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The Fickenscher Files [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7X4ptH7LVIvkJ9OxOk6uqCz8UmUM-LnCZLEljiLItHUcOwhNcTbmc652XQeyYqUiTOwBBqTesE0_44oMz2R8B4PiXtpn97Eb7z9c_U0NK5i-jJ1f5bVVQq0]
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The Fickenscher Files, Vol. 2, Issue 11 [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7X4ptH7LVIvkJ9OxOk6uqCz8UmUM-LnCZLEljiLItHUcOwhNcTbmc652XQeyYqUiTOwBBqTesE0_44oMz2R8B4PiXtpn97Eb7z9c_U0NK5i-jJ1f5bVVQq0]
Kevin M. Fickenscher [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7UjD8a_Dq4eP3qcw5j38GlBVY2ekLZyd9nSsXjYzwQDSSisBLEzO-np4u7B7L1VFRkqLRXg7DJlWuDA4AHUA_A3yNs2zmfDnmBIs6rJ03T2yDzNmHfq4BcOj6kJbWeXdheYOSBu1DVlYgs5iFxndCX2XnTYNyDX4p2YIfp-cz-_8-7JcKwK8_WBa0rVMsAbOIL7wp_7oYOqEw==],
MD, CPE, FACPE, FAAFP
@MDKev
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Quote of the Week

"Gridlock is not an acceptable option when the debt is growing faster than the
economy. We don't need a consensus. No, we need a deal ... and, there's a growing
necessity to cut a deal."

Alice Rivlin, Former Director for the Office of Management and Budget in comments
at the Brookings Institute on healthcare and the 2012 Presidential Campaign

"If we want to affect healthcare we should focus on obesity. One in three of all
Americans are obese and it has been estimated that 21 percent of the nation's healthcare
costs are related to obesity. And, besides, obesity is a non-partisan issue."

Ross Hammond, Ph.D., Senior Fellow at the Brookings Institute in comments on healthcare
and the 2012 Presidential Campaign

"Parties don't succeed for long if they stop appealing to voters who may disagree
with them on some issues."

Senator Richard Lugar (R-IN) in an admonition to his challenger and in accepting
defeat in the Indiana Republican Senatorial primary last week.

The Most Important Thing to Do This Week
You've got to follow-up on this one ...

The Best Video I've Seen In A Long Time -- Nancy Lorenzi, Ph.D. of Vanderbilt University
who sits on my AMIA Board of Directors introduced me to a YouTube video featuring
Simon Pinek at a recent TED Conference. The video is titled "WHY? [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7V8eZLnN_UCGQK74Nr0ik1F2O1bq7zqutjcckdRnmEcpyqmcSVn0wv463m7v_A9wWITmDlFogC0U7madTfA2Hc-OklsTGtnPQFHB61PmGS28HrSHApvilvXPt_6t8r2IUy3goikQLifBe9CjESNRRYQ5SHuUpy91NsRcCSh0y1JIg==]"

Pinek challenges our notion of how to engage people in change -- something that
every leader in healthcare is grappling with over the last couple of years. What
can we do to engage the people in our organizations to adopt changes in the way
work is done? How do we get them involved? Why should they do it? Pinek's basic
premise is that, in fact, the order of the questions -- What? Then How? Then Why?
-- is exactly the reverse of the approach we should be taking. We need to engage
our followers by discussing Why, then How, and then get to What. Watch the video.
It's the best. It will change your whole approach toward driving change in your
organization.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Consulo Indicium

Information for your Consideration ...

Obesity: The Looming Crisis in America -- The Institute of Medicine of the National
Academe (IOM) recently released a 478-page report, Accelerating Progress in Obesity
Prevention: Solving the Weight of the Nation [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7X6YmVfSWhulC3UV5mkZVWbr44MQUnR5D9t_FN3dCGMfC5nJnyxiWkfOprodJ_J72zIyeRWRi0n09OOpg0NmtzYHofRbmqQyWpfW4dg3xH6ge-TbooHR0vu5NNxjTtmyra5ycYy4sPMBK5A7eF6Q0ypd3DHVPBnAMZM2w8msKG3p6vAL98tBm2R]
that directly challenges the notion that obesity results from a lack of willpower
on the part of individuals. The study group specifically embraced policy proposals
and argued for the implementation of multiple, parallel strategies in the U.S.
to counterbalance the evolving crisis the looms from the nation becoming more "obesogenic."
The IOM study was funded by the Centers for Disease Control and Prevention (CDC)
which projects that by 2030, 42 percent of American adults will be obese, compared
to 34 percent today with 11 percent percent in the "severely obese" category, compared
to 6 percent today.

Exacerbating the problem is the fact that another one-third of American adults
are overweight today, and one-third of children aged 2 to 19 are overweight or
obese when the definition of obesity is having a body mass index (i.e., a measure
of height to weight) of 30 or greater. Overweight means a BMI of 25 to 29.9.

Obesity is directly responsible for an additional $190 billion a year in healthcare
costs, or about one-fifth of all healthcare spending in the nation. And, these
numbers do not include the billions more that are paid in higher health insurance
premiums, lost productivity and absenteeism from work. Clearly we have a national
crisis. In fact, obesity is the low hanging fruit of the nation's healthcare problem.
If we simply focused on this one problem and got the weight of one-half of our
obese citizens back to normal weights -- think of the cost savings that would
accrue to society. So, instead of concentrating on the traditional healthcare delivery
system, perhaps our attention should be directed at exercise and diet. It's simple.
It's possible. It's got to be a consideration ...

Read more [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7Us9X33cH7bWV5FDWtyx5TszKN-AgT9I42vuC977PCYyWyf_4vowrI1zn7al1cJBq8IFaqaXg1P8mI3OGOaSbw70TElcyjE8rjf_w9xs90quzU_ZtC09q9bff6GlsUu-htgkVJVbPob6xrO_g6hLAknxrYL2yD-wNgOtZ0NQeG2tvJFIaXcSSTJHdP6RAMSSgg=]
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HIEs: Where Do We Go From Here?

The state of the Health Information Exchange initiative and why some states are
moving forward while others are not.

In March of 2010, the 50 states and 6 eligible territories and qualified State
Designated Entities (SDE) received funding totaling nearly $550 million from the
Office of the National Coordinator (ONC) to begin the arduous task of building
health information exchanges (HIE). These exchanges were conceived as a result
of growing evidence that health information technology (IT) can reduce national
healthcare spending by decreasing unnecessary expenditures such as duplicative
testing and unnecessary diagnostic where other efforts have failed. HIE projects
vary widely from state to state, but the common thread is that they always involve
bringing diverse groups of stakeholders together to plan, finance and implement
IT systems that will facilitate the sharing of elec­tronic health information.

Within the domain of HIEs, some states, such as Wisconsin, Indiana, Colorado and
Michigan have made tremendous progress in the HIE arena


* Wisconsin: The Wisconsin Health Information Exchange (WHIE) [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7VXFEvAPAB-dxnxb8mTUq0LWI_V4Sh-jsLNujYsxXLl7P9NwqE0D6Sv3CP3Qqj2M8tHMcKbwD4SZQ2mGGqnxX1taxvE_RtHNAQ=]
was founded in 2004 and began clinical operations in March 2008. There has been
considerable success in demonstrating the value of an HIE infrastructure through
broad participation of providers.
* Indiana: The Indiana Health Information Exchange [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7W8-7btWDmEvLXVrc2EJyJUzZAiYBna60kfKm95BqITbiNz0Fr8YekHgUMYhxaVvCI8-j69CPlHVHyvi4jRYORujt1_JDxYtmQ=]
was also launched in 2004 and in 2010, named as a Health IT Beacon Community by
the US Department of Health & Human Services. As a Beacon Community, Indiana serves
as a model for what can be accomplished at the state level.
* Colorado: The Colorado Regional Health Information Organization (CORHIO) [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7XdBW3scMPvrrLG6L80nSre-LkOSHv-YWpCi98UjqG1MaXDLPEqbBC2SD3xHnpI5fitps7BVonl48JFIJch96BJHCMlQquM0oEr2YQwvkPSEw==]
has made tremendous progress in not only the development and continuous improvement
of their health IT infrastructure, but also boasts a long list of provider participants
covering the majority of the state.
* Michigan: The Southwest Michigan Health Information Exchange [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7WLGY1XONscKO2paZKmaCPEgUUqLZ_Bt-uqj8cj0fk_zjJG0oAGapFszvy9gN7yL_6_f5huBstYgj3vaxC1Qoqn8bwQ5niDwOrMJPxvb4zbJw==]
or mihealthelink [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7X4fklsFDgcdnqR5FPLtLhispG2YcpVQFSCn7Pm1qQSvSwto0FqP8tgU4gUWHmdP5hhXsJnlqJ7maOidUoN8TrmIvuj18BnmAa0uQUgVJSQYQ==],
has successfully brought all five major providers across the seven-county area
of Southwest Michigan together to begin planning for the development of an HIE
to serve their patient population.
Read more [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7W9yhvI3LY_0jNEVjCP4VuQhdbmBBINWo9saRXiJi4i_FjTJmV-r_tgfYW_XljQYH9Wi1spk7cuoz3FjKrUa_9BSbGEZDMPhwgoIS4eIGK8BYc8G5CHY5F8hSRlYvm69xsFiDtypAk9qBRRy_X4XC8u8om2Xh1CZZooHvaJvHzu2P6uOTy0JM2dd41ZBWBUQ3nXxRiM42mzGQ==]
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Knowledge Management and Clinical Decision Support

The Agency for Healthcare Research and Quality released its report last week related
to clinical decision support, a cornerstone for enabling Electronic Health Record
(EHR) capability.

Last week, the Agency for Healthcare Research and Quality (AHRQ) released its report
entitled: Enabling Health Care Decision-making Through Clinical Decision Support
and Knowledge Management.

The report effectively singles out the importance of clinical decision support
systems and electronic knowledge management systems as a central component of electronic
health record systems -- if we are going to realize the benefits. The report defines
a clinical decision support system (CDSS) as any electronic system designed to
aid directly in clinical decision making in which the characteristics of individual
patients are used to generate patient-specific assessments or recommendations that
can then be presented to clinicians for consideration. Examples of electronic
CDSSs include alerts, reminders, order sets, drug-dosage calculations, and care-summary
dashboards that provide performance feedback on quality indicators or benchmarks.

The knowledge management system (KMS) is defined as a tool that selectively provides
information relevant to the characteristics or circumstances of a clinical situation
but which requires human interpretation for direct application to a specific patient.
Examples of electronic KMSs include information retrieval tools and knowledge resources
that consist of distilled primary literature on evidence-based practices.

Read more [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7XThq0sM6Bn2wPokKxFncZDAYoOxud76m9QlPqAWU7vbTtw2-ZG3n-6luwxipBnJTKrUcW9uwzJvKXTyfQTyXwy5RKhmSMApqWuwUarrU7xe9HK21Zc6NVijiU1UC_x0swnhsScyVYa-hgZVkXcgwJlybzxigXvqe9oUxCyJ2d7BQ4QUbTRnzLkfVnq4Zc46U8KIf5HuGscgFoGq2aaLGFYuwolqu2q4jLzbmsTNZ8_AQ==]
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

The Weekly Whisk

Musings from a foodie ...

If you have the chance to visit downtown Chicago and you favor seafood, you should
definitely consider Catch 35 [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7XengUUInEEvCeO1VCuYHZxsABaGGDXYM0YnL_3ZcYa279RMVRU6ZK97AqI3Lec7pGI3j74qqVG2APNuGPG8vB7zf_xMSGWlRV8ptKLYqMmY5LhNMjvG20m]
[]. I enjoyed it so much that I actually went there two nights in a row. First,
the seafood is selected every morning and is absolutely fresh. You can start with
a variety of both chilled and warmed appetizers followed by the obligatory salad
of your choice. I started with mussels (both nights!) and then proceeded to the
blue cheese and walnut salad on a bed of fresh greens. The offerings range from
fish and chips (my mainstay when I lived in London) to Asian infused seafood to
grilled seafood steaks. They also offer a smattering of beef for those who insist
on the red stuff. Finally, it's the kind of place that accommodates a "walk-in"
without the long wait. We arrived on a Friday evening around 7:00 p.m. and were
promptly led to a table.

Read more [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7V-PWzCp2R0D8xfgVA1gorZtTec_nwVuYObgpnFyrO2HjDb1qWPssxG-VKjf8LjCCzKFNoC7vcIvR7-dXqTc_kl74cCAMNn0fJQC5OFPAGZRlafvcjJx4euLEWg5gXAce1iTL8DREOfrEZwNynB4Z_kbeVB9E-2AYjRDfPD6cCpUpJfm6JLIbpQ90nviN4yEkk=]
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

The Good, The Bad, and The Ugly

The ongoing saga ...

The Good -- The work of basic scientists like Christopher Walsh, M.D., Ph.D. at
Children's Hospital Boston [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7UdMXn2A_axfDlH-80slWOy36B4je4Oj1bgH71z-jmxKl-0UT9efHITnaBrpst2KKDHhiKqCtcTa-BFqdjImBNICfdZUZ00BVBm7uhcc82BNYhB2AcG9MclDQRcm8wHCtWD5NbnlhQHVLM0-YE4gyo3N4FPobEp45HERQxuvNnlC6O2Y9C-8432fwX4Vt94VFI=]
is a daily occurrence in American medicine where dedicated healthcare professionals
work on solving problems that face families around the world. Dr. Walsh is focused
on rare genetic brain disorders [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7Ui429Rt9kzis_GxjfioynSNQtx4tV-fpGc6UH3qWDQivO7D-M0t9SRFS8W7oqoznncdP5rl6qxkb5T7xIqNIfeZ_XzGjWjSCVsloLw2kZzMwwUJYeYfVCS18nCoZAq2hQ=]
of children. We need the Dr. Walsh's and the Dr. Whoevers of the world to keep their
focus AND, we need to support them ...

The Bad -- Another moderate Republican goes down in defeat, Senator Richard Lugar.
It seems that we are losing "the middle" which is where most decisions are made
in the USA. Without a moderate middle -- on both sides -- we should anticipate
that the legislative stalemate will continue.

The Ugly -- Richard Cohen had an editorial [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7VYshgkWwWhXRRUlvnqPJLLEPkMjqRk7CVgO3LxIgOUCFIhoTXQn3cNs8sr8e0Jo-M7X8kb8HYcZsYlHNybvY9n4CoFMRXH2TtuDO8LsvmcqMDJWhCBKaF1_8tr75YM4cKcx85Rk46puBNceHytsEFSDwVMvovSQDbqbeEWkD9rc9cbKUyKnFNmlAQm_6cap3u85cnwUbBQb7PL_zFxK5H8CwrGzYd87nR_OgbSmfNPs-_GplNbvu7nRgQD6Ct7K0o=]
in The Washington Post several weeks ago that speaks to the continuing sad saga
of the people in Syria. It's a tragedy ...
Read more [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7WvZyBg-7jNPL1gE7oVSnSAoP-vMQKb8F2kXy_P1jiSfsJFikm5CllCDGVjaj4Znnxmc7wzts4C7mU606Qfct-d8sybIxQR7JA5YfV4KdFpoObLEH1O4i2pprIE9oZPUq5xY2SqZLDQ3dcDYz18VNipHmcTtRpg0G26ktU1do7JKabqTnmXFaIeperJ6YX9h9RnPlW9iOcKDQ==]
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Send to a Colleague [http://ui.constantcontact.com/sa/fwtf.jsp?m=1105336033970&a=1110087001784&ea=hbiden%40rosemontseneca.com]

In This Edition

Quote of the Week
Consulo Indicium
HIEs: Where Do We Go From Here?
Knowledge Management and Clinical Decision Support
The Weekly Whisk
The Good, The Bad, and The Ugly

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Sponsors
Dearborn Advisors, LLC [http://r20.rs6.net/tn.jsp?e=001tEnfN2pyb7XHjA_7eTcR4p9pQ1RaoM9NPu4jJGIWIW-6Mo8GFUZGrsoz-Fq6Y5xN8-Q0o-ZHaT4LnhybdmpVlgfDrhQjS_JNPKiA4w6Sau92Zh3Jxhp5iHHJvmBvG01h]

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