I thank you for your interest in the Wellness Wiki. I include background information about my company and me, that I offer as a means of introduction, so you can understand my reason for co-authoring this paper with Dr. Steven Beller; who I enjoy working with and who I have grown to trust through this process.

Professionally, I am a Management Consultant. I am an Information System Engineer, with a personal stake in the healthcare industry delivery process. As I grow older, I will be one of the 100,000,000 seniors who will rely on it for help at some point. Having health power of attorney for my di seased parents, I learned first hand the difficulties healthcare practitioner’s experience at the patient bedside because they do not have basic information technology tools.

As President of ES Enterprises Inc., I believe we are at a threshold in Health Information Technology (HIT). I believe this wiki provides a blue print for action and a wake up call for all of us. I urge you to read it in its entirety and consider adding your ideas and concerns to a growing number of proponents for change regarding how best to “Cure the American Healthcare System.”

Throughout my career, I designed systems in a team environment that solved business problems. Many were very complex. Some dealt with super computer, oil refinery models; some dealt with manufacturing processes, some with hardware/software development and still others with the transformation of enterprise business processes. In each instance a major paradigm shift occurred. In one instance an oil refinery model that required a week of computing power, running 24 hours per day, was reduced to just 30 minutes with the results made available to engineer’s world wide in six seconds. The impact on refinery performance was significant having great economic benefit to the business. Other systems were used to ensure better communications between suppliers and customers for continued customer loyalty.

However, not until my mom and dad became ill did I realize that the healthcare delivery process was broken. My experiences took place through out the 1990’s. I learned little things that struck me as crazy; for instance, it was possible for two physicians working with the same patient to offer up prescriptions that could interact in such a way as to cause an adverse reaction, even death. I was exposed to bed sore problems. These sores didn’t go away because skin integrity had broken down due to lack of nutrition, contributed to by a lack of feeders for patients suffering from dementia. I was exposed to errors due to overwork, lack of education regarding equipment, or omissions occurred because no one could read all the hand written scribble on charts nor respond quickly when an error occurred.

It seemed that there was a need for some good old process improvement and the introduction of easy to use information technology tools. Many were readily available but the industry hadn’t embraced them because of the many reasons outlined in this wiki. Being a small business, it is necessary to collaborate with other small business to survive. We are all very familiar with technology that enables us to communicate in real-time. But I quickly found out that the healthcare industry wasn’t very familiar with these tools. The industry deployed process technology that aligned itself with procedures performed in operating rooms and recovery rooms, etc., but everything was restricted to a silo. Nothing could talk to or share anything with anything else. In some cases, billing was delayed by months due to lost information.

It was in 2001 that ES Enterprises began to address these issues. I formed a consortium, similar to a farmer’s cooperative, to respond to requests made by the Insurance Industry, the Center for Medicare and Medicaid, the Office of National Coordination for Health Information Technology, and others. Together this team, lead by ES Enterprises constructed a pilot system known as Patient Health Information Network. It rolled out for demonstration purposes January 2004 at Loyola College in Maryland. Today this system is working and capable of changing the way healthcare is delivered. Our initial work regarding this system and the issues and challenges facing US healthcare is published, reference the International Journal of Electronic Healthcare. With this wiki, Steve and I take the NHDS and ES Enterprises Inc. healthcare vision to a new level of sophistication. Our technology will make a difference:
  • It will embrace wellness
  • It will react whenever an error or omission occurs and notify a responsible healthcare provide
  • It will promote communications, collaboration and interoperability
  • It will ensure that our first responders are able, in a disaster, to respond to the needs of a victim by leveraging patient information and tracking their movement from triage to trauma unit
  • That physicians and nurses will be able to leverage decision support tools to ensure they are applying best practice guidelines when developing care plans for their patients.

As a senior member of the IEEE, I am aware of the need for IEEE and the AMA, along with ANSI and the Certification Commission for Healthcare Information Technology (CCHIT) to identify the standards by which communications can occur securely and in context between and among healthcare providers. I am also aware that each of us must become an educated consumer of healthcare products and services, so that, as a mobile society you or I can receive the same care in Miami, Florida as we would receive in Berwick, Pennsylvania. We expect the best quality of care at the best price and we expect that our healthcare provider have access to our medical records so that they are able to provide the best care possible. It seems irresponsible for us to do anything else. How silly is it for each of us to rewrite our history every time we see a new healthcare provider, or for the healthcare industry to lament their lack of best practices.

I hope that as you read our wiki you become a proponent for change. I recently presented a seminar titled, “Modern Medical Records” at a Northeast Pennsylvania, IEEE meeting. The audience during discussion believed that the onus was on the small rural community to step up and make a change in healthcare delivery. They believed as I do that regional health is a local matter. We are 100,000,000 souls. We live in rural America. We must demand better healthcare, and we must see that Health Information Technology (HIT) is used effectively at the Regional Health Information Organization (RHIO) level. As a member of the Pennsylvania eHealth Initiative (PAeHI), Business Analysis and Technology Committee, I hope to bring this mantra forward at our organization meeting April 5, 2006. I hope all of you who read this wiki will support these efforts.

Please contact me if you have any question, concern or expectation that you would like addressed. I can be reached at

Sabatini Monatesti

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