Publisher's Message: A Few Thoughts
by Marv Rosenfeld
 For almost as long as we have
been publishing Practical Pain Management, Greg Winterkamp of Addison Health
Systems—a supplier of Electronic Medical Records software—has been writing
articles addressing the need and ‘how to’ for pain physicians to incorporate
Electronic Medical Records (EMR). If you’ve been listening to the agenda of the new
federal administration you know much of what he has been writing about is coming to
fruition and that the time is approaching when there will be mandatory requirements. There
is over $20 billion dollars in the new Economic Stimulus plan towards this effort.
The new legislation would provide incentive payments of up to $44,000 to $64,000 spread
over a few years for physicians who buy and use EMRs. These payments would go towards the
‘meaningful use’ of digital records as defined by the government. There is
already some meaningful use of electronic generation and organization. By 2011, doctors
will be required to electronically communicate with other caregivers and agencies as well
as comply with a proposed government initiative to communicate electronically with
Regional Health IT Centers. Full implementation takes time and doctors need to start now
in order to be ready and to qualify for such incentive payments.
Progress has been made. There are State Workers Compensation (WC) and insurance
companies that are already using incentives. Doctors have received 1-2% reimbursement
bonuses from WC when EMR reports have been submitted exceeding their state’s
requirements. Further, there have been as much as 10% reductions in malpractice insurance
because of incorporating an EMR. Of great concern is Medicare’s expansion of
“recovery audit contractors,” (RAC) that audit hospitals and doctors to collect
back payment of unsubstantiated claims to all 50 states in 2010. That could be very
harmful to the pain management profession but EMR can get you throusgh an audit
painlessly.
One very important point is that software is not the same for all specialties. Be sure
the software you purchase is specifically designed for pain. The only company we know that
has designed software specifically for pain management is Addison Healthcare Systems.
There is much more to be said about the value and requirements with regard to EMR and we
will leave it to you to further investigate them. A good source is the series of articles
by Mr. Winterkamp in this journal. Archived articles may be found at www.Writepad.com
(select ‘Items of Interest’ and then ‘Archived Articles’).
Amino Acids as Adjunct to Opioid Therapy
For the first time we are publishing an article on amino acid in this issue. It is written
by Julia Ross in collaboration with our own Dr. Forest Tennant. Amino acids are the
building blocks of endorphins and in the hands of skilled practioners can be a useful
adjunct to opioids. The article in this issue is the first in a series and presents a
basic introduction.
Longevity Study
We continue to collect data on patients who have been treated with opioids for over ten
years and our report will be published in a later issue. To date, three doctors have
reported approximately one hundred patients with over ten years of treatment. One doctor
reported on sixty-four patients—with one patient treated for over thirty years. The
data will have significant meaning when patient conditions are tabulated.
World Institute of Pain
We attended the World Institute of Pain meeting in New York and, from the attendance of
over 2,000 from all over the world, one could say that pain management is weathering the
economic crisis.
It was interesting to note that radio frequency (RF) therapy was promoted at quite a
few booths and we are now interested in articles on that approach. If it is something you
practice, perhaps you would like to share your experiences with your colleagues. Forward
manuscripts to me at MLR@PPMJournal.com.
Restoration of Normal Cervical Lordosis
The renowned Dr. Norman Shealy recently completed a study, due to be published shortly,
comparing axial linear traction (ALT) with Expanding Ellipsoidal Decompression
(EED«)available with the Posture Pump«. He was kind enough to write a synopsis for us.
The major point of the report is that EED via Posture Pump decompresses and hydrates
damaged discs while aligning vertebra into their natural curved shape. This is a vast
improvement over common linear traction where the cervical lordosis is forcefully removed.
Cervical neck pain is relieved without damaging the cervical lordotic curve. It is an
important article that advocates using an approach that maintains the lordotic curve and
sheds light on some side effects of procedures commonly employed.
— Marvin Rosenfeld
Publisher
Please refer to the April 2009 issue for the complete text. In the event you need to order a back issue, please click here.
— April 2009
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