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Industry News
For some insured, EDs the "usual place" for care
Recently insured patients appear to use the emergency department for nonemergency care more than they did when they were uninsured, according to research published in the American Journal of Emergency Medicine. Among ED users who reported no usual source of care and who reported relying on the ED, 27.7 percent and 35.1 percent, respectively, said lack of access forced them to the ED. None reported an actual emergency. Patients without a stable usual source of care were reported using the ED because it was their "usual place to get care," it was their "closest provider" or because they "didn't have another place to go." (Becker's Hospital Review; American Journal of Emergency Medicine; announcement)
Investigation finds lack of scrutiny for home care workers
The move from nursing home to in-home care continues, driven by cost-cutting and patient preference. But caregivers are largely untrained and unsupervised, even when paid by the state, leaving thousands of residents at risk for possible abuse, neglect and poor treatment, according to a Kaiser Health News investigation of California's In-Home Supportive Services program. "The program is so big that it appears nobody knows what to do," says one IHSS case worker with 493 clients. "We are being told it's quantity, not quality." (Kaiser Health News)
The Agency for Healthcare Research and Quality recently released standardized instructions for pill administration. Provides in English, Chinese, Korean, Russian, Spanish and Vietnamese, they are intended to help patients understand and adhere to medicine regimens and reduce possible errors. The instructions follow the Universal Medication Schedule, which simplifies complex medicine regimens by using standard time periods for administration. ( AHA News Now; AHRQ)
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Innovation & transformation
Toyota, Boeing model for Seattle health care
A production line model of medical care has transformed the environment of health in the Seattle area. Inspired in part by Boeing and Toyota, Virginia Mason is among several area medical centers that use the same quality assurance system the aircraft company relies on at its plants, including standardized processes and precise scheduling to boost efficiency. The precisely choreographed processes have led to an effective method of health care delivery, better outcomes, lowered costs and increased patient satisfaction, the LA Times reports. ( LA Times)
Payers agree on data-sharing solution
A group of seven payers in Colorado has accomplished something they believe to be unprecedented: They have agreed on a multi-payer data-sharing solution. The idea emerged from the Colorado Comprehensive Primary Care initiative. The payers' goal: Put in place a single source for patient-level, practice-accessible data that is both interoperable and sustainable. The selected vendor for that tool, Rise Health, will partner with Colorado's Center for Improving Value in Health Care and other state and local entities to ensure a comprehensive approach to data aggregation. (Becker's Hospital Review)
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Incentives not enough to change physician behavior
Hospitals and practices are implementing value-based reimbursement models, but many facilities don't have plans to sustain doctor engagement aside from providing incentives, according to research published in the American Journal of Managed Care. Physician engagement in health care reform is largely incentivized via pay-for-performance models and metrics. "This strategy appears to be an insufficient precondition for behavior change, and, ergo, quality improvement," the researchers conclude, noting there's little evidence to suggest health systems have sustainable plans to engage physicians beyond performance incentives. (Becker's Hospital Review; American Journal of Managed Care)
More than 40 percent of caregivers in U.S. broadband households currently use a digital health device as part of their caregiving routine, including 8 percent who use online tools to coordinate their efforts, according to a report from market researcher Parks Associates. Current and future caregivers also expressed interest in using technologies such as electronic sensors, home monitoring security systems and GPS devices. "The appeal of digital services to help provide care is far greater than current adoption levels of digital health solutions in general," Harry Wang of Parks Associates said in a news release. (Healthcare Informatics)
One-third of patients in private rheumatology practices can't follow dosing instructions for ibuprofen correctly; one-fifth can't follow instructions for methotrexate, according to research conducted in Australia and published in Medicine. The investigators report 32 percent of patients taking ibuprofen and 21 percent taking methotrexate misunderstood dosing instructions. The methotrexate question asked patients to count out the pills needed to take their weekly dose, plus a daily dose of folic acid. Results for rural and urban patients were similar. (Medicine; MedPage Today)
Overall, 85 to 96 percent of patients found EHRs useful, vs. 57 to 68 percent for paper records, according to a new study from the National Partnership for Women & Families, Engaging Patients and Families: How Consumers Value and Use Health IT. Patient trust in the privacy and security of EHRs has increased since 2011. Those with online access to their health information have a much higher level of trust in their doctor and medical staff (77 percent) than those with EHRs that don't include online access (67 percent). The survey also found patients want to communicate with their clinicians. (National Partnership for Women & Families)
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New & Noted
Changes in charity charges: The IRS has completed final regulations that will impose a cap on how much charitable hospitals can charge needy uninsured and underinsured patients for emergency services and medically necessary services. (final regulations; LifeHealthPro)
MU penalties: Starting this month, nearly 257,000 eligible professionals will receive penalties for failure to demonstrate Meaningful Use of EHRs, according to the Centers for Medicare & Medicaid Services. (AHA News Now)
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Multi-media
Brill on "profiteering" and the limits of the ACA
Journalist Steven Brill appeared on public radio's Fresh Air this week to discuss America's Bitter Pill, his new book about the political fights and industry lobbying that led to the compromises of the Affordable Care Act. "A patient in the American health care system has very little leverage, has very little knowledge, has very little power," he told host Terry Gross (NPR)
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MarketVoices...quotes worth reading
"The insurance companies are in many ways like us: They pay health care bills. The culprit here--and the reason that the Affordable Care Act doesn't work is, is not going to work--is that nothing has been done to curb the marketplace of exorbitant bills and exorbitant profiteering on the part of hospitals, medical device makers and obviously the drug companies. The insurance companies are as much the victim of that as we are." -- journalist Steven Brill, in a Fresh Air interview
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