JamesLHollyMD.com

	James L. Holly, M.D.

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Letters - Kathleen Kimmel Information from SETMA’s Website for ONC February 11, 2016

February 11, 2016

Kathleen:

After your response to the previous materials, I have tried to organize other materials which may be helpful to you, Genevieve and Marc. At the end of the note, there are several links to personal information.

One executive wrote the following response to our website: “Thanks for the opportunity to review the Automated Team Tutorial Workbook. I found the information very informative. I believe your organization is well ahead of the curve in balancing the needs of the patient and the medical staff. I took the opportunity to review both the documents you provided to me and the website information. The information was informative and well organized.” He added, “…you have the most informative web site I have ever utilized. Bravo, for sharing valuable information with the entire medical community.” Our webmaster has told me that if we printed out our entire website would be over 50,000 pages.

I hope some of this is helpful. Thank you for receiving it.

SETMA’s Model of Care Patient-Centered Medical Home: The Future of Healthcare Innovation and Change -- http://jameslhollymd.com/the-setma-way/setma-model-of-care-pc-mh-healthcare-innovation-the-future-of-healthcare

The Primary Care Team: Learning from Effective Ambulatory Practices (PCT-LEAP): Performance Measures Worksheet - Robert Wood Johnson Foundation; SETMA’s use of analytics and auditing -- http://jameslhollymd.com/letters/Robert-Wood-Johnson-Foundation-PCT-LEAP

Designing an EMR on the Basis of Peter Senge's -- The Fifth Disciple by James L. Holly, M.D. -- http://jameslhollymd.com/EPM-Tools/designing-an-emr

“It is possible for healthcare providers to be overwhelmed by the volume of valuable information available for medical decision making. The organization and storage of that information is particularly ill suited for easy access and application in clinical settings. Electronic patient records has the potential for making current and future information available for use in improving the quality of treatment out comings.

“Success in applying medical science and random-controlled-trials date to healthcare will be dictated by the design of EMR products and particularly by the display of data and treatment decision-making tools. In his book, The Fifth Discipline, Dr. Peter Senge identifies "systems thinking" as the solution to the management of complex data issues in business. These principles are equally applicable in medicine and particularly in the design of EMR tools for the support of healthcare decision making.

“Utilizing Senge's concepts of metanoia and circular causality, this paper examines the implications of systems thinking for the design of EMRs and for the display of data. In addition, the issues of data sharing between specialties, disciplines and disease management is addressed.”

The SETMA Team and the SETMA Culture -- http://jameslhollymd.com/About-SETMA/the-setma-team-and-the-setma-culture

This link is to the foundation of our 18 year history with electronics in healthcare followed by a link to a discussion of process analysis and its value in practice transformation -- http://jameslhollymd.com/your-life-your-health/medical-records-more-than-a-transcription-service

A skill set which can be taught and learned is “process analysis.” We have had two groups visit SETMA from Mainland China. This competencies was one which fascinated them. They have asked me to visit China to teach and this is one thing they want to learn. They have and continue to translate our material into Chinese -- http://jameslhollymd.com/your-life-your-health/process-analysis-and-how-many-tasks-can-you-get-a-provider-to-perform-at-each-encounter

This is a teaching tool prepared for a single, real patient. It is presented with an index of hyperlinks which makes it easy to access -- http://jameslhollymd.com/Letters/teaching-tool-for-pc-mh-course-patient-care-activation-engagement

Ten Principles Identified in 1999 which evolved into Patient-Centered Care; the link has a length index to PC-MH tools used by SETMA -- http://jameslhollymd.com/medical-home/display-and-explanation-of-setmas-patient-Centered-medical-home-tools

SETMA's Accreditation. SETMA is the only practice in the USA to be accredited for PC-MH by all four (NCQA, AAAHC, URAC and The Joint Commission) groups -- http://jameslhollymd.com/accreditations

Our History in Three Seven Year Segments; this is a review of our history as reviewed from three seven year periods of development -- http://jameslhollymd.com/your-life-your-health/setmas-past-defined-by-three-seven-year-segments-which-help-guide-the-future

The AMA, CDC, ADA and the Ad Council have announced the launching of a Pre-diabetes education program; when the AMA setnt this announcement to SETMA last month, we sent them a description of our program which has been in place for over 15 years -- http://jameslhollymd.com/your-life-your-health/ama-ada-cdc-ad-council-announce-their-pre-diabetes-public-awareness-campaign

How an annual review of performance allows us to prepare a vision for the future -- http://jameslhollymd.com/your-life-your-health/looking-back-as-a-foundation-for-envisioning-the-future-part-ii

Response to SETMA of The Joint Commission (they not only know what they are doing, they know why they are doing it) and The Robert Wood Johnson Foundation (how centrally and essentially electronics are positioned into SETMA and how all other things are driven by the power of electronics). http://jameslhollymd.com/Letters/joint-commission-accreditation-for-ambulatory-care-and-pc-mh-conclusion-about-setma

Managed Care and Electronic Patient Records – presented at National Conference in May, 2000 -- http://jameslhollymd.com/your-life-your-health/tepr-modified-as-delivered-at-may-2000-conference -- the following is from this presentation:

In the past five years, Southeast Texas Medical Associates has committed its future to two beliefs:

Managed Care strategies can provided excellent care to my patients while helping control the cost of that care.
Electronic Medical Records is the only methodology and/or technology, which can make this happen at the provider level.

Once you get by the methods of managed care: precertifications, limited provider panels, formularies, authorizations, referrals, etc, you are left with the dynamics of Managed Care. Those dynamics are:

A continuum of Care model of delivery, which addresses the quality component of the value equation, and which is a data issue.
An integrated delivery network organization of that delivery, which addresses the cost component of the value equation, and which is also a data issue.

In the history of medicine, the following has been the nature of medical records:

In the 18th Century, for practical purposes, medical records -- as a documentation of individual patient treatment -- did not exist.
In the 19th Century, medical records were not much better, but those that existed were based on pencil and paper.
In the 20th Century, the standard of excellence for medical records was transcription. This was a vast improvement, but fundamentally employed the same methodology as the 19th Century -- paper. Fundamentally, 18th, 19th and 20th Century medical records were documents.
In the 21st Century, medical records will be based on some form of electronic medical records.

A presentation to the Beaumont Chamber of Commerce, August 24, 2000 on Healthcare Issues Facing Southeast Texas -- http://jameslhollymd.com/Your-Life-Your-Health/pdfs/setx-healthcare-issues-facing-southeast-texas.pdf

The difference between electronic patient records and electronic patient management -- http://jameslhollymd.com/your-life-your-health/electronic-medical-records-only-distantly-related-to-real-electronic-patient-management

If all we generally talk about is Electronic Patient Records or Computerized Patient Records or Electronic Medical Records, or ...then everyone is going to get the idea that when they create the ability to produce an electronically generated document of a patient encounter, they have arrived. The problem with this is that many health care providers, who are very interested in joining the 21st-Century methodology of health care (EPM), are going to buy a product which they suddenly find is wholly inadequate for the tasks at hand.

Four 1999 Events which transformed SETMA -- http://jameslhollymd.com/Your-Life-Your-Health/may-1999-four-seminal-events-in-setmas-history

Personal:

What it takes to build a practice -- http://jameslhollymd.com/Letters/SETMA-and-the-Future-of-Primary-Care-Note-from-Dr-Vardiman

Recounting of May, 1996 message to SETMA about our principles -- http://jameslhollymd.com/Your-Life-Your-Health/True-May-30-1996-True-June-2011

Awarded Distinguished Graduate of undergraduate University -- http://jameslhollymd.com/Letters/response-to-my-approaching-induction-into-the-nsu-long-purple-line

Awarded Distinguished Graduate of School of Medicine -- http://jameslhollymd.com/Presentations/UTSAMS-Distinguished-Alumnus-Award-2012-Acceptance-Address

Response to presentation -- http://jameslhollymd.com/Letters/response-to-dr-hollys-presentation-to-health-leaders-media

Letter of support -- http://jameslhollymd.com/in-the-news/pdfs/Letter-of-Transmittal-for-Support-of-Holly-Distinguished-Professorship-Universal-American.pdf

Sincerely yours,

C.E.O. SETMA
www.jameslhollymd.com

Adjunct Professor
Family & Community Medicine
University of Texas Health Science Center
San Antonio School of Medicine

Clinical Associate Professor
Department of Internal Medicine
School of Medicine
Texas A&M Health Science Center

Related Letters

	Additional materials about SETMA's development, hisotry, philosophy and principles Dr. Holly's Response to Kathleen Kimmel Note Further Dialogue with Kathleen Kimmel from ONC HIT February 10, 2016 Summary of Dialogue between Kathleen Kimmel and Larry Holly Evening of February 11, 2016 Thank you note from Kathleen Kimmel

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