Archive for the ‘Health IT’ Category

Four Transitions for Back-To-School

September 12th, 2011 by Cheryl Miller

It’s back to school time, and the healthcare industry is undergoing its fair share of transitions.

  • NCQA is launching a new accreditation program for ACOs this fall. The organization worked with consumer advocates, purchasers and other healthcare and managed care experts to develop seven standards by which it will evaluate ACOs. Early bird adopters of the accreditation effort can get reduced rates on survey fees, online education tools and promotion. Order the NCQA ACO standards.
  • The one-year report card on Cigna’s ACO approach with Medical Clinic of North Texas (MCNT) is in; and both healthcare systems are reporting excellent grades in four key areas: reducing avoidable emergency room visits, following evidence-based medicine, lowering medical costs and better controlling diabetes. Since the accountable care program began, MCNT has received the highest level of recognition from NCQA for meeting national quality standards for physician group medical homes. Cigna helped by sharing patient-specific data that identifies individuals who could benefit most from additional outreach and follow-up care.
  • Medical students, rather than teachers, are getting apples this year: Apple iPads. Many universities, including Yale Medical School, profiled here, are downloading curriculum onto the tablets in an effort to be more “green,” save money, and protect patient confidentiality. Computer security has been a particular concern for the Yale School of Medicine, and the iPad is compliant with security and privacy laws and does not carry the same risk of information loss that a laptop might, Yale officials say.
  • And finally, a lesson that can’t be taught enough: smoking just a few cigarettes can kill. A new report from the CDC shows that smokers are smoking less: the percent of daily smokers who smoke nine or fewer cigarettes per day rose to nearly 22 percent in 2010, up from an estimated 16 percent in 2005. But smokers need not be heavy or long-term smokers to be affected with a smoking-related disease, or suffer a heart attack or asthma attack, CDC officials say. And states with the toughest anti-smoking campaigns, like like Maine, New York and Washington, have the fewest smokers. Which just goes to show that even the most resistant students can be taught to change their ways.
  • mHealth: There’s a Grant for That

    August 5th, 2011 by Cheryl Miller

    By 2015 more than 500 million smartphone users worldwide will be using healthcare applications, research studies show. So it’s not surprising the FDA is taking a closer look at some of these apps, specifically, those whose misuse could endanger its users.

    These “medical mobile apps,” as the FDA is calling them, are specific to medicine or healthcare and are designed for use on smartphones and other mobile computing devices and will offer everything from blood sugar monitoring to ECG machines.

    As we reported in a previous HBWU issue about IBM, the benefits of these health and medical apps are immeasurable, not just here, but in underserved, frequently rural communities around the globe, especially where patients have no access to doctors, these devices can save lives.

    And they can save billions of dollars as well. According to studies from Juniper Research using mobile health, or mHealth, technologies for health monitoring could save from $1.96 billion to $5.83 billion in healthcare costs by the year 2014. So the Center for Technology and Aging (CTA) (techandaging.org), with funding from The SCAN Foundation, has awarded nearly $500,000 in one-year grants to five organizations that will demonstrate the best ways to implement mHealth technologies for older, chronically ill adults, ironically, the population least likely to own a smartphone. The grants will help the CTA to meet its four areas of opportunity that it feels can best transform lives: medication optimization, remote patient monitoring, care transitions, and mobile health. And in a recently published paper the agency discusses how

    cell phones, smart phones, laptop and tablet computers, and other mobile enabled devices are being used to help millions of older Americans as well as their physicians and caregivers manage chronic disease, use their medications properly, avoid safety risks (e.g. fall detection), access online health information, and stay well.

    With the exploding growth of mHealth technology it seems that smartphones will eventually be used for everything but plain old talking. Hopefully the dialogue between a patient and physician won’t be relegated to a tiny FaceTime screen on an IPhone.

    No Place Like a Medical Home for Patients with Diabetes

    July 18th, 2011 by Jackie Lyons

    Two recent studies focused on diabetes patients reveal that the saying “There’s no place like home” may be true — in this case, it’s a patient-centered medical home (PCMH).

    The PCMH model of care has always focused on improving care quality and reducing costs for the chronically ill. Now, the PCMH has been found to increase the percentage of diabetes patients who achieve goals that reduce their sickness and death rates, according to health researchers.

    A report from the eHealth Initiative found that using electronic health records (EHRs) in medical homes to coordinate care resulted in numerous process improvements for patients with Type 2 diabetes and heart disease in a medical home.

    The initiative reported improvements in provider-patient communications, intra-office coordination, EHR use, care planning, patient coaching, specialist referrals and several other areas. The care plan enabled by the EHR allowed researchers to streamline the care process for the patients and more efficiently track their progres:

    At one site, six separate cardiology referral forms were used before the project began. Following the intervention a single form was developed and formatted within the EHR, said Victor Villagra, MD, president of Health and Technology Vector.

    In a second study, Pennsylvania researchers say the key of the PCMH is to make physicians not only look at individuals, but at their patient population in general.

    In PCMH, medical practices learn to work together as a team, coordinating care centered on the patients’ needs. The researchers report a significant improvement in adherence to evidenced-based care guidelines and in clinical outcomes. In one year, the number of patients with better LDL levels, better blood pressure and or lower A1c levels increased. The number of patients receiving yearly foot exams, eye exams and pneumonia and influenza vaccines also increased, according to a Penn State College of Medicine press release.

    Pennsylvania leads the nation in implementing the PCMH, based on the chronic-care model (CCM) of care, which promises to improve health and reduce costs of care. This type of care attempts to move from a reactive approach to a focus on long-term problems in healthcare delivery.

    One Third of Medical Homes Will Join an ACO

    July 18th, 2011 by Cheryl Miller

    New market research shows that one third of medical homes will join an ACO in the next 12 months. And more than half of those interviewed by the Healthcare Intelligence Network for our fifth annual survey on patient-centered medical homes said they had already established a medical home for their population. The PCMH is a favored model of integrated care delivery and a cornerstone of accountable care — two core elements of healthcare reform. More in this issue.

    About $216 million nationally is spent each year managing drug
    shortages in the hospital setting, with three drugs in particular
    affecting over 80 percent of health systems, says a new study
    released by the American Society of Health-System Pharmacists
    (ASHP). The problem is not only increasing hospital costs but
    harming patient care: nearly a third of the 353 pharmacy directors
    surveyed said they had to pull clinical staff to manage the crisis.

    More than $300 billion each year is spent on care for dual-eligibles,
    the 9 million Americans currently receiving both Medicare and
    Medicaid benefits. HHS hopes to lower these costs — and improve
    care — with three new initiatives: financial models to better align
    finances between the agencies; a quality care program for nursing
    home residents, and a resource center program.

    Telemedicine continues to serve the underserved. A new remote
    monitoring pilot project from the University of Utah seeks to help the
    chronically ill who are unable to reach traditional care facilities easily
    on a regular basis. The project will feature a centralized care
    coordinator, four clinics monitoring 15 to 20 patients each and two
    locations using kiosks to monitor another 30 patients each. Read more in this week’s Healthcare Business Weekly Update.

    8 Ways EHRs Can Enhance Care Coordination for the Chronically Ill

    June 27th, 2011 by Cheryl Miller

    Care planning, provider-patient communications and intra-office coordination are just some of the ways that EHRs can significantly improve care coordination for the chronically ill in a medical home, finds a new report from the eHealth Initiative. The report based its results on a 12-month project that tracked 119 patients with Type 2 diabetes and heart disease at two test sites. Notably, the EHR systems used at both sites had functions to support care coordination that were not utilized. This week’s Healthcare Business Weekly Update issue provides the details.

    Also this week, we report on consumers worldwide who are tightening their belts in response to the current tenous economic climate, according to a new Deloitte Center for Health Solutions’ survey of more than 15,000 global healthcare consumers in 12 countries. In the United States alone, more than a third said they were using generic instead of brand name drugs to save money; one fourth of those surveyed in the United States admitted to skipping doctors’ visits entirely.

    Eliminating claims payment errors could help to defray some portion of healthcare costs, says the AMA. According to the association’s fourth annual National Health Insurer Report Card, commercial health insurers have an average claims-processing error rate of nearly 20 percent, an increase of two percent from last year. AMA estimates that eliminating health insurer claims payment errors would save $17 billion annually.

    And finally, a significant segment of the healthcare industry is reframing its care delivery structure as an accountable care organization (ACO) or will do so in the near future. You can find out more in our new video, 2011 Benchmarks in Accountable Care Organizations: Healthcare ACO Readiness Assessment:

    Sensei mHealth App Coaches Diabetics Virtually

    June 10th, 2011 by Cheryl Miller

    Forget Angry Birds. There’s a new app on the market, and it’s promising to be a lot better for your health.

    Sensei, Inc., a technology company that designs mobile health, or mHealth solutions, has been awarded a National Institute of Health (NIH) grant for diabetes and prediabetes research in association with the University of Miami, the Miami VA healthcare System, and the Health Foundation of South Florida. Together, they will trial Sensei’s new mobile application for diabetes and prediabetes users.

    The application encourages simple lifestyle changes through personalized expert guidance. Users’ mobile devices are transformed into virtual health coaches that personally guide them to better health through healthier nutrition, fitness, weight loss and tips on self management.

    Research shows that modest lifestyle changes, including losing weight and increasing activity, can improve or delay the onset of diabetes in almost 50 percent of cases, according to the Diabetes Prevention Program. Participants in this trial will be prompted to measure key biometric data, eat healthier, and learn and practice appropriate self management of diabetes, hypertension and hyperlipidemia. There will be daily health coach alerts that teach and create calls to action supplemented by a daily agenda and reference information around the different conditions and wellness.

    Mobile Health, or mHealth, the utilization of mobile devices to improve health outcomes, is emerging as an important technology not only for developed countries but for developing countries as well. According to a survey conducted by the World Health Organization (WHO), more than 80 percent of countries across the globe are using mobile phone technology in different ways to improve their health services. In fact, only 19 of the 114 studied countries have no mobile health initiative, although many of the initiatives in place are at the pilot stage. The most popular mHealth programs globally are mobile technology call centers, emergency services management, including toll-free telephone services, telemedicine services like text messaging with pill reminders and health information and transmission of tests and lab results, and managing emergencies and disasters. The survey goes on to state that many of these countries’ citizens have no other means of access to health care.

    If this technology can be so beneficial for some of the poorest countries in the world, it isn’t hard to see how beneficial it can be for some of the richest countries in the world. And if users, like the diabetes and prediabetes patients being trialed with Sensei’s app, devote only a fraction of the time, passion and commitment to these kinds of health apps that others do to apps like Angry Birds, then they are sure to be an important resource for healthcare.

    Patient Satisfaction: What’s It Worth to Your Organization?

    May 23rd, 2011 by Patricia Donovan

    There’s a lot of heated debate about whether patient satisfaction ratings should figure into healthcare quality and reimbursement models. The fact is, CMS already posts patient satisfaction ratings in 10 key areas on its Hospital Compare site. It’s only a matter of time before the Physician Compare site follows suit.

    We’ve just launched a new survey on Improving Patient Experience and Satisfaction. Please tell us how your organization is working to improve patients’ and members’ experience and satisfaction with their care by June 20. We’ll e-mail you a free summary of survey results once it is compiled in mid-July. We’ll be sharing some of the most impressive strategies in future blog posts and publications.

    In the meantime, we’ve heard about a hospital that claims to be the first in the nation to solicit and publish patient reviews. Hill Country Memorial in central Texas integrates online rating and review tools into its Web site. Patients can rate the Patient Experience, Quality of Care, or any of a number of hospital departments. The published reviews capture the good, the bad and the ugly…and Mark Peterson, the hospital’s director of customer experience, responds to many of them.

    In an April 2011 post on patient satisfaction, a blogger for Better In Emergency Medicine describes how he has come to view that there is value in pursuing a goal of more satisfied patients:

    Needless to say, as I mature in my practice, I have come to realize that there is a lot of truth to the statement, “They don’t care how much you know until they know how much you care.” With that in mind, I want to share some key points from a nice review of customer satisfaction that I stumbled upon from the Emergency Medicine Clinics of North America.

    So why pursue a goal of having more satisfied patients?

    There are multiple demonstrating benefits from hospitals which perform better:

    • Staff morale improves (Turnover decreases, work is more enjoyable)

    • Malpractice risk decreases (Happy patients sue less frequently)
    • Patients respond better to treatment (Patients follow instructions when they believe that they received good care)
    • Hospital finances improve (Patients recommend the facility and will come back)

    We came across this brief video from HcPro on improving patient satisfaction. While geared to hospitals, the six tips contained herein can be adapted for physician practices as well as health plans.

    To Engage Patients, Meet Them Where They Are — On The Internet

    May 9th, 2011 by Patricia Donovan

    Online interaction with patients will engage them in health management, setting up healthcare providers for success in patient-centered models such as the medical home and ACOs. That’s one of 10 tips for patient engagement in a new Institute for Health Technology Transformation report profiled in this week’s Healthcare Business Weekly Update.

    Health IT also links patients in rural areas to health services they might not otherwise be able to access. CMS’s new telemedicine rule, another featured story this week, simplifies the credentialing and privileging processes among providers to enhance access to telemedicine by remote patients.

    Didn’t have a chance to read the results from our 2011 Telehealth and Telemedicine survey? Download the executive summary here.

    Use of Expensive Prostate Cancer Treatments Among Medicare Patients

    March 28th, 2011 by Jessica Papay

    This week’s issue of the DM Update looks at newer, expensive cancer treatments being adopted by Medicare patients, along with the effect of stem cell treatment on MS patients.

    Also this week, learn which online behavior was ignited by the 2009 cigarette excise taxes.

    Near Consensus on HIT Benefits, But ‘Meaningful Use’ Elusive

    March 14th, 2011 by Melanie Matthews

    The gap is closing between early adopters of health IT and other organizations, particularly smaller medical practices, in benefits achieved from HIT. An ONC review of articles published on HIT benefits shows increased evidence of improved quality and efficiency of care and better access to care for leader and non-leader organizations alike.

    Driven by incentives for HIT adoption, the number of healthcare organizations, including smaller practices, using HIT is increasing. However, concerns exist about the financial investment and clinician support necessary to achieve meaningful use of the technology, according to a new study by Beacon Partners. In this week’s Healthcare Business Weekly Update, read more about these challenges as well as concerns among healthcare industry professionals about the perception of health reform legislation changes.