MMA News
Plan to Attend “Day at the Capitol”
The Minnesota Medical Association (MMA) and the MMA Alliance “Day at the Capitol” on Feb. 17 is an opportunity to talk with legislators about the issues that affect the practice of medicine.
Participants will attend a luncheon and legislative briefing at the Sheraton Four Points Capitol in St. Paul and then adjourn to the state Capitol, where they will meet with legislators and attend committee hearings.
The MMA and MMA Alliance are presenting this event together with Midwest Medical Insurance, the Minnesota Society of Anesthesiologists, the Minnesota Academy of Family Physicians, the Hennepin Medical Society, the Ramsey Medical Society, and the Zumbro Valley Medical Society.
For more information about the Day at the Capitol, contact Wendy O’Donnell at 612/362-3745 or 800/342-5662.
AMA Adopts Minnesota Resolutions
The Minnesota delegation introduced five resolutions at the Interim Meeting of the American Medical Association in Atlanta, Dec. 4-7. The most controversial Minnesota resolution called on the AMA to educate its members about the risks and benefits of drug importation and reimportation, and to support federal efforts to facilitate the safe reimportation of drugs as an interim step toward a more affordable system of providing prescription drugs.
The AMA has consistently opposed drug reimportation, citing concerns about safety.
In lieu of the Minnesota resolution, the AMA adopted a policy that supports the importation of prescription drugs by wholesalers and pharmacies, but only if certain conditions are met. All drug products must be Food and Drug Administration (FDA)–approved and must be subject to reliable electronic track and trace technology. In addition, Congress must give the FDA the authority to ensure the authenticity and integrity of imported prescription drugs. Dave Renner, MMA director of state and federal legislation, said it was unclear whether, in light of these conditions, the AMA would now support legislation to allow reimportation.
Paul Matson, M.D., an MMA alternate delegate and past MMA president, in an interview with the Chicago Tribune, explained why the Minnesota delegation was pushing for the AMA policy change. “Drug costs are so cumbersome to patients that they are going to Internet sites, and we believe that the FDA with newer technologies can support safe importation,” Matson was quoted as saying.
The AMA adopted a Minnesota resolution asking that the AMA support better physician educational materials on prescribing for pain management and take a leadership role in resolving conflicting federal agencies’ expectations in regard to physician responsibility in pain management. The Minnesota resolution also asked the AMA to promote risk management educational programs on administrative procedures such as billing practices in order to reduce the number of medical malpractice suits.
In addition, the AMA adopted a Minnesota resolution asking the AMA to request that the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Board institute a moratorium on new “do not use” abbreviations until there is evidence of overall compliance with the current list. Although the MMA delegation supports the “do not use” list of abbreviations as a way to eliminate misunderstandings and improve safety, they think that physicians need more education about the current list, according to Renner.
A Minnesota resolution asking the AMA to support legislation to expand the scope of the National Vaccine Injury Compensation Program to apply to all recommended adult vaccines, including influenza, was referred to the AMA Board of Trustees.
MMA Responds to Pawlenty’s Plan to Curb Health Care Costs
MMA leaders expressed support for aspects of Gov. Tim Pawlenty’s plan to restrain rising health care costs but also raised questions and pointed out missing elements.
Gov. Pawlenty announced a plan on Nov. 29 that calls for a purchasing coalition, called the Smart Buy Alliance, whose members would buy health insurance independently, using principles that reward high-quality care, use of new technology, and the use of centers of excellence. The alliance includes the state, the Buyer’s Health Care Action Group, the Minnesota Business Partnership, and the Minnesota Chamber of Commerce.
The governor’s plan would also create incentives for using health savings accounts, encourage new technologies, and reduce paperwork, bureaucracy, and regulations.
MMA President J. Michael Gonzalez-Campoy, M.D., Ph.D., FACE, in an interview on Minnesota Public Radio said that the MMA supports the plan’s proposals to streamline services and enact government regulatory reform but is concerned about health care provider rankings because physicians treat patients under different circumstances.
“Who gets to determine what centers for excellence are, and how does this affect those physicians who by necessity or by choice are serving patients that are underserved with poorer financial resources, where the quality of care isn’t going to be as good as other places?” Gonzalez-Campoy asked.
The MMA shares Pawlenty’s concerns about rising health care costs, and agrees with many of the concepts in the governor’s plan, including having health savings accounts as an option, rewarding health care providers who provide excellent care, and giving consumers information about costs and quality.
The governor’s plan does not, however, address the problems of providing care for the uninsured and of cost shifting. “Most people agree that ensuring access to care for all Minnesotans is necessary,” said Robert K. Meiches, M.D., CEO of the MMA. “This access, including preventive services and care to address problems early in the course of illness, can also help reduce costs by avoiding emergency room visits and/or hospitalization.”
MAPS Conference Emphasizes Role of Patients and Families
Engaging patients and their families in efforts to improve patient safety was the theme of the Minnesota Alliance for Patient Safety (MAPS) conference, Meet the Challenge: Partnership for Patient Safety, in Brooklyn Park in November. MAPS is an alliance of more than 50 health care organizations, spearheaded by the Minnesota Medical Association, the Minnesota Hospital Association, and the Minnesota Department of Health.
Speakers at the conference suggested ways to involve patients in their medical care and improve safety, including the use of electronic medical records, information for patients, clinical protocols, and patient satisfaction data.
In a breakout session on using electronic medical records to improve safety, Barry Bershow, M.D., quality and informatics medical director at Fairview Clinics, said that implementing an electronic system helps reduce medical errors because it creates more standardization of care. “The less you leave it up to an individual, the less chance for error,” he said. Fairview has seen an upswing in success rates since implementing an electronic medical records system and found that patients liked it better, he said.
Enlisting the advice of patients can help improve communications. Kevin Palattao, HealthPartners’ vice president of patient care systems, said that HealthPartners used a patient council to advise them in the creation of their Web site, which allows patients to order prescriptions, make appointments, and access information. He said that involving patients in Web design can help reduce complexity and jargon, thus making information easier to understand.
In a breakout session on using protocols to deliver safe, evidence-based care, Nancy Jaeckels, director of education and resources for improvement at the Institute for Clinical Systems Improvement (ICSI), said that as ICSI develops its clinical guidelines, it routinely uses patient focus groups to gain insight into the patients’ and families’ perspectives on their diseases and conditions. She added that patients are involved in ICSI’s board and other steering committees.
Carolyn Olson, C.P.N.P., M.S.N., pediatric case coordinator and children’s center educator and facilitator for family-centered care at St. Cloud Hospital, described how listening to patients has led to improvements in many aspects of care, even in the renovation of the hospital, where there are now private areas for conversation, a family lounge with a refrigerator stocked with food, and a computer area. “By involving patients in care, you’re going to improve patient satisfaction and patient safety,” Olson said.