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Issue Date: June 2006

Disasters Foster Innovations in Health Records
As another hurricane season begins, concern about protecting medical records rises yet again. Last year, during hurricanes Katrina and Rita, one million Americans lost their records of immunizations, medications, allergies, diseases, or insurance. These records are critical in emergencies or when one needs a vital prescription or life-saving dialysis.
A number of companies have been seeking solutions to this problem. Meanwhile, the best solution is still being developed: a nationwide system of electronic health records and a corresponding network of regional health information organizations (RHIOs). A number of markets are working to develop RHIOs, but having an interconnected network of RHIOs to store all patient records in a secure but accessible fashion is still a number of years away. Planners envision a day when medical information will not be stored in paper charts subject to the whims of nature or disasters.

Targeted Treatment Therapies
The battle on cancer has begun to include therapies targeted specifically at malignant cells, adding a level of refinement to earlier approaches based on the wholesale killing of any rapidly growing cell. Colorectal cancer (CRC) has been at the forefront of studies into these new targeted therapies, and some of the agents are now considered standard components of therapy for metastatic disease. Two biological pathways have been targeted in CRC therapies: the epidermal growth factor (EGF) pathway and the vascular endothelial growth factor (VEGF) pathway. In both cases, the goal of therapy is to disrupt the signaling that occurs when the growth factor molecule binds to its receptor on the cell surface. Both receptors contain an intracellular tyrosine kinase (TK) domain that is critical for signaling. Here, however, the similarities end.

New Systems Help Growing Practice
Physicians are often reluctant to adopt new electronic medical record (EMR) systems, fearing that using computers will interfere with the physician-patient relationship. But Nassim & Associates, a fast-growing pediatrics practice, found a way to introduce practice management and EMR systems without disrupting interactions between physicians and patients.
“Our new systems offer the best of both worlds,” says Chris Mescia, MD, one of four physicians in Nassim & Associates, PSC, in New Albany, Ind. “All of the programs we looked at involved viewing a computer screen while entering data when you were with a patient. If you’re entering data, that eliminates some of the good eye contact that you want with a patient.” Rather than have physicians enter patient-visit data on computers, the practice developed an office visit template on a sheet of paper that allows physicians to write the history, physical assessment, and plan of care on one page.

Treating GERD: Optimizing Compliance in Children
Physicians have often rued one implacable truth: Medicine can’t help the patient if he or she doesn’t take it. Medication compliance is an issue for all conditions and all patients. However, health care professionals who treat children face unusual challenges. They must address the needs not only of the patients involved, who range from infants to adolescents, but also of their parents or caregivers. In addition, issues involving administration, such as the taste or texture of the medicine, can be key factors among children, particularly those who are too young to understand why treatment is necessary. Regardless of the age of the patient being treated, compliance is critical to treatment success. And it involves more than simply taking the prescribed medication. Full compliance also requires the patient to adhere to the dosing schedule and to take the medication for the required length of time. These aspects of compliance are particularly important for therapies that need to be administered at a specific time with respect to food or ones that are prescribed in multi-week courses.