NFL To Convert To Electronic Health Records In Effort To Address Concussions

The NFL today was expected to announce that it will “convert to an electronic health record system next season with software provided" by Massachusetts-based eClinicalWorks, according to Deborah Kotz of the BOSTON GLOBE. The NFL under a 10-year contract will pay $7-10M “for a system that would store X-rays, blood test results, physical exam notes, medications -- even video clips documenting a game injury -- in one online server that players and physicians could access from anywhere in the country.” The technology will also “allow researchers to tap into the medical records with names removed to analyze a vast treasure trove of data and learn more about field conditions that raise the likelihood of ankle injuries or the types of concussions that are likely to lead to early dementia.” Each NFL team currently “relies on its own medical records system, with some using paper records and others electronic systems that do not necessarily allow players to have access to their records when they switch teams or see doctors for second opinions.” eClinicalWorks CEO Girish Navani said, “The NFL wanted an electronic health record that was usable across the entire system. This system will allow physicians to send prescriptions electronically to the pharmacy or an order for an X-ray or MRI. It can hold a workout regimen for rehabilitation and will allow trainers to examine X-rays from previous injuries to compare with new ones.” Kotz reports NFL players will have “access to a system that alerts their team physician when they are due for a vaccination or cholesterol screening and will keep track of how many players are complying with their health screening.” The system will include “firewalls in place to prevent team trainers and others from accessing health information that players may not want to reveal to all medical staff, like treatment for depression or a sexually transmitted disease” (BOSTON GLOBE, 11/19).

DISABILITY PAYOUT: ESPN's "Outside the Lines" and PBS' "Frontline" in a joint investigation found that the NFL's retirement board "awarded disability payments to at least three former players after concluding that football caused their crippling brain injuries -- even as the league's top medical experts for years consistently denied any link between the sport and long-term brain damage." Documents obtained in the investigation show that he board paid at least $2M in disability benefits to the players in the late '90s and '00s (ESPN.com, 11/16). NFL Senior VP/PR Greg Aiello said the ESPN report “underscores that we have had a system in place with the union for many years to address player injury claims on a case-by-case basis.” Aiello added the disability plan was “collectively bargained with the players.” Aiello: “All decisions concerning player injury claims are made by the disability plan’s board, not by the NFL or by the Players Association” (N.Y. TIMES, 11/17).

NO SMOKING GUN: PRO FOOTBALL TALK's Mike Florio noted ESPN's “supposed bombshell in the concussion cases against the NFL, while not erroneous in its factual content, makes an illogical leap in interpretation.” Specifically, cases from the NFL’s disability board in which "benefits were paid to former players for long-term health consequences are being characterized by ESPN as the ‘smoking gun’ in the concussion litigation brought by former players.” Florio: “Apart from the fact that the information has been well known for years and the NFL’s disability board is independent from the league, the fact that the board consists of representatives from both the NFL and the NFLPA underscores the fact that the players’ union (i.e., the players themselves) had an integral role in the development of knowledge and/or the alleged concealment of it from players.” Florio wrote it has been a “rough year" for "OTL.” Florio: “From the Bernie Fine fiasco or the Mickey Loomis wiretap witch hunt, Bristol’s investigative unit has been doing plenty of swinging -- and plenty of missing” (PROFOOTBALLTALK.com, 11/17). In Boston, Greg Bedard wrote "something seems amiss" on the ESPN story. Bedard: “If the NFL gave the players a check, then they have something. But the board is independent of the league and includes player representatives. So if you’re saying the NFL was covering something up, then the NFLPA wasn’t exactly in the dark” (BOSTON GLOBE, 11/18).

TAKING EVERY PRECAUTION? The GLOBE's Bedard wrote the NFL has “come a very long way in a very short period of time.” Bedard: “Whether they led or were dragged kicking and screaming will be addressed with the many concussion lawsuits.” The “next leap is going to come in a couple of years” when new equipment is “ready to be used.” Concussions at that point “will be much easier to diagnose and in a more timely matter.” But what happened last weekend has “led to questions about whether the league is doing everything it can right now.” Bedard: “The NFL does have the ability to put an independent neurologist on each sideline -- something the Players Association has asked for -- yet it has not done so. Why?” (BOSTON GLOBE, 11/18). But CBS’ Dr. Neal ElAttrache said the on-field diagnosis and management of concussions is “still best done between the player and the doctor that knows him best, and that’s the team physician.” ElAttrache: “Doing that says one of two things if you put these guys on the sidelines. It either says that the experienced team physicians are not competent to make the diagnosis and to manage it on the field or that they’re conflicted and wouldn’t do it properly. I can tell you that neither one of these things is the case. I really think that this is still a diagnosis best made between the player on the field and the doctor that knows him best” (“The NFL Today,” CBS, 11/18).

FORMER PLAYERS NEED HELP: NFL Commissioner Roger Goodell spoke at the Harvard School of Public Health last week, and the AP’s Tim Dahlberg wrote Goodell’s “timing seemed odd,” with his speech “coming after a week in which three starting NFL quarterbacks were knocked out of games with concussions.” Dahlberg: “No matter, because the NFL commissioner is nothing if not a spin doctor extraordinaire.” However, Goodell’s speech “left unsaid” what to do “with the players of the past.” In addition to changing the current game, there is “something else the NFL can change.” Dahlberg: “Doing something to improve the lives of the guys who helped get the league where it is today would be a good place to start” (AP, 11/17).