The Health Care Blog – Page 409 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

What Company Will You Keep? Strategy In Health Care’s New Era

Jul 15, 2015• 4

By JOE FLOWER

Joe-Flower How do you plan? Obviously, you have to. Obviously, you can’t.

For your organization, and for you as a health care leader, the rapid and, at times, chaotic changes in the payment systems, the purchasers’ strategies, your population base, new technological possibilities, and the competitive landscape mean that you must plan for the future and act vigorously to make that future happen — or you fail. At the same time, those very same factors render traditional planning methods irrelevant, impossible, even deadly.

The movie line that comes to mind is, “Forget it, Jake. It’s Chinatown.” But we can’t just forget it. We must figure this out.

Let’s step through it: the shape of the complexity we are dealing with, how the process must change to deal with it. Then we get to a core issue that often gets overlooked: What kind of mind do we need for this new thinking, and how do we cultivate it?

Why Health Care Performance Measures Need Their Own Grades

Jul 13, 2015• 1

By MATT AUSTIN

Some measures of health care quality and patient safety should be taken with a grain of salt. A few need a spoonful.

In April, a team of Johns Hopkins researchers published an article examining how well a state of Maryland pay-for-performance program measure for dangerous blood clots identified cases that were potentially preventable. In reviewing the clinical records of 157 hospital patients deemed by the state program to have developed these clots — known as deep vein thrombosis and pulmonary embolism — they found that more than 40 percent had been misclassified. The vast majority of these patients had clots that were not truly preventable, such as those associated with central catheters, for which the efficacy of prophylaxis remains unproven.

These misclassified cases of blood clots resulted in potentially $200,000 in lost reimbursement from the state, which penalizes hospitals when the additional treatment costs related to more than 60 preventable harms exceeds established benchmarks.

Why the discrepancies? The state identified cases of these clots using billing data, which utilize the diagnosis codes that medical billing specialists enter on claims. These data, also known as administrative data, lack the detail that would be available in the actual clinical record, considered by many to be the most trusted source for safety and quality measures.

Bungled Payments

Jul 13, 2015• 2

By PAUL KECKLEY

The proposal involves a five-year bundled payment model across 75 geographic areas whereby hospitals would be eligible for a bonus if their costs and outcomes were optimal or be penalized if not based on results 90 days post-discharge. The agency noted that in 2013, it spent more than $7 billion on hospitalization for these procedures with the payments for hospitalization and recovery ranging widely from 16,500 to $33,000. Comments about the proposal will be received by CMS through September 8, 2015, aiming for implementation January 1, 2016.

Their rationale, according to Secretary of Health and Human Services Sylvia Burwell, in the HHS statement announcing the proposal: “By focusing on episodes of care, rather than a piecemeal system, hospitals and physicians have an incentive to work together to deliver more effective and efficient care. This model will incentivize providing patients with the right care the first time and finding better ways to help them recover successfully. It will reward providers and doctors for helping patients get and stay healthy.”Continue reading…

How Big Data Can Be Used to Improve Early Detection of Cognitive Disease

Jul 13, 2015• 1

By CYNTHIA RUDIN

The aging of populations worldwide is leading to many healthcare challenges, such as an increase in dementia patients. One recent estimate suggests that 13.9% of people above age 70 currently suffer from some form of dementia like Alzheimer’s or dementia associated with Parkinson’s disease. The Alzheimer’s Association predicts that by 2050, 135 million people globally will suffer from Alzheimer’s disease.

While these are daunting numbers, some forms of cognitive diseases can be slowed if caught early enough. The key is early detection. In a recent study, my colleague and I found that machine learning can offer significantly better tools for early detection than what is traditionally used by physicians.

One of the more common traditional methods for screening and diagnosing cognitive decline is called the Clock Drawing Test. Used for over 50 years, this well-accepted tool asks subjects to draw a clock on a blank sheet of paper showing a specified time. Then they are asked to copy a pre-drawn clock showing that time. This paper and pencil test is quick and easy to administer, noninvasive, and inexpensive. However, the results are based on the subjective judgment of clinicians who score the tests. For instance, doctors must determine whether the clock circle has “only minor distortion” and whether the hour hand is “clearly shorter” than the minute hand.

Powering Medical Research With Data: The Research Analytics Adoption Model

Jul 13, 2015

By HEALTH CATALYST SPONSORED CONTENT

Research is a critical part of creating a learning health system that routinely incorporates the latest treatment guidelines into its clinical care. The efficacy of new treatments and guidelines are studied by researchers who recommend better, more personalized treatment protocols. Increasingly, researchers have been tasked with not only identifying new interventions to create better clinical outcomes, but also with partnering with healthcare delivery systems to implement those new discoveries.

Analytics are becoming imperative to researchers in recruiting patients into studies, making breakthrough discoveries, as well as monitoring the clinical implementation of these discoveries. This webinar will be for organizations that want to leverage their enterprise data to power more effective research.

Date: Wednesday, July 22, 2015

Time: 1:00–2:00 PM ET

Join Eric Just, Vice President of Technology at Health Catalyst, as he presents a Research Analytics Adoption Model that outlines ways that a research organization can leverage data and analytics to achieve greater speed and ROI on research.The Adoption Model walks through analytics competencies starting with basic data usage and culminating with using analytics to incorporate the latest research discoveries into clinical practice.

Attendees will be presented with:

A summary of some of the challenges in using data and analytics for research
A research analytics adoption framework for all organizations interested in using clinical data for research
What is needed from a workflow and organizational perspective to power research with data

We look forward to you joining us.

Death By Documentation

Jul 11, 2015• 2

DIKE DRUMMOND, MD

In my work with hundreds of over stressed and burned out physicians, one thing is constant. Documentation is always one of their biggest sources of stress.

In fact, if you ask the average working doctor to make a list of their top five stresses, documentation chores will take up three of the five slots.

1. EMR – especially if you use multiple EMR software programs that don’t talk to each other

2. Dealing with lab reports and refill requests

3. Returning patient and consultant calls and documenting them adequately and all the other places information streams have to be forced together by the sweat of your brow.

The average doc is walking the cliff edge of overload on a significant number of office days in any given month. Now comes ICD-10 and my biggest fear is the extra work of the new coding system will push many physicians over the edge into burnout.

How much more time will ICD-10 take?

What the Atlanta HIV Data Tells Us About Public Health in America

Jul 10, 2015

By MAITHRI VANGALA

“The night I found out, I slept one and a half hours,” recalls D, a 29-year-old black gay man.

He’s talking about being diagnosed with HIV, the virus that causes AIDS.

“Even though I work in public health and tell people daily that HIV is not a death sentence, that first night that’s all I could think of,” says D. “This has to be wrong, I thought. I work in public health. This can’t happen to me.”

D, who requested anonymity, says he contracted the virus when a condom broke during sex. Two weeks later, he was tested for two sexually transmitted infections (STIs) – chlamydia and gonorrhea – but not for HIV. Shortly afterward, he went back for an HIV test and found out that he had the virus.

Soon after his diagnosis, D moved to Atlanta, which also happens to be the epicenter of a re-emerging national HIV crisis.

To Make Hospital Quality a Priority, Take a Page From Finance

Jul 9, 2015• 1

By PETER PRONOVOST, MD

When you are a patient at a hospital, you want to know that the executives who run that facility put the safety and quality of care above all other concerns. Encouragingly, more of them are saying that safety is indeed their number-one priority—a fitting answer given that preventable patient harm may claim more than 400,000 lives a year in the United States.

Yet when you look at the way that most hospitals and corporate health systems are organized, weak infrastructure exists to support that priority. True, some hospital boards of trustees have made safety and quality their first order of business. At meetings, they might hear directly from a patient who suffered a medical error, sit through a case study of a unit that reduced complications, or get an overview of various efforts to boost the patient experience and improve outcomes.

Stories can inspire culture change. Sustained improvements, however, require health care organizations to institute top-to-bottom accountability for performance.

What would it look like if safety and quality truly were addressed this way? It might be something like how most hospitals’ finances are managed, from the board level to the smallest unit.Continue reading…

Why Doctors Quit (And What to Do About It)

Jul 8, 2015• 21

By JOHN HAUGHOM, MD

I got an e-mail from out of the blue the other day.

The e-mail informed me that a colleague, a man I respected greatly, had tendered his resignation at the hospital. That coming Friday would be his last day. There would be an informal gathering for staff at the hospital cafeteria and that would be that.

I was shocked. The physician in question was an institution at our hospital. As far as I knew he was happy, his patients loved him, he was respected by his peers. I could think of no earthly reason for him to go. This did not did not sound like the old friend I knew.

I did what any friend would do: I picked up the phone and called him.

“I just got the e-mail. What’s going on?” I asked “Is something up at home? Is everything ok with Sarah and the kids?”

“Nothing’s wrong. I’ve just been doing a lot of thinking. I’ve decided I want to spend time with the kids and explore some outside projects.

Outside projects? What sort of outside projects?

My friend was the not kind of guy who you thought of as spontaneously quitting his job. I pressed him. He finally broke down and confessed. He was miserable at work.

“It’s the bean counters. They’re everywhere. Every day I get an e-mail that says I’m underperforming on this metric or that metric. It’s making me crazy. My self-esteem can’t take it. Last week, I got an e-mail that told me I need to do a better job of answering patient e-mails. I didn’t even know they were allowed to e-mail us. How long has this been going on? I tell you, I love my patients, but I just can’t take it anymore.”

(Even) More Disruption, Please !!

Jul 8, 2015• 3

By KYLE ARMBRESTER

There are two questions I hear all the time from digital health care entrepreneurs: 1) How can I gain initial market traction? 2) How do I grow my client base?

Health care is an incredibly tough market to sell into. Even if you have a highly-differentiated solution with proven value, the barriers to access and scalability are extremely high.

For entrepreneurs trying to break in, the problem is two-fold. First, the majority of providers are focused on patient care – getting on their radar is difficult. Second, even if an entrepreneur does gain buy-in and proves value to a single provider or group, it’s difficult to build upon that success.

Negotiate Strategic Partnerships

The first lesson to get ahead: Learn how to spot a valuable partnership and negotiate a good deal—whether with an accelerator, incubator, or VC.

There are 87 accelerators (and counting) dedicated to jumpstarting the most promising health care startups in the country, and each is as differentiated as the companies they nurture. These accelerators vary in how structured their programs are, as well as the threshold of capital they invest. Timeframes differ, the amount of equity required varies, the level of mentorship fluctuates, and the quality of contacts/potential clients runs the gamut. Despite the differences, the objective is the same: to help propel entrepreneurs into health care.