Medicines for good health

LINks will be set up in England from April 2008 to give individuals and groups a stronger voice in how their local health and social care services are delivered. By talking directly to the service providers and saying what they want, the community is much more likely to receive better care.

What is a LINk?

Sometimes the people who use services don’t feel they have a strong enough voice to change aspects of their health or social care. The introductions of LINks are part of a wider process to help the community have a stronger local voice.
What a LINk will do

Run by local individuals and groups, a LINk will:

* ask what local people what they think about local healthcare services and provide a chance to suggest ideas to help improve services;
* investigate specific issues of concern to the community;
* use its powers to hold services to account and get results;
* ask for information and get an answer in a specified amount of time;
* be able to carry out spot-checks to see if services are working well (carried out under safeguards);
* make reports and recommendations and receive a response;
* refer issues to the local ‘Overview and Scrutiny Committee’.

An example

A number of people raise the issue of GP opening hours with a LINk. The local surgery say they want to open during the evening and at weekends but they have limited resources.

The LINk offers to help the surgery find out the hours that will best suit local people. The LINk surveys the community and asks for their views. It also asks LINks in other areas how they have dealt with the issue.

The LINks research finds that those who work would prefer more early morning appointments, so they can see a GP but not be late for work.

As a result, the surgery decides not to open one afternoon during the week so that they are able to open more early morning appointments. They also start a call-back service, so people can have quick telephone consultations.

A LINk will be independent; they will be hosted and supported by a community organisation with experience of engaging people.
Anyone can be part of a LINk

A LINk will ask the community what they think. It’s up to you how and when you get involved - you can just comment on issues when contacted or you can get more involved for example, helping to raise awareness of an issue or helping to find solutions (for example, meeting providers, being part of a working group).
How much time will it take?

There are so many ways you can be involved. You can take a few minutes to answer a survey or take longer to represent the community when a health or social care service is being discussed with service providers.
How is a LINk run?

The Department of Health will provide money to each local council, who will then give it to a ‘host organisation’. A host organisation will:

* tell the community that a LINk has started;
* hold meetings so people can hear about what the LINk will do;
* encourage local groups, individuals and organisations to get involved – especially those who are not always heard;
* help decide how the LINk will be run;
* be responsible for and keep records of how the money is spent – but the LINk members decide what the money is to be spent on.

Getting started

At the start of April 2008, host organisations should start work in most areas of England, setting up a LINk. Opportunities exist for individuals and local groups to help plan a LINk or to get involved after April. To find out what is happening in your area, contact your nearest local council with social services responsibility.

Find out how you can access your medical records, how much it will cost you and how to access someone else's medical records if you need to.
How to access your records

Your doctor's surgery holds your medical records while a hospital holds records of any treatment you have had there. You have the right to view these under the Data Protection Act 1998. You can simply ask your GP, surgery staff or health authority, if you can inspect your medical records. Check with them, but there is usually a charge (see 'How much it will cost' below) and you may be asked for proof of identity.

However, it is recommended that you apply for access in writing by sending a letter by recorded delivery, including any payment and the required proof of identity. You should receive a response no later than 21 days after your application was received, although by law (according to the Data Protection Act) the hospital or surgery has 40 days to respond to a request in writing.

If the records are held at a hospital, you should address the letter to your hospital Patients Services Manager or Medical Records Officer.

Your records, when presented to you, should be in a format that you understand.

* More about accessing your medical records;

If access to records is denied

You will not be allowed access to your records:

* if healthcare professionals believe that information in the records is likely to cause serious harm to the patient or another person
* details about third parties are included in the records - these may be removed

However, if you are denied access you can approach the Information Commissioner's Office if you think the organisation has breached the Data Protection Act.

* Visit the Information Commissioner's Office website;

How much will it cost?

It will cost you:

* £10 for information held in a computerised format
* up to £50 for manual records

Accessing someone else's records

If you are applying for medical records on behalf of someone else, you will need their consent or a power of attorney.

* Managing your affairs and enduring power of attorney (over 50s section)

Getting more information

The Patients Association has produced a booklet called 'How to obtain access to your medical records' which you may find helpful. It takes you through the necessary steps and includes examples of the kind of letter you will need to send to gain formal access.

Retail health clinics are all the rage these days, but not everyone sees their popularity as a positive

In a world where dinner comes in a paper bag handed through a drive-thru window at McDonald’s and ATM’s man virtually every street corner, retail medical centers are giving new meaning to one-stop shopping. In addition to bread, orange juice and toilet paper, people can add flu shots, routine blood tests and treatments for a variety of other everyday ailments to their grocery lists.

With hair and nail salons, vision centers, restaurants and banks already opening shop right inside big box stores like Wal-Mart, it should come as no surprise that the health industry would be next in line, but the thought of retail clinics is a little unnerving to many primary care physicians. In Colorado alone, there are 15 SmartCare Family Medical Centers in Wal-Mart Supercenters, including ones in Loveland, Greeley and Brighton.

“SmartCare is another option for access to health care for the community located where people live, work and shop,” said Rebeca Imgrund, chief nurse practitioner from SmartCare Family Medical Centers. “It’s very convenient when you have an acute condition.”

The first SmartCare clinics opened in 2006 and the Greeley and Loveland clinics have been open just over a year. The clinics, which are staffed by nurse practitioners, require no appointment and charge about $65 for an average visit. By not having physicians on staff, the clinics are able to keep the cost down and do not require as much expensive medical equipment. Common things like the stomach flu, coughs, sore throats and physicals are the types of things these retail clinics treat. For more complicated things, patients are referred to primary care physicians.

“Our goal is to refer them to the level of care that is appropriate,” said Dr. Brian Erling, SmartCare’s National Medical Director.

Erling, who has a background working in emergency rooms, said he would see people come into the hospital and rack up a $400 bill for a soar throat because of a lack of access. Though retail clinics attempt to address this issue, many physicians do not necessarily think it’s the best solution.

Dr. John Bender, Larimer County Medical Society president and medical director of Miramont Family Practice in Fort Collins, said there is a concern that these retail clinics will negatively impact primary care physicians.

“Considering we have had 16 primary care physicians go bankrupt, prematurely retire or close their doors and no solo clinics left in Fort Collins, the concern is that 10 years from now, when our neighbors get sick they will go to a retail clinic and when they are really sick, they will try to go to the emergency room and everyone will try to send a report back to the primary care physician who no longer exists,” Bender said. “This will adversely impact the longitudinal and continuity which is the foundation of a healthy society.”

Others, like Dr. Ken Olds of the Family Physicians of Greeley, feel that retail clinics lack the personal information needed to take care of patients.

“As a family doctor, I believe that continuity is a good idea,” Olds said. “Our physicians will take care of an entire family over a long period of time. They know about your allergies and your past health. I don’t see how a retail clinic could offer that.”

Erling said that it isn’t about taking patients from primary care physicians, but improving access for people who may not have it and making it more convenient. Imgrund agreed, adding that about 30 percent of the people who visit the clinics do not have a primary care provider and might otherwise end up at the emergency room door.

SmartCare is but one of many retail health companies that is continuing to expand across the nation with talks of expanding into Fort Collins and Colorado Springs. According to the Convenient Care Association, there are more than 200 clinics operated by over a dozen companies across America.

“The reality is there is going to be more of them,” Bender said. “The question is whether they will delay people from getting the preventative services they need from a primary care physician.”

As the retail clinic industry has continued to grow, it has also caught the eye of many lawmakers. In early December, GOP lawmakers purposefully selected a SmartCare center as the site to announce their version of health care reform.

Sen. Steve Johnson, R-Fort Collins, said when they rolled out their agenda, the retail clinic was a perfect fit because it makes health care more affordable and is also a great avenue for education on health-related issues.

“I think it’s a good development as long as the quality is good.” he said. “A lot of people, if they didn’t have this option would go without care.”

Dr. Edward Norman, president of Big Medical Group, met with SmartCare officials before the clinic opened in Loveland. He said the emergent medical clinic and pediatric at Skyline Center for Health, which is located next to the Wal-Mart Supercenter, has not been impacted by the retail clinic.

“If you have good doctors and well-run clinics, then you don’t have a problem,” he said.

He said that retail clinics serve a small niche right now, but could be a benefit for a city where there is poor access to primary care services. However, he doesn’t think they will be a dominant force in the medical market.

“The only emotional feeling I have is I don’t think it provides very good continuous care,” Norman said. “I think this is a form of medicine does not even attempt to do this. Medicine is more than just going to McDonald’s and getting a hamburger. You need to find a physician you trust.”

By Erin Frustaci

Computerized physician order entry (CPOE) has been a key component of patient safety since the publication of the Institute of medicine’s 1999 report, To Err is Human. This report found that in hospitals throughout the United States, up to 98,000 individuals die each year from preventable mistakes.

CPOE is more about clinician acceptance and workflow than it is about software and hardware platforms. But the ability of software and hardware to successfully support the clinician, with dependency and speed, is absolutely critical to support the CPOE effort in a hospital.

Seneca Data focuses on providing the best hardware to support CPOE deployments. Our solutions include:

- Computers on Wheels (COWS);
- Mobile Point of Care Solutions;
- Fixed Point of Care Solutions;
- Remote Access Solutions.

Whether your CPOE project is focused on simply presenting clinical results and other information to medical staff, doing electronic order entry, or both, Seneca Data solutions can support your needs!

Due to our expertise in software integration we work with Independent Software Vendors (ISVs) who focus on CPOE. Our engineering, production, and quality control processes make Seneca Data the logical choice for partners looking for stable platforms and custom image work. We will house your custom written programs and based on your specifications, we will leverage our technical expertise to co-engineer solutions specifically for your business!

by www.senecadata.com/markets

Why Seneca Data for Healthcare?

Seneca Data helps hospitals, clinics and physicians’ associations improve patient care through the use of information technology solutions. Seneca Data offers critical technologies to support key healthcare initiatives like:

* Computerized Physician Order Entry;
* Electronic Medical Record;
* Picture Archiving and Communication Systems;
* Mobile Point of Care.

Seneca Data brings innovative technology solutions to healthcare organizations to enhance patient care and patient safety while supporting regulatory compliance. We believe that the digitization of healthcare creates a more efficient clinical workflow, allowing for better staff utilization, information flow and patient care.

Electronic Medical Record

Electronic Medical Records (EMRs) are a computer-based patient medical record.

EMR facilitates include:

- A central repository of a patient’s healthcare information;
- Access of patient data by clinicians in any location;
- Ability to check for allergy and drug interactions;
- Clinical notes and prescriptions;
- Scheduling;
- Lab results and orders.

Positive benefits of EMR are obvious. Consider a patient receiving care by a number of clinicians in a variety of settings. This care may be provided by the primary care physician, a hospital team, surgical or medical specialists, physical therapists, social workers, and others. In a paper system, the patient’s medical record is fragmented, scattered, and difficult to tie together. However, with EMR, the record is digitized and centrally stored, making it available to any member of the healthcare delivery team, at any time, from any location. The security and practical hazards of a patient hand carrying his/her record from one healthcare provider to another are avoided.

Seneca Data supplies the tools necessary for healthcare facilities to successfully deploy an EMR system.

Email healthcare@senecadata.com to learn more.

Aerotherapy. Among the hundred or more types of healing offered to the sophisticated is aerotherapy. Obviously, aerotherapy means treatment by air, but in this instance hot air is particularly concerned. The patient is baked in a hot oven. Heat relieves pain and produces an increased flow of blood to the part heated. The blood aids in removing waste products and brings to the part the substances that overcome infection. There is nothing essentially wrong about hot air therapy.

Since the time of Hippocrates and indeed even in Biblical legend men have availed themselves of the healing powers existing in nature. The light and heat of the sun, the burning steam from natural hot springs, the dry air of the desert, and even the buffeting of the waves of the sea have been used for physical stimulation in overcoming disease. It has remained for the astute commercial minds of our progressive land to incorporate these qualities for their personal gain.

Aerotherapy as one department of physical therapy be-comes a cult when it is used to the exclusion of all other forms of healing. In New York a progressive quack established an institute equipped with special devices for pouring hot air over various portions of the body. He issued a beautiful brochure, illustrated with the likenesses of beautiful damsels in various states of negligee, smiling the smile of the satisfied, under his salubrious ministrations. In this document appeared incidentally the claim that hot air will cure anything from ague to zoster. The same claim has been made by the faith healers and the apostles of manipulation. But the first call it Christian Science and the second call it chiropractic.

Before the discovery of antibiotics, sulphur was the leading anti-bacterial drug. Every Queensland household in the 19th century would have a kilo or two of sulphur flowers for burning, and a few bottles of sulphurous acid for gargling.

Diphtheria was one of the greatest killers of the 19th century and the one and only line of defence against Diphtheria was sulphur. First the patient’s room was sealed tightly, and while the patient was still in it, ½ kilo of sulphur was burnt in the room. Next, the tonsils were brushed with sulphurous acid. Great care had to be taken to make certain that sulphurous acid and not sulphuric acid was used. There were many cases of patients’ throats being burnt out, because of this mix up. The patient then gargled a mixture of sulphur and water before going to bed with a few teaspoons of sulphur folded in their pyjamas. This cure was hard on the patients but spare a thought for the rest of the household and the neighbourhood for that matter. During diphtheria outbreaks the suburbs reeked of sulphur.

The great child killer of the 19th century was croup. The most dreaded sound a mother could hear was the sharp cough of the croup. Mothers were desperate for cures. One mother wrote to the newspapers with her cure. Her pen name was ‘Experienced” and with good reason. She had beaten off over twenty attacks of the croup with her cure. First the patient was given an enema made of mustard, salt and water. Next a mustard plaster was applied to the throat and chest and the patient was placed in a hot bath and covered to the neck with a blanket. After the bath the patient was wrapped in blankets, kept in bed, and after a few days, the patient would be right as rain.

Skin cancer ravaged our forebears just as much as it does today. One cure shows what a different world it was then. Spirit of salt applied once a day for a week would turn the cancer black and it would drop off within a few days. Ah, if it only could be so simple.