Electronic Medical Records (EMR) Incentive Reimbursement - Who Qualifies?

There are many pros and cons to converting to electronic health records; depending on the point of view, it may have more pros or more cons.

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How is Electronic Medical Records (EMR) Incentive Reimbursement - Who Qualifies?

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The American Recovery and Reinvestment Act is planning to give billion to physicians as an incentive to encourage physicians to use electronic medical records. This money will be given to physicians and practices over the duration of five years to invest in electronic medical records. Unfortunately, this incentive is not going to be given to just any practice that purchases the system. A practice must qualify in order to receive the reimbursement. The hard truth is that not everyone who applies for an incentive reimbursement is going to get it.

Who Qualifies for EMR Reimbursement?

In order to qualify for an incentive reimbursement, practices must pass a few things on the list. The incentive money is meant to use the electronic system in a meaningful way. This can mean several things. The electronic medical records system must be able to communicate with other systems from different vendors and have advanced features, such as the clinical decision support feature. In addition, you must be a meaningful user, meaning you prescribe electronically, exchange data with different providers, and generate reports on how well you do compared to the unspecified clinical quality measures. These measures may resemble what you would find in the Quality Reporting Initiative.

The qualification list does not stop there. In addition to the qualifications listed above, electronic medical records must also be certified. The American Recovery and Reimbursement Act has yet to specify who can certify electronic health records; however, the federal government will most likely choose the Certification Commission on Healthcare Information Technology (CCHIT). In order to receive the full disbursement of ,000 over the course of five years, physicians must also qualify as a meaningful electronic health record user beginning by 2011 or 2012. The later physicians choose to wait to qualify, the less they will receive in incentive payments.

There is another catch as well. Many physicians are eligible to receive incentive reimbursements, but not all physicians. Dentists, physicians, nurse practitioners, nurse midwives, and some physician assistants are included. Physicians who are not eligible are hospital-based professionals, such as radiologists, emergency physicians, pathologists, and anesthesiologists. Practices that choose not to use electronic health records will be penalized a 1% reduction in 2015 in their Medicare fee schedule and it can continue up to 5% as the years pass. Many physicians disagree with the federal government's plan to give incentive reimbursements. Many feel it is just one way the government can control how healthcare is administered, and as a way to push national healthcare coverage.

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Abebe Bikila: World's Most Legendary Marathon Runner, Double Olympic Marathon Wins and World Records

***Do you know about - Abebe Bikila: World's Most Legendary Marathon Runner, Double Olympic Marathon Wins and World Records

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Ethiopian legend Abebe Bikila was Africa's first world record breaking athlete/ marathoner and first Ethiopian and first sub-Saharan African Olympic gold medalist. He would also become Africa's first Olympic double-gold medalist and double world-breaking athlete. No one else in the world has won two Olympic gold medals in the marathon, while simultaneously breaking the world record! The statistics and the honors go on and on, and many structures and trophies exist in honor of the infinitely memorable Abebe Bikila.

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How is Abebe Bikila: World's Most Legendary Marathon Runner, Double Olympic Marathon Wins and World Records

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To many, Bikila was Africa' overall first Olympic marathon gold medalist. However the continental African Alain Mimoun (Alain Mimoun O'Kacha) of Algeria which was then a colony of France won the marathon gold medal at the previous Olympics held in Melbourne in 1956. Mimoun was listed as a competitor for France throughout his legendary running career during which he won one Olympic gold medal, three Olympic silver medals, and four Mediterranean Games gold medals. And even before Mimoun, there was Algeria-born Ahmed Boughera el Ouafi who won the Olympic marathon gold in Amsterdam in Amsterdam but considered himself French. The 1956 Olympic win by Mimoun brought back the spotlight on Boughera El Ouafi who was then miring in poverty!

At the 1960 Olympic Games in Rome on September 10th, Bikila who had previously never ran the marathon outside Ethiopia, and did not start running competitively until he was 24 years old, completed the course in the world record 2hrs-15min:16.2secs. The previous world record was held by Sergei Popov (2-15:17.0) of the Soviet Union. The Rome 1960 marathon course was quite trying given that Bikila's bare feet had to contend with the heavily cobble-stoned Rome roads. Further, because of the heat, the race began at sunset and even had to be guided by Rome's armed forces holding up torches in the dark. Aforementioned previous Olympic marathon champion Alain Mimoun, aged 39, finished 34th in 2-31:20.0. As the winner in Melbourne, 35 year-old Mimoun had finished in a relatively slow 2-25:00

Abebe Bikila was born on August 7th 1932 in Jato Village in the Semien Shewa (~North Shewa) zone of the province Amhara in Ethiopia. As a competitive runner Bikila was approximately 130 pounds (60 kg), very slender at a tall 5' 10" (1.77m). The son of an Oromo shepherd, Bikila was a last-minute addition to the Ethiopian Olympic team. Bikila had moved from Jirru Village early in the 1950's after leaving his father and rejoining his mother in Addis Ababa. Bikila became impressed by the city, and most of all the neatly dressed and precise and disciplined Imperial Bodyguards. He would join the force and became a private in 1956. Abebe had as a youngster been known to be a good swimmer, a skillful horse rider, and a guna hockey player.

About the forthcoming Olympics, the preferred 1960 marathon entrant Wami Biratu had recently suffered a broken ankle from playing soccer and Bikila was added to the national team just before the plane to Rome would leave. Legendary Mamo Wolde who would win Olympic silver/ gold and bronze, later on in the 1968 and 1972 respectively would also be an Olympian in Rome where would fourth in the 10000m finals.

As for Bikila, the last-minute inconvenience also involved the shoe sponsor Adidas not having enough shoes left to avail to athletes. The closest to his shoe-size were poorly fitting and uncomfortable that two hours before the marathon race Bikila decided to run barefooted--just like he had trained at home for the race.

For the first quarter of the race, Abebe was behind but in eye-distance the leading pack. He speeded up and after a third of the distance had caught up with the leading pack that included Aurele Vandendriessche (Van den Riessche) of Belgium, Arthur Kelly (Great Britain) and Rhadi Ben Abdesselam (Morocco). Halfway through the race, it was Rhadi and Bikila in the forefront and running side-by-side. But Abebe did not know that this was the Rhadi that he had been warned about!

Before the race, Bikila's Finnish-Swedish trainer Major Onni Niskanen whose primary duties were to set up the Ethiopian Imperial Guard in which Bikila was a private, indicated to Bikila that one of his main rivals would be the Moroccan Rhadi who was assigned to wear "26" on his bib. However, Rhadi mysteriously did not wear his black marathon bib, and instead wore his regularly assigned track (he also competed in the 10000m) bib that was numbered "186." Rhadi had not even been listed in the marathon program!

As the race progressed, Bikila searched and looked in the distance.for the athlete numbered "26" as he passed other athletes. Bikila had been unaware that the athlete numbered "186" and running beside to him after the two had created quite a significant lead from the rest of the pack was actually Rhadi. At three miles toward the end of the race, the two then ran alongside each other neck-to-neck. A quarter mile towards the end, Bikila unleashed a sprint for the finishing line after gaining a considerable distance from Rhadi! Bikila won by nearly 200 yards ahead of Rhadi, beating a field of 75 men. At the end of the race, Bikila still looked fresh and ran quite past the finishing line. He exercisingly stretched and jumped up and down after the race, and later claimed that he would have been capable of maintaining the same pace for ten more miles. Bikila, undoubtedly, would have lowered the world record further.

Asked by John Underwood (1965: 4) as to why Bikila had ran barefooted in Rome, Major Onni Niskanen would years later remark:

"...not...strange for an Ethiopian to run barefoot... When he runs I...count-98 steps a minute barefoot.... With shoes, 96.... But shoes are better on a strange course because of stones...things...might cut you....in Rome we could not get the shoes...right. He had blisters from some he...tried....Abebe said to me '...I will win without shoes. We will make...history for Africa.' He is a great patriot"

Niskanen adds:

"Before 1959 I hardly knew...Abebe.... He...third in the marathon trials for...Olympics...he was 27.... At the beginning...trouble. He did not hold his head properly, his arms flew all over...balance...bad. I had to [nearly] keep yelling at him....sometimes he was hard to convince.... But the dedication, the willpower of this man-none like him.... Abebe was made by Abebe, not by me or anyone. People asked if he was surprised he won in Rome. He had never run out of the country before....Abebe...always expects to win....He has no anxieties" (Underwood 1965: 5).

On May 7th 1961, Bikila participated in the fourth Classical Marathon. Here in Athens, a barefooted-running Bikila was the victor in 2:23:44.6, defeating marathoners from Finland, Turkey, United Arab Republic, Belgium, and Greece ("Ethiopian Runs Barefooted, Sets Marathon Mark" in "St. Joseph Gazette," May 8th 1961, page 7).

On July 25th 1961, Bikila was a participant in the annual Osaka (Mainichi) Marathon. This marathon striated in 1946 in Osaka and in 1962 was renamed Lake Biwa Mainichi Marathon when the competition was relocated to Otsu city which is the home of Japan's oldest and largest lake (Biwa). Bikila had earlier been laid off from competition by his coach, for six months, to allow for recovery from a leg ligament injury acquired at the starting of a race in Praha. The conditions in Osaka. were notably chaotic with the now legendary Olympian becoming halted to a stop three times during the course by excited fans who darted in to take flicks of him! A whole 19 of the 47 competitors were frustrated enough (also courtesy of the very high temperatures) to quit the race. Though Bikila won, he was timed at a relatively slow 2-29:27. Nevertheless, a good-natured Bikila was to remark, "At least I'm thankful for the cheers of the crowd" ("A Roundup Of The Sports Information Of The Week" in "SI Vault": July 10th 1961).

In the 1962 New Year's Sao Silvestre "around-the-houses" 7300m (4.5 miles) street race held in Sao Paulo in Brazil, Bikila was beaten into second place by the schoolmaster Martin Hyman of the United Kingdom. Hyman finished in 21:24.7, 5.1 seconds ahead of Bikila.

Later, on October 12th 1962, Bikila would win in the marathon held in Kosice in Czechoslovakia in 2:20:12. In the same year, in Berlin, Bikila won in the 10000m run at a track meet. He became internationally ranked as among the top ten runners in the distance. The same year, in Copenhagen witnessed Bikila win a 20000m race in which he finished in 1-11.0.

At the Boston AA marathon staged in April 1963, Bikila seemingly wobbly toward the last stretch, was beaten by the Belgian Aurele Vandendriessche (Van den Rieessche). The Rieessche finish in 2-18:58 involved Vandendriessche became surprised at catching up with the leading Bikila when there were two miles left. It was a course record in an event that fielded nearly 300 runners! Vandendriessche, who held the 30000m world record, won by about 450 meters (In "Lewiston Daily Sun," April 20th 1963, pp 6: "Belgian Bookkeeper, Vandendriessche Establishes Record; Johnny Kelley Second"). Bikila was surprisingly fifth behind second-placed Johnny Kelly of Connecticut (2-21:00), then Brian Kilby (2-21:43) of England, with 3-time Boston Marathon and defending champion and detective Eino Oksannen of Finland settling for fourth place in 2-22:23. Bikila (2-24:43) would claim that his loss was a result of his misreading the route. This was the first time in the foregone ten races Bikila had participated in, that he had lost! Perhaps the muscles on his spindly legs were getting worn out! But no Olympic champion had ever won in the Boston Marathon!

About the Boston Marathon, Major Niskanen who had not accompanied his athlete this time, suggested that the temperatures were low and Bikila had not dressed up appropriately for the challenging cold. Plus he and Mamo Wolde did not have the glucose that would have negated the lactic acid builds-up; both started cramping about five miles to the end when Bikila lost his lead. Both intermittently stopped and sat and massaged their legs up to four times (Underwood 1965: 5).

Also noteworthy of the marathon is that in 1963, the world record was shattered three times, and then once prior to the forthcoming Olympics that would take place in Tokyo in 1964. On February 17th 1963, 28 year-old Toru Terasawa of Japan reduced Bikila's world record by less than a second to 2-15:15.8 during the Beppu-Oita Marathon held on the Kyushu Island in Japan. Later, on June 15th 1963, Leonard Edelen (Leonard Graves "Buddy" Edelen) of the United States improved on that to 2-14:28 and thus became the first sub 2-15 marathoner. This was during the Polytechnic Marathon (an annual run that was held in or around London between 1909 and 1996 and was notably the first marathon to be held regularly).

Less than a month later, on July 6th 1963, Brian Leonard Kilby of the United Kingdom, at that time the European and also Commonwealth Games champion, won Port Talbot Marathon in Wales. Although Kilby finished in 2-14:43, many regard this as having been a world record, indicating that there was some mis-recording or disputation over Leonard Edelen's previous faster marathon finishing.

Just prior to the forthcoming Olympics in Tokyo, Basil Heatley (Benjamin Basil Heatley) of the United Kingdom established a new world record as a competitor in the Polytechnic Marathon. He won in 2-13:55. The Olympics were only four months away and Bikila, who had been hardly competitive and impressive in 1963, was training hard for Tokyo! Even then, four to six weeks before the Olympics, Bikila's troubling appendix was removed, the coach Niskanen fearsome that it might burst during the forthcoming Tokyo quest! The doctors assured Niskanen that Bikila's slender build would enhance his chances to recover quickly and be well prepared for the Olympics. Indeed Bikila would return to training, two weeks after the appendectomy! At the Ethiopian Olympic trials, Bikila finished in a relatively impressive 2-16:18.8, beating Mamo Wolde by a second! Previously, on May 31st in a local marathon in Addis Ababa, Bikila had won in
2-23:14.8.

In Tokyo at the 1964 Olympics, Sergeant Bikila was comfortably ahead and out-of-sight of the rest of the 68-man pack with more than 10 miles to go. Abebe had previously stayed close to the leading pack that was lead by Ron Clarke of Australia and Jim Hogan of Ireland. In the end, Bikila finished more than four minutes ahead of runner-up Basil Heatley (2-16:19.2); Ron Clarke was ninth; Mamo Wolde did not finish. After winning at the Olympics in Tokyo, in a new marathon world record time of 2-12:12.2, Bikila performed calisthenics, push-ups and sit-ups similar to what he did after the races. The 80000 spectators were amazed and amused. But it turned out that Bikila did this, not to show off, but in the belief that exercising after the races would reduce the probability of his body stiffening and cramping. In this race he wore shoes, and even long socks to keep him warm. "Abebe plodded into the stadium ahead of his nearest pursuers, and trotted once around. He raised his arms to break the tape, and then he ran over to the infield grass and flopped on his back and did some bicycle-like exercises with his legs in the air" (Associated Press; 1964).

Bikila would, throughout his international running career, be the subject of curiosity. Was his marathon running endurance associated with adaptation to high-altitude running that is associated with east African world record breaking athletes? What did he eat? Many measured such aspects. Many regard Bikila as the greatest marathoner, ever. He is also credited for halting the tradition of running with the pack and breaking away for the win near the end of the race. Bikila became the modern marathoner by running his own race, sometimes leaving the rest of the pack ahead or far behind instead of taking cues from them. Bikila became the first runner ever to win two Olympic marathon gold medals, the first African ever to win double gold at the Olympics. Perhaps with memories of his legendary world athletic status and notably his winning of the Osaka Marathon in 1961, and his familiar looks of a slender hollow-cheeked runner, Abebe Bikila had prior to the marathon at the Tokyo Olympics ranked by Japanese women as the foremost affectionate darling. As a Japan celebrity Abebe was comfortably ahead of much younger well-built figures like the 1964 Olympic heavyweight boxing champion and future legend Joseph "Joe" Frazier (USA) and Donald ("Don") Arthur Schollander (USA) who won five gold and one silver medals in swimming at the same Olympics (Richman 1964: 14).

On May 9th 1965 Bikila competed in the Otsu Marathon, near Tokyo, and won. The following year he won in the Zarautz (Zarauz) Marathon in Barcelona, finishing in 2-20.28.8. On October 30th 1966 at the Seoul Marathon in South Korea, Bikila was the victor in 2-17.04. Apart from the Boston Marathon of 1963, Abebe Bikila had won in all the marathons that he competed in.

Bikila at 36 years of age did appear in Mexico City for the 1968 Olympics. Only days before the marathon in Mexico City, just before a training road run, Bikila expressed guarded confidence:

"Of course I expect to win here I have never felt better....Anything can happen in such a long race... I believe that if anyone can beat me, it will be one of my countrymen--Mamo Wolde or Marawi Gabru" ("Bikila Seeks Third Marathon" in Montreal Gazette: October 2, 1968). In the same vein, Bikila expressed that the high-altitude conditions, which simulated the conditions in his native Ethiopia would favor his team.

But ultimately a stress fracture would prevent Bikila from becoming impressive. He was ill in bed for four days before the starting of the race. He dropped out at about 6 miles into the marathon. Instead, friend and fellow team-mate Mamo Wolde (ironically also 36 years old) won--this establishing three consecutive Ethiopian wins in the marathon at the Olympics--an unprecedented national and international feat! Wolde finished in 2-20: 26.4, more than three minutes ahead of runner-up Kenji Kimihara of Japan. The other Ethiopian hope, Gabrou Merawi [Marawi Gabru] (also aged 36), was sixth.

But March 22nd 1969 would be a tragic one for Bikila. While driving at night in his Volkswagen Beetle, he swerved to avoid an oncoming vehicle and his beetle rolled down a ditch. His sixth and seventh vertebrae became dislocated and Bikila became a quadriplegic. Despite all the medical attention, including that of Stoke Mandeville Hospital in England, Bikila was unable to use his legs again. He had some limited recreational and competitive success as an archer. Use of his fingers was limited, such that he stretched the bow with his wrist and held the bow with a custom-designed hook on his right hand. At the end of July 1969, a determined Bikila finished ninth in the Novice Archery Class at the Wheelchair Olympics. He was a guest at the 1972 Olympics in Munich where the gold medalist Frank Shorter acknowledged and honored him.

In 1973, Bikila just aged 41 died from a stroke-related brain hemorrhage. Many events, trophies and structures are named after Abebe Bikila. He became the first internationally recognized black African athlete that signaled the growing significance of African runners.

Summary of Abebe Bikila's Major Performances

July 3rd 1960; (1st) in 2-39:50; Addis Ababa Marathon, Ethiopia.
August 7th 1960; (1st) in 2-21:23; Addis Ababa Marathon, Ethiopia.
September 10th 1960; (1st) in 2:15:17; Olympic gold medal and world record, Rome.
May 7th 1961; (1st) in 2-23:45; Athens Classical Marathon, Greece.
June 25th 1961; (1st) in 2-29:27; Mainichi Marathon, Osaka.
October 8th 1961; (1st) in 2-20:12; Kosice Marathon, Czechoslovakia.
April 19th 1963; (5th) in 2-24:43; Boston Marathon, USA.
May 31st 1964; (1st) in 2-23:14.8; Addis Ababa Marathon, Ethiopia.
August 3rd 1964; (1st) in 2-16:18.8 Ethiopian Olympic Trials, Addis Ababa.
October 21st 1964; (1st) in 2-12:11.2; Olympic gold medal and world record, Tokyo.
May 9th 1965; (1st) in 2-22:55.8; Otsu Marathon, Tokyo.
July 24th 1966; (1st) in 2-20:28.8 Zarauz Marathon, Spain.
October 30th 1966; (1st) in 2-17:04; Seoul Marathon; South Korea.

Works Cited

Associated Press (October 22, 1964). "Fastest Marathon Ever and Abebe Did Not Tire," in "Calgary Herald."

Montreal Gazette (October 2, 1968). "Bikila Seeks Third Marathon."

Richman, Milton (October 27, 1964). "Skinny Ethiopian Toast of the Olympics," in "The Deseret News."

SI Vault (July 10, 1961). "A Roundup Of The Sports Information Of The Week."

St. Joseph Gazette (May 8, 1961). "Ethiopian Runs Barefooted, Sets Marathon Mark."

Underwood, John (April 12, 1965). "The Number Two Lion In The Land Of Sheba" in "SI Vault."

I hope you obtain new knowledge about Queen City Physicians. Where you possibly can offer easy use in your everyday life. And above all, your reaction is Queen City Physicians.Read more.. Abebe Bikila: World's Most Legendary Marathon Runner, Double Olympic Marathon Wins and World Records. View Related articles related to Queen City Physicians. I Roll below. I have suggested my friends to assist share the Facebook Twitter Like Tweet. Can you share Abebe Bikila: World's Most Legendary Marathon Runner, Double Olympic Marathon Wins and World Records.

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Disadvantages of Electronic Health Records System

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Do you know about - Disadvantages of Electronic Health Records System

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Electronic health record system is definitely a better way to do store patient's medical health records. It allows for accurate record keeping, increased level of healthcare and a reduction in malpractice insurance premiums. It involves doing away with the pen and paper system of keeping medical records and embracing the digitalizing of all information. Like every new thing, change is not always welcome. A few physicians are stuck in their ways and are not embracing this new system without a fight.

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How is Disadvantages of Electronic Health Records System

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The good news is that you can work around disadvantages to turn them into positive territory or find a replacement. Some of the disadvantages include:-

Privacy Protection
There will always been privacy issues in the healthcare system on who has access to your medical records. With a pen and paper system, with the physical file located at a particular institution there is a limit to who can see your records. Even if there was a security breach and your information is not secured, it is only available to people in that proximity.

But in a situation where your information is sent to a centralized information repository in digital format, all bets are off. This privacy concern is a big issue with many people and will continue to be an issue until it is addressed for good.

Medical records synchronization
Until recently with centralized information repositories, individuals being treated at different facilities could not have their information updated at the same time which could lead to healthcare providers not having updated information when they become available. However, with centralized repositories this problem has been solved, but it has given rise to the above mentioned issue of data security and protection.

High start up cost
There is a high start up cost when transforming a pen and paper system to EHR. Some physicians do not see any immediate benefit to their practice in the short run and drag their feet in implementing EHR.

Legal issues
Taking the healthcare industry to court has in the past few decades been a lucrative venture for attorneys trying to right the wrong done to a patient, whether by omission or commission.

Doctors are already practicing defensive medicine and electronic health record system brings a new potential avenue for litigation and revenue stream for lawyers. With a new system, anything can go wrong, the system could fail or the stored data stolen. Improper uses of collected information are all potential avenues for a law suit.

Gradually, electronic health record system is gaining traction. More and more doctors are embracing it, and depending on the part of the country you are looking at, conversion could be as high as 40%. With government involvement and the amount of resources it is investing, the time will come when digital medical record keeping will be the norm.

I hope you get new knowledge about Pediatric Physicians. Where you may put to utilization in your evryday life. And most significantly, your reaction is Pediatric Physicians.Read more.. Disadvantages of Electronic Health Records System. View Related articles associated with Pediatric Physicians. I Roll below. I even have recommended my friends to assist share the Facebook Twitter Like Tweet. Can you share Disadvantages of Electronic Health Records System.

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Electronic healing Records - The Pros and Cons

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In this digital age, more and more bulks of data which used to be paper-based, from library catalogs to telephone books, are digitized and stored in a central location for easy access. The idea of Emrs started about 40 years ago.

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How is Electronic healing Records - The Pros and Cons

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The main proponents of Emrs cite the following advantages:

(1) The use of Ehrs supposedly reduces errors in curative records. There is no doubt that handwritten records are field to lots of human errors due to misspelling, illegibility, and differing terminologies. With the use of Emrs standardization of patient health records may finally become acheivable.

(2) Paper records can be undoubtedly lost. We have heard how fires, floods and other natural catastrophes destroy bodily records of many years, data which are lost forever. Digital records can be stored virtually forever and can be kept long after the bodily records are gone. Emrs also help keep records of health data that patients tend to forget with time, i.e. Inoculations, former illnesses and medications.

(3) Emrs make health care cost-efficient by consolidating all data in one place. Previously, paper-based records are placed in different places and getting entrance to all of them takes a lot of time and money. In a systematic review, Kripalani et al. Evaluated the transportation exchange in the middle of primary care physicians and hospital-based physicians and found necessary deficits in curative data exchange. The report recommended the use of Emrs to rule these issues and facilitate the continuity of care before, during and after hospitalization. Emrs translates into better treatment for patients. Take the example of one asthma center's palpate with Emr: "A major benefit associated with Emr implementation was the growth in the estimate of children who were hospitalized with an asthma exacerbation and received an asthma performance plan upon discharge. Prior to the Emr system, [only] 4% received an asthma performance plan upon discharge. After implementation of the Emr system, 58% received an asthma performance plan upon discharge."

(4) Emrs can save lives. VeriChip, advanced by VeriChip Corporation is the first one of its kind ever popular ,favorite by the Us Fda. It enables rapid identification of at-risk patients and entrance to their curative history, thereby enabling rapid pathology and treatment especially in emergency situations. Superior examples are people with diabetes and/or heart problems who have high risk of collapsing and having attacks. VeriChip is also useful in vehicular accidents and other trauma incidents where the victims aren't capable of answering questions. In cases of large-scale catastrophes, VeriChip facilitates tracking and identification of victims. Agreeing to a coroner in Mississippi, VeriChip helped identify victims during the Hurricane Katrina incident.

Earlier this year, Google health was launched, an online personalized health records service. Google health is based on the principle that since it's the patient's curative record, the patient should control it, rule what should be in it, and who gets entrance to it. One of the features of the service includes records from hospitals and pharmacies that are Google Health-enabled or are registered Google health partners.

The HealthVault is another online health data storage service offered by Microsoft with features similar to Google Health. Keith Toussaint, senior program employer with Microsoft HealthVault recently stated " foremost hospitals like Beth Israel Deaconess curative town are undoubtedly integrating their systems with both us and Google -- because some people like one or the other. It's a Coke or Pepsi thing."

What are the disadvantages of Emrs? Not surprisingly, privacy rights advocacy groups are the main opponent of Emrs. Here is what they have to say:

(1) Emrs threaten our privacy. In this day and age when people's mantra is "I need my privacy", not many people are comfortable about having their whole curative history recorded and digitized for approximately just anyone to see - in other words, incursion into people's privacy. The confidentiality of doctor - patient association is still sacrosanct. Besides, curative data can be used against a someone in some cases - be it for a job application, guarnatee coverage or a college scholarship. Although it is against the law to discriminate against people with illnesses and disabilities, it is a fact of life that the fitter you are, the more contentious you are in the job market. The planned incorporation of genetic data in Emrs supplementary adds to people's fear of incursion into their private sphere.

(2) Emrs can lead to loss of the human touch in health care. In the process of digitalization, the interpersonal aspect in health care may be lost. In handwritten hospital charts, doctors and other health care practitioners may write what they think and they feel based on their personal observations in their very own words. Emr is naturally about ticking off boxes and crossing out things in electronic forms. The doctors are forced to think in categories and can seldom express a personal concept on an individual case. Because of the lack of flexibility of many electronic reporting systems, cases of misclassification of patients and their conditions have been reported.

(3) Emrs are not that efficient. Despite efforts in digitalization and standardization, Emrs are undoubtedly far from being standardized and not as efficient as it is purported to be. It often happens that one clinic's Emr ideas is not compatible with that of a normal practitioner or another clinic's system, thus belying the claim of added efficiency. In addition, not all users of Emrs are satisfied with the current state of the art. Although the objective is mainly efficiency and healthcare quality, one study showed that nurses in the Netherlands are not completely satisfied with their Emr implemented in 2006-2007.

(4) Emrs are not safe and secure. Google health and HealthVault are quick in assuring patients of the safety of their online health accounts. entrance to the patient's list is only possible using log ins and password. In addition, HealthVault assures that "all health data transmitted in the middle of HealthVault servers and program providers' systems is encrypted" and that Microsoft does it best to use the "highest standards of safety to safeguard buyer health data from theft, loss, or damage."

However, there are cases wherein passwords and encryptions do not seem to be adequate as data safety tools. Stories of data hacking, stolen identities and blackmail abound. Even high safety databases such as those run by banks and reputation institutions are often compromised. This impression was aggravated by the many well-publicized incidences of data loss or breach. A few examples are listed below:

November 26, 2007, Canada. Hackers accessed curative data on Hiv and hepatitis from a Canadian health division computer. - September 22, 2008, Uk. The National health service (Nhs) reported the loss of 4 Cds in the mail containing data on 17,990 employees. - September 30, 2008, Us. The business Blue Cross and Blue Shield of Louisiana confirmed breach of personal data, along with social safety numbers, phone numbers and addresses of about 1,700 brokers. The data was accidentally attached to a normal email.

In addition, there is comment over Google health not being a "covered entity under the health guarnatee Portability and accountability Act of 1996 and the regulations promulgated thereunder (Hipaa)" under its terms and conditions and is therefore not field to Hipaa privacy of individually identifiable health information. The HealthVault terms and conditions do not mention Hipaa privacy laws so it is not clear what its status is concerning this issue.

(5) VeriChip is not for humans. It is to be staggering that although many of us are amenable to the use of Rfid chips in pets, the idea of implanting similar chips in human beings is bound to raise hackles in humans, no matter what the Us Fda says. A big opponent of the VeriChip and similar chips of its kind is the buyer advocacy group Spychip.com. In a position paper, Spychip and many advocacy and buyer awareness groups see Rfid tagging (be it on your someone or on the items you buy) as a major threat to privacy and civil liberties. They see the tagging as some kind of "Big Brother" operation. another group, the No VeriChip Inside Movement, likens VeriChip as "cataloguing" humans similar to the way the Nazis have tattooed numbers on the skin of attentiveness camp detainees. Popular Hollywood films on privacy incursions (e.g. The Net, social Enemy No. 1) increased supplementary people's paranoia about personal data.

Where do we go from here? Without doubt, we have the technology to make Emrs standardized and efficient. Google Health, Microsoft HealthVault and similar online personalized health data accounts are enabling patients to take control of their curative records. The main issues that need to be overcome are data security, safety of privacy and gaining the reliance of the patients. It doesn't seem obvious that the use of Rfid and similar tagging chips will become suitable or Popular anytime soon. However, we live in a digital world and we cannot hold back strengthen indefinitely. With improved technology and data safety tools, let us hope the Emr issue will be resolved soon.

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