monitor their own progress, schedule appointments and e-mail their doctors—and
can do so from anywhere.
Hariteeny Fritz, 79, a retired banker
from Bloomsburg, recalls the time she
was in Bar Harbor, Maine, and developed
double vision. Taken to a clinic there, she
told the staff to use her
password so they could
access her entire medical
record online. “There was
this kind of disbelief,” she
says. “But it saved them a
good deal of time.”
Patients don’t see everything in their records that
the doctor does. “One of
the things we don’t share is
physician’s notes,” e-health
manager Jodi Norman says.
Lab test results are posted
quickly, but must be released by the doctor first.
Sensitive results, such as
HIV tests or just bad news,
are withheld so that the
doctor can discuss them in
person with the patient.
at Geisinger. “If you brought
your car in, told them to re-
build the transmission and a
week later the reverse gear
was slipping, you’d demand
they fix it because you paid
them good money to fix it
the first time.”
In 2006 Geisinger em-
barked on a bold gamble
to improve the situation.
Starting with elective cor-
onary bypass surgery, Ca-
sale and others drew up a
40-point checklist of best
surgical practices devel-
oped by the American Col-
lege of Cardiology and the
American Heart Associa-
tion. Each point on the list
has to be checked off before
a procedure begins, or it’s
canceled. Then Geisinger offered insur-
ers what is in effect a warranty: Pay a flat
price for each operation, and any further
treatment arising from complications that
put the patient back in the hospital within
90 days is free.
This system has so far succeeded in lowering the readmission rate by 44 percent and
raised net hospital revenue by 7. 8 percent.
made use of her
during a medical
; Alpha Sudoku
ALPHA SUDOKU BY FRANK STOLZENBERG
Sudoku is a test of logic and patience, even with letters
instead of numbers. Fill in the grid so that the letters B, D,
E, I, L, Q, S, T and U appear only once in each row, column
and 3x3 mini-box. The solution reveals a 9-letter phrase.
“Where costs can really
come down is in more
engaged patients doing
more preventive care for
themselves,” says Paulus. But lifestyle
changes—like losing weight—are a tall
order for many.
Yet with help from the medical home
staff, patients can learn the value of their
own efforts—quite often with the subtle
prod of seeing a cool graphic in their e-health record showing their progress.
In another innovation, patients facing
hip and knee replacement surgery are offered a two-hour class in which the whole
team—surgeon, anesthetist, pharmacist,
physical therapist and social worker—
demonstrate what’s in store and how they
can improve the outcome.
Registered nurse Linda McGrail, who organizes the classes, says patients who take
them are often ready to leave the hospital
earlier and are less likely to be readmitted.
That’s because individually tailored plans
for coping after patients leave the hospital,
and the exercises they’ve begun even before surgery, make them “more confident
and better able to bounce back.” ;
; Parallel Thinking
Link the items in the group below, alternating between
numbers and words. Each category should be in
increasing numerical or alphabetical order. This exercise
tests mental flexibility, concentration and visual acuity.
Electronic health records A vast room
filled with black consoles humming away
is the hub of Geisinger’s electronic record
system in Danville. Paulus says it allows
“every one of our 750 doctors, whether
they’re spread across 20,000 square miles
or right down the hall from one another,
to use the same health record with all the
information about a patient available at
the click of a mouse.”
Many patients are sold on it, too. About
119,000 have so far signed up to access
their own records through personal por-
tals. They track their medical test results,
; Answers See page 23.
; For a greater mental workout, go to www.aarp.
org/games or www.happyneuron.com. Play an interactive
Sudoku at bulletin.aarp.org.