records often say they will never go back to paper, citing a reduction in medical errors and wasteful spending among other benefits.

Of course, there are real challenges facing doctors and other health providers trying to upgrade to new systems. It can be a daunting task for doctors in small practices to find the right vendors and training.

For physicians in this position, we are working with the federal government to help them access more than $27 billion available through federal authorities to help ease the transition to electronic health record systems. Eligible health professionals can receive up to $60,000 to ease the transition to electronic records. Hospitals are eligible for even more.

Our proactive approach to encouraging new solutions in health care has had results. This week’s conference is about extending those results and making new progress.

Going forward, our approach to streamlining and improving our health care infrastructure will adhere to a few simple principles.

Our first priority must be privacy. Electronic health data is highly sensitive information and the security of any network is our foremost concern.

In Massachusetts, the eHealth Institute is developing a statewide Health Information Exchange to make clinical information even more secure, while maintaining accessibility to providers and consumers.

Second is standardization. No provider’s network operates in isolation, and we are joined by the federal government in our resolve to ensure that all certified health record systems are capable of communicating with one another.

Massachusetts is fortunate to be home to some of the world’s most advanced health care institutions, research centers and technology companies. We are the home of more than 50 health IT companies, employing more than 5,000 Bay Staters.

This innovation has cultivated economic growth and impacted patient care across the commonwealth. And with 98 percent of our residents covered through the nation’s most successful model for universal coverage, we are a national leader in pushing the frontiers of health care.

Modernizing and strengthening the infrastructure that supports health care is good for Massachusetts, good for patients and good for our economy. And it’s a step toward building a better, stronger commonwealth for all of us.

Dr. JudyAnn Bigby is state secretary of Health and Human Services, and Rick Shoup, Ph.D., is director of the Massachusetts eHealth Institute and the state’s health IT coordinator.

The world used to dream of a paperless universe. Today we use more paper than ever. But a new technology may make this dream a reality for healthcare providers, allowing for better patient care and reduced practice costs.

Called digital pen technology, it’s something that lets doctors write prescriptions and make diagnoses the same way they always have – with pen and paper, but using a special pen that goes one step further – uploading what they write immediately into an electronic database instead of onto paper.

“We call it ‘smart’ paper,” says Virginia Carpenter, vice president of marketing for the Swedish Anoto Group, the company which pioneered this alternative way to capture data. “The only thing that’s changed is the pen.”

The reason it’s becoming so important is the Health Information Technology for Economic and Clinical Health Act (HITECH), which went into effect on February 17, 2010. HITECH promotes the adoption and meaningful use of health information technology. The act promises maximum incentive payments for Medicaid to those who adopt and use certified electronic health records (EHRs). Doctors who do not adopt an EHR by 2015 will be penalized 1 percent of Medicare payments, increasing to 3 percent over 3 years.

The advantage of digital pen technology is that it allows clinicians to continue to work the way they always have – with pen and paper, and lets the technology do the work.  As many as 80 percent of healthcare facilities still use the old way.

But this technology makes the transition to EHR for these facilities much easier and more seamless, says Carpenter.  “And the costs associated with training and workflow interruption are dramatically reduced when using a data capture method that is as easy to use as pen and paper.”

All EHR systems must rely on some form of data capture to get healthcare information into the digital domain.  The data capture options that are often considered–desktop data entry, laptops, tablet PCs, or voice recording–have limitations in many clinical processes.

Digital pen technology allows healthcare data to be captured digitally without changing how clinicians do their work, thus minimizing associated training and workflow interruption costs.  This in turn eliminates many of the barriers to EHR adoption, and most agree that a high EHR adoption rate is critical to better patient care and reducing healthcare costs over the long term, says Carpenter.

“Even better, the digital pen technology allows clinicians to do what they do best, have face-to-face contact with patients, something very important to both healthcare practitioners and their patients but something that is not possible with other data capture devices such as laptops or desktop computers,” says Carpenter.

Anoto technology has two main components:  The Anoto digital pen and the Anoto dot pattern.  The digital pen has a tiny digital camera under the tip of the pen that takes pictures at 70 times per second as the user writes.  The Anoto dot pattern is a microscopic series of dots placed on an invisible grid on the paper that the user writes on.  This dot pattern is printed on regular paper with standard desktop printers.  The dot pattern just looks like a faint gray background to the user, but to the digital pen, the dot pattern indicates where on the page the user is writing and on which page. All that positioning information is stored in the pen’s memory as X, Y coordinates.

When the pen is synched with a PC via a USB docking station or through Bluetooth transmission, the X, Y coordinates can be uploaded into any of a wide variety of applications developed by Anoto partners that translate the X, Y coordinates into an image of the handwriting that is much clearer and more accurate than if the document had been scanned.  Usually, handwriting recognition software is then applied.  This translates the handwriting into machine-readable data which can then be imported easily into any EHR or other back-end system.

Not even physicians’ often indecipherable handwriting can foil the technology. “That’s easy,” says Carpenter. “We set up a database for each medical field and special software can translate most terms based on what’s in the database. There’s intelligence behind it to interpret it.”