“Wired” hospitals have lower death rates January 29, 2009
Posted by Obi Jo in E Health.Tags: clinical information technolgies, E Health, EMR, health, health care reform, health reform, healthcare, Hospitals, patient care
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This is just the tip of the iceberg. Just the beginning of the data storm that is going to revolutionize health care. Is anyone familiar with hospitals, medical records, pharmacies, physician orders, nursing notes etc., surprised that the more we link data, codify it and share it among member of the health care team, that care improves? I am not. Medicine has been lagging sadly behind other fields (banking and financial sector for example) in using the power of the web, electronic data storage and other e-tools to transform and streamline care delivery. Hopefully, this article and others will spur improvements in funding and compensation for implementation of these types of solutions . . . jomaxx
The more “wired” a hospital is, the lower its rate of patient deaths, study suggests
The more ‘wired’ a hospital is, the lower its rate of patient deaths and complications according to a new study. Researchers, “compared inpatient death rates, complications, length-of-stay, and cost associated with greater and lesser levels of automation in 41 Texas hospitals,” eventually looking at “more than 167,000 individuals over the age of 50 who were hospitalized between Dec. 1, 2005, and May 30, 2006. The level of automation was measured by physician interactions with the system, using a tool that takes into account how well the physician is trained in the system, the usability of the system, and other factors.” They found that “a 10-point increase in the computerization of notes and records meant a 15 percent decrease in the death rate. This translated into a 1.4 percent mortality rate among those with the highest scoring on notes compared with a 1.9 percent rate among those with the lowest scores, or five fewer deaths per 1,000 patients.”
read more @ http://www.bloomberg.com/apps/news?pid=20601103&sid=a0_Nonz7joYE&refer=us
read the original article @ http://archinte.ama-assn.org/cgi/content/full/169/2/108
Medical Outsourcing: The Time Is Now January 28, 2009
Posted by Obi Jo in E Health, health reform.Tags: health reform, EMR, health care reform, Physicians, E Health, patients, physician billing, PHR
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If ever the need for new solutions existed for physician practices it is now. Reimbursement pressures, documentation demands, overhead costs, personnel demands, and government regulation at all levels is placing physicians at a crossroads in practice management. The key for 21st century practitioners is to move to outsourcing operational functions as much as is possible. This includes payroll, billing and collecting, bill payments, medical records, patient eduction and other related services. The ability for most small or even medium practices to keep up with the changing demands of these areas and still provide personal, one on one health care, is increasingly a losing battle. Additionally, the significant overhead costs in terms of staffing to meet these needs is placing a drain on many practices and their financial viability. Outsourcing is coming of age as more and more providers are creating new and innovative ways to address the needs of practices. The key is to make these solutions integrative as well as making sure they fit within the patient flow/thru put model that generally exists. Solutions that require vast changes in practice ergonomics are likely to be slowly adopted or not at all . . . jomaxx
There are a myriad of providers of all stripes in the arena, here a but a few with their links and their core competency:
Physician directed patient education along with extended services for physicians @ http://www.icsciences.com/index.cfm
Integrated back office services focused on all aspects of billing and collecting @ http://www.athenahealth.com/index.php
New, web based core medical history information, secured and editable by the patient @ http://www.google.com/intl/en-US/health/tour/index.html
Supplier of EHR and EMR solutions @ http://www.nextgen.com/
Hospitals must pay bills like all businesses January 27, 2009
Posted by Obi Jo in Hospitals.Tags: underinsured, dependent health coverage, uninsured, Medicaid, Hospitals, medical care access, hospital billing, insurance benefits, pediatric care
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The combination of discordant reimbursement policies by insurers, dysfunctional Medicaid programs, as well as a surge in under and uninsured children, many born to women illegally in the United States especially in border states such as California, are contributing to these types of actions. Hospitals must pay bills like all business entities and they MUST be profitable (even if they are labeled “non-profit”) or they will close. So tough choices are made daily by hospital administrators, hospital boards and hospital medical staffs. Real Health Reform will require real insurance reform first followed by a series of additional steps to stop the financial hemorrhaging that is occurring among many of our hospitals . . . jomaxx
Faced with financial pressure, California hospitals continue to reduce pediatric units.
California parents and medical professionals are grappling with a significantly diminished network of care for the state’s 10 million children. Driven more by financial pressure than any shift in medical protocol, some 65 hospitals have either eliminated their children’s units or shut down altogether. Many hospitals have been shifted resources toward adults, who receive higher state and federal subsidies. This trend continues even as the number of children has grown. According to one analysis, over 800 inpatient children’s beds were lost from 1998 through 2007 — a 19 % drop. The state currently has one licensed pediatric bed per 2,500 children. Meanwhile, policy experts, nurses and many pediatricians worry that young patients are now concentrated at too few hospitals, even with more children being treated as outpatients. Moreover, the cuts are occurring without serious, coordinated analysis of how the losses statewide could affect the quality of care. In fact, researchers are only just beginning to study the phenomenon . . . read more @ http://www.latimes.com/news/local/la-me-pediatric-hospital25-2009jan25,0,3471232.story
EHRs and PHRs should frame a dialogue, not a monologue January 27, 2009
Posted by LaunchPath in E Health, EHR (electronic health records).Tags: E Health, early adopter, EHR, EMR, health care reform, health insurance reform, incentives, PHR
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While we read about more traction with electronic medical records and plans for incentivizing physicians, along with the consequent debate around sharing these records with the patient population http://www.healthdatamanagement.com/news/legislation27566-1.html we need to enlist and educate both sides on how to make this dialogue work. Why not start by making the existing PHR ecosystem better integrate with the federal EHR initiatives and leverage the “early adopter” patient population to evangelize and educate others to take responsibility for partnering with their physician more actively around electronic records? Is there a call to action for the PHR providers and the patient population to do their part?
Integration, not competition! January 27, 2009
Posted by LaunchPath in E Health, EHR (electronic health records).Tags: health reform, EMR, health care reform, health insurance reform, E Health, PHR, Personal Health Record
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The new federal incentives for medical records adoption are encouraging, following standards defined in recent past years for better data leverage, we still have a practical gap around records transportability. Positive and negative examples abound; but it is reassuring to report a recent example in the form of the recent re-vamp and re-release of the Surgeon General’s Family Health History, as recently reported in the media at http://www.boston.com/business/healthcare/articles/
2009/01/13/tracking_red_flags_in_family_history/ .
This online solution has been designed to be “EHR ready” and is available as a module that can be integrated to existing EHRs and the code base modified for integration (https://familyhistory.hhs.gov/fhh-web/popup/getHelp/helpDetailsLearnMore.action). Family history context for care is a valuable tool for diagnosis and prediction, and this add “meat” to existing clinical solutions that may lack this data. The solution is represented as a platform for patient and provider partnership, as shared responsibility will be required to fill in the health data landscape for patients over time.
But while I am encouraged by Health and Human Services’ launch of the history tool, and the subsequent encouragement and framework linking it to EMRs (or PHRs or other mechanisms) as a key building block to effective, leverageable, and portable data associated with more widespread EMR/EHR/PHR adoption, I am surprised that private industry hasn’t moved further in modularizing and making standards-ready the multiplicity of patient and provider solutions leverage web delivery. Private industry, wake up! Time for a focus on integration, not competition.
Leavitt emphasizes need to implement health IT standards to make stimulus spending effective January 20, 2009
Posted by Obi Jo in E Health, EHR (electronic health records).Tags: health reform, EMR, health care reform, E Health
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Right on target. Money alone is not the answer. Only a part of the solution. As we have noted before, inoperability (read integrated, translatable, uniform) is a key when it comes to digital health information. Regardless if we are talking about EMR (electronic medical records), DMR (digital medical records), PHR (personal health record), DHR (digital health record), etc., the need for a common interface still exists. This site believes the place to start is with web based PHRs that can allow us to evolve into a true EMR set up . . . obi jo
Leavitt emphasizes need to implement health IT standards to make stimulus spending effective
Health and Human Services (HHS) Secretary Mike Leavitt cautions, “Congress is considering adding money for health information technology to January’s stimulus package. Doing so could spur a critical mass of the nation’s doctors to finally enter the information age, but unless the funds are tied to standards for the interoperability of health IT systems, the expenditure could do more harm than good.” After describing HHS efforts to promote standardized Health IT systems, Leavitt concludes, “If we’re going to build a 21st-century health infrastructure, we need to do it strategically, continuing the careful work on harmonized standards that will create one nationwide, interoperable system. That’s the only way to make an investment in health IT produce value for providers and patients, and improve the quality of healthcare overall.”
read more @ http://www.washingtonpost.com/wp-dyn/content/article/2008/12/21/AR2008122101448.html
Americans (patients) need to decide their role in Real Health Reform January 16, 2009
Posted by Obi Jo in health reform.Tags: affordable health insurance, Congress, health insurance reform, health reform, mandated health coverage, mandatory coverage, medical care access, personal health mandates, personal health responsibility, underinsured, uninsured
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Like many, it seems the something for nothing philosophy is alive and well among our population. Bottom line, Americans seem to favor all kinds of health reform and benefit expansion, as long as they are not asked to pay for it. Take it from smokers, drinkers, the so-called “rich”, anything but ask ME to ante up. Well my friends, I do not think it can work that way. In the end, all will need to step up the plate. The most onerous reality is that since the 1950’s and 1960’s both government and industry have been REMOVING RESPONSIBILITY from INDIVIDUALS through corporate and business health plans as well as federal and state intervention with Medicare and Medicaid programs. While these programs have been successful in the main, like all “prescriptions” the have had one major side-effect: to remove the RESPONSIBILITY FOR PERSONAL HEALTH from the equation. We can see it all around us – smoking is not my fault, it is the tobacco companies; drinking is not my fault, it is the bars, lounges and distillers; obesity is not my fault, it is the fault of fast food restaurants and eating establishments – need I go on? So is it any wonder that so many feel that health insurance is not their problem, but a problem to be solved for them by business, labor, government, medicine and others, anybody but the individual. Again, read The Plan, on this site and learn from step one that we should mandate health insurance coverage as a PERSONAL RESPONSIBILITY, end the burden on business and reform health insurance and health insurance access to allow this to be successful. No plan will work 100%, but The Plan, as outlined herein, will allow for the preservation of what is best in our private market system along with needed governmental oversight, input and reform . . . jomaxx
Survey indicates Americans’ support for health reform decreases when faced with trade-offs
According to a national survey conducted by the Kaiser Family Foundation and the Harvard School of Public Health, the “prospects for health reform drop significantly when Americans hear potential financial trade-offs associated with expanding health-insurance coverage.” The survey revealed that “nearly seven in 10 people say they favor the concept of” employer-sponsored health insurance, or “requiring employers…to contribute into a fund that pays to cover the uninsured.” But, support fell “to about three in 10 people” when they “heard the mandate would cause some employers to lay off workers.” Meanwhile, support for a mandate “requiring all Americans to have health insurance” fell from “two out of three people” to 19 percent when told “some people may be required to buy insurance that’s too expensive.”
Read more @ http://www.google.com/hostednews/ap/article/ALeqM5hb3Oc40M53KyoBPLQv3D46poQCwAD95NSBU80
Among those surveyed, “Americans ranked helping the newly unemployed afford health coverage second behind helping businesses keep or create jobs as a priority for any federal economic stimulus plan,” according to (1/16, Vesely). Meanwhile, “providing states with more federal help to pay for healthcare for lower-income residents ranked third.”
Read more @ http://www.hsph.harvard.edu/news/press-releases/2009-releases/health-provisions-publics-top-priorities-economic-stimulus.html
and
http://www.kff.org/kaiserpolls/kaiserpolls011509nr.cfm
And on it goes . . . January 16, 2009
Posted by Obi Jo in health insurance.Tags: health insurance, health reform, physician payments, health insurance reform, Insurance Profits, physician payment, Hospitals, hospital billing, insurance fraud
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Oh what a tangled web we weave . . . remember learning that as a child? Well, here are some of the largest, biggest names in health insurance working diligently to devise a system essentially designed to deceive. Deceive providers, patients, premium payers and so on. All in the name of exaggerated profits for so called health insurance entities. The practices are a stain on the many legitimate persons working in the health insurance industry who are trying, within the constraints that exist, to make coverage more affordable and accessible. A rose by any other name is still FRAUD AND BAD FAITH (a phase insurers hate) . . . obi jo
Aetna agrees to $20 million settlement in reimbursement system probe.
Health insurer Aetna, Inc. said Thursday it will pay $20 million to help set up a database to calculate out-of-network medical payments in an effort to end a dispute with UnitedHealth Group, Inc. over a system that allegedly passed more costs to plan members.” Working with the office of New York Attorney General Andrew Cuomo, under the agreement, Aetna is expected to “set up an independent public database,” as well as “a system to help plan members find out what they will have to pay out of pocket before they visit a doctor who is not part of Aetna’s network.”
Aetna said it has been working cooperatively with the attorney general’s office over several months to share its processes for determining out-of-network claim payments and to provide insight into the Ingenix database. The insurer is expected to contribute “to the nonprofit group in installments for a period of up to five years.” The nonprofit “will serve as the sole arbiter and decision maker with respect to all data contribution protocols and all other methodologies used in connection with the database.”
read more @ http://www.forbes.com/feeds/ap/2009/01/15/ap5927070.html
and
http://money.cnn.com/news/newsfeeds/articles/djf500/200901151330DOWJONESDJONLINE000962_FORTUNE5.htm
UnitedHealth brought to task for fraud allegations January 16, 2009
Posted by Obi Jo in health insurance.Tags: health insurance, health insurance reform, health plans, hospital billing, insurance fraud, Insurance Profits, patients, physician billing, physician payment
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In an addition to an earlier post, we note that UnitedHealth has been forced to end its incestuous relationship with Ingenix which clearly benefited the insurer at the expense of providers and ultimately patients. Once again we find evidence that so called “health insurers” are in reality “health insurance arbitragers” out to maximize profit by denying, delaying, and underpaying just claims for provider services. We again call on the new administration to read The Plan as outlined at this site and adopt all, or at least most of our ideas about health insurance reform . . . jomaxx
UnitedHealth agrees to pay $50 million to settle billing fraud allegations
UnitedHealth Group has agreed to end a practice that allegedly caused patients to overpay for care outside the insurer’s network. In doing so, UnitedHealth will close a much-criticized database health insurers have used for years to determine payment rates and help start a more impartial successor. The agreement resolves an investigation by New York Attorney General Andrew Cuomo (D) into allegations that the database, run by UnitedHealth subsidiary Ingenix intentionally skewed rates lower through faulty data collection . . . read more @ http://www.usatoday.com/news/health/2009-01-13-unitedhealth_N.html
Cuomo claimed that the relationship between Ingenix and UnitedHealth “is a gross conflict of interest” that “gave Ingenix an incentive to set rates that benefited” the insurer. Under the settlement, “a nonprofit entity will provide data on ‘reasonable and customary’ costs that insurers use to set reimbursement rates to patients. Cuomo plans to get the new entity up and running in six months, including a website where, for the first time, consumers can find out in advance how much they may be reimbursed for common out-of-network services in their area . . . read more @ http://www.bloomberg.com/apps/news?pid=newsarchive&sid=a13QfOKQMTQs
The agreement is expected to have a “much broader” impact than on the 26 million UnitedHealth members alone, “because other health plans…use the Ingenix database,” Cuomo and the American Medical Association (AMA) stated . . . read more @ http://www.chicagotribune.com/business/chi-biz-united-healthcare-scheme-jan13,0,6282629.story
Commenting on the settlement, AMA President Nancy Nielsen, M.D., said that insurers can drive a wedge between doctors and patients when they underpay medical bills. She added that with the new database, “people will know what they’re getting, and it will be clear and transparent . . . read more @ http://www.nydailynews.com/news/2009/01/13/2009-01-13_ag_andrew_cuomo_reins_in_health_care_gia.html
Obama’s stimulus package includes funding to help physicians adopt electronic records January 16, 2009
Posted by Obi Jo in E Health, EHR (electronic health records).Tags: E Health, EMR, health care reform, health plans, Hospitals, patient health record, PHR, Physicians, web based health records
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Sounds good doesn’t it? However, throwing money to hospitals and doctors without a clear view to the technology related issues of EMR (electronic medical records) versus PHR (patient health records) will likely not bring the desired results. Health care record keeping is too complex an issue for us to experience a cassette versus CD battle, or a VHS versus DVD battle, or DVD vs Blue ray battle etc. We need some common ground on which to build a fully integrated, interactive, universal, translatable, dynamic EMR system. As of this moment, that system, despite many vendors and iterations, does not truly exist. Let’s think please before we throw money at a perceived solution which may in the end not be easily adopted . . . obi jo
Obama’s stimulus package includes funding to help physicians adopt electronic records
Five years after President Bush announced plans for Americans’ health records to go digital and didn’t provide enough money to make it happen, only one in five doctors has converted from paper to electronic record keeping.” But, this could soon change, since President-elect Barack Obama has “promised a $50 billion investment to store patient records electronically. His economic stimulus package is expected to contain two year’s worth of funding, or about $20 billion.” The funds “would be distributed to hospitals and doctors through grants, and through higher reimbursement rates when serving Medicare patients.” Notably, “for doctors who do not make the switch, Obama will propose lowering reimbursements from government-subsidized healthcare programs.” According to Kara Calvert, director of government relations for the Information Technology Industry Council, “They’re talking about real dollars that will make a big impact on adoption.”
When Barack Obama takes over the White House next week, this could change. During his campaign for president, Obama promised a $50 billion investment to store patient records electronically. His economic stimulus package is expected to contain two year’s worth of funding, or about $20 billion.
The money would be distributed to hospitals and doctors through grants and through higher reimbursement rates when serving Medicare patients. And for doctors who do not make the switch, Obama will propose lowering reimbursements from government-subsidized health care programs.
Read more @ http://www.washingtonpost.com/wp-dyn/content/article/2009/01/14/AR2009011402146.html
