Patients overall in the United States are very satisfied with their physicians and with treatment they receive in outpatient settings, according to new information which challenges common public perceptions about outpatient medical treatment.
"Particularly surprising is that even a lot of patients who reported average encounters with physicians, such as average national wait times and average physician encounter time, seem to be giving full marks to their physician in terms of visit satisfaction," said Rajesh Balkrishnan, lead study author and associate professor in the University of Michigan School of Public Health and College of Pharmacy.
The study analyzed data from an online survey tool*, where 14,984 patients ranked visits from 2004-2010 on a 10-point scale, with 10 being the highest. The study included only physicians with 10 or more ratings, and patients could rate a particular doctor only once every three months, to prevent skewed scores.
For the full article please go here.
Monday, November 28, 2011
Risky release Uninsured patients discharged earlier from Nurse.com
Patients without insurance have significantly shorter hospital stays than patients with insurance, raising concerns that hospitals may have incentive to release these patients earlier to reduce their own costs of uncompensated care, according to a study.
Researchers analyzed nationally representative data on a weighted sample of more than 90 million hospitalizations between 2003 and 2007 of patients ages 18 to 64. They found that across all hospital types (for-profit, nonprofit and government), the average length of stay for preventable hospitalizations — those thought to be avoidable with the use of appropriate preventive care and disease management — was significantly shorter for individuals without insurance (2.77 days) than for those with either private insurance (2.89 days) or Medicaid (3.19 days).
For patients hospitalized for other diagnoses, the average length of stay was also shorter for uninsured patients (2.74 days) than for those with private insurance (2.86) or Medicaid (3.13).
For the full article please go here.
Researchers analyzed nationally representative data on a weighted sample of more than 90 million hospitalizations between 2003 and 2007 of patients ages 18 to 64. They found that across all hospital types (for-profit, nonprofit and government), the average length of stay for preventable hospitalizations — those thought to be avoidable with the use of appropriate preventive care and disease management — was significantly shorter for individuals without insurance (2.77 days) than for those with either private insurance (2.89 days) or Medicaid (3.19 days).
For patients hospitalized for other diagnoses, the average length of stay was also shorter for uninsured patients (2.74 days) than for those with private insurance (2.86) or Medicaid (3.13).
For the full article please go here.
Wednesday, November 23, 2011
Are electronic health records becoming common place in healthcare? From HealthIT.com
Electronic health records will become the norm, sooner than later, experts said at a summit hosted Friday by the Office of the National Coordinator for Health IT (ONC).
The bottom line, said many of the speakers at ONC's Grantee and Stakeholder Summit, is that consumers are demanding EHRs. The government is helping with adoption, but this is not nearly as influential as the healthcare consumer's pressure on providers.
National Coordinator for Health IT Farzad Mostashari, MD, said the patient is not just "a ticket holder crammed into economy."
"The patient is the copilot" with his or her healthcare provider, Mostashari said. "Increasingly, we'll hear patients, consumers, people expecting more out of their interactions with others. So we're going to see all of the pieces come together for this."
For the full article please go here.
The bottom line, said many of the speakers at ONC's Grantee and Stakeholder Summit, is that consumers are demanding EHRs. The government is helping with adoption, but this is not nearly as influential as the healthcare consumer's pressure on providers.
National Coordinator for Health IT Farzad Mostashari, MD, said the patient is not just "a ticket holder crammed into economy."
"The patient is the copilot" with his or her healthcare provider, Mostashari said. "Increasingly, we'll hear patients, consumers, people expecting more out of their interactions with others. So we're going to see all of the pieces come together for this."
For the full article please go here.
Tuesday, November 22, 2011
Report: ICD-10 presents challenges, opportunities for CMS from HealthCare IT
WASHINGTON – The Centers for Medicare and Medicaid Services has its work cut out in transitioning to ICD-10. As the largest payer and the force driving the new code sets in the United States, CMS has a task at least as intimidating as anyone else when it comes to implementation.
“Given the extent to which the code set is built into many business and operating processes and systems, the size of CMS operations, and the complexity of its systems,” the challenges CMS faces are indeed formidable, according to a report published last week from the National Research Council, which CMS assigned to help it better understand how to modernize CMS’ own IT.
For the full article please go here.
“Given the extent to which the code set is built into many business and operating processes and systems, the size of CMS operations, and the complexity of its systems,” the challenges CMS faces are indeed formidable, according to a report published last week from the National Research Council, which CMS assigned to help it better understand how to modernize CMS’ own IT.
For the full article please go here.
Friday, November 18, 2011
6 golden rules of EMR implementation from Health Care IT News
A few months ago, we chronicled the 7 most deadly sins of EMR implementation. From ignoring nurses to declining help, these offenses can be hard to make right.
But, in an effort to help big and small practices alike avoid the most common EMR faux pas, we followed up with Rosemarie Nelson, principal of the MGMA Consulting Group, and asked for her opinion on the best practices for implementing an EMR system.
Here are Nelson’s six golden rules of EMR implementation:
For the full article please go here.
But, in an effort to help big and small practices alike avoid the most common EMR faux pas, we followed up with Rosemarie Nelson, principal of the MGMA Consulting Group, and asked for her opinion on the best practices for implementing an EMR system.
Here are Nelson’s six golden rules of EMR implementation:
For the full article please go here.
Thursday, November 17, 2011
The “3-Day DRG Payment Window”
11/15/2011
The “3-Day DRG Payment Window”
Legal News Alert: Health Care
On November 1, 2011, the Centers for Medicare and Medicaid Services (CMS) issued the final rule for the 2012 Physician Fee Schedule, to be published in the Federal Register on November 28, 2011. One of the anticipated sections of the Physician Fee Schedule Final Rule was a clarification of the application of the 3-Day DRG Payment Window for pre-admission non-diagnostic services. The 3-Day Window was long interpreted as applying to diagnostic services furnished in a hospital's provider-based departments or entities. This 3-Day Window required the bundling of all pre-admission diagnostic services furnished within three days of an inpatient admission in the inpatient claim. Medicare also required the bundling of pre-admission non-diagnostic services furnished within three days before the inpatient admission only if there was an exact match of the principal ICD-9 CM diagnosis code for the outpatient encounter and the inpatient admission.
access full article
The “3-Day DRG Payment Window”
Legal News Alert: Health Care
On November 1, 2011, the Centers for Medicare and Medicaid Services (CMS) issued the final rule for the 2012 Physician Fee Schedule, to be published in the Federal Register on November 28, 2011. One of the anticipated sections of the Physician Fee Schedule Final Rule was a clarification of the application of the 3-Day DRG Payment Window for pre-admission non-diagnostic services. The 3-Day Window was long interpreted as applying to diagnostic services furnished in a hospital's provider-based departments or entities. This 3-Day Window required the bundling of all pre-admission diagnostic services furnished within three days of an inpatient admission in the inpatient claim. Medicare also required the bundling of pre-admission non-diagnostic services furnished within three days before the inpatient admission only if there was an exact match of the principal ICD-9 CM diagnosis code for the outpatient encounter and the inpatient admission.
access full article
Nurses At the Forefront of Change
As the nation continues its historic effort to overhaul health care under the 2010 Patient Protection and Affordable Care Act, nurses have been working quietly for the last decade to implement their own brand of reform. Nurses have been redefining and expanding their roles, championing quality of care improvements, spearheading research innovation, advocating for patient rights, and challenging the status quo..
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access article
Mystery disease diagnosed at clinic of last resort from MSNBC
Thanks to the medical detectives at the nation’s first mystery disease clinic, Louise Benge now knows why her legs feel like they’ve turned to stone.
The 57-year-old Kentucky woman finally has an explanation for the strange disorder that began crippling her — and her four siblings — nearly three decades ago, making it hard to walk, first a few blocks, then any distance at all.
“Oh, goodness, it’s very hurtful,” said Benge, a retired food stamp clerk from Brodhead, Ky. “Our calves and legs just get as hard as rocks. Sometimes, I just have to stop, period.”
There’s still no treatment or cure for the problem, which also causes severe pain in her hands, Benge acknowledges. But at least there’s a name for the first completely new ailment discovered through the fledgling Undiagnosed Diseases Program begun in 2008 by the National Institutes of Health.
It’s ACDC, or arterial calcification due to deficiency of the protein CD73. Through extensive testing, scientists discovered a genetic glitch that allows bone-like calcium deposits to build up in the blood vessels of victims’ hands and lower limbs. They published their findings earlier this year in the New England Journal of Medicine.
For the full article please go here.
The 57-year-old Kentucky woman finally has an explanation for the strange disorder that began crippling her — and her four siblings — nearly three decades ago, making it hard to walk, first a few blocks, then any distance at all.
“Oh, goodness, it’s very hurtful,” said Benge, a retired food stamp clerk from Brodhead, Ky. “Our calves and legs just get as hard as rocks. Sometimes, I just have to stop, period.”
There’s still no treatment or cure for the problem, which also causes severe pain in her hands, Benge acknowledges. But at least there’s a name for the first completely new ailment discovered through the fledgling Undiagnosed Diseases Program begun in 2008 by the National Institutes of Health.
It’s ACDC, or arterial calcification due to deficiency of the protein CD73. Through extensive testing, scientists discovered a genetic glitch that allows bone-like calcium deposits to build up in the blood vessels of victims’ hands and lower limbs. They published their findings earlier this year in the New England Journal of Medicine.
For the full article please go here.
Wednesday, November 16, 2011
Medical Malpractice reform losing doctor support? from Medicaljustice.com
Michael Kirsch, M.D. – author, MD Whistleblower
With regard to physicians’ support for medical malpractice reform, the times they are a changin’. These iconic words of Bob Dylan, who has now reached the 8th decade of life, apply to the medical liability crisis that traditionally has been a unifying issue for physicians.
The New York Times reported that physicians in Maine are going soft on this issue, but I suspect this conversion is not limited to the Pine Tree State. Heretofore, it was assumed that physicians as a group loathed the medical malpractice system and demanded tort reform. The system, we argued, was unfair, arbitrary, and expensive. It missed most cases of true medical negligence. It lit the fuse that exploded the practice of defensive medicine. Rising premiums drove good doctors out of town or out of practice.
What happened? The medical malpractice system is as unfair as ever. Tort reform proposals are still regarded as experimental by the reigning Democrats in congress and in the White House. The reason that this issue has slipped in priority for physicians is because our jobs have changed. Private practice is drying up across the country for the same reasons that family owned hardware and appliance stores are vanishing. Look what has happened to independent bookstores? If you want to find one in your neighborhood, you may need to hire a private investigator. Private physician offices are being squeezed out by surrounding medical institutions that, using Ross Perot’s famous phrase uttered in the 1992 presidential campaign, have created a ‘giant sucking sound’ as it vacuums up patients from private doctors’ waiting rooms.
For the full article please go here.
With regard to physicians’ support for medical malpractice reform, the times they are a changin’. These iconic words of Bob Dylan, who has now reached the 8th decade of life, apply to the medical liability crisis that traditionally has been a unifying issue for physicians.
The New York Times reported that physicians in Maine are going soft on this issue, but I suspect this conversion is not limited to the Pine Tree State. Heretofore, it was assumed that physicians as a group loathed the medical malpractice system and demanded tort reform. The system, we argued, was unfair, arbitrary, and expensive. It missed most cases of true medical negligence. It lit the fuse that exploded the practice of defensive medicine. Rising premiums drove good doctors out of town or out of practice.
What happened? The medical malpractice system is as unfair as ever. Tort reform proposals are still regarded as experimental by the reigning Democrats in congress and in the White House. The reason that this issue has slipped in priority for physicians is because our jobs have changed. Private practice is drying up across the country for the same reasons that family owned hardware and appliance stores are vanishing. Look what has happened to independent bookstores? If you want to find one in your neighborhood, you may need to hire a private investigator. Private physician offices are being squeezed out by surrounding medical institutions that, using Ross Perot’s famous phrase uttered in the 1992 presidential campaign, have created a ‘giant sucking sound’ as it vacuums up patients from private doctors’ waiting rooms.
For the full article please go here.
Monday, November 14, 2011
ESRI names top 10 healthcare tech dangers from HealthcareIT
November 14, 2011 | Bernie Monegain, Editor
PLYMOUTH MEETING, PA – Hazards from clinical alarms top the list of 10 technology hazards for 2012, according to the ECRI Institute, an independent nonprofit that researches the best approaches to improving patient care.
Now in its fifth year of publication, ECRI Institute bills its annual Top 10 hazard list as a comprehensive report designed to raise awareness of the potential dangers associated with the use of medical devices and systems. Most significantly, the report includes action-oriented recommendations on addressing these risks.
The top 10 hazards on ECRI Institute’s 2012 list are:
For the full article please go here.
PLYMOUTH MEETING, PA – Hazards from clinical alarms top the list of 10 technology hazards for 2012, according to the ECRI Institute, an independent nonprofit that researches the best approaches to improving patient care.
Now in its fifth year of publication, ECRI Institute bills its annual Top 10 hazard list as a comprehensive report designed to raise awareness of the potential dangers associated with the use of medical devices and systems. Most significantly, the report includes action-oriented recommendations on addressing these risks.
The top 10 hazards on ECRI Institute’s 2012 list are:
For the full article please go here.
Friday, November 11, 2011
Making Sure Discharged Patients Stay That Way from H and HN
By Bill Santamour November 08, 2011
Nurses closely monitor medication use, reduce readmissions.
Marcy left the hospital with a lot of paper work, a container of pills and an appointment to see her physician the following month. The instructions were thorough and the discharge staff were patient and pleasant. But Marcy was still a little weak from the infection that had landed her in the hospital in the first place, and flustered by the whole experience. And, she had to admit, these days she got confused more easily than she had in the previous 83 years of her life; neither her memory nor her sight were what they used to be.
A few days later, Marcy mistakenly thought she had forgotten to take her morning medication and swallowed a day's worth all at once. The overdose nearly killed her, and she landed back in the hospital.
Her experience is not unusual, but with the renewed emphasis on improving quality of care and reducing readmissions, it has to become a lot more rare.
For the full article please go here.
Nurses closely monitor medication use, reduce readmissions.
Marcy left the hospital with a lot of paper work, a container of pills and an appointment to see her physician the following month. The instructions were thorough and the discharge staff were patient and pleasant. But Marcy was still a little weak from the infection that had landed her in the hospital in the first place, and flustered by the whole experience. And, she had to admit, these days she got confused more easily than she had in the previous 83 years of her life; neither her memory nor her sight were what they used to be.
A few days later, Marcy mistakenly thought she had forgotten to take her morning medication and swallowed a day's worth all at once. The overdose nearly killed her, and she landed back in the hospital.
Her experience is not unusual, but with the renewed emphasis on improving quality of care and reducing readmissions, it has to become a lot more rare.
For the full article please go here.
Wednesday, November 9, 2011
10 IT challenges for physician practices in 2012 from HealthIT
By now, we know physician practices have slightly different rules when it comes to their IT, and just as their technology is different, so are the challenges they’ll face in the upcoming year.
Whether it’s meaningful use or simply finding the right personnel, 2012 promises to be chock-full of tricky IT issues for physician practices. Bob Dean, vice president of technology at ChartLogic, gives us the top 10 challenges for physician practices in the new year.
1. Choosing the right technology. According to Dean, physicians will face a significantly increased number of data reporting requirements in 2012 and 2013. "For practice leaders, the decision is not whether to purchase an EHR, but what type is right for their office," he said. “In addition to the technology, customer service will play a key role, since many small medical groups are unable to hire a full-time, or even part-time, IT staffer.” And when it comes to meaningful use requirements, Dean said providers should keep in mind they’ll have to collect vital signs during patient visits, in addition to nurses and medical assistants. “The surgeon will need to document his evaluation of the patient. So, surgeons should look for an EHR system that can speed up the data entry process through dictation or click minimization.”
For the full article please go here.
Whether it’s meaningful use or simply finding the right personnel, 2012 promises to be chock-full of tricky IT issues for physician practices. Bob Dean, vice president of technology at ChartLogic, gives us the top 10 challenges for physician practices in the new year.
1. Choosing the right technology. According to Dean, physicians will face a significantly increased number of data reporting requirements in 2012 and 2013. "For practice leaders, the decision is not whether to purchase an EHR, but what type is right for their office," he said. “In addition to the technology, customer service will play a key role, since many small medical groups are unable to hire a full-time, or even part-time, IT staffer.” And when it comes to meaningful use requirements, Dean said providers should keep in mind they’ll have to collect vital signs during patient visits, in addition to nurses and medical assistants. “The surgeon will need to document his evaluation of the patient. So, surgeons should look for an EHR system that can speed up the data entry process through dictation or click minimization.”
For the full article please go here.
Tuesday, November 8, 2011
Be careful when writing a letter of recommendation From Medical Justice
Michael J. Sacopulos, Esq.
A Louisiana physician was fired for diverting Demerol from his patients and reporting to work under the influence. Upon the dismissal, a colleague wrote a letter of recommendation for the physician. The discharged physician took his glowing recommendation and found a new job thousands of miles away in Washington State.
About a year into working at this new job, the physician was caught “under the influence.” Further, he was caught after he failed to properly administer anesthesia and his patient fell into a permanent vegetative state, according to court records. The patient’s family filed a malpractice lawsuit against the physician and the medical center where the surgery took place. The case was settled with the physician paying $1 million and the medical center paying $7.5 million.
For the full article please go here.
A Louisiana physician was fired for diverting Demerol from his patients and reporting to work under the influence. Upon the dismissal, a colleague wrote a letter of recommendation for the physician. The discharged physician took his glowing recommendation and found a new job thousands of miles away in Washington State.
About a year into working at this new job, the physician was caught “under the influence.” Further, he was caught after he failed to properly administer anesthesia and his patient fell into a permanent vegetative state, according to court records. The patient’s family filed a malpractice lawsuit against the physician and the medical center where the surgery took place. The case was settled with the physician paying $1 million and the medical center paying $7.5 million.
For the full article please go here.
Brain Parasite Directly Alters Brain Chemistry from science daily
ScienceDaily (Nov. 4, 2011) — Research shows infection by the brain parasite Toxoplasma gondii, found in 10-20 per cent of the UK's population, directly affects the production of dopamine, a key chemical messenger in the brain.
Findings from the University of Leeds research group are the first to demonstrate that a parasite found in the brain of mammals can affect dopamine levels.
Whilst the work has been carried out with rodents, lead investigator Dr Glenn McConkey of the University's Faculty of Biological Sciences, believes that the findings could ultimately shed new light on treating human neurological disorders that are dopamine-related such as schizophrenia, attention deficit hyperactivity disorder, and Parkinson's disease.
For the full article please go here.
Findings from the University of Leeds research group are the first to demonstrate that a parasite found in the brain of mammals can affect dopamine levels.
Whilst the work has been carried out with rodents, lead investigator Dr Glenn McConkey of the University's Faculty of Biological Sciences, believes that the findings could ultimately shed new light on treating human neurological disorders that are dopamine-related such as schizophrenia, attention deficit hyperactivity disorder, and Parkinson's disease.
For the full article please go here.
Tuesday, November 1, 2011
The Case For A 'Check In' Instead Of A Checkup from NPR
by Michelle Andrews
It can't hurt to ask if that blood test is really necessary.
People who visit their primary care doctors for routine care often find themselves poked, prodded and advised in all kinds of unnecessary and unhelpful ways.
Add it all up, and the cost of the dubious tests and medical interventions runs to about $6.8 billion a year. The annual checkup, an American medical tradition, is a prime offender.
Some of the waste seems so obvious. We're talking about doctors ordering blood tests when a patient has no risk factors or symptoms of illness, for example, or prescribing a brand-name cholesterol-lowering drug without first making sure a generic won't do the job.
For the full article please go here.
It can't hurt to ask if that blood test is really necessary.
People who visit their primary care doctors for routine care often find themselves poked, prodded and advised in all kinds of unnecessary and unhelpful ways.
Add it all up, and the cost of the dubious tests and medical interventions runs to about $6.8 billion a year. The annual checkup, an American medical tradition, is a prime offender.
Some of the waste seems so obvious. We're talking about doctors ordering blood tests when a patient has no risk factors or symptoms of illness, for example, or prescribing a brand-name cholesterol-lowering drug without first making sure a generic won't do the job.
For the full article please go here.
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