Archive for the ‘Medication Management’ Category

Infographic: The Growing Industry, Effects of mHealth

April 11th, 2014 by Jackie Lyons

mHealth is currently a $1.3 billion industry that is expected to reach $20 billion by 2018, according to a new infographic from Mobile Future and Infield Health.

This infographic shows savings attributed to remote patient monitoring and medication adherence resulting from mHealth. It also assesses how mobile tools are transforming healthcare as more Americans, including healthcare providers, adopt mobile devices and wireless connectivity, and more.

Learn more about mHealth in 2013 Healthcare Benchmarks: Mobile Health, which delivers a snapshot of mHealth trends, including current and planned mHealth initiatives, types and purpose of mHealth interventions, targeted populations and health conditions, and challenges, impact and results from mHealth efforts. This 50-page resource provides selected metrics on the use of mHealth for medication adherence, health coaching and population health management programs.

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Infographic: U.S. Prescription Drug Costs

April 9th, 2014 by Jackie Lyons

American consumers pay 50 to 100 percent more for prescription drugs than any other country, with the average American paying $983 per year, according to a new infographic from Clarity Way.

This infographic outlines the cost of specific prescription drugs in comparison to other countries and the cost of drug research and development. It also identifies the benefits of access to prescription drugs, such as savings, prevention of death and hospital visits and more.

Drug Benefit Trends and Strategies: 2013 includes insight and expert analysis — from the publishers of Drug Benefit News and Specialty Pharmacy News — to help you understand what pharmacy benefit management trends are on the horizon in regards to: market share, formulary structures, PBM contracting, transparency, copays and Rx drug costs and utilization.


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Infographic: Technology Poised to Change Future of Nursing

April 4th, 2014 by Jackie Lyons

Healthcare reform is not the only change that will affect the nursing profession, evolving technology is likely to alter the future of nursing as well.

Among emerging healthcare technologies is barcode medication administration, which allows medications to be scanned before being administered. This enables nurses to check that the medication is correct, for the right patient and in the right dosage, according to a new infographic from Norwich University Online.

This infographic outlines other technologies that will change the nursing industry in years ahead, as well as how healthcare reform and education will affect the nursing profession.

Looking for other ways to increase medication adherence? You may also be interested in 2013 Healthcare Benchmarks: Improving Medication Adherence. This 56-page resource provides actionable information from more than 100 healthcare organizations on efforts to improve medication adherence and compliance in their populations.

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Infographic: Timeline of the Patient Experience

March 24th, 2014 by Jackie Lyons

From the first encounter on a benefits enrollment website to hospital discharge, the healthcare industry is looking to improve care quality and patient satisfaction.

However, 83 percent of Americans do not follow treatment plans given by their doctor as prescribed, according to a new infographic from Codebaby. This infographic chronicles the average experience of Americans, from making an appointment to follow-up treatment and everywhere in between.

Looking to enhance the patient experience and better coordinate care? You may also be interested in this webinar replay: Integrating Mobile Health Remote Patient Monitoring with Telephonic Care Management for Improved Care Coordination Results. Improving care coordination improves the overall patient experience and satisfaction. During this webinar, Gail Miller, the vice president of telephonic clinical operations in Humana's care management organization, Humana Cares/SeniorBridge, shared details of their telephonic care management program and how these remote monitoring pilots will enhance their care coordination efforts.

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3 Reasons Home Visits Critical During Care Transitions

February 20th, 2014 by Cheryl Miller

As far back as 2010, home visits were a vital component of the Durham Community Health Network (DCHN), a primary care case management program for Medicaid recipients who live in Durham County, NC, explains Jessica Simo, program manager with Durham Community Health Network (DCHN) for the Duke Division of Community Health. Conducted in three-month increments, and designed initially to better address Medicaid recipients' needs and link them to their medical homes, the face-to-face visits helped establish a level of trust between case manager and patient, eventually leading patients to better outcomes, including improving medication reconciliation.

Why are home visits so important? Number one, it is very challenging to observe problems that individual patients may have with adhering to their medication regimens if providers can’t see the medicines in the bottle in the patient’s home. You need to be available to count the medicines and ascertain definitively that they are not missing. Trying to do medication reconciliation over the phone is nowhere near as effective as being in a patient’s home.

Another reason home visits are more effective is that you can physically see what activities of daily living (ADL) or instrumental activities of daily living (IADL) deficits the patient may be experiencing in their natural environment. This is something you can’t directly observe within the confines of an exam room.

The engagement of family or other support persons is also important. Home visits are an excellent way to see somebody in their natural environment, find out who the support people are for the patient, have a comfortable discussion in their home about an individual plan of care and get the people who can assist with that on board.

For all of the previous reasons, home visits were critical to the DCHN pilot. It’s especially important in a medically complex patient population where there are frequent transitions, whether they be from the acute care setting, from any emergency department (ED) visit or back into the home from an assisted living facility.

Excerpted from 2013 Healthcare Benchmarks: Home Visits.

3 Nurse Navigator Tools to Enhance Care Management

January 29th, 2014 by Jessica Fornarotto

Where does the nurse navigator spend their day? Certainly on transitions of care. Bon Secours Health System nurse navigators use a trio of tools to identify patients' obstacles to care and connect them to needed resources, explains Robert Fortini, vice president and chief clinical officer of Bon Secours Health System.

One tool that our nurse navigators use that's built into our EMR is the hospital discharge registry from Laburnum Medical Center, one of our largest family practice sites with about nine physicians. This tool is used to identify which patients the navigators need to work with, and it's where the navigators begin and end their day. This registry provides a list of all the patients who have been discharged from one of our hospitals in the last 24 hours, and each patient is listed by the physician. The navigators have to reach out to each of these patients and make telephonic touch within 24 to 48 hours of discharge. Medication reconciliation is extremely important at this time and can be very challenging. When a patient goes into a hospital, often their medications get scrambled, and they come out confused and taking the wrong prescriptions. Nurse navigators spend a lot of time on medication reconciliation at this point.

The Navigators also conduct 'red flag' rehearsals with this tool, so that the patient knows the signs and symptoms of a worsening condition and what to do for it. We also schedule the patient with a follow-up appointment, either with a specialist who managed the individual in the hospital or with their primary care physician. We try to do it as close to the time of discharge as possible, within five to seven days, or more frequently if the risk of readmission is higher.

Second, nurse navigators also use a documentation tool to help manage the care of heart failure patients. This tool allows the navigator to stage the degree of heart failure using a hyperlink called the 'Yale tool.' The Yale tool allows us to establish what stage of heart failure the patient is in: class one, two, three, or four. Then, a set of algorithms is launched based on these stages' failure; we manage the patient according to those algorithms. For example, if a patient falls into a class four category, we might bring them in that same day, or the next day, for an appointment rather than wait five or seven days because they're at more risk. We might also make daily phone calls or network in-home health, as well as make sure that the patient has scales for weight management and an assessment of heart failure status. All of those interventions will be driven by the patient's class of heart failure.

The last tool we use is a workflow for ejection fractions. The patient's ejection fraction will define specific interventions that the navigator will follow.

Excerpted from: Profiting from Population Health Management: Applying Analytics in Accountable Care.

Infographic: The Impact of U.S. Healthcare Spending

January 24th, 2014 by Jackie Lyons

Medical bills cause more than 60 percent of bankruptcies in the United States, where healthcare is the most expensive in the world, according to an infographic from CauseWish.

This infographic also identifies reasons why individuals are uninsured, shows average prescription spending per person and hospital spending per discharge, and shows the states with the highest uninsured populations.

Statistics and Trends of Healthcare in the U.S.

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You may also be interested in this related resource: Healthcare Trends & Forecasts in 2014: Performance Expectations for the Healthcare Industry.

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Healthcare Business Week in Review: Home Visits; Patient Portals; Health Insurance Marketplaces; Hospital Pricing

January 17th, 2014 by Cheryl Miller

There is no place like home visits to address safety issues, and patient care concerns. Despite the explosion of mobile and telehealth technologies, there is no substitute for person-to-person contact — at least when it comes to populations at high risk of hospital admission or readmission, the results of the Healthcare Intelligence Network’s inaugural Home Visits study indicate. Three-fourths of healthcare organizations visit some percentage of their patients or health plan members in their homes in order to keep patients safer and healthier and to keep readmissions and costly utilizers at bay.

But there is a time and place for telehealth technology, and new research in the journal Medical Care shows that diabetics who used an online patient portal to refill medications and schedule their appointments, among other tasks, increased their medication adherence and improved their cholesterol levels by 6 percent, compared to occasional users or non-users. Researchers say the current study provides new evidence that patient portals may help patients adhere to their medications and achieve improved health outcomes.

About one-quarter of Americans potentially eligible for health coverage visited insurance marketplaces by December, up from 17 percent in October, according to a new Commonwealth Fund survey. Forty percent of these visitors were young adults; three-quarters said they were in good health; and more than half said they are likely to try to enroll by the March 2014 deadline. The survey, conducted between December 11 and 29, 2013, is the second in a series aimed at tracking Americans’ experiences with the marketplaces in the ACA’s first open enrollment period. The first Commonwealth Fund survey, conducted in October, found that 17 percent of people potentially eligible for coverage had visited the marketplaces during the first month.

Despite increasing scrutiny on hospital pricing practices, some U.S. hospitals are charging more than 10 times their cost, or nearly $1200 for every $100 of their total costs, according to new data released by National Nurses United (NNU) and the Institute for Health and Socio-Economic Policy (IHSP).

The 100 most expensive hospitals listed charge 765 percent and higher, more than double the national average of 331 percent, the report says. Fourteen U.S. hospitals charge more than $1,000 for every $100 of their total costs (a charge to cost ratio of 1,000 percent) topped by Meadowlands Hospital Medical Center in Secaucus, NJ, which has a charge-to-cost ratio of 1,192 percent. California, with a statewide average of 451 percent charge to cost ratio, ranks third overall in the United States. The detailed report includes the most expensive hospitals, the top 10 for each state, and the 50 most expensive hospital systems.

Discussions about end-of-life care for adults are never easy; they are even more difficult when they concern children. The National Institute of Nursing Research (NINR) has launched a new campaign, Palliative Care: Conversations Matter, that is designed to help children and families navigate a serious illness, and better inform them of supportive resources. A component of the National Institutes of Health (NIH), it brings together parents and palliative care clinicians, scientists, and professionals, who give their input and expertise on what they feel is needed in the field. Don’t miss the video which tells one mother’s story about her daughter’s bout with neuroblastoma and how palliative care helped them through it.

You can share your organization’s work in palliative care in our current e-survey: 10 Questions on Palliative Care. With more organizations focusing on palliative care as a means to enhance the patient experience during advanced or terminal illness, many are strategizing new ways to assess and address patients’ needs at this time, from consultations in the ED to face-to-face evaluations in outpatient clinics. Describe your organization's efforts in palliative care by February 7, 2014 and you will receive a free summary of survey results once it is compiled.

Our congratulations to one of our survey participants, Timothy Price, a market research analyst with Caresource, who was randomly selected as the winner of our training DVD from our 10th annual Healthcare Trends & Forecasts webinar.

5 Pillars of Stanford Coordinated Care Home Visits

December 31st, 2013 by Patricia Donovan

Connecting its high-risk patients to essential community resources is the fifth pillar of Stanford Coordinated Care's post-discharge home visits program.

This community connection for complex patients rounds out the four elements of the CTI that take place during each home visit: medication reconciliation, red flag education, follow-up physician visits, and a personal health record (PHR).

"We think it’s important to get the patient hooked into whatever resources in the community can also help them to have good outcomes and not have to go back into the hospital," explained Samantha Valcourt, clinical nurse specialist with Stanford Coordinated Care, during a recent webinar on Home Visits: Assessing Complex Patients Post-Discharge to Reduce Readmissions.

These local resources might include recruiting the patient's church group to visit or assist with meals preparation, she said.

Stanford visits their just-discharged complex patients in the home environment because it offers a close look at the individual's mobility, safety, nutrition status and support system. Of the five-point program, medication reconciliation is the most important task performed during the home visit, Ms. Valcourt noted.

Medication management problems immediately following the hospital discharge are a key factor driving hospital readmissions among high-risk Medicare beneficiaries, she said.

Just as it modified the CTI to suit its population, Stanford has added three questions to the HARMS-8 readmissions risk assessment tool developed by Care Oregon to identify patients who would benefit from a home visit. The post-discharge visits, which last about an hour on average, are conducted by Ms. Valcourt, an advanced practice nurse. Her preparation for the home visit begins when the patient is still in the hospital, she explains.

"About 20-25 percent of my time is spent on the pre-work and post-work around home visits, such as seeing the patient in the hospital, reviewing hospital notes and the discharge summary, coordinating with the PCP and care coordinator, and making follow-up phone calls."

Among the process and outcome measures Stanford uses to evaluate the effectiveness of the home visits, which are separate from traditional home care, is the Patient Activation Measure®, which identifies a patient's level of engagement in their own care.

Although program results are anecdotal at the one-year point, Stanford hopes the home visits will not only reduce rehospitalizations in the approximately 200 high-risk patients it serves, but also reduce lengths of stay, empower patients to partner in their care, improve patient satisfaction and bridge the hospitalist-primary care provider gap, Ms. Valcourt noted.

Ms. Valcourt provides more details on Stanford Coordinated Care's home visits program in this interview.

Healthcare Business Week in Review: Oncology PCMH; Medication Management; Seniors on FB

November 29th, 2013 by Cheryl Miller

As families gathered this week to celebrate Thanksgivikkuh, (which won't happen again for 77,000 years!) we offered several stories that demonstrate the strength of partnerships.

To begin, a first-of-its-kind patient-centered medical home (PCMH) model for oncology from Aetna and Consultants in Medical Oncology and Hematology, PC (CMOH).

The collaboration combines evidence-based decision support in cancer care with enhanced personalized services and realigned payment structure and is designed to increase treatment coordination and improve quality outcomes and costs for cancer patients. Researchers found that more than half of all new cancer patients are 65 or older, and most have one or more health conditions in addition to cancer. Given their frequency of contact with patients, oncologists are well positioned to help their patients coordinate care for multiple conditions.

Physician-led, team-based models of care are the future of healthcare, according to the AMA, which has issued a set of recommendations for implementing these models, including a report for the development of payment mechanisms that promote satisfaction and sustainability of team-based models in various practice settings. Among the recommendations: establishing payment distribution models that foster physician-led team based care, and reimbursing those physicians who lead these teams accordingly.

High-risk heart failure patients receiving nursing interventions were four times as likely to take their medication, but their hospital readmission rates were not impacted, according to a new study at Duke Medicine.

Patients who were tutored about managing their symptoms, taking their pills on schedule, and developing an action plan for addressing their symptoms were more likely to take their prescribed medications. They were encouraged to use doctors’ offices and clinics rather than the emergency department.

But when the researchers looked at the hospital readmission rate, they found that readmissions were not significantly different between the two groups. Medication management is just one of many issues facing patients most at risk for their conditions to worsen, researchers found, and redesigning care to confront the issues that are keeping the vulnerable from regaining their health has to be addressed.

Developing a communication hub, virtually and in person, is critical to a successful care coordination plan for dual eligibles, says Timothy C. Schwab, MD, FACP, former chief medical officer of SCAN Health Plan. It ensures that all members of the immediate and long-term support team are in sync with each other.

Seniors want to stay connected. According to a new Accenture survey, more than half of seniors 65 years and older are seeking digital options for managing their health services remotely. In fact, researchers found that at least three-fourths of Medicare recipients access the Internet at least once a day for e-mail (91 percent) or to conduct online searches (73 percent) and a third access social media sites, such as Facebook, at least once a week.

And lastly, a way for you to communicate with us: participate in our fourth comprehensive online survey, Reducing Hospital Readmissions Benchmark Survey, and we will send you a free e-summary of the results once they are compiled.