#WWBR Week of June 29, 2015

by | Jul 3, 2015

How to Take Charge of Your Medical Records
(Note: this complements Naveen’s post earlier in the week on this subject)
Melinda Beck in The Wall Street Journal
“This piece, on the issues surrounding patient access to their own records, might as well have been written five years ago. Few of the issues have changed, and though the technology is purportedly much-improved, access remains sporadic and difficult. With healthkit in the mix and July 4th’s “Data Independence Day” on the horizon, we are hopeful that we’ll see more tangible progress in the next 18 months than we have seen in the last 36.” – Naveen

ONC’s Michael McCoy, M.D. at AMDIS: Information-Blocking for Proprietary Reasons Is “Just Wrong”
Mark Hagland in Healthcare Informatics
“Many believe that the hubbub about information blocking is just noise. ONC continues to signal that the feds are taking it more seriously. The fundamental question about ownership of patient data is still out in the ether. Actual legal ownership of this data has not been unambiguously established. This article says that ONC is not required to pursue policies that are important to any business’s mission. Its job is to pursue policies consistent with the public good.” – Brian M.

Reducing Hospital Readmissions Through Medication Management and Improved Patient Adherence
NEHI Report
“A report by the Network for Excellence in Health Innovation (NEHI) focused on the hosptital’s role in medication management. The report made 6 specific recommendations that hospitals can adopt in the short-term including adoption evidence-based transition models; screening ER patients upon arrival for highest risk of readmissions; talking to the hospital staff about the quality of medication reconciliation; incorporate PCMHs in their organization; and use MMTM services for eligible Medicare patients. In the long-term, the report says HCOs should work to make real-time patient medication data available at all points of care; create a state-level discussion on how to use pharmacists with appropriate clinical skills to implement comprehensive medication therapy management; and explore opportunities to implement evidence-based changes to prescription drug coverage payment policy among all payers. Biggest challenge though often for hospital & hospital staff is simply one of time in a number of these circumstances since a full and comprehensive medication reconciliation process can take up to 15 minutes with a patient.” – Matt

The Use of Telemedicine to Address Access and Physician Workforce Shortages (PDF link)
Committee on Pediatric Workforce for American Academy of Pediatrics
“In a policy statement, the American Academy of Pediatrics has called for the reduction of barriers to the use of telemedicine, as well as equitable payment for pediatricians who practice telemedicine. However. the AAP also cautions that telemedicine only works well when it’s part of the medical home model – episodic one-off visits only lead to fragmented care, which begets incomplete care, which begets redundant services, which begets wasted dollars. That’s why the AAP also calls for broader funding, research, credentialing and licensure so that pediatricians can more easy incorporate telemedicine into their workflow.” – Brian E.

Taking a load off nurses: Hospitals eye installing patient lifts but face technical, cost challenges
Adam Rubenfire in Modern Healthcare
“The oversize wheelchairs that cluster around the similarly oversized entries in most hospitals have been around for a long time and signal a workplace hazard within. Lifts help reduce the incidence of injury when moving patient in and out of beds. But the obstacles to using this technology can be more complicated than the obstacles to using EHRs. This article has some surprising information. Innovation is coming from Europe where waistlines are smaller and the costs are more than you would think.” – Brian M.

County aims for a Healthier Allegheny
Patrick Cloonan in TRIB Live
“The Allegheny County Health Dept. in PA (Pittsburgh) finally released its 200-page report on how the county and numerous stakeholders plan to improve health in their county over the next 3 to 5 years. Five critical priority areas had been identified, with objectives, metrics and actionable strategies to help achieve improved health outcomes for the county. This plan is the product of a process that included 14 community meetings last year, and 1,000 responses to an online survey and community needs assessments conducted by 15 nonprofit hospitals. The advisory council was made up of over 70 stakeholders including a number of large employers, local education institutions, several special health and environmental groups, community/social organizations, and key hospital networks. Given how paralyzing a topic health reform is even at the state level yet in a number of states, county and city health departments have a key opportunity to drive local health improvement through these types of comprehensive plans.” – Matt

Health IT–Enabled Care Coordination: A National Survey of Patient-Centered Medical Home Clinicians
Suzanne Morton, et al in Annals of Family Medicine
“A study published in the Annals of Family Medicine found that health IT capabilities for care coordination, as defined by the meaningful use stage 3 proposed criteria, don’t align with what practices large and small actually need. For example, more than 3 in 4 providers deemed timely notification of hospital discharges to be “very important,” but fewer than 1 in 2 had systems capable of providing these types of notifications. The research suggests that the systems providers have don’t really meet their needs.” – Brian E.

Pursuit of Cash Taints Promise of Gene Tests
Reed Abelson and Julie Creswell in The New York Times
“What happens when the promise of tomorrow’s vision of advanced, personalized medicine comes crashing into today’s reality of tightening efficiencies, utilization reviews, and cost analyses? Here is one example: Startups who are inflating the number of lab tests ordered (and sending Medicare the bill) are facing the heat. Stories like this one help to shed light on how multiple billion dollar industries are running around independently under the broader umbrella of the ‘health care industry.'” – Naveen

Patient Use of Email, Facebook, and Physician Websites to Communicate with Physicians: A National Online Survey of Retail Pharmacy Users
Joy L. Lee, et al, in Journal of General Internal Medicine
“An online survey of more than 2,200 CVS Health customers with at least one chronic condition found that 37 percent had emailed their doctor within the last 6 months; another 18 percent had contacted their doctor via Facebook. The researchers from Johns Hopkins and Partners HealthCare admit that a survey of Internet-savvy users of a retail health clinic doesn’t represent the population at large, but the results do show an interest in communicating with physicians outside the clinical setting – just not on a patient portal.” – Brian E.

Senior Tech: A Tablet for Aging Hands Falls Short
Jennifer Jolly in The New York Times
“Nice read here – what could go wrong if AARP offered a “senior-friendly” tablet product without doing proper background research on what their target demographic wants and needs? As with any consumer facing technology, optimizing the user experience is a pre-requisite to success.” – Naveen

Transforming Health Care Scheduling and Access: Getting to Now
Institute of Medicine Report
“In a report commissioned in response to last year’s Veterans Health Administration scandal, the Institute of Medicine called for “leadership involvement from stakeholders in every aspect of healthcare,” from national leaders all the way down to front-desk receptionists at health clinics, to commit to “immediate exploration and engagement” of patients’ needs – not day, weeks or even months later. Increased use of telemedicine will help reduce wait times, the IOM said, as will better scheduling software, more robust EHR systems, more timely patient engagement and new models of care delivery.” – Brian E.


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