It's not easy to start a movement, but a new group of physicians and healthcare researchers are hoping to do so. They are looking to the Institute of Medicine to bolster their efforts to reduce diagnosis errors that lead to delayed or inappropriate treatments.
“It's affecting hundreds of thousands of people a year, but it gets very little attention from healthcare organizations and physicians in general,” said Dr. Mark Graber, founder and president of the Society to Improve Diagnosis in Medicine. “We haven't encountered any pushback, it's more just apathy.”
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While the patient-centered medical home has been touted as the foundation for a better coordinated and more efficient healthcare system, experts now say medical home practices need to be connected to other parts of the healthcare system. To this end, the Patient-Centered Primary Care Collaborative has released a report listing 10 “essential” health information technology tools needed to make these population health connections.
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New research calls into question the validity of using post-operative blood clot rates as a metric of hospital quality. According to a study published Monday in the Journal of the American Medical Association, rates of venous thromboembolism—a term that includes pulmonary embolism and deep vein thrombosis—could be skewed by surveillance bias.
Such bias can occur in hospitals that have more expansive screening criteria for VTE, including the testing of asymptomatic patients, or in hospitals that rely more heavily on imaging for diagnosis, said the authors, who analyzed data from the CMS' Hospital Compare, the American Hospital Association and Medicare claims.
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A Medicare test of accountable care in Wisconsin slowed cost growth last year for about 20,000 seniors. That's good news, of course, to economists and policymakers. But for hospitals, the news was not all good because most payers continue to reimburse on a fee-for-service basis rewarding more admissions and more volume of services.
An article in the Journal of the American Medical Association said that for hospitals that participate in Medicare accountable care programs, such as ThedaCare in Appleton, Wis., competing financial incentives can make their ACO efforts counterproductive.
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As healthcare providers work to adopt electronic health records and achieve Stage 2 meaningful-use standards, most Americans are confused and concerned about the transition from paper to digital, according to a survey by Xerox.
Xerox, which polled about 2,000 U.S. adults in its fourth annual EHR survey, found that only 29% of them had been told by their physicians that their medical records would be converted from paper to digital format. And although most of the respondents think EHRs will reduce healthcare costs (62%) and improve quality of healthcare service (73%), even more (83%) worry about digital issues including security. Nearly seven out of 10 do not want their medical records in a digital format.
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Wachter
At the sixth International Conference on Diagnostic Error in Medicine on Wednesday, Dr. Robert Wachter gave a quick history of patient safety and quality improvement but noted that activity to reduce diagnostic errors was noticeably absent from the movement's timeline.
“There's still not a lot of action promoting this agenda,” said Wachter, professor and associate chair of the Department of Medicine at the University of California at San Francisco. He made the remark after describing events that took place after the Institute of Medicine published “To Err is Human,” its report on medical errors, in 1999.
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The American College of Physicians is nervous about where HHS is headed with the criteria for meaningful use of electronic health records.
The organization wrote a letter to the Office of the National Coordinator for Health Information Technology addressing “what has been released for Stage 2 and what we have been told to expect for Stage 3” in the federal EHR meaningful-use program.
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Hoven
“To paraphrase Mark Twain, the reports of the death of private practice medicine have been greatly exaggerated,” Dr. Ardis Dee Hoven, president of the American Medical Association, said in a news release touting the findings of a recent survey that indicates how the trend toward hospital employment of physicians may be overstated.
According to the AMA's new Physician Practice Benchmark Survey, 53.2% of physicians were self-employed in 2012, 41.8% were employed and 5% were independent contractors.
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Spending on healthcare is expected to rise just 4.5% next year as employers and providers make a number of moves to bring down costs.
In its annual Behind the Numbers report, PricewaterhouseCoopers' Health Research Institute is forecasting a medical cost trend of 6.5% for 2014—offset by health insurance changes that will effectively lower that number two percentage points.
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But wait, there's more!
For those who know they exist, the state health insurance exchanges set to open next month are primarily a vehicle by which the reform law will offer individuals, families and small businesses a choice of health plans and an opportunity to receive a federal premium subsidy.
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But wait, there's more!
For those who know they exist, the state health insurance exchanges set to open next month are primarily a vehicle by which the reform law will offer individuals, families and small businesses a choice of health plans and an opportunity to receive a federal premium subsidy.
Read more »
