Friday, October 2, 2009
Tough time ahead for US and global economy
In September, employers in the US cut 263,000 jobs. The unemployment rate increased to 9.8%. Stocks and the US dollar slumped. Reality is beginning to set in that this recovery is going to be very slow in developing and erratic as it goes on. The prospects for the global economy is also bleak.
Electronic Medical Record - Singapore
MOH Budget Speech (Part 2) - Transforming Healthcare
06 Mar 2007
By Mr Khaw Boon Wan, Minister for Health
Venue: Parliament
Electronic Medical Record
7. First: an important infrastructure is the Electronic Medical Record (EMR). I have coined the slogan, "One Singaporean, One EMR" to catalyse this initiative. Right now, it is one Singaporean, multiple medical records, stored away in different clinics and hospitals in different formats, and not connected or consolidated. As a result, when patients visit different doctors, they have to have tests repeated and scans redone. This adds to unnecessary cost.
8. We are moving towards this target of "One Singaporean, One EMR". Because of legacy systems, we cannot achieve it in one step. But we have made progress. As pointed out by Dr Lam Pin Min, public hospitals now have the EMR eXchange (EMRX). We achieved a first but important psychological step in 2004 when public hospitals began to electronically exchange their Hospital Inpatient Discharge Summaries. Since then, we have made the EMRX more comprehensive, by adding other patient records such as laboratory tests, radiology reports and medication information. The electronic volume of laboratory results exchanged has grown 7 times in 2 years. Thousands of patients benefit from EMRX every month.
9. Our doctors' feedback is that EMRX has made their work easier. In particular, our Emergency Department doctors have said that the EMRX gives them greater reliability and confidence in treating patients, especially those with long and complicated medical histories. Extending EMRX to private doctors will be a natural step and is the objective. As Dr Lam pointed out, a National EMRX will minimise unnecessary medical investigations. More importantly, I see EMRX playing a critical role in the integrated delivery of care to patients.
10. However, this is a complex national project - very few if any countries have successfully implemented a system that links up public, private and the charity sector. This is because there are many issues such as data protection, regulation and audit to be addressed. We need to take a measured approach, to pilot and put together a comprehensive framework that takes care of these issues. This will begin with common data standards. We will do this within the public sector, and extend this to the step-down institutions. We have started to build the linkages to the private sector GP clinics by helping them to set up their IT systems under the Chronic Disease management effort. I am confident that we will get there.
06 Mar 2007
By Mr Khaw Boon Wan, Minister for Health
Venue: Parliament
Electronic Medical Record
7. First: an important infrastructure is the Electronic Medical Record (EMR). I have coined the slogan, "One Singaporean, One EMR" to catalyse this initiative. Right now, it is one Singaporean, multiple medical records, stored away in different clinics and hospitals in different formats, and not connected or consolidated. As a result, when patients visit different doctors, they have to have tests repeated and scans redone. This adds to unnecessary cost.
8. We are moving towards this target of "One Singaporean, One EMR". Because of legacy systems, we cannot achieve it in one step. But we have made progress. As pointed out by Dr Lam Pin Min, public hospitals now have the EMR eXchange (EMRX). We achieved a first but important psychological step in 2004 when public hospitals began to electronically exchange their Hospital Inpatient Discharge Summaries. Since then, we have made the EMRX more comprehensive, by adding other patient records such as laboratory tests, radiology reports and medication information. The electronic volume of laboratory results exchanged has grown 7 times in 2 years. Thousands of patients benefit from EMRX every month.
9. Our doctors' feedback is that EMRX has made their work easier. In particular, our Emergency Department doctors have said that the EMRX gives them greater reliability and confidence in treating patients, especially those with long and complicated medical histories. Extending EMRX to private doctors will be a natural step and is the objective. As Dr Lam pointed out, a National EMRX will minimise unnecessary medical investigations. More importantly, I see EMRX playing a critical role in the integrated delivery of care to patients.
10. However, this is a complex national project - very few if any countries have successfully implemented a system that links up public, private and the charity sector. This is because there are many issues such as data protection, regulation and audit to be addressed. We need to take a measured approach, to pilot and put together a comprehensive framework that takes care of these issues. This will begin with common data standards. We will do this within the public sector, and extend this to the step-down institutions. We have started to build the linkages to the private sector GP clinics by helping them to set up their IT systems under the Chronic Disease management effort. I am confident that we will get there.
Marketing technique of property consultant
My friend visited a new property launch. The price of the property had increased by more than 30% during the past six months. At the current price, the property was very expensive.
The property consultant recommended a specific unit at a good facing and with the price still not adjusted by as much as the other units. There is only one unit left with "good value". It was so enticing, that my friend almost presented a cheque to book that unit. She did not consider the heavy commitment, the monthly repayment, affordabilty and other factors.
Fortunately, a family member stopped her from making this "on the spot" purchase. After returning home, she realised that it was really beyond her reach.
The property consultant recommended a specific unit at a good facing and with the price still not adjusted by as much as the other units. There is only one unit left with "good value". It was so enticing, that my friend almost presented a cheque to book that unit. She did not consider the heavy commitment, the monthly repayment, affordabilty and other factors.
Fortunately, a family member stopped her from making this "on the spot" purchase. After returning home, she realised that it was really beyond her reach.
Thursday, October 1, 2009
Privacy of patient data
According to this report from the consultant McKinsey, it is better for the patient records to be available for analysis and hold doctors accountable to deliver the expected level of care. Campaigners for privacy may be playing into the hands of people who does not wish to be accountable for their mistakes or bad practice. This is an interesting conclusion.
Central Medical Records
A few months ago, I carried out a survey about the value of a central medical record system. Many respondents replied that they are interested to join this system, as it allow any doctor that is treating them to access the medical records. It also avoids having duplicate medical tests to be taken. Here are the survey results.
This system is designed primarily to handle the outpatient records (i.e the medical records that are kept in GP clinics). It is not intended to capture the detailed specialised records that are kept in hospitals.
You can read more about this system in this document. You can test the Demonstration system directly here.
This system is designed primarily to handle the outpatient records (i.e the medical records that are kept in GP clinics). It is not intended to capture the detailed specialised records that are kept in hospitals.
You can read more about this system in this document. You can test the Demonstration system directly here.
If you like the system, please help me to pass the word around to doctors, employers, insurance companies and the health authority. It can help to improve the delivery of medical services in Singapore.
NOTE: The records in this demonstration database are fabricated. In the real system, there will be controls to ensure that only the patient and the doctors authorised by the patient can see the records.
Benefit Illustration for a Life Insurance Policy
When the agent gave you a benefit illustration, did the agent explain the following?
1. That you have a 14 day free look period to cancel the policy for a full refund?
2. That the amount shown as "distribution cost" s taken away from your premium?
3. That the "effect of deduction" is taken away from your investments to pay the various charges under the policy?
If the agent has explained these points to you clearly. the agent is being transparent and can be trusted. If some of the information is hidden from you or the explanation is not clear, you have to read the benefit illustration again. If you need help, you can approach FISCA, www.fisca.sg
Tan Kin Lian
1. That you have a 14 day free look period to cancel the policy for a full refund?
2. That the amount shown as "distribution cost" s taken away from your premium?
3. That the "effect of deduction" is taken away from your investments to pay the various charges under the policy?
If the agent has explained these points to you clearly. the agent is being transparent and can be trusted. If some of the information is hidden from you or the explanation is not clear, you have to read the benefit illustration again. If you need help, you can approach FISCA, www.fisca.sg
Tan Kin Lian
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