Tuesday, April 1, 2014

Burnt Out Primary Care Docs Are Voting With Their Feet

This KHN story was produced in collaboration with wapo
Janis Finer, 57, a popular primary care physician in Tulsa, Okla., gave up her busy practice two years ago to care full time for hospitalized patients. The lure? Regular shifts, every other week off and a 10 percent increase in pay.
Illustration by Doug Chayka
Lawrence Gassner, a Phoenix internist, was seeing four patients an hour. Then he pared back his practice to those who agreed to pay a premium for unhurried visits and round the clock access to him.  "I always felt rushed," said the 56-year-old. "I always felt I was cutting my patients off."
Tim Devitt, a family physician in rural Wisconsin, took calls on nights and weekends, delivered babies and visited his patients in the hospital. The stress took a toll, though: He retired six years ago, at 62.
Physician stress has always been a fact of life.  But anecdotal reports and studies suggest a significant increase in the level of discontent-especially among primary care doctors who serve at the frontlines of medicine and play a critical role in coordinating patient care.
Just as millions of Americans are obtaining insurance coverage through the federal health law, doctors like Finer, Gassner and Devitt are voting with their feet. Tired of working longer and harder because of discounted insurance payments and frustrated by stagnating pay and increasing oversight, many are going to work for large groups or hospitals, curtailing their practices and in some cases, abandoning primary care or retiring early.
"I was thinking of leaving medicine; I didn't think I could maintain the pace," Gassner said about why he switched to a concierge-style practice with the help of consultant MDVIP.  "I went to bed many nights lying awake, worrying that I missed something."
The timing couldn't be worse. "The lack of an adequate primary care infrastructure in the U.S. is a huge obstacle to creating a high-performing health care system," said David Blumenthal, president of The Commonwealth Fund, a health care research foundation.
A 2012 Urban Institute study of 500 primary-care doctors found that 30 percent of those aged 35 to 49 planned to leave their practices within five years. The rate jumped to 52 percent for those over 50.
Stressed doctors, meanwhile, often mean anxious, dissatisfied patients. Many consumers report feeling shortchanged after waiting weeks or even months for an appointment, only to get a quick once-over and be told there isn't time to address all their complaints in one visit.
"Your actual one-on-one with the doctor is getting to be less and less," said Christine Miserandino, 36, of Valley Stream, N.Y., who sees many doctors to manage her lupus.
Unhappy Doctors, Unhappy Patients

There are no hard national data on physician burnout. But nearly half of more than 7,200 doctors responding to a survey published in 2012 by the Mayo Clinic reported at least one symptom of burnout that indicated a loss of enthusiasm about medicine or cynicism about it. That's up from 10 years ago, when one quarter of doctors reported burnout symptoms in another survey.
A RAND study for the American Medical Association last year found that nearly half of surveyed physicians called their jobs "extremely stressful" and more than one-quarter said they were either "burning out," experiencing burnout symptoms "that won't go away," or "completely burned out" and wondering if they "can go on."  Nonetheless, many described themselves as satisfied with their profession.
But should the happiness of physicians - a fairly privileged lot - be of concern to their patients? Experts answer with a resounding 'yes,' saying that unhappy doctors can make for unhappy patients.
Indeed, one of the drivers of physician dissatisfaction is their sense they are shortchanging patients: that they are too rushed, don't have enough time to listen and aren't always providing good care.
"Being a doctor is a bit like being a parent, where they say you're only as happy as your least happy child," said Martin Kanovsky, 61, an internist in Chevy Chase, Md., who reduced the number of patients he is seeing from 1,200 to 400 last December when he switched to an MDVIP concierge practice. "At the end of the day, if you have one patient who's unhappy, you're unhappy."
Research shows that patients of satisfied doctors are more likely to show up for their appointments and adhere to treatment for diabetes and high blood pressure. Another survey found dissatisfied physicians reporting more difficulty than other doctors in caring for patients.
And in another study, burned-out surgeons were more likely to report having made a major medical error, in the past three months. 
"What drives physician satisfaction is also what patients and payers want - delivering good care. And we're less and less able to do that," said Christine Sinsky, an internist in Dubuque, Iowa, who is working with the AMA to try to improve physician satisfaction. "You spend less time listening to patients, getting to know them, and thinking more deeply about their care." 
'I Knew I Had To Be Able To Sleep At Night'
That was the situation that confronted Janis Finer, who loved - but ultimately left -primary care to work with hospital patients.
Like many physicians, she did not want to be bothered with the business of medicine -dealing with insurers, hiring staff and making bank deposits -and sold her practice to a hospital.
But hospital administrators dictated the pace, telling her she needed to see 22 to 28 patients a day.  "At one point, we were scheduled to see patients every 11 minutes," Finer said.
She was supposed to suggest they schedule another visit if they had more than one or two medical complaints. But Finer worried they wouldn't come back.
"I knew I had to be able to sleep at night," she said. "I was trained to dot every 'i,' and cross every 't' and leave no stone unturned."
If a patient had anemia, for example, she could simply prescribe iron, but she wanted to find out what was causing it. 
But she found she was unable to do such things while seeing so many patients.
At the same time, her income lagged far behind that of her peers in specialties, a pay disparity that irked her more over time. Salaries of primary care physicians were around $220,000 in 2012, according to the 2013 Medical Group Management Association's compensation survey, while specialists were averaging close to $400,000, with cardiologists and orthopedic surgeons earning over half a million dollars.
Efforts to boost compensation for primary care doctors have been largely unsuccessful. Specialists' pay is based largely on procedures, but primary care doctors are usually paid per visit, and not reimbursed for managing their patients' care outside of visits, which can consume a lot of their time.
Richard J. Baron, president of the American Board of Internal Medicine, set out to document how much time a doctor spends managing care and discovered that on a typical day, he or she handles 18.5 phone calls; reads 16.8 e-mails; processes a dozen prescription refills (not counting those written during a visit); interprets 19.5 lab reports; reviews 11 imaging reports; and reads and follows up on 13.9 reports from specialists.
"This is not just busy work -- this is about meeting the patients' needs," Baron said.  "But … it doesn't generate revenue."
'I Used To Be A Doctor; Now I'm A Clerk'

Perhaps the single greatest source of frustration for many physicians is a tool that was supposed to make their lives easier: electronic medical records.
Many do not merely dislike electronic health records - they despise them. "We were surprised by the intensity of their reports," said Mark Friedberg, a physician and co-author of last year's RAND study.
In 2009, President Obama committed billions of dollars to help defray providers' costs of going digital. The goal was to boost coordination of care and to reduce errors and rampant duplication. Most primary care doctors got financial help from the federal government and also face potential penalties beginning next year if they don't use the new systems.
But many physicians say that instead of speeding things up, digital records have slowed them down. They say the designs often frustrate patients and providers -with the doctor's face often turned to the computer screen while the patient is talking.
Digital records often contain numerous, repetitive information fields but leave little room for the kind of personal, nuanced observation that was captured in an old-fashioned doctor's note. And restrictions on who is allowed to input the data have shifted many administrative tasks from medical assistants and nurses to physicians.
Using electronic medical records is often more time-consuming for primary-care physicians than for specialists, because they are often taking more comprehensive medical histories, tracking more tests and lab results and filling in more fields.
"Many physicians said to us, 'I used to be a doctor, now I'm a clerk,'" said Dr. Jay Crosson, a pediatrician and vice president of professional satisfaction for the AMA.
Worsening Shortage Forecast
Meanwhile, the promise of electronic health care records to reduce errors and duplication and facilitate communication has so far gone largely unfulfilled, as far as many doctors are concerned.
John Schumann, a primary care doctor who teaches at the University of Oklahoma's School of Community Medicine in Tulsa, sees patients at three different hospitals, with three different record systems. "They're all different and none of them talk to each other," he said. "That's the kind of thing that drives doctors' nuts."
To ease the burden, some physicians have started using scribes - laptop-carrying assistants who follow them in and out of the exam room.
Scribing is one of several proposals to provide greater support to physicians by giving more responsibility to nurses, health coaches and health educators. But adding personnel involves additional costs, which worries physicians trying to limit their overhead.
The trend line, meanwhile, is troubling. The Association of American Medical Colleges estimates the United States will be short 45,000 primary-care doctors in 2020, when 268,000 are projected to be practicing. That compares to a shortfall of 9,000 in 2010, with 254,800 practicing.
Even a recent uptick in medical students who are electing primary care is not enough to avert the projected shortage. Meanwhile, experienced doctors are joining large groups or becoming hospital employees, which some argue reduces clinical autonomy and discretion -such as deciding how much time to spend with patients -and which may potentially drive up health-care costs because hospitals may tack on additional fees to their bills.
"They want a place to shelter from the storm," Blumenthal said.


Gaming technology saves millions for Spanish healthcare


Technology in health isn’t just about investment, it’s about massive savings


Teki takes advantage of the Kinect system on Xbox.
In Spain’s Basque Country patients with chronic diseases including asthma, diabetes and arthritis are turning on their Xbox games consoles with their doctors’ approval. They are using a system called Teki which has been developed for the Basque health authorities by IT consultants Accenture.
Teki takes advantage of the Kinect system on Xbox which has a video camera that tracks a gamer’s movement so they can interact with games without a joystick or controller. The off-the-shelf technology means that patients can be monitored in their homes but also interact with health professionals without constant visits to a clinic or hospital.
Teki is part of a larger move towards using the phone and internet for interacting with the health system. During the first year of the project, Accenture estimates there was a €50 million saving through reducing the number of visits to hospitals. Some 18 per cent of primary care interactions in the Basque Country now happen online or over the phone.
Irishman Sean Shine is Accenture’s senior managing director for health and public service, and has been involved in major healthcare technology projects around the world in recent years including Teki.
He says “connected health” – where medical records are stored electronically and then linked up so that trends in the overall system can be spotted – is key to getting the most out of technology in the health system. Accenture is involved in connected health projects in Australia, Norway, Singapore and the US but Shine says they are not the sole preserve of wealthy countries with well-funded health systems.
“Brazil is beginning to look at connected health and beginning to look at a public-private partnership where they may get the private sector to invest to build some of that infrastructure and provide it back to them on an ongoing basis,” says Shine. “They don’t have the funding to provide for everything up-front but they want to see if they can do it almost on a month-by-month basis.”
In the UK, Accenture delivered a project for Cambridge University Hospital to address acute bed shortage which saved £5.7 million (€6.9 million) annually. One hospital in the group also managed to reduce the average length of stay by five days.
Despite the cost savings, some might be uncomfortable with the notion of a management consultant deciding how long you need to recuperate after a major procedure. “Obviously in order to do that you need to have the right skills because you can’t just have a generic consultant coming in and saying what if we moved this or changed this around. Having the mix of the clinical skills and the typical consulting and engineering type capabilities and bringing those together is essential.”
Shine also points out that Accenture has hired the necessary skills so it can help its clients make clinical decisions. “I’m still amazed when I meet some of the doctors we have on our payroll. They are lifetime physicians, they’ve been around but they’ve moved from being active clinicians into the consulting space.”
The use of technology in the Irish health system has a decidedly mixed history not least because of under-investment. In most European countries, 2-3 per cent of the healthcare budget has been invested in IT, in Ireland it’s been less than 1 per cent. As a result, Shine believes difficult decisions need to be made about investing at a time when costs are under severe pressure.
“There is a recognition [in the health system] that many of these things need to be done. I think we’ve seen a renewed focus on recognising that investments in the IT and administrative infrastructure are needed. And that the benefits of doing that are as significant, perhaps even more so, than some of the clinical things that are being done.
“You say you are putting in a new financial system and everyone falls asleep but actually you need that as a base.”

Cole Memorial offers telemedicine for pediatric emergencies


COUDERSPORT — Cole Memorial Hospital in Coudersport has launched pediatric telemedicine in the emergency department and maternity unit, thanks to the Optimizing Utilization and Rural Emergency Access for Children (OUTREACH) program through the University of Pittsburgh Medical Center.
Hospital officials said when a child requires emergency health care, pediatricians and emergency medicine providers at Cole Memorial will be able to consult with clinical specialists at Children’s Hospital of UPMC via the new state-of-the-art telemedicine technology.
“The telemedicine unit is portable so it can be used in the emergency department or in the newborn nursery at the hospital, allowing our providers to collaborate with pediatric specialists in Pittsburgh,” said Ann Slotta, RN, director of maternal/child and inpatient behavioral health services at Cole Memorial.
Telemedicine offers two-way audio/video conferencing applications to provide high-level clinical consultations between a Cole Memorial provider and a specialist at a distance.
Cole Memorial director of emergency services Shannon Work, RN, said 18 percent of the patients that visit the hospital’s emergency department are age 18 and under. 
Hospital officials said so far, the benefits of Cole Memorial’s pediatric emergency telemedicine service include patients and their family travel less to receive specialized care; the need for hospital admissions may be reduced; when higher-level care or a special procedure is required, transfers may be made immediately; expert care is available 24/7; and provides patients, their family members, hospital providers and staff with an increase in satisfaction with the outcomes.
“The first pediatric tele-emergency patient visit ... allowed our patient to be evaluated by an emergency room provider at the Children’s Hospital of Pittsburgh, who agreed with me that he was stable for discharge to his own home,” said Dr. Marlene Wust-Smith, a pediatrician. “Our patient was relieved to not have to travel four and a half hours to Pittsburgh, and I was reassured that his presenting complaint did not require further work-up.” 
In addition, the following tele-medicine services are available at Cole Memorial with expert clinical partners such as: Rheumatology with the Geisinger Health System in Danville and cardiology and neurology with UPMC Hamot Heart and Vascular Institute in Erie. 
For more information, visit the website www.colememorial.org.

Monday, March 31, 2014

AAPC Alert - Keep Calm and Code On


The United States Senate just passed HR 4302, the Protecting Access to Medicare Act. If signed into law by President Obama, then this bill will delay ICD-10 and shift required implementation from October 1, 2014 to as early as October 1, 2015. The act also extends the “doc fix” for Medicare’s Sustainable Growth Rate (SGR) payments for a year.

The bill was rapidly introduced to the House of Representatives on Thursday, March 27th, for vote. After a voice vote passage, it moved to the Senate for today’s vote. Primary arguments cited for delaying the ICD-10 implementation included lack of readiness surrounding clinical documentation, vendor solutions, and systems testing.

We encourage you to keep calm and code on. 

If you are ready for implementation, then we know this delay may be difficult; we will support you with both access extensions and refresher courses. If you need another year, then this change offers an opportunity to increase your readiness through proactive education, practice, and testing. The postponement allows improvement of anatomical knowledge, review and adjustment of documentation quality and clinician education, and adjustment of coding and billing procedures.

AAPC remains committed to serving you with the highest quality training and support to help you adapt to the ever-changing healthcare environment.

www.aapc.com

ICD-10: Translation 101

Never let it be said that the implementation of ICD-10 has not been exciting.

ICD-10 is still a critical project that will continue to require our full attention. One of the areas of implementation that seems to create the most anxiety is translation. So let’s talk about it.

You’ve probably heard about the concept a hundred times and in several ways, such as mapping, crosswalking, translating, converting, etc. But what does it really mean? And what is the best verb to describe it? I offer, for your consideration, a breakdown of the verbs that are associated with the act of identifying the ICD-10 counterpart for a given ICD-9 code, or vice versa:
  • Mapping – Using a starting point (ICD-9 code) and plotting an end point (ICD-10 code).

  • Crosswalking – Identifying a code that is the equivalent of a starting code (ICD-9 or ICD-10).

  • Converting – Changing policies, processes, and systems from current ICD-9 logic to ICD-10 logic, including the codes themselves.

  • Translating – Using all methods available (including mapping, crosswalking, and converting, along with review of business requirements, clinical equivalence and appropriateness, and standard coding methodologies and guidelines) to identify the equivalent code or codes in ICD-10.
Many people use these terms interchangeably, but I am here to offer a little perspective, having done all of the above with my own two hands. These are not the same actions, but each can be a step in a much larger process that we all must embark upon if we are to implement ICD-10. 

We can’t use just one technique and call it a day. Case in point: we have all heard of the general equivalence mappings, or GEMs, that were developed by the Centers for Medicare & Medicaid Services (CMS) and 3M and released for free to the public for use in the transition to ICD-10. These mappings are also the standard “crosswalk” as required by the Patient Protection and Affordable Care Act. But these mappings, of which only a small percentage could be considered an actual “crosswalk,” are only a starting point in a much larger process. Look at this statement found in the GEMs User’s Guide:

“There is no simple ‘crosswalk from I-9 to I-10’ in the GEM files. A mapping that forces a simple correspondence — each I-9 code mapped only once — from the smaller, less detailed I-9 to the larger, more detailed I-10 defeats the purpose of upgrading to I-10. It obscures the differences between the two code sets and eliminates any possibility of benefiting from the improvement in data quality that I-10 offers. Instead of a simple crosswalk, the GEM files attempt to organize those differences in a meaningful way, by linking a code to all valid alternatives in the other code set from which choices can be made depending on the use to which the code is put.”

A simple solution is not always the best solution, and the translation process is anything but simple. In fact, it is a dynamic process that can change between business areas based on the use of codes or code data. Not everyone uses the codes in a standard way. If we’re completely honest, not everyone applies the codes according to the official coding guidelines. What we code is wholly determined by our understanding of the codes and how to apply them. The same is true for how codes are used within a payor system and how claims processing and adjudication rules are coupled with codes in the systems. Therefore, a standard “crosswalk” is not a solution based in reality in today’s healthcare environment.

But we shouldn’t feel defeated or start looking at ICD-10 implementation as some sort of insurmountable obstacle. Instead, let’s set aside our frustrations, breathe, and take a moment to assess what needs to be done to translate our ICD-9 world into the language of ICD-10. Here are some tips to get you started:
  1. Assess and prioritize what requires modification. Because the implementation clock is ticking, don’t waste your precious time on efforts that can wait until after the implementation date has come and gone. Focus on what absolutely needs to get done in time for testing and ahead of implementation.
  2. Take stock of your internal coding expertise. Leverage the human resources you have to help in any translation efforts you may have going on, regardless of whether they are expert coders or know “just enough to be dangerous.” Get started and assess where your gaps in knowledge are.
  3. Identify your clinical resources. Clinical knowledge may be all you need to address any gaps that can’t be filled by your coding expertise. Sometimes it’s only a small piece of the puzzle that will yield the solution.
  4. Take advantage of free resources – GEMs and ICD-10 manuals are available free of charge through CMS (www.cms.gov/Medicare/Coding/ICD10) along with the new Road to 10 provider portal (www.roadto10.org). Start by familiarizing yourself with the ICD-10 code set using the manual, and then you can begin any translation by looking up your ICD-9 codes in the GEMs. Use the manuals, which provide coding guidelines, to identify any codes that the GEMs do not identify. Remember, the GEMs are only an approximation.
  5. Align your translations with your business requirements. Translation does not end with the identification of the appropriate ICD-10 codes. Review your translations in the context of your business requirements. Some ICD-10 codes may not be applicable, and there may be additional gaps that will need to be addressed.
  6. Create a review and approval process. Employ more than one set of eyes to review the translations, ensuring that all solutions are as complete and accurate as possible. Formalize the approval process by identifying the owner of the process, and make sure he or she is responsible for approving any translation solution along with when the approval was given.
  7. Archive your translation solutions. Who knows what will be needed in terms of documentation, post-implementation, so make sure you have all solutions and their related information archived and available for future reference.
Don’t sweat the small stuff. And don’t bite off more than can be chewed properly before October 1, 2015. But do get started sooner rather than later!


About the Author
Mandy Willis is a Certified Coding Specialist and AHIMA Approved ICD-10 Trainer with 15 years of experience in the healthcare industry. She has worked in the small physician practice environment, commercial payer and Medicare and Medicaid. Currently, her focus is on assisting all sectors of the healthcare industry in making the transition to ICD-10.

Contact the Author

http://icd10monitor.com/enews/item/1162-icd-10-translation-101

Expert panel recommends functional status quality measures for skilled nursing facilities


Expert panel recommends functional status quality measures for skilled nursing facilities
Expert panel recommends functional status quality measures for skilled nursing facilities
An expert panel convened by federal regulators has offered recommendations for functional status quality measures in skilled nursing facilities. Released Friday was a summary of the experts' advice to create a functional status quality measure in SNFs, as well as inpatient rehabilitation facilities and long-term care hospitals.
The panel also announced that it had decided against recommending that items from Section G of the Minimum Data Set be used to determine a restorative goal. 
The Centers for Medicare & Medicaid Services contracted with nonprofit research organization RTI International to convene the experts, including rehabilitation clinicians, administrators and researchers.
The discussion centered on the use of items from the Continuity Assessment Record and Evaluation (CARE) set, which was developed as part of a demonstration project to standardize assessments across different post-acute settings. Specifically for SNFs, the experts examined four outcome measures: the change in self-care and change in mobility scores for medical rehabilitation patients, and the discharge self-care and discharge mobility scores for these patients.
Most CARE mobility and self-care items already are assessed in SNF settings, as well as in IRFs, the experts noted. However, “challenging mobility activities” such as car transfers are not routinely assessed in these settings. Assessing these abilities is important for residents who are returning home or to a community-based setting, they concluded.
The panel also addressed risk adjustment. Individuals who have an incomplete stay — including those who die or are unexpectedly transferred to a hospital — should not be included in calculating the quality measure, they recommended. Neither should those who have maximum scores on the self-care and mobility items at admission, since they have no room for improvement. Gender and Medicaid status should be excluded, but age, history of falls and prior functional status would be appropriate risk-adjustment factors, the panel determined.
Not all self-care and mobility items would be applicable in each post-acute setting, the panelists noted. For example, they discussed dropping the “wash upper body” item for SNFs, because most residents bathe in a tub or shower.
Click here to access the complete CMS document.

Hospital medicine doctors are key to improving patient satisfaction


Improving patient satisfaction and enhancing the hospital experience is all the buzz today in health care. Every hospital executive across the country is talking about it, and coming to terms with how their organization’s reimbursements will be directly tied to their performance in this area.
A decade ago, none of us had ever heard of HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores, the core metric by which health care facilities are now being evaluated. And while improving patient satisfaction scores is a complex issue that requires a multifaceted approach from all levels of the organization, one thing is certain: As the most visible frontline clinicians during any medical patient’s hospitalization, hospital medicine doctors are key to driving this improvement. They are the face of the hospitalization, act as the main point of contact for the patient, and are the doctors who will be most involved in their care. The old model of the hospitalist being present “to just round” on patients in place of their regular PCP is long outdated. It’s therefore crucial to recognize their role in improving the hospital experience. Here are some everyday ways hospitalists can do this:
  • Making clear to the patient from the beginning the role of the hospitalist, their relationship with the patient’s PCP, and how they will be in charge of the patient’s complete care as part of a collaborative care team. This helps to reassure an often anxious elderly patient and their family.
  • Regular use of aids such as explanatory introductory cards, pamphlets and business cards. Leave them on the table in the room so that family members can also see them and know the doctor who’s in charge of the care.
  • Making a clear plan for the patient every day. Utilize whiteboards in the patient’s room and keep them updated.
  • Developing more optimal patient rounds, including multidisciplinary rounding models to ensure that all members of the health care team are on the same page.
  • Setting aside dedicated time for extended patient and family meetings each day, usually in the afternoons.
  • Making clear that you are regularly communicating with the specialists who are also involved in the patient’s care.
  • Developing and maintaining good communication skills, always displaying empathy and compassion.
Statistics show that two of the most frequently cited patient complaints are a lack of time with their doctors and health care staff exhibiting poor communication skills. On a practical level, in order to maximize time with patients, hospitalists obviously need a manageable daily patient census. Formal communication skills training is often well received by physicians, especially if feedback is given in a friendly and collegial atmosphere. It’s traditionally been an area that the health care profession hasn’t got into, and older physicians in particular are much less likely to have ever received any formal training or skills advice.
Worried about pushback if you bring up the concept? Most physicians actually enjoy thinking about the topic, and are very keen to improve their skills. Ultimately, it’s all about making the patient feel comfortable, at ease, and listened to. Some proven communication techniques that physicians should utilize include making eye contact, sitting down, and asking open-ended questions. These are very basic, but often forgotten about during a typical hectic day. They can all be taught, improved upon, and coached.
Specialists also need to step up to the mark. They need to be encouraged to maximally collaborate with the hospital doctor and to make the patient feel like all their care is being coordinated. The other touches that go into improving a hospital stay, such as regular nursing checks, being clear on wait times, and following up post-discharge with a personal (non-automated!) message from a nurse or administrator, should all be added to the mix.
Let’s remember that this isn’t simply about saying that you’ve “improved patient satisfaction” and raising survey scores for the sake of reimbursements. Patient satisfaction is really about understanding what the patient is experiencing and the emotional roller coaster that goes with being sick. HCAHPS scores, while by no means the perfect survey, may be the jolt the medical profession needs to strive for what it should have been doing all along: providing patients with a high level of customer service at a low point in their lives.
Hospital medicine doctors are best placed to engage the patient from the beginning, and by focusing on the hospitalist group to lead the way, organizations can soar to new heights.
Suneel Dhand is an internal medicine physician and author of Thomas Jefferson: Lessons from a Secret Buddha and High Percentage Wellness Steps: Natural, Proven, Everyday Steps to Improve Your Health & Well-being.  He blogs at his self-titled site, Suneel Dhand.

Sunday, March 30, 2014

Mountain Summit Physical Fitness Challenge: mHealth Games




We are getting ready to watch the highly anticipated men's freestyle mountain climb.

This is the "iron man" of the Olympics, what you have all been waiting for.

Natalie, I hate to interrupt but I have just received breaking news in tonight's games, it appears the two favorites:

Johnny Three-Scoops and Earl Strong-Fit will not only be fighting for their individual victories tonight, but the fate of their entire teams may lie in the outcome of this single event.

With only 3 events to go, and this being the only event in which their respective teams have a real contender, this could decide the gold Dr. D. If I am correct, TEAM UNFIT and TEAM HEALTH are tied 9 to 9 in the medal count!

ALL EYES WILL BE ON THESE TWO TONIGHT!

YOU, can help TEAM HEALTH reach the top first by correctly answering the questions!


ARE YOU UP FOR THE CHALLENGE?

Click the picture above to launch the game or visit us at www.mhealthgames to play!

Saturday, March 29, 2014

The “Next Generation” of Patient Engagement –



With mHealth’s innovative patient facing platform your ordinary tablet can transform the way you deliver care and improve the experience for all stakeholders.

Imagine the value of engaging and empowering your patients anytime, anywhere on your own innovative learning platform.

Well, now you can!

With state of the art analytics that track and measure more than just the experience -

You can actually visualize when your patients have “mastered” specific objectives relating to their chronic diseases!

With our our innovative API we can connect with and analyze up to 5 different data sources including any EHR or patient device.

Take your analytics to the next level while gaming your way to wellness!


Click on the picture above to launch the new patient experience from mHealth Games. 

Or, visit us at www.mHealthgames.com


Thursday, March 27, 2014

Update: House votes to delay ICD-10 within temporary SGR fix

After a fiery debate on the House floor that nearly ended when Rep. John J. Duncan (R-TN) declared the bill had the requisite two-thirds majority to pass, Rep. Joe Pitts (R-PA) objected to the vote, saying that a quorum was not present.
That appeared to push back a bill that would have created a temporary Sustainable Growth Rate fix and delayed the ICD-10 compliance deadline.
Only, not so fast.
That was at 10:31 am. Then after quickly moving on to debate supporting the independence of Ukraine, and a short recess, at 12:09 pm the House convened and “on motion to suspend the rules and pass the bill Agreed to by voice vote,”according to the House's Office of the Clerk website.
Before ICD-10 is formally delayed and the SGR fix becomes permanent, however, the Senate has to vote on the proposed legislation and President Obama must sign it into law.
During the 40 minutes of debate prior to the House’s first verbal vote, Pitts cited a Heritage Foundation statement saying that a temporary SGR patch was better than a deficit.
“A vote now is a vote against seniors,” Pitts said. “We are not voting for the AMA today. We’re at a deadline and this is the last vote we’ll have. If you vote no, you’re voting against seniors.”
The American Medical Association surprised ICD-10 observers by circulating a statement urging House members to vote down the proposed legislation – without a mention of the code sets at all – because it wants payment stability for its constituency.
Without a fix to the Sustainable Growth Rate formula, Medicare physicians face a 24 percent reimbursement cut beginning April 1. The debated bill, H.R. 4302, introduced by Joseph Pitts (R-Pa.), proposed replacing the reimbursement cut with a 0.5 percent payment update through the end of 2014, and a zero percent payment update for the period of Jan. 1 through March 31, 2015.
Several House members spoke out against the bill, including Sandy Levin (D-MI).
“This bill is very disappointing,” Levin said. “We got this bill just 24 hours ago.”
Levin continued that serious discussion about how to pay for the permanent fix has been lacking and the result is a complicated bill that several Representatives said is a misstep, and one that House members have yet to even understand.
“I challenge any member to come up here and say I have read this bill,” said Rep. Steny Hoyer (D-MD). “None of us know what the substance of this bill is. We do not have the courage to rationally fund that agreement. This is a game unworthy of this institution and the American People.”
The leadership, House Speaker John Boehner (R-OH) and Senate Majority Leader Harry Reid (D–NV), bringing this bill to the floor without most people having had the chance to digest it is what Rep. Nancy Pelosi (D-CA) called a missed opportunity.
“We should be seeking a bill that would permanently fix SGR,” Pelosi said. “This band-aid is the wrong way to go. It doesn't address the underlying problem. We could have done that, we’ve been trying to for 10 years. It’s always something the Republican majority backs away from.”

Revisiting how Christensen’s “disruption innovation” in healthcare means decentralization

By: Jonah Comstock | Mar 26, 2014   

The term “disruptive innovation” has become so much of a buzz word, it’s not uncommon to hear it applied to just about any radical shift in care. But for Harvard Business School professor Clayton Christensen, who invented the term, it has a very particular meaning. Most innovations are “sustaining innovations” — they make an existing product better and cheaper for its existing customers, and allow producers to sell it at a better margin. Disruptive innovations actually drive costs down, but ultimately end up more profitable because they open up the market to customers that didn’t exist before.
At Better Health Boston, a one-day event for healthcare industry stakeholders hosted by McKesson Corporation, Christensen talked about how the idea of disruptive innovation really applies to healthcare — and what the healthcare system needs to do to go forward.
As an example of a disruptive innovation cycle, Christensen talked about the computer business, specifically the move from $2 million mainframes to $200,000 minicomputers to $2,000 personal computers, and finally to $200 smartphones. He pointed out two things: each innovation brought computing technology to a larger segment of the population, and none of the market leaders in any part of the chain was able to stay a market leader in the next part (with the possible exception of Apple).
“[Makers of minicomputers] got no signal that the personal computer mattered to their customers, because it didn’t matter to their customers,” he said. “We started using a PC for simple things and then the tech got better and better and better, until we could solve all our problems with a personal comupter and we didn’t have to buy a mainframe anymore. And the leaders in that space got killed. … It’s not that the market leaders didn’t see it coming. It’s that it made no economic sense.” 
In healthcare, the market already includes all the possible consumers. The way disruptive innovation will happen, he believes, is in the form of decentralization. Rather than just innovating diminishing returns on better and better hospital-based treatment mechanisms, innovation will consist in taking equal or even inferior versions of technology that exists in hospitals and moving it outward — to clinics, retail clinics, and, eventually, the home.
The way that technology enables that shift outward in care is by doing what Christensen calls “commoditizing experience.” As the scope of medical knowledge has increased, doctors have already made a shift from intuitive care, where educated guesses and trial and error came to bear in treating patients, to evidence-based medicine, where doctors devise treatment plans based on what’s worked best historically in patients with the most similar symptoms.
The shift from evidence-based medicine to personalized medicine, where the doctor uses detailed data about a particular patient to devise a highly specific treatment plan, will be the same kind of shift. Each gradation makes diagnosis and treatment easier to teach, allowing more parts of care to scale out from physician specialists to nurse practitioners to patients and families.
Decentralization will also solve what Christensen considers a fundamental business problem for hospitals.
“In a typical hospital, overheads account for 85 to 90 percent of total costs because of the complexity of offering a ‘one size fits none’ offering,” he said. “It turns out there are three different business models inside a hospital, and those three business models are incompatible.”
The diagnostic function of a hospital functions similarly to a consulting firm, he explained, and works best with a fee for service business model. The acute care and surgery functions of a hospital are a process business, like manufacturing or education, and should have an outcomes-based business model. Finally, chronic disease management and patient community-building are facilitated networks, like telecom companies or insurance companies, and they want a membership-based payment model. Decentralization of care would enable each of those businesses to operate more efficiently, with less overhead.
Christensen thinks actual disruptive innovation in healthcare hasn’t really begun yet. But technologies on the horizon — from home health sensors, to telemedicine, to increasingly sophisticated population health management, could start to move that needle.



Wednesday, March 26, 2014

What's in your Patient Portal???


Now consider what could be in your portal…



A revolutionary new way to engage and empower all stakeholders in the healthcare learning system.

Think for a moment about Gamification and The Institute of Medicine's new report  "The Path to Continuously Learning Health Care in America"

The Characteristics of a Continuously Learning Health Care System...

Science and Informatics
Real-time access to knowledge—A learning health care system continuously and reliably captures, curates, and delivers the best available evidence to guide, support, tailor, and improve clinical decision making and care safety and quality.

Digital capture of the care experience— A learning health care system captures the care experience on digital platforms for real-time generation and application of knowledge for care improvement. 

Patient-Clinician Partnerships
Engaged, empowered patients— A learning health care system is anchored on patient needs and perspectives and promotes the inclusion of patients, families, and other caregivers as vital members of the continuously learning care team.

Incentives
Incentives aligned for value— A learning health care system has incentives actively aligned to encourage continuous improvement, identify and reduce waste, and reward high-value care.

Full transparency— A learning health care system systematically monitors the safety, quality, processes, prices, costs, and outcomes of care, and makes information available for care improvement and informed choices and decision making by clinicians, patients, and their families.

Continuous Learning Culture
Leadership-instilled culture of learning— A learning health care system is stewarded by leadership committed to a culture of teamwork, collaboration, and adaptability in support of continuous learning as a core aim.

Supportive system competencies— A learning health care system constantly refines complex care operations and processes through ongoing team training and skill building, systems analysis and information development, and creation of the feedback loops for continuous learning and system improvement.

These games represent more than education, more than engagement – they represent an innovative way for patients and clinicians to work together for a healthier tomorrow.

We are successfully changing the current landscape through integrated delivery systems, higher quality care, and advanced technology. These innovations are transforming the way we manage populations through big data.

But once the opportunity has been identified, do we have the tools to close the gap?

We do now -

This has been the most amazing journey yet, and now because of your overwhelming interest and support we have a new venture…. www.mHealthgames.com

If you are looking to add games to your current patient portal – this is AWESOME!


If you need a portal and games - We can HELP you too!


Patient enrollment, use, and satisfaction with patient portals

Many physicians are adopting patient portals in response to governmental incentives for meaningful use (MU), but the stage 2 requirements for portal use may be particularly challenging for newer electronic health record (EHR) users. This study examines enrollment, use based on MU requirements, and satisfaction in a recently-adopting fee-for-service multispecialty system. The Centers for Medicare and Medicaid Services (CMS) financial incentives for meaningful use (MU)1 likely will persuade many reluctant doctors to adopt electronic health records (EHRs). However, there are strong concerns about whether most physicians will be able to adopt and utilize these EHRs to meet MU standards.
The study team examined data from 2010 to 2012 of users of a available patient portal linked to the EHR of a multispecialty academic group practice and 10 affiliated community primary care clinics. Patient portals linked to commercial EHRs are likely to offer the most commercially practical way for new EHR users to meet CMS MU patient access regulations. The results indicate that even some large centers with patient portals will have difficulty with some of their physicians' enrollment targets.
The study suggests that patients at later-adopting centers are moving quickly to embrace online programs, and that primary care, but not specialty physicians, can satisfy many of their expectations even without large redesigns of care.

The next-generation set of standards for patient-centered medical homes, called PCMH 2014.

The National Committee for Quality Assurance has released a next-generation set of standards for patient-centered medical homes, called PCMH 2014.
The accreditation organization uses the standards to assess primary care practices seeking NCQA PCMH Recognition. About 7,000 practice sites with 35,500 clinicians have received recognition and that accounts for more than 10 percent of the nation’s practices, according to NCQA.
The new standards cover six primary areas: patient-centered access, team-based care, population health management, care management and support, care coordination and care transitions, and performance measurement and quality improvement.
Further, there are six must-pass elements necessary for recognition: patient-centered appointment access, components of the practice team, using data for population management, care planning and self-care support, referral tracking and follow-up, and implementing continuous quality improvement.
“To earn NCQA recognition, practices must meet rigorous standards for addressing patient needs; for example, offering access after office hours and online so patients can get care and advice where and when they need it,” according to the organization. “PCMHs get to know patients in long-term partnerships, rather than through hurried, sporadic visits. They make treatment decisions with their patients, based on patient preference. They help patients become engaged in their own healthy behaviors and healthcare.”
NCQA also continues to emphasize the importance of meaningful use of health information technology and health information exchange to support coordinated and patient-centered care, across provider sites.
According to NCQA, changes in the new standards include:
* Integrating behavioral health into a practice: Practices are expected to collaborate with behavioral health providers and communicate the benefits of such treatment to patients.
* Focusing care management on high-need populations:  Practices are expected to address socioeconomic drivers of health and poorly controlled or complex conditions.
* Enhanced emphasis on team-based care: This includes a higher emphasis on collaboration with patients and establishing team-based care as a “must-pass” criterion.
* Implementing the Triple Aim of care: Practices must demonstrate improving use of the three domains of Triple Aim--patient experience, cost and clinical quality.
* Sustained transformation: Practices must show they comply with NCQA standards over long periods.
The new patient-centered medical home standards are available here.