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By Wendy J. MeyeroffTHE ERICKSON TRIBUNE

Statistics show the faceof retirement is changing.Many age 62 and up seethis time as a chance to “notquite retire.” They joincommunities like thosebuilt and managed byErickson RetirementCommunities, and letsomeone else mow the lawn

and take care of the repairs,while they go off to explorecontinued or new careeroptions.

According to an AARPstudy, 54 percent of olderAmericans say they contin-ue working to keep them-selves mentally active, 49percent want to stay physi-cally active, and 47 percent

see NOT RETIRED page 2

Talk for Your Travelsee page 5

OrganicFoodsee page 5

Join the ‘NotQuite Retired’

Electronic MedicalRecords Save LivesWhite House Urges ComputerizationBy Wendy J. MeyeroffTHE ERICKSON TRIBUNE

In his 2005 State of theUnion address, PresidentBush called for doctors andhospitals to make better useof technology to store andshare medical records. In asubsequent memo, theWhite House said, “com-puterization was necessarybecause information abouta patient is often scatteredand unavailable in an emergency.”

Whatever your opinionof the current administra-tion’s policies, the fact iswhen organizations notonly computerize healthrecords but also find a wayto share information, peo-ple’s lives can be saved.

Mark Leavitt, M.D.,Ph.D., chief medical officerof the Healthcare Infor-mation and Management

Systems Society, a nonprof-it organization dedicated toleading changes in themanagement of health careinformation, emphasizesthat proper computerizationnot only helps in an emer-gency—it helps preventemergencies.

“Imagine going to aspecialist you’ve never seenand he has all your medicalrecords instantaneously.Think of all the medicationerrors that could be avoided,” he says.

“Consumers shouldn’tbe overly concerned aboutprivacy risks when healthcare experts share informa-tion. Think of it more likegetting your money out ofan ATM,” Leavitt adds.“You should be more con-cerned over the risk oferrors if doctors don’t have

By Keith GamboaTHE ERICKSON TRIBUNE

When the BushAdministration launched itsNo Child Left Behind(NCLB) educational initia-tive in 2001, it set inmotion a nationwide effortamong the states to complywith the new testingrequirements that are suchan important component ofthe law.

As explained in the U.S.Department of Education’swebsite (www.ed.gov),“Under the law's strongaccountability provisions,states must describe howthey will close the achieve-ment gap and make sure allstudents, including thosewith disabilities, achieveacademically.”

The primary means tothat end is to gauge progressin “closing the achievementgap” through extensive stu-

dent testing. This is animportant issue because thesuccess or failure of childrenin achieving academic stan-dards not only reflects onstudents, it impacts thefuture of schools as well,since lack of progress can

see TESTING page 9Courtesy of Eric LangeEric Lange works full-timedesigning auto parts andwouldn’t dream of cuttingback his hours.

Do standardized testsmake better students?

State House Photo/ Abby Brack

File Photo

Concern Over Chemicals in FoodIn one month alone, more than 80 millionU.S. adults purchased and/or consumedorganic food or drink.

Percentage who say:

30%

I trust the government to regulate the chemicals.

I’m concerned aboutchemicals used togrow food.

57%

PuttingEducationto the TestThe Pros, Cons, and Maybesof Testing Our Kids

Source: NaturalMarketing Institute

n Meet the AuthorSilhouettes, How to Cut for Fun & Money by Ann Woodward. Page 2

n Erickson NewsbriefsErickson community coming to Denver, new cooking show at Riderwood, Greenspring wins four ‘Tellys,’ Oak Crest crochets blankets for charities, NorthBay adventure camp ready to open its doors. Page 4

n L.A. Times Crossword PuzzleThis month’s crossword puzzle. Page 4

n Ask JoeKeep your computer safe and secure. Page 6

n Aford the TurtleThe antics of Aford T. Turtle and his friends. Page 6

n Good Health Starts HereThe latest in knee and hip replacements and what you need to know about choosing and using at-home medical tests. Page 7

n From the Chef’s KitchenChef de Cuisine James Little’s “Seafood Macaroni and Cheese.” Page 9

Massachusetts Gov. Mitt Romney (left) speaks with Sec.of Health and Human Services Ron Preston (center) andDr. Allan H. Goroll after announcing plans to launch anew initiative to reduce medical errors and save costs byconverting paper medical records into electronic form.

see RECORDS page 8

Community Specific Indicia Goes Here.

THE ERICKSON TRIBUNE GOOD HEALTH STARTS HERE AUGUST 2005PAGE 8

the information they need,than over the risk of infor-mation being stolen.”

Stopping Mistakes BeforeThey Start

One of the best exam-ples of the possibilities ofcomputerized efficiency isthe Centricity electronicmedical records system usedat communities built andmanaged by Erickson. Thesystem passed its two-yearanniversary this spring, sothe professionals in theErickson HealthSM systemhave seen first-hand thebenefits of effective comput-erization, something used inless than 5 percent of thiscountry’s health facilities.

But Centricity is notyour average doctor’srecords system. WilliamRussell, M.D., medicaldirector of Oak Crest, acommunity in Parkville,

Md., built and managed byErickson, says Centricitygives him and otherErickson HealthSM physi-cians instant access to thecomplete medical historiesof more than 15,000 peopleacross eight states.

That’s important whensomeone is using an outsidespecialist. “If the specialisthas prescribed a drug wedon’t know, we useCentricity to check fordrug/drug or drug/alcoholinteractions. Centricity notonly allows doctors to checkfor interactions betweenprescriptions drugs, but alsobetween prescribed medica-tions and many foods, herbs,and other remedies,” saysRussell. (See the story onnatural supplements in theJuly Tribune online.)

“When patients leavethe office, we give themtheir current list of medica-tions and tell them to com-

pare it to the drugs theyhave at home,” says Russell.“If an outside physician pre-scribes a new medicine noton their list, Centricityhelps determine if the drugis appropriate, given thatperson’s age, medications,and other factors. If not, wetalk to the specialist and getanother drug prescribed.”

Other Drug-RelatedAdvantages

Finding constantlyupdated information ondrug side effects and inter-actions through computersystems like Centricity helpsboth doctors and patients.“If a new product comesout and it’s superior or morecost-effective, we can see forwhich community memberswe can make therapeuticsubstitutions,” says Russell.

Minimizing drug dan-gers is a major advantage ofa system like Centricity.

This spring a study wasreleased showing ten HMOsnationwide were allowingprescriptions to be filled formedications that had beenlabeled “always avoid” or“rarely appropriate” for upto 15 percent of their sub-scribers. Erickson HealthSM

physicians used Centricityto check these medicinesand found such prescrip-tions had been virtuallyeliminated among peoplethey were treating.

Last fall, when the drugVioxx was suddenlyrecalled, Erickson HealthSM

physicians accessedCentricity to find which ofthe 15,000 residents atErickson-built and –man-aged communities were tak-ing it. “We found all 331residents on this drug andwithin 24 hours notifiedthem to come in and talk totheir doctors about alterna-tives,” says Russell. “Thatprocess could have takenweeks if we were laboringthrough paper records.”

When Seconds CountLast but not least, a

truly advanced computersystem helps physicians savelives when seconds count.“Centricity gives us accessto a patient’s records at alltimes,” says Russell, “some-thing that’s critical in emer-gency situations. If I get anemergency call in the mid-dle of the night, I can accessthe patient’s chart and lookat his or her most recentdata.” That gives the on-callphysician a huge advantagein determining if an ambu-lance or hospital is needed.

Systems like Centricityalso help hospitals maximizecare. Arlon Quigley lives atFox Run, an Erickson-builtand -managed communityin Novi, Mich. When hepunctured a lung and suf-fered other injuries while

hiking with his grandkids inPennsylvania, his physiciansback home were able toinstantaneously transmit hismedical records to the doc-tors at the Pennsylvania hos-pital. It not only saved pre-cious time and avoideddeadly mistakes, it gotArlon home to Michigan a

lot sooner.Will nationwide com-

puterization of healthrecords be difficult? Yes. Butis it impossible? AsCentricity shows atErickson HealthSM, theanswer is No.

From RECORDS page 1

Erickson HealthSM physician, Eugenio Machado, M.D., (left) demonstrates the Centricityelectronic medical records system via his handheld tablet to Mark B. McClellan, M.D.,Ph.D., (right) administrator of the Centers for Medicare & Medicaid Services.

Photo By Wendy Meyeroff

overall—rather than theirchronologic age.” Someonemay be 65, for example,and not have the upperbody strength to handle thewalker or cane they’ll needwhile recovering.

Interestingly, he alsochecks his patients’ teeth. “Ilook at whether they’re looseor in poor shape. If so, theyneed to be fixed; otherwisesuch problems can lead tobacteria entering theirblood.”

McCarthy says,“Medicare often doesn’treimburse the hospital fornewer and more expensive

technology, such as metal-metal or ceramic-ceramicbearings.” So while those65-plus can potentially ben-efit from these advances,they may not be encouragedto use them. The only realsolutions: talk carefully toboth your surgeon and thehospital, and start lobbyingCongress.

Optimizing SurgeryResults

Both McCarthy andBennett agree with WilliamRussell, M.D., medicaldirector of Oak Crest, acommunity in Parkville,Md., built and managed byErickson, that a total teamapproach is critical to opti-mizing the efficacy ofreplacement joints. “Everypatient should include theirprimary doctor, especially ifhe/she is a geriatrician whois trained to deal with thewhole patient,” saysRussell. “I can’t tell youhow many times I’ve seensomeone get a joint replace-ment, then doesn’t have theenergy to participate inrehab adequately. They endup worse than when theystarted.”

McCarthy adds,“Direct communication iscritical: between the sur-geon and the patient’s pri-mary doctor; between thespecialists, the primary, andthe surgeon; and betweensurgeon and the patient.”He adds that for such com-munication, “a system like

Centricity (see page 1) isgreat.”

Speaking of rehab, it’scritical the patient committo it because—as Russellnotes—“You only have arelatively small window ofpost-op opportunity to opti-mize results.” McCarthyencourages patients to exer-cise before surgery, so as tostrengthen muscles. Russellnotes that residents at com-munities built and managedby Erickson often have ateam approach available,thanks to on-site rehabfacilities.

Finally, all three doctorsemphasize patients shouldmaintain realistic expecta-tions. “I always remindthem it’s not a ‘new’ joint,it’s an artificial joint,”Russell says.

McCarthy adds, “Thereare spectacular develop-ments, giving much greaterquality of life than was pre-viously possible. But it’ssomewhat presumptive tothink any device—be it anartificial joint or a heartvalve—can be better thanwhat nature gave you.”

for “home” use, Russelldoesn’t think prothrombinself-monitoring is a goodidea.

“This test is best doneby trained personnelbecause the results requirecareful analysis, and errorsin testing can lead to prettysubstantial complications,”he says. Besides, he pointsout, “prothrombin tests areexpensive: about $1,000and then (like glucose tests)a constant investment intest strips.”

“Home” prothrombintests have been a lifesaver indoctors’ offices. “Since we’vestarted using prothrombinkits in our on-site MedicalCenter—as opposed todrawing blood and sendingit to a lab—we’ve seen a realimprovement in the qualityof patients’ Coumadin dos-ing. It’s not out of range asoften as it could be whenwe had to wait for overnightlab results, and complica-tions are considerably less.Physicians can now makeimmediate, very fine adjust-ments to someone’s medica-tion dosage,” says Russell.

Beyond Test StripsThere are other home

kits using test strips, butRussell finds very few thatthose 62-plus really need.“You can do home choles-terol testing, but you mightas well have it done duringyour regular physical.”

Where he sees someinteresting developments foraverage consumers is med-ical devices they can usethemselves. One example heoffers is home blood pres-sure (BP) monitoring whichhe says generally is a goodthing.

As with all home tests,be careful about interpretingresults. “Let’s say you have aheadache, check your BP,and see your pressure’s up40 points. Your headachecould be the cause of yourhigher pressure, but thatpressure may also have goneup just out of concern overyour headache. It’s best tocheck with your doctor forguidelines,” Russell says.

Patients with heartrhythm disorders mightwant to discuss home eventmonitoring with theirphysicians. “When patientscomplain of rhythm prob-lems, doctors often recom-mend wearing a 24-hourheart monitor, but it’s oftenlike taking your car to themechanic—that ‘weirdsound’ disappears as soon asyou bring it in. Cardiacevents don’t happen everyday. It’s a matter of statis-tics,” says Russell.

But now there are car-diac “home event monitors”that the cardiologist pro-vides which you can wearfor weeks. “If you havesymptoms, you hit a buttonon or near the phone and itconnects you to a phone

line where a cardiac techcan see an EKG strip, thengive that strip to a cardiolo-gist to review,” he says.

The Key to Home TestingCheck with your insurer

as to which home test anddevices they’ll cover. If theygive you a choice, talk to ahealth expert including thepharmacist as to which is agood investment.

Finally, Russell urgeseveryone to remember,“The main disadvantage tohome testing is it doesn’tcome with counseling, theway office testing does.” Asan example he points to dia-betes monitoring. “Thebeauty of the EricksonHealthSM approach to geri-atrics is we address thewhole patient, not just aspecific disease, like dia-betes. If people are goingto a special event and wantto eat cake, that diabetesmonitor and their log bookis just part of how we helpthem find a way to eat cakeand still maintain theirhealth.”

He concludes: “Hometesting is never a substitutefor a physician’s assessmentand a treatment plan thedoctor can develop for you.Test results can be mislead-ing or even dangerous ifthey’re not connected to adoctor’s advice and a totalwellness program.”

From JOINTS page 7From HOME TESTING page 7

This past May, Massachusetts became the first stateto officially commit to a statewide electronic medicalrecords system, launching its eHealth Collaborative inthree pilot areas.

Governor Mitt Romney explains, “It will allow us todo a better job in treating patients and preserve ourresources so that we’re able to help those who need ourhelp the most.”

One of the main barriers so far to such systems isthat hospitals and doctors have no real incentive to par-ticipate. It costs them money to upgrade systems andthey don’t reap the payback; the insurance companies do.

Massachusetts is getting the insurance industryinvolved from the outset. BlueCross BlueShield ofMassachusetts has committed $50 million to the initialproject.

To carry the Erickson and Massachusetts programsfor electronic medical records systems to a national level,Mark Leavitt, M.D., Ph.D, chief medical officer of theHealthcare Information and Management SystemsSociety, says four things will be needed. He laid themout in an exclusive to The Erickson Tribune:

1. Money - “I believe there’s more than enough withwhat we’ll save in health care administration, costlyerrors, and so on, to pay for the system we need,” saysLeavitt.

2. Standards - One of the greatest challenges to anational network is lack of standardization. “We haveconflict in systems, like the old VHS versus Beta video-tapes,” says Leavitt. He chairs a voluntary organizationto create standards.

3. Education - “Doctors and hospitals need educa-tion on how standardization benefits them” he says.

4. Consumer involvement - “Getting doctors’ sup-port is critical and you can steer yours toward better uti-lization of electronics. You should ask, ‘Don’t you have away to access that information electronically yet?’ or,‘My neighbor’s doctor lets her email questions in themiddle of the night. Why don’t you?’

“Then imply that maybe you’ll switch to your neigh-bor’s doctor,” he laughs. “That’s when we’ll get the doctors on board.”

MassachusettsLeads the Way

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