Professional Medical Documents: Master Your 'Word' from Nurse Together

Remember typewriters? We sure have come a long way since then. Granted, those clunky old machines were wonderfully straightforward—a few keys, the occasional bottle of Wite-Out®, and you were all set. But before you start getting nostalgic for the good old days, consider this: contemporary word processing programs such as Microsoft Word offer countless ways to compose, organize, and enhance written documents quickly and more efficiently in the workplace. And in the healthcare setting, its high degree of usability makes Word the premier choice for creating professional-quality documents for a broad range of purposes.

For the full article please go here.

Countering Conflict in the Workplace from Nurse Together.

The following is an excerpt of the NurseTogether.com Community members’ online chat with Dr. Catherine Garner, Dean of Health Sciences and Nursing at American Sentinel University.

NT.com: Today, we are hosting a chat session focused on "Countering Conflict in the Workplace." Our special co-hosts today are Dr. Catherine Garner, Dean of Health Sciences and Nursing at American Sentinel University, and Pam Broyles, Senior Manager for Education and Training at Sarah Cannon Research Institute. Pam is also a graduate student in American Sentinel University's Doctor of Nursing Practice (DNP) program. I feel very passionate about this topic, and I'm glad that we are addressing it today.

For the full article please go here.

8 key issues for population health management in 2012 from HealthIT.com

Recently, the Care Continuum Alliance, an advocate for population health management, surveyed industry leaders to assess the market and predict key issues for 2012. According to the alliance’s white paper, two predominant themes were brought to light as a result of the survey.

“First, significant market movement will occur toward accountability and value creation in healthcare, driven partly by new physician-guided and collaborative models,” according to the report. “And second, population health management is well-positioned to add value to and support these emerging models, but must continue to build the case for wellness and prevention.”

Here are eight additional key issues, identified in the report, that could affect population health management in 2012.

1. Accountable care and the Medicare Shared Savings program. Many comments from survey respondents centered on accountable care and collaborative models, as well as federal support for both. According to the report, population health has a lot to offer collaborative care, such as health risk assessment and predictive modeling, HIT infrastructure, data analytics, care coordination and other core competencies. “But tempering optimism around accountable care models were caveats,” the report noted. One respondent summed it up: “If ACOs become a reality and are structured in a way that provides a real incentive for managing health, they could be a major market opportunity. If they just become HMOs redux, not much will change."

For the full article please go here.

When Medicare Isn't Medicare from Huffington Post

Let's say you have a Ford and decide to replace everything under the hood with Hyundai parts, including the engine and transmission. Could you still honestly market your car as a Ford?

That question gets at the heart of the controversy over who is being more forthright about GOP Rep. Paul Ryan's plan to "save" Medicare, Republicans or Democrats.

If you overhaul the Medicare system like you did your Ford and tell the public it's still Medicare, are you doing so honestly?

As I noted last week, PolitiFact, the St. Petersburg Time's fact checker, decided that the Democrats' claim that Ryan's plan would mean the end of Medicare was so blatantly untrue it merited designation as the 2011 "Lie of the Year." Republicans, whose erroneous claims about health care reform garnered "Lie of the Year" prizes in 2009 and 2010, cheered. Democrats, as you might imagine, jeered -- as did some journalists and pundits.

For the full article please go here.

Things Medicare Won't Tell You from Yahoo News

1. "We fork over millions for unproven procedures."

Medicare spends millions of dollars each year on treatments that many medical experts deem unnecessary. One example: Digital mammograms. These are often more expensive than traditional mammograms but not necessarily better for older women. A five-year clinical trial conducted by the National Cancer Institute found that digital mammograms were no more effective in finding cancers in women 50 and older than traditional mammograms. But the number of digital mammograms that Medicare paid for has risen from 426,000 in 2003 to nearly 6 million in 2008 -- a jump that increased the cost of breast cancer screening by more than $350 million, according to an analysis by The Center for Public Integrity, a nonprofit investigative news organization.

Medicare also often pays significantly more for liquid-based cytology, a screen for cervical cancer, than it does for routine pap smears, even though a large 2009 study found that the expensive test is no more effective than the traditional procedure when it comes to detecting cancer. Using the newer, more expnsive test costs Medicare an extra $90 million since 2003, according to The Center for Public Integrity. Another point of contention is that Medicare pays for screening colonoscopies for people over 75 despite the fact that the United States Preventative Task Force "recommends against routine screening for colorectal cancer in adults age 76 to 85 years."

For the full article please go here.

A New Threat: Patient Predatory Lending Claims from Medical Malpractice Blog

Michael J. Sacopulos, Esq.

An doctor was sued several weeks ago for her use of a healthcare financing company. The suit was brought as a class action and is based upon consumer fraud laws. The allegations center around the way the credit application was presented and when it was signed by the patient. The patient claims that she did not understand that she was signing a credit application and that the practice performed unnecessary work in an effort to collect the entire amount of her line of credit. The doctor needs to prepare for a long, painful process. This is not a medical malpractice case, so normal professional liability policies will not cover it. Further, given the general public’s current hostility towards finance firms, there is a risk to taking the case to a jury.

Basically, this is a predatory lending case. Predatory lending is a general description for activities that violate consumer laws. A common element to most predatory lending cases include the lender or lender’s agent engaging in fraud or deception to conceal the true nature of the loan obligation from an unsuspecting or unsophisticated borrower. This means that a practice could be sued based on what information was presented to a patient or for how a signature of the application was secured.

For the full article please go here.

Sun's UV Rays May Stop Spread Of Chickenpox from Medical News Today.

If you look at the evidence to date from a different perspective, a virologist at St George's Hospital, University of London in the UK believes it suggests the sun's UV rays inactivate the chickenpox virus on the skin before it has a chance to transmit to another person, thus explaining why the disease spreads less readily in tropical countries. Dr Phil Rice told the press last week he hopes his findings will lead to new ways to prevent chickenpox and its more severe cousin, shingles.

The idea that ultraviolet (UV) rays can inactivate viruses is not new, but this is the first time that such firm conclusions have been made in connection with the varicella-zoster virus, the herpes virus responsible for chickenpox and shingles.

Writing about his work earlier this year in Virology Journal, Rice shows how chickenpox is much less common in parts of the world with high levels of UV rays compared with places where the levels are low, and why in temperate zones, the disease peaks in winter and spring, when UV rays are at their lowest.

For the full article please go here.

Hospitals Try To Control Readmissions, Even When It Hurts Profits from Health.com

This story is part of a reporting partnership that includes WNYC, NPR and Kaiser Health News.

What doesn’t kill you only makes you a repeat customer.

So says Prescott Pharmaceuticals, fictional and macabre sponsor of The Colbert Report.

But it’s no joke to the health care system. Repeat customers in hospitals are seen as a big problem – not to the hospitals themselves, which can profit from some patients’ frequent visits, but to the entities that pay for the care: Medicare, Medicaid and private insurers.

The U.S. Department of Health and Human Services, especially, is taking hospitals’ repeat customers very seriously. Almost one out of five Medicare patients discharged from a hospital is back within 30 days. Research suggests as many as 75 percent of those return visits could be prevented with better treatment in the hospital and better care once people are back home.

For the full article please go here.

Reduce Misunderstandings in Patient Care from Nurse Together

For the full article please go here.The patient, Carol, was a 36 year-old married woman with two young children. She did not see her doctor much in the last two years. She was feeling fine.

Carol was admitted to the hospital with a serious leg infection. The staff tried to save her leg but were unsuccessful. Her leg needed to be amputated below the knee.

Carol had insulin dependent diabetes for over ten years. She knew how to check her blood sugar and how to give herself insulin. She could return-demonstrate those skills quite well. But a few months before the infection started, she felt a tingling in her fingers and thought it was a side effect of the insulin; she stopped taking her daily shots.


Her husband was not aware of her finger-tingling symptoms or her decision to stop taking her insulin. He felt guilty for not having intervened. He left for work every day before she woke up. There is no record that Carol had ever been evaluated for depression.

Berwick: Don’t Blame Medicare, Medicaid. It’s The Delivery System from Kaiser Health News

Dr. Donald Berwick, who oversaw Medicare and Medicaid until earlier this month, defended the programs Monday, but said they are trapped in a U.S. health system that promotes wasteful spending and inefficient care.

"Health care is broken," Berwick said in an interview with Kaiser Health News. "… We have set up a delivery system that is fragmented, unsafe, not patient-centered, full of waste and unreliable. Despite the best efforts of the workforce, we built it wrong. It isn't built for modern times."

Berwick said the 2010 federal health law is changing how doctors and hospitals are paid and deliver care through such new arrangements as accountable care organizations, which are designed to improve coordination and lower costs.

For the full article please go here.

Infection Prevention and Control: The Next Hot Career from Nurse Together

Review of chat session with Dr. Catherine Garner, Dean of Health Sciences and Nursing at American Sentinel University and Alice Maciarelli, medical practice administrator and DNP student at American Sentinel University.

NT.com: Today, I am proud to welcome Dr. Catherine Garner with American Sentinel University as my co-host for this chat. I am also excited to welcome Alice Masciarelli, who is a medical practice administrator and DNP student at American Sentinel, as a second co-host. She can give us real time/real life insight into this topic. Alice, I think it's wonderful that you are currently enrolled in American Sentinel's DNP program, and I think your current role in a medical practice will give us more insight about the opportunities available.


For the full article please go here.

Disease Registries: Improving Care and Lowering Costs From H and H Networks

By Matthew Weinstock

Effective use of disease registries could dramatically improve clinical outcomes and reduce health care costs, according to a study published yesterday in Health Affairs. Researchers from the Boston Consulting Group and three Swedish institutions studied 13 registries from Australia, Denmark, Sweden, the United Kingdom and the U.S. and interviewed 32 health care professionals to assess not just the application of registries, but their effectiveness.

They found that "by making outcome data transparent to both practitioners and the public, well-managed registries enable medical professionals to engage in continuous learning and to identify and share best clinical practices. The apparent result: improved health outcomes, often at lower cost. For example, we calculate that if the United States had a registry for hip replacement surgery comparable to one in Sweden that enabled reductions in the rates at which these surgeries are performed a second time to replace or repair hip prostheses, the United States would avoid $2 billion of an expected $24 billion in total costs for these surgeries in 2015."

For the full article please go here.

My ER Doctor Is Billing Me For What Insurance Didn't Pay, What Can I Do? from Kaiser Health News

KHN's "Insuring Your Health" consumer columnist Michelle Andrews answers a question about what to do when you're billed by an out-of-network doctor for an in-network hospital visit - a practice known as balance billing. She says negotiating is a good way to address the problem.

For the video please go here.

When 'Critical Access Hospitals' Aren't So Critical from National Public Radio

Hood Memorial Hospital, in Amite, La., hasn't been full in at least two decades. Some people say that makes it's a perfect target for efforts to reduce federal spending.

On an average day, fewer than four of the hospital's 25 beds are occupied. Last year, Hood posted a $700,000 loss on its $7.5 million in total operating expenses. One of the few bright spots on Hood's balance sheet: the extra money it receives from the federal government through a program for critical access hospitals — small facilities that receive a higher Medicare reimbursement rate to help keep them afloat.

In the ongoing deficit reduction talks, critical access hospitals have been singled out at least twice as a program ripe for cutting: in President Obama's budget proposal and by the Congressional Budget Office.

For the full article please go here.

Obesity And Diabetes Undermining America's Overall Health From Medical News Today

America's overall health is being undermined by obesity and diabetes, other chronic diseases, and child poverty; these detriments have been deemed greater than the benefits from improvements in cardiovascular deaths, preventable hospitalizations and smoking cessation, says a new report titled 2011 America's Health Rankings.

The Rankings is a collaboration between United Health Foundation, the America Public Health Association, and Partnership for Prevention.

No improvement in overall health - while the country's overall health improved by an average of 0.5% from 2000 to 2010 and 1.6% since the 1990s, the rate was unchanged from 2010 to 2011, the authors wrote.

For the full article please go here.

Excellent podcast on informing patients about residents' role.

H&HN Daily Contributing Editor Richard Hill talks with experts about implementing a new rule from the Accreditation Council of Graduate Medical Education.

For the video please go here.

Bad Grades On New National Health Report Card from Kaiser Health News

Ahead of the unveiling Tuesday of the latest United Health Foundation’s America’s Health Rankings, Reed Tuckson, a foundation board member, had a scary message for the nation: We’re facing “a tsunami of preventable illness,” Tuckson said. “We aren’t prepared for the consequences of that.”

In an interview with KHN in advance of the release of the rankings, Tuckson characterized the state-by-state report card of health stats as a grim call to arms. After improving an average of 1.6 percent a year since the 1990s, the annual index remained flat this year for the first time in its 22 years of existence. And, as Tuckson bluntly asserts, a sicker nation means a more expensive nation at a time when health costs are already stretching consumers and employers beyond their limits. He warned: “You’re going broke!”

For the full article please go here.

4 debatable points on the delay of ICD-10 from HealthIT.com

Fighting words were heard from both sides of the ICD-10 debate after the AMA called for a delay of the Oct. 1, 2013 deadline for conversion. LinkedIn and Twitter were bustling with yea or nay responses, which is why we asked Steve Sisko, IT consultant and avid ICD-10 blogger, and Rob Tennant, senior policy advisor at the MGMA, to weigh in.

1. The effect ICD-10 implementation will have on physician practices.

Sisko:

It won’t be as bad as they think. According to Sisko, some practices will be burdened more than others with the switch to ICD-10. “But specialists only need to learn a subset [of codes],” he added. “They say ’70,000 ICD codes we’ll have to know,’ well, that’s BS because if you’re an orthopedic surgeon, there are subsets you don’t need to know; you don’t need to learn about other specialties’ codes.” He added, though, facilities will be impacted to a greater extent than professionals, due to the fact institutions have to collect, “Present on Admission and discharge diagnosis that professionals do not have to collect. They’ll have to lean on existing resources or hire external assistance.”

For the full article please go here.

High Level Of Waste In Health Spending, Says Medicare And Medicaid Boss from Medical News Today

Dr. Donald M. Berwick, head of Medicare and Medicaid until last Thursday, stated that up to 30% of spending on health is wasted with absolutely no benefit to beneficiaries (patients). He added that his agency's cumbersome and archaic regulations are partly to blame. He claims too many resources and too much time is dedicated to things that do not help patients one bit; something doctors are fully aware of too.

In an interview last Thursday, Dr. Berwick said:

"Much is done that does not help patients at all,
and many physicians know it."



During the interview, Berwick talked about the previous 17 months, while he was at the helm as Administrator of the Centers for Medicare and Medicaid Services, his failures, successes and frustrations, and dealing with criticisms from Republican lawmakers.

For the full article please go here.

Physicians must learn how to put patients in the center from HealthIT.com

WHITE OAK, MD – Physicians need to learn "patient-centeredness" as one of their core medical skills so they can incorporate it into their daily practice. But many clinicians are unfamiliar with what is involved in practicing with the patient at the center of his or her care, despite it being a foundation for improved quality and new delivery models.

Some physician professional organizations are stepping up to offer teaching aids about patient-centered care.

Patient-centeredness should be a part of education in medical schools, training for residency and included within competencies for certification and re-certification, according to physician executives of professional organizations.

[See also: Patient-centered healthcare is essential healthcare.]

To be certified by the American Board of Internal Medicine (ABIM), physicians must demonstrate medical knowledge, patient care and procedural skills, interpersonal communication skills, professionalism, systems-based practice and practice-based quality improvement, said Eric Holmboe, MD, chief medical officer for the ABIM. Patient-centeredness fits into all these competencies.

For the full article please go here.

Medicare Offers Expanded Coverage To Battle Expanding Waistlines from Kaiser Health News

Keeping off the pounds is tough at any age. Now seniors are getting a helping hand from the Centers for Medicare and Medicaid Services (CMS), which has announced that it will cover screening and counseling for obesity as a free preventive service for Medicare beneficiaries.

Coverage is effective immediately.

Advocates hope that CMS’ decision may encourage private insurers and Medicaid to begin covering obesity screening and counseling as well.

“I think it’s fantastic,” says Dr. Marijane Hynes, a primary care physician at George Washington Medical Faculty Associates Weight Loss Clinic.

For the full article please go here.

Cholesterol-Lowering Lipitor: FDA Okays First Generic Version from Medical News Today

The US Food and Drug Administration (FDA) announced on Wednesday that it has approved the first generic version of the world's top-selling medicine, the cholesterol-lowering drug Lipitor (atorvastatin), currently marketed by Pfizer Inc.

Ranbaxy Laboratories Limited, India's largest pharmaceutical company, has gained FDA approval to make generic atorvastatin calcium tablets in 10 milligram, 20 mg, 40 mg, and 80 mg strengths. The tablets will be made by Ohm Laboratories in New Brunswick, New Jersey, says the FDA.

A statement from Raxbaxy says Ranbaxy Pharmaceuticals Inc, a wholly owned subsidiary of Ranbaxy Laboratories Ltd, will be marketing the generic atorvastatin in the US.

Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research, told the press the agency was "working very hard" to ensure patients get generic drugs as fast as the law will permit:

For the full article please go here.

Researchers Examine Role of Inflammatory Mechanisms in a Healing Heart from ScienceDaily

ScienceDaily (Nov. 30, 2011) — Virginia Commonwealth University researchers have found that an inflammatory mechanism known as inflammasome may lead to more damage in the heart following injury such as a heart attack, pointing researchers toward developing more targeted strategies to block the inflammatory mechanisms involved.

Following a heart attack, an inflammatory process occurs in the heart due to the lack of oxygen and nutrients. This process helps the heart to heal, but may also promote further damage to the heart. The mechanisms by which the heart responds to injury are not fully understood, so researchers have been examining the cellular pathways involved to gain further insight.

For the full article please go here.