Dear NVOS Members,
The articles contained in this e-newsletter are excerpted from AAOS newsletters and other media sources to help our members stay current on national issues.
The NVOS Staff |
Are EHRs Reliable Enough To Be Admitted Into Evidence In Legal Proceedings?
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An analysis published in the summer issue of Ave Maria Law Review  argues that electronic health records (EHR) systems may not necessarily reflect care actually provided to patients, and should therefore be verified for reliability and authenticity before being admitted into evidence in legal proceedings. "Currently there are no regulatory health information technology requirements or Federal [health information technology] program qualifications for these systems that assure, or reference, their fitness as business or clinical records," the authors write. While some regulatory reference exists to supportive functions, such as 'audit trails,' at this writing, their use is not required in deployed systems, meaning that evidentiary non-reliability will persist as a challenge to e-Discovery and to all business record-supported or dependent processes in the healthcare industry for a long time."
Read the complete analysis (PDF)...
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FDA Commissioner Says Agency Is Working To Speed Up Device Review Process
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According to The Boston Globe, FDA is working to speed up the approval process for medical devices and diagnostics. The commissioner of FDA stated that the agency is considering an expedited approval process for devices to treat life-threatening or irreversibly debilitating diseases and for which other options are not available. However, she acknowledged that the agency has fewer programs to fast-track experimental medical equipment and diagnostics than it does for experimental drugs. Industry representatives have pointed out that devices may be approved as much as 3 years earlier in Europe than in the United States.
Read more...
Read the FDA draft guidance from April 2014 (PDF)...
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Study: Allergic Reaction To Orthopaedic Implant May Slightly Increase Risk Of Rare Cancer
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Findings from a mouse study and a case study published online in The Journal of Clinical Investigation suggest that patients who develop persistent skin rashes after metal devices are implanted near the skin may be at increased risk of a rare and aggressive form of skin cancer. The researchers note that allergic contact dermatitis (ACD) is a well-recognized adverse event associated with implantable medical devices containing allergenic materials like nickel. They used a standard murine model of contact hypersensitivity to determine whether chronic ACD promotes skin carcinogenesis in mice and found that chronic application of 1-fluoro-2,4-dinitrobenzene (DNFB) to carcinogen-treated skin was associated with the development of papillomas and aggressive squamous cell carcinoma (SCC). Further, DNFB-driven chronic ACD was marked by type 2 inflammation in the mice. The researchers noted similar tumor-promoting inflammation in a patient diagnosed with Marjolin's ulcer-an invasive SCC that developed in response to chronic ACD linked to an orthopaedic implant.
Read more...
Read the complete study...
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Hospitals Face Medicare Fines Over Readmission Rates
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Medicare is fining 2,610 hospitals across the country for higher-than-expected readmission rates from July 2010 through June 2013, Kaiser Health News reports. Hospitals that had the highest readmissions within a month will receive 3 percent lower payments for every Medicare patient stay-not just readmissions-over the next year, an increase from a maximum penalty of 2 percent last year. One reason for the higher and more widespread fines is that Medicare is tracking more conditions, including elective hip and knee replacements.
Created by the Affordable Care Act, the penalties are intended to get hospitals to improve their focus on patients' health after discharge. However, many believe that the punishments are too harsh and administered unfairly. Bills are pending in both houses of Congress that would require Medicare to consider the socioeconomic status of a hospital's patients when calculating fines.
Read more...
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Physician Survey Notes Shift In Demographics; Many Describe Themselves As "Overextended"
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A survey of physicians commissioned by The Physicians Foundation finds that 81 percent of physicians describe themselves as either "overextended" or "at full capacity," while only 19 percent indicate they have time to see more patients. The research team surveyed 20,000 physicians between March 2014 and June 2014, and found that 44 percent of respondents have considered plans that would reduce patient access to their services, including cutting back on patients seen, retiring, working part-time, closing their practice to new patients, or seeking nonclinical jobs. The research team also notes that, in 2014, only 17 percent of physicians indicated that they are in solo practice-a reduction from 25 percent in 2012-and only 35 percent of physicians describe themselves as independent practice owners, down from 49 percent in 2012 and 62 percent in 2008.
Read more...
Read the complete survey (PDF)...
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CMS Extends Meaningful Use Hardship Exception Application Deadline
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The U.S. Centers for Medicare & Medicaid Services (CMS) intends to reopen the submission period for hardship exception applications for eligible providers who may not be able to demonstrate meaningful use of Certified Electronic Health Record Technology due to significant hardship. To be considered for an exception, an eligible professional or eligible hospital must complete a hardship exception application and provide proof of the hardship. If approved, the hardship exception is valid for 1 payment year only. The new deadline for hardship exception applications is Nov. 30, 2014.
Read more...
View the CMS guidance document on hardship exceptions (PDF)...
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Are Physicians, Debt Collectors, And Patients On The Same Page?
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An article in HealthLeaders Media looks at the issue of medical debt collection and argues that the practice is becoming more important for physician practices as some insurance plans shift more costs to the patient. The writer argues that practices should review their policies on payment and collection as well as their procedures for appealing denied reimbursement claims, and cites information from a stakeholder task force that noted a lack of clear communication to patients about payment and debt collection policies. "The debt collection folks don't know what the physician practice is telling people, and the physician practice doesn't know what the debt collectors are telling people," a spokesperson for the Healthcare Financial Management Association is quoted as saying. "The patient is caught in the middle because they're going with whatever they were told, when they might be held accountable for a different set of expectations." |
Open Payments Website Opens To Public Confusion, Doubts About Accuracy
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As mandated by the Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) unveiled the Open Payments (Sunshine Act) website on Sept. 30, amid concerns among providers about the accuracy of the information it reveals to the public. The website is supposed to reflect payments made to doctors and teaching hospitals by medical device and drug manufacturers and group purchasing organizations during the period Aug. 1-Dec. 31, 2013. Medical association leaders have contended that the window for physicians to review and dispute payment information was too short, and many physicians and other users have reported that technical snafus prevented them from identifying errors in their profiles. Although the American Association of Orthopaedic Surgeons (AAOS) supports providing patients and others with accurate and easily understandable information about a physician's relationship with an enterprise, it joined other organizations in asking CMS to delay the public launch until spring 2015. The newly unveiled database reveals that 546,000 doctors and 1,360 teaching hospitals received 4.4 million payments totaling $3.5 billion, according to Kaiser Health News, which reports that about 40 percent of those payments do not have a specified recipient due to uncertainty about accuracy or consideration of the short time frame allowed for corrections by providers. Another 199,000 records were not published because they detailed ongoing pharmaceutical research or because physicians were still disputing their contents. That information will be updated and published as it becomes ready, according to CMS.
Read more...
Read AAOS Advocacy Now...
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2014-2015 Board of Directors
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