industry except healthcare, d said Dr. Frank Din (Apelon).<br><br> cIt 9s time we brought healthcare into the 21st Century. If we do not, cost will continue to skyrocket and the quality of healthcare will suffer. d Dr. Valerie Powell (RMU), a member of the Pennsylvania Commission on Chronic Care Management, Reimbursement, and Cost Reduction, said: cWe feel that it is vital that the National Health Information Network (NHIN) effort in Health and Human Services (HHS) look forward to this integration in healthcare while the basic building blocks of standards for NHIN are designed.<br><br> There are two streams of care, both with medication and surgery events, inadequately articulated. This condition of U.S. healthcare is not a recipe for safety or for quality of care.<br><br> Chronic care, prenatal care, and pediatric care (among others) will not be optimally supported and healthcare costs will not be optimally reduced until this integration need is actively addressed in U.S. healthcare. While Federally-supported systems (VA VistA, IHS, AHLTA) all offer this integration, in general, with the beginning exception of Aetna, such integration of care is not available to Americans in private sector healthcare. d Dr.<br><br> Humberto Torres-Urquidy (University of Pittsburgh) cited an Institute of Medicine (IOM) report, Preventing Medication Errors: Quality Chasm Series that conservatively estimates that hospitals commit 400,000 drug errors a year, costing $3.5 billion, not including lost productivity and other costs. Another 530,000 errors involving Medicare patients in out-patient facilities occur each year. Over a quarter of these medication-related injuries are preventable.<br><br> Moreover, Healthcare Information and Management Systems Society more than 98,000 Americans are killed each year due to medical errors. Instead of saving lives, our current paper-based health system is taking them. Hospitals and physician practices that implement electronic health records (EHRs) have proven they save lives.<br><br> The Center for IT Leadership suggests that utilizing interoperable ambulatory EHRs alone will save $112 billion a year, representing approximately 7 percent of healthcare spending. The Office of the National Coordinator for Health Information Technology conservatively estimates that annual savings due to widespread EHR adoption are likely to range between 7.5 and 30 percent of annual healthcare spending. The discussion group, which included experts from industry, academia, public policy, and clinical care, provided clear examples of the dangers to overall health of a patient when dental information and medical information are NOT shared.<br><br> In each example, the use of records that seamlessly incorporate dental and medical information prevent or mitigate the dangers. To bring these records together requires the coordinated efforts of informaticists, clinicians, researchers, IT specialist, and policy officials. As such, the discussion group has agreed to a set of goals and recommendations that will be forwarded to the Department of Health and Human Services for policy adoption that will direct further progress.<br><br> The 12 recommendations are: 1. Analyze, identify, and plan to resolve the discrepancies in shared medical and dental data. 2.<br><br> Study the communication model practices (or lack of them) in existence. Establish a model with both medical and dental input that can be used across the spectrum of patient care. Sources of experience, include but are not limited to Wisconsin Diabetes Guidelines, Marshfield Clinic, University of Detroit Mercy, and IHS and VHA health care systems.<br><br> 3. HHS/ONC should continue leadership with regard to the integration of medical and dental care and data especially as it relates to NHIN standards. 4.<br><br> Certification (CCHIT) standards should be examined to see if changes and explicit acknowledgement of the importance of oral healthcare for systemic healthcare are needed. 5. Medical and dental insurance should be analyzed for their contribution to the continuing separation of medical and dental treatment.<br><br> Where barriers to medical and dental integration are the result of the insurance process, changes are necessary. Specifically, the oral care needs of patients with medical problems needs to be represented within the medical insurance benefit programs. 6.<br><br> Support and fund the terminology work necessary to ensure semantic interoperability of the data, i.e. when data is exchanged, the meaning is the same for the sender and the recipient. 7.<br><br> Strongly encourage standards organizations, such as HL7 and HITSP, to embark on efforts to assess what adverse impact, if any, has occurred in standards development so far because of the separation of medical and dental data and care delivery. 8. Design incentives to encourage the training additional dental informaticists.<br><br> The integration of medical and dental records can only be accomplished with trained dental Healthcare Information and Management Systems Society informaticists who understand the complexities of the effort leading the effort. Training opportunities should be open to dental auxiliaries. 9.<br><br> As the AAMC and ADEA both recommend, move forward with modifications to medical and dental education (both pre-graduation and continuing) to assure that providers can deliver the best care that integrates attention to oral and systemic health. Add informatics and IT training to expose the students to the reality that informatics and IT are now integral to clinical practice. 10.<br><br> Amend the Social Security Act of the U.S. to include provision for routine and preventive oral healthcare (dental care) as an integral part of systemic healthcare. 11.<br><br> Deal with liability concerns of providers and privacy concerns of patients with regard to EHR/EDR adoption and use of networks and registries. Network liability issues can be addressed by legislation like West Virginia §16-29G-5: Immunity from suit; limitation of liability. 12.<br><br> Deal with costs concerns of medical and dental providers with regard to EHR/EDR adoption. A clear and unambiguous statement on how a software provider, clinic, hospital, insurance company, etc. may be able to help fund the adoption of EHR/EDR without violating Stark is necessary.<br><br> For greater details on this topic and recommendations, please contact Valerie Powell or Frank Din or visit http://www.infroref.org/MedDentDataArtic7.htm , http://www.infroref.org/MedDentDataArtic18.htm . This discussion was prompted by an invitation from the Obama-Biden Transition Team, which asked Americans to host community discussions to help the transition team develop appropriate healthcare policy recommendations. HIMSS members are sponsoring more than 30 health IT community discussions across the country.<br><br> HIMSS is the healthcare industry's membership organization exclusively focused on providing global leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare. Founded in 1961 with offices in Chicago, W ashington D.C., Brussels, and other locations across the United States and Europe, HIMSS represents more than 20,000 individual members a nd over 300 corporate members that collectively represent organizations employing millions of people. HIMSS frames and leads healthcare pub lic policy and industry practices through its advocacy, educational and professional development initiatives designed to promote information a nd management systems 9 contributions to ensuring quality patient care.<br><br> # # #

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