Archive for the ‘News’ Category

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.

IBM Predicts Top 5 Health and Wellness Devices of the Future

July 11th, 2011 by Cheryl Miller

Imagine a future where those suffering from dementia never get lost, those prone to blood level inconsistencies always know the second their levels spike or drop, and those unable to speak are able to communicate with their doctors through their brain waves.

Sound like something out of a science fiction movie?

It just might be in our near future, if scientists continue to tap the limits of technology. A survey released by IBM reveals that consumers are ready for the next wave of health devices that will not only aid the sick but maintain wellness. More on this in this week’s Healthcare Business Weekly Update.

And that penny in your pocket could hold the secret to keeping infection at bay. More science fiction? No; according to a new study, antimicrobial copper surfaces in ICUs kill 97 percent of bacteria that can cause hospital-acquired infections. And HAIs account for 100,000 deaths and $45 billion in costs annually,
according to the CDC. The trial results must first be reviewed and approved by the EPA.

And finally, a sad reality: obesity rates, and obesity-related diseases, are up in 16 states, according to a new report from the Robert Wood Johnson Foundation. But the report also lists a number of recommendations to reverse this trend, and perhaps, in the foreseeable future, make it more fiction than fact.

A Look Back at 2010’s Top Healthcare Stories

December 29th, 2010 by Patricia Donovan

Without a doubt, the March 2010 passage of the Patient Protection and Affordable Care Act (PPACA) — a.k.a. healthcare reform — was the biggest healthcare story of the year. The effect of the November midterm elections on this legislation, its ability to withstand dozens of legal challenges and its continued rollout and implementation will be among the stories we’ll monitor for you in the year ahead.

But in this second annual “Best Of” issue of the Healthcare Business Weekly Update, we present the stories that resonated most with you, our readers. Our top story of the year was one that ran only two weeks ago: 5 Key Trends That Will Shape Healthcare. (It must have been those glucose-monitoring tattoos.) To this list I add an innovation lauded in the New York Times 10th annual Year In Ideas issue: taking your pulse by webcam.

Our other top stories covered the United States’ dismal ranking in healthcare quality as well as standout efforts to curb readmissions, improve medication adherence and employ a case manager to more closely and efficiently coordinate care.

The staff of the Healthcare Intelligence Network and the Weekly Update wish you, your colleagues and your families a healthy, peaceful and profitable 2011.

Tis the Season for Constitutional Challenges to PPACA

December 22nd, 2010 by Patricia Donovan

‘Tis the season to discuss the constitutionality of the healthcare reform bill, according to developments in Virginia and Florida last week. The bill was dealt a legal blow last Monday when a Virginia federal judge ruled unconstitutional the bill’s mandate for health insurance for all Americans beginning in 2014. Last Thursday, a federal judge in Florida began hearing arguments on the constitutionality of the same key provision, in response to a lawsuit filed on behalf of 20 states.

Meanwhile, a new Commonwealth Fund report featured in this week’s Healthcare Business Weekly Update looks ahead to 2014, detailing how more than 18 million men and women of a certain age will benefit once the Patient Protection and Affordable Care Act (PPACA) kicks in completely.

More immediately, three of the four most critical aspects of PPACA are tied to finances, according to healthcare organizations responding to our 2011 Healthcare Trends & Forecasts e-survey in October. I encourage you to download the complimentary executive summary of these survey results, which should greatly assist you in your planning for the year ahead.

Social Networks That Are Good for Your Health

August 3rd, 2010 by Patricia Donovan

Social networks are good for your health — not the Facebook, Twitter, LinkedIn kind of networks, but the live connections we forge with friends, family, neighbors and colleagues, says a new Brigham Young University study featured in this week’s Healthcare Business Weekly Update. A lack of live social bonds is tantamount to being an alcoholic or smoking 15 cigarettes a day, say the researchers.

Another area where connections are important is the hospital discharge. This issue also contains six tips for improving communication with patients during hospital discharge.

And finally, a health coach is a good person to have in your social network. Take our third annual Health Coaching survey by August 31 to find out how healthcare organizations are implementing health coaching and the financial and clinical outcomes that can result. Respondents will be e-mailed a free summary of the survey results next month.

Don’t Just Sit There, Prevent Disease

July 30th, 2010 by Jackie Lyons

Prolonged time spent sitting can increase the risk of death and certain diseases, according to a new study from the American Cancer Society. Discover in this issue how simply getting up and moving around can prevent certain diseases. Also, learn why clinicians want more details in cancer research reports and the link between breast cancer and African ancestry.

Healthcare Case Managers Carving Out Larger Role, Survey Finds

July 1st, 2010 by Melanie Matthews

A national emphasis on reducing healthcare costs and improving care efficiency is expanding the work sphere of the healthcare case manager, according to new research by the Healthcare Intelligence Network.

HIN’s December 2009 survey on healthcare case management found that more than four-fifths — 84 percent — of survey respondents are using case managers in their organizations, with many co-locating the case manager with providers and achieving ROI of up to two and three times program cost.  Results from the survey have been compiled in the 2010 Benchmarks in Healthcare Case Management: Responsibilities, Results & ROI. For information on this resource, please visit: http://store.hin.com/product.asp?itemid=3997

Jersey Shore Health Reality: 6th out of 21

February 22nd, 2010 by Melanie Matthews

Good or bad, the Jersey Shore has been getting a lot of press lately, thanks to a hugely popular reality show filmed about 10 miles south of our office. A new report issued last week offers a reality check on the health of residents at the Jersey shore and nationwide. The County Health Rankings, a collaboration of The Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, ranks the overall health of every county in all 50 states after examining its health behaviors, clinical care, social and economic factors and the physical environment.

Interactive maps allow you to drill down to each county, which is ranked within the state on how healthy people are and how long they live. The maps provide an eye-opening look at key factors that affect health, such as smoking, obesity, binge drinking, access to primary care providers, rates of high school graduation, rates of violent crime, air pollution levels, liquor store density, unemployment rates and number of children living in poverty.

Our home base of Monmouth County fares pretty well, receiving an overall rating of 6 out of 21 New Jersey counties. However, there’s room for improvement: we have the highest saturation of binge drinkers in the state (a risk factor for at least 10 adverse health conditions), offer only average access to primary care and could boost the numbers of Medicare enrollees receiving diabetic screenings.

Registry Can Fill EHR Reporting Void

January 14th, 2010 by Melanie Matthews

Advice from a multi-payor medical home pilot: get a patient registry and start using it. It’s the single tool that can help transform practices into a medical home, promote quality improvement and deliver evidence-based care, recommends Julie Schilz, IPIP and PCMH manager for the Colorado Clinical Guidelines Collaborative in a new podcast — even more effectively than current electronic medical records on the market.

Registries are collections of secondary data related to patients with a specific diagnosis, condition, or procedure. Registries range in simplicity from a collection of paper cards maintained by an individual physician to simple spreadsheets accessible by a small group of physicians to complex databases accessed online across multiple organizations.

Many of the physician practices in Colorado’s year-old medical home pilot already have EMRs but are still doing double data entry into registries in order to generate the reports they need to improve care management and delivery, says Schilz, who will provide an update on the Colorado Multi-Payor Medical Home Pilot in an upcoming webinar. The registry allows practices to better understand its population, perform outreach to patients, verify that it is practicing in conjunction with evidence-based guidelines and generate valuable reports that let them know how they’re doing, Schilz notes.

The lack of a reporting feature is a common complaint among physicians using EMRs as well as a significant barrier to meeting CMS’s proposed objectives for meaningful use of EMRs, finds a new report from KLAS Research. The report found that physicians with ambulatory EMR software say EMRs lack a number of functional areas, including reporting tools, patient access to medical records and the ability to share key clinical data. More than 17 percent of providers say reporting is difficult or impossible with their current tools, and another 24 percent report needing specific technical expertise to manipulate the tools provided, said Mark Wagner, KLAS director of ambulatory research and author of the new report.

Here’s an example of how a registry can improve care for chronic conditions. Two years ago, Apple Valley Medical Center, one of six clinics participating in Medica’s clinic-based chronic care management program, developed a registry of its patients with diabetes to allow the clinic to track them better. The registry provides staff with daily reminders on patient status so that any issues are addressed promptly. Based on the issue, the provider involved may be a nurse, nurse practitioner, physician or other provider. As a result of this approach, Apple Valley Medical Center was able to improve its community standing on this measure by 110 percent in the first year of the program. Its patients with diabetes “at goal” for optimal diabetes care, as reported to Minnesota Community Measurement, moved up 23 percentage points in one year.

According to a new national study by the Center for Studying Health System Change, only four in 10 of primary care physicians whose practices care for patients with four common chronic conditions—asthma, diabetes, congestive heart failure and depression—were in practices using registries to keep track of patients with chronic conditions.

25 EHR Meaningful Use Objectives for Eligible Providers

January 4th, 2010 by Melanie Matthews

CMS has proposed 25 objectives for eligible providers (EPs) to demonstrate meaningful use of EHRs to further the care goal of improving quality, safety, efficiency and reducing health disparities. Read the measures necessary for each objective in the full CMS proposed rule. More than $17 billion in federal funds have been set aside as incentives for meaningful use of certified EHRs.

Click here for CMS’s 23 EHR meaningful use objectives for eligible hospitals.

  1. Use computerized physician order entry (CPOE) to directly enter medical orders (for example, medications, consultations with other providers, laboratory services, imaging studies, and other auxiliary services) from a computer or mobile device.
  2. Implement drug-drug, drug-allergy, drug-formulary checks.
  3. Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED CT®.

  4. Generate and transmit permissible prescriptions electronically (eRx).
  5. Maintain active medication list.
  6. Maintain active medication allergy list.
  7. Record the following demographics: preferred language, insurance type, gender, race and ethnicity and date of birth.
  8. Record and chart changes in the following vital signs: height, weight and blood pressure and calculate and display body mass index (BMI) for ages 2 and over; plot and display growth charts for children 2 – 20 years, including BMI.
  9. Record smoking status for patients 13 years old or older.
  10. Incorporate clinical lab-test results into EHR as structured data — data that have specified data type and response categories within an electronic record or file.
  11. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research and outreach.
  12. Report ambulatory quality measures to CMS (or, for EPs seeking the Medicaid incentive payment, to individual states).
  13. Send reminders to patients per patient preference for preventive/follow-up care. Patient preference refers to the patient’s choice of delivery method between Internet-based delivery or delivery not requiring Internet access.
  14. Implement five clinical decision support rules relevant to specialty or high clinical priority, including for diagnostic test ordering, along with the ability to track compliance with those rules.
  15. Check insurance eligibility electronically from public and private payors.
  16. Submit claims electronically to public and private payors.
  17. Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists and allergies) upon request
  18. Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies)

  19. Provide clinical summaries to patients for each office visit.
  20. Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic test results) among providers of care and patient authorized entities electronically.
  21. Perform medication reconciliation at relevant encounters and each transition of care.
  22. Provide summary care record for each transition of care and referral.
  23. Capability to submit electronic data to immunization registries and actual submission where required and accepted.
  24. Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice.

  25. Protect electronic health information maintained using certified EHR technology through the implementation of appropriate technical capabilities.