JamesLHollyMD.com

	James L. Holly, M.D.

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Letters - Response to Houston Business Journal's article about Universal American and SETMA in what they call a "heated debate"

Mr. Joe Martin, writer for the Houston Business Journal, published a piece today entitled “Electronic Medical Records at center of heated debate.” There is no “heated debate” particularly between Ms. Erin Page and me. In fact, Ms. Page and her husband traveled to Washington, DC, last week to attend the PC-PCC’s award ceremony where SETMA received their first annual Patient-Centered Medical Home Practice Award. Far from a “heated debate,” there is only an attempt by me to correct the wrong information which was previously published by the Houston Business Journal. Unfortunately, rather shedding light on the subject, Mr. Martin only added his “artificial heat” to the distortions of his first column on the subject.

After his first article, Mr. Joe Martin and I had an extensive discussion; there was no “heated debate”. In his second piece, he excluded everything of substance and used our conversation as a straw man to pretend that there is a controversy in the healthcare industry about the value of electronic patient records. One EMR industry executive and the designer and founder of one of the top five EMRs in the nation wrote me, in response to my note to Mr. Martin and said, “Thank you ...from the entire industry.” The following link is to my response to Mr. Martin: Dr. Holly's Response to Houston Business Journal November 6, 2014 Article entitled Why EMRs Won't Solve Healthcare Problems.

It does not take long to realize what I should have known that often the press is not interested in informing but only inflaming. Healthcare leaders are working hard to improve healthcare delivery for all of our citizens. SETMA is committed to excellence in the care of all of our citizens has eliminated ethnic disparities in the care of hypertension and diabetes. At our encouragement primary care co-pays for care were eliminated from Texan Plus making it possible for all of our patients to seek care as often as necessary without any cost. This was in collaboration with Universal American. Now the entire industry in Southeast Texas (Houston and Beaumont) has followed suit. There are many other areas where SETMA in collaboration with Universal American have helped the transformation process.

Mr. Martin’s associating SETMA’s use of EMR only with only “communicating” is a distortion of the transformative power of disease management, clinical decision support. Before most medical practices had adopted EMR, SETMA had already been awarded the HIMSS prestigious Davies Award and their Stories of Success. In 2012, Dr. Holly was named HIMSS’ Physician Leadership Award for Information Technology.

The following link gives a brief introduction to SETMA: Choosing a Provider & Provider Organization (2014). The demeaning of SETMA by referring to our use of HIE and EMR as “working in a small way,” ignores a sixteen-year successful development of our EMR. Mr. Martin’s negative article ignores the opinion of national organizations such as:

The Joint Commission who accredited SETMA for Patient-Centered medical Home and for Ambulatory Care. Both the surveyors and one of the executives at The Joint Commission commented about the philosophical foundation of SETMA’s work. One summarized his response to SETMA saying, “I was just talking to one of my colleagues and showing him SETMA’s notebook which was prepared in response to The Joint Commission’s Standards and Requirements Chapter Seven on leadership.” The executive said, “Look at this; everything they do is founded upon a philosophical foundation. They know ‘what they are doing,’ but more importantly, they know why they are doing it.’” SETMA is not the result of random efforts but of innovations and advances which are consistent with a structured set of ideals, principles and goals. It is helpful that The Joint Commission recognized this and commented upon it. It is one of the strengths of SETMA and it is one of the principle guides to SETMA’s development history, i.e., what caused SETMA to become what it is.

SETMA was selected as one of thirty exemplary practices in American for the Robert Wood Johnson Foundation LEAP Study conducted by the MacColl Institute. After a four-day site visit the team concluded, “the uniqueness of SETMA was a surprise. It was SETMA’s IT Department. The RWJF team felt that SETMA has approached healthcare transformation differently than anyone they have seen. They related that uniqueness to the decision SETMA made in 1999 to morph from the pursuit of “electronic patient records” to the pursuit of “electronic patient management.” They were surprised to see how centrally and essentially electronics are positioned into SETMA and how all other things are driven by the power of electronics. They marveled at the wedding of the technology of IT with clinical excellence and knowledge. The communication and integration of the healthcare team through the power of IT is novel, they concluded..

Others have recognized the uniqueness of SETMA including:

A seven-man delegation from China who not only visited SETMA but who are now training doctors in China using the materials on electronics and medical home given to them by SETMA.
Baylor Scott and White is visiting SETMA to examine our transformative efforts.
Kelsey Seybold visited SETMA for the same reason.
A team from Puerto Rico with the Texas Department of Health is visiting SETMA in December.
Teams from Texas Medical Schools have visited SETMA
Most of our physicians have adjunct or clinical faculty appointments at Schools of Medicine.
Medical Residents and Senior Medical Students spent four-week rotations at SETMA learning our electronic record and medical home systems.
The Blue Cross/Blue Shield Association in Chicago has contacted SETMA to discuss Multispecialty Practice Uses Electronic Templates to Provide Customized Support at Every Visit, Contributing to Improved Patient Behaviors and Outcomes. Their introductory letter said, “As we explore opportunities to implement innovative programs and interventions to improve community health, we reviewed the AHRQ Innovations Exchange programs. We were particularly interested in programs that addressed chronic conditions (i.e. hypertension, hyperlipidemia, obesity, diabetes, and coronary artery disease) as well as a clinical, nutritional, or fitness focus. Our research indicated you would be the proper contact.”

The list can go on and on. SETMA’s website at www.jameslhollymd.com includes details of almost everything SETMA does. We are not perfect and we continually attempt to improve but neither are we a “small” user of EMR. Our accreditations and awards are listed on our website.

When I contacted Mr. Martin, I should have known that any response which he published would have been as incorrect as his original article. I am sorry for that for he could have made a positive and effective contribution to an important part of healthcare innovation. He chose rather to inflame rather than to inform.

James (Larry) Holly, M.D.
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

houston business journals article

Related Letters

	Dr. Holly’s Response to Houston Business Journal November 6, 2014 Article entitled Why EMRs Won’t Solve Healthcare Problems Houston Business Journal's Response and Dr. Holly's Answer

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