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.”

http://www.govhealthit.com/news/house-postpones-vote-fix-sgr-delay-icd-10

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.

http://mobihealthnews.com/31470/revisiting-how-christensens-disruption-innovation-in-healthcare-means-decentralization/

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.

http://www.medicalnewstoday.com/releases/274538.php

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.

http://www.healthdatamanagement.com/news/NCQA-Sets-New-Higher-Standards-for-Medical-Homes-47568-1.html

LA doctors practice speeding up trauma care

WEST HOLLYWOOD, Calif. (AP) - Before the car-wreck victim reached the emergency room, doctors, residents and nurses at Cedars-Sinai Medical Center knew what to expect by glancing at their smartphones.

The details came in the staccato of text messages: A 35-year-old man had driven head-on into a bus. He suffered major chest injuries. His vital signs were crashing.

This was not just another day in the hospital. It was a laboratory billed as the "OR of the future," an ongoing experiment aimed at breaking down barriers that bog down care through open communication, better use of technology and teamwork.

In reality, trauma care is rarely this organized. But those who are prized for individual skills are increasingly learning that when it comes to treating trauma patients from accidents, natural disasters or terrorist bombings, communication and coordination can determine whether someone lives or dies.

At an office building less than a mile from the main Cedars-Sinai campus, doctors are guinea pigs in simulations designed to test such skills.

There's a "mission control" room filled with video screens where trainers keep track of the action. The walls are see-through. Open workspaces are favored over cubicles.

At the heart of the lab is a room that could be outfitted as the ER, operating room or intensive care unit - depending on the practice of the day. Medical simulation labs have evolved over the years, from simple lifelike models of body parts that doctors train on to full-blown replications of hospital rooms where trainees can practice different situations. The Cedars-Sinai space strives to speed up trauma care by eliminating workflow disruptions and honing communication skills.

"Health care today is delivered more by teams rather than by individuals. We have to educate folks in teamwork skills," said William McGaghie, who heads a professional training institute at Loyola University Chicago Health Sciences Division.

Registered nurse Anna Doyle is used to working with doctors who parachute into the latest crisis, whether it's tending to the victim of a gunshot wound or rollover accident. It's often a chaotic scene, and not everyone takes the time to get to know one another.

During a recent rehearsal, a resident piped up and asked for everyone's names. For a second, it felt like the first day of school as introductions were made.

Doyle said she found the introductions calming - even if it was just practice.

"We had a personal moment ... that never happens," said Doyle, acknowledging that there's always a line of walking wounded in an emergency.

Armed with a $4 million grant from the Defense Department, doctors and nurses at Cedars-Sinai have been testing ways to improve trauma care by running simulations at the newly opened lab that oozes tech startup.

"This is a place for experimentation," surgeon-in-chief Dr. Bruce Gewertz said.

Before the lab opened, Gewertz and his colleagues followed real trauma patients from the moment they were unloaded from the ambulance to their transfer to the ICU. Along the way, the team documented obstacles that slowed down care: Too many people spoke at the same time, prompting a nurse to ask a resident to speak up. A patient went for a CT scan only to find another patient already in the scanner. A resident's cellphone rang while scrubbing in.

Most of the time, researchers found, delays in care were caused by a lack of communication and logistical hurdles.

The goal is to get everyone on the same page during the "golden hour," a concept borrowed from military medicine when time is of the essence.

The team recently partnered with a consulting firm to develop an in-house iPhone app that displays a patient's vitals and blasts out the information to the trauma team as members are assembling. There's also a text-messaging feature that allows doctors and nurses swarming in from various parts of the hospital to communicate with one another before the patient arrives.

It's too early to determine how much it would cost if the app was part of routine care, but Gewertz said it'll be relatively inexpensive, involving the cost of the phones and a monthly license fee for protected data storage.

On a recent weekday, the team's cellphones buzzed with the condition of the first "patient" of the day, the bus-crash victim.

Typically, doctors don't know vitals until a nurse scrawls them on a whiteboard.

Apps can be helpful, allowing medical teams to "know the information en route so they're not coming in cold," said Pam Jeffries, president of the Society for Simulation in Healthcare and a professor at the Johns Hopkins University School of Nursing. Jeffries is not involved in the Cedars-Sinai effort.

The patient - a high-tech dummy - was wheeled in, moaning and complaining. Doctors and nurses sprang into action, ripping off the dummy's clothes and placing a breathing tube before transferring him.

Despite the quick response, there were hiccups, mainly because of a lack of experience. Residents had trouble inserting the tube, and it took several tries to get it right.

For the second scenario, the team was not given advance information about the patient and kept going in circles asking for any details. A doctor said he heard it was a case of a pedestrian hit by a car.

"Do we know if it's male or female?" another asked.

"I don't know much more than auto versus" pedestrian, the doctor said.

The chief resident said there's worry about internal injuries and to make sure blood supply and other essentials were ready.

As if that weren't enough, they also had to deal with a fire - simulated smoke from dry ice was pumped into the room. One called out for the fire alarm to be shut off while the rest prepared to move the patient to a gurney.

In the chaos, doctors didn't realize the wheel on the gurney was locked and wasted time fiddling.

Despite the hiccups, the patients survived in both cases.

http://www.cbsatlanta.com/story/25062722/la-doctors-practice-speeding-up-trauma-care

Medical advice without visit to a doctor

E-visit a doctor: A new service allows patients to send an electronic message to Sanford Clinic, hear back from a doctor and have a prescription sent to a pharmacy. Reporter Jon Walker interviews a Sanford official and a patient 

A visit to the doctor now comes without the visit.

Sanford Health has begun offering an electronic option in clinical care. A patient with a health problem can sit at a computer, type a summary of symptoms, attach a credit card number and hit the send key. A response from a Sanford provider with a prescription or medical advice comes back in four hours or less. It costs the patient $55.

The format depends on a patient’s skills in self-diagnosis and the medical system’s ability to respond without any conversation or face-to-face interaction, but it’s mostly a bow to consumer convenience in the computer age.

“It’s so a patient can receive information they can trust as opposed to just Googling,” said Louise Papka, a physician assistant in acute care for Sanford.

Michele Kleinwolterink, 44, said it helped her. She could feel a sinus headache developing two weeks ago as she drove to her job as executive assistant at Bluestem, a private equity company in downtown Sioux Falls.

“I knew I needed to go to the doctor but it was a busy day,” she said. “Sinus headaches don’t just go away. You need meds as soon as possible.”

From her desk, she logged on to her account at My Sanford Chart, the health system’s online records platform. A prompt directed her to an e-visit page, where she answered questions and described her condition in a box allowing a narrative up to 250 characters.

“You answer the same questions you would in the doctor’s office and tell them about your pain,” she said.

It took her 10 minutes. She filed her request and waited.

Sanford pledges a response within four hours but says the average is half that time. It was shorter for Kleinwolterink.

“It only took 10 minutes ... to get an email back from a doctor and they said, ‘You have a prescription waiting for you at your pharmacy that you selected,’” she said.

Sanford has been doing a trial run with the program and last week began offering it to all patients in South Dakota, Iowa and Minnesota. It hopes to add North Dakota this summer. Patients filing an e-visit likely are not communicating with their own doctor but with someone in Sioux Falls who is either a physician or an advanced practice provider such as a physician assistant or nurse practitioner. Sanford has been receiving 20 to 30 requests a week.

7 nonemergency conditions covered

It’s only for adults, only for patients enrolled in the My Chart program and only for seven conditions that are not emergencies. The seven are sinus headache, pink eye, urinary tract infection, vaginal discharge, diarrhea, cough and back pain.

Helping patients control their health

Self-diagnosis plays to a Sanford goal of having patients take ownership of their own welfare, which is one pillar of the national health reform movement. Patients still will visit clinics to see doctors, and they still can call for what still is free advice over the telephone. The e-visit is an option for those with relatively minor problems, who prefer texting and don’t want to sit in a waiting room.

“A lot of problems, a patient is looking for confirmation,” said Dr. Dan Heinemann, chief medical officer at Sanford Clinic. “They don’t have anything serious that they can’t continue to manage at home. ... If I have chest pain, this is not going to do it. But if I have a cough, it’s relatively easy.”

Medicare doesn’t cover an e-visit, but some insurers do. Kleinwolterink said she paid $25 of the $55 fee with a credit card and that Blue Cross Blue Shield covered the rest.

The health charts are a secured format requiring membership and a password entry to ensure privacy. Identity fraud is always a concern in health care, with the intent usually to misuse insurance. The e-visit, though remote, is reliable communication, said Terri Carlson, vice president at Sanford Clinic.

“Our risk folks prefer this over telephone calls. We have objective data in the questions patients have answered,” Carlson said.

Sometimes intimate details in writing

Still, the e-visit marks a cultural shift for patients to commit to writing private details about their health in order to communicate with a website. Some of the seven conditions, such as sinus headaches and back pain, are generic problems, while the others are more intimate.

“It’s a sign of the times to be using technology ... to be making that connection between the consumer and the health care market,” said Lorna Saboe-Wounded Head, assistant professor of consumer affairs at South Dakota State University. “With the social networks, maybe people are more willing to explain the problems they have, even if it’s very personal.”

Safeguards for prescriptions

Randy Jones, executive director of the South Dakota Board of Pharmacy, said health providers are allowed to prescribe drugs by electronic format without seeing a patient. It should be an established patient-doctor relationship that includes safeguards to prevent prescriptions that are improper or premature, he said.

“If they say I’ve got this hacking cough, do they know if it’s viral or bacterial without a lab exam? The answer is no. I would have some concerns,” Jones said. “If the prescriber has valid concerns, they should require that patient to come in for a physical exam and potential lab tests.”

Sanford says it has those safeguards in place. Under those circumstances, “it can be done with care,” Jones said.

Heinemann said the questions a patient must answer serve as a filter.

“If a patient says in an e-visit, ‘I’m really short of breath, I have pain when I breathe,’ those are red flags and probably the individual needs to get in to see a doctor,” Heinemann said. “Most of the time ... I think we can do a pretty good job without seeing the patient.”

http://www.argusleader.com/article/20140325/NEWS/303260002/Medical-advice-without-visit-doctor

Nintendo CEO outlines plan to move into health-related entertainment

Boxed in by rivals in video games, Nintendo outlined its plan to redefine itself as a health-oriented entertainment company in the coming decade. In a letter to shareholders, Nintendo chief executive Satoru Iwata said the company plans to expand beyond games to make entertainment that improves “quality of life” for people.

It is a risky strategy to expand beyond video games at a time when its core business is losing money and rivals like Sony, Microsoft, and mobile companies are gaining ground on it. But it’s also the kind of “blue ocean” strategy that Iwata has tried before — something that worked with the Wii console, which recorded more than 100 million in worldwide sales during its life.

Iwata talked about Nintendo’s history since its founding as a seller of Hanafuda, or traditional Japanese playing cards, 125 years ago. It innovated and shifted to becoming a toy company, then an electronic toy company, and then a video game company. Nintendo launched its first game console, the Nintendo Entertainment System, in 1983. Its Wii console in 2006 was a big success, but the Wii U has been a disaster, and the 3DS handheld isn’t selling as many as its predecessor, the DS.

So to adapt to the shifting market, Nintendo is expanding into health.

Above: The Nintendo Vitality Sensor.

Image Credit: Nintendo

“As the business environment around us has shifted with the times, we have decided to redefine entertainment as something that improves people’s quality of life (“QOL”) in enjoyable ways and expand our business areas. What Nintendo will try to achieve in the next 10 years is a platform business that improves people’s QOL in enjoyable ways,” Iwata said.

Back in 2009, Nintendo hinted at a health entertainment strategy when it announced a “vitality sensor” that could measure your heartbeat and input that data into a Nintendo Wii game. But Nintendo never shipped that sensor.

Health tech is a rising, competitive field in the U.S. But to compete in it, Nintendo not only has to deal with competitors with more knowledge and more experience in the sector, but it may also need to learn how to work with the U.S. Food and Drug Administration. (Ask 23andMe how that went.)

He said that Nintendo will still remain focused on dedicated video game hardware and software platforms.

But he added, “We will attempt to establish a new business area apart from our dedicated video game business. We have set ‘health’ as the theme for our first step and we will try to use our strength as an entertainment company to create unique approaches that expand this business.”

While Nintendo continues to lose money, investors and analysts have clamored for the publisher to get into the mobile gaming business. But this is something the Japanese company has denied it’s doing. Others have talked about it acquiring or merging with other game companies.

Nintendo wants to expand its base of users, much like it did with the Wii, whose motion-sensing controller was so easy to use that it appealed to people who weren’t traditional video game fans. With its new health products and services, Iwata said that Nintendo wants to “create an environment in which more people are conscious about their health and in turn expand Nintendo’s overall user base.”

“What has remained the same from the past is that we have always tried to create something new from materials and technologies available at that time, to position entertainment as our core business and to improve people’s QOL in enjoyable ways,” Iwata said. “We will continue to value self-innovation in line with the times and aim for growth.”

http://venturebeat.com/2014/03/03/nintendo-ceo-outlines-plan-to-move-into-healt-related-entertainment/

The Glucose Grizzly Challenge - We Need Your Help!!!

Unpredictable blood sugar swings, including a record amount of carbs, has made for difficult going this season. Practices have taken place in the gym, the parking lot, the cafeteria and rented facilities.

Mr. Apple White, the lead attacker for the defending champions the “Great Glucose Grizzlies” has a tremendous season, but it is that incredible teamwork that has gotten them this far.

With only 2 games left to go in the 2014 season the Grizzlies are up by one, but in jeopardy of forfeiting tonight’s game. They only need one more player! Are you up for the challenge? Click the bear above to play!

Isn't it time to become the STAR of your own HEALTH?

Do Consumers Understand Their Health Terms? New Health Literacy Innovations' Survey Suggests

When it comes to understanding basic health information, many Americans do not understand simple terms, even some of America's biggest chronic conditions, so says a new survey from Health Literacy Innovations (HLI), a company that creates tools to eliminate confusion from low health literacy.

Using Amazon Mechanical Turk (MTurk), a crowdsourcing Internet site, HLI asked 1,000 respondents to define 21 health terms. Some of the respondents offered correct definitions for some of the terms, yet many did not know what these terms meant or gave incorrect answers.

When asked to define "hypertension," 53.7% of those surveyed defined it as "high blood pressure." Yet, 12% "did not know" and another 9.8% defined hypertension as high blood sugar, a potentially dangerous wrong description, especially in a medical emergency. 

Other findings include:

Melanoma 

• 59.2% defined melanoma as "skin cancer;" 15% defined it as "cancer" 
• 11.3% "did not know"

Myocardial Infarction 

• 64.5% defined "acute myocardial infarction" as "heart attack" 
• 8.3% "did not know" 
• 2.4% defined it as a "body part"

Hyperglycemia 

• 59.4% defined "hyperglycemia" as "high blood sugar" 
• 13% "did not know" 
• 7% defined it as "diabetes"

Edema 

• 44.7% defined edema as "swelling of a body part due to fluid retention" 
• 29.7% "did not know" 
• 24% defined it as a "body part"

Benign 

• 64.9% defined benign as "not very harmful" 
• 16.4% "did not know" 
• 13.5% defined it as "very severe"

Other consumer responses included:

• Bilateral: 16.9% "did not know"; 2.3% defined it as an "Illness" 

• Analgesic: 24.5% "did not know" 

• Angina: 28.9% "did not know"; 3% defined it as a "body part" 

• Transdermal: 12.2% "did not know"; 8% said it was "skin issue"

"Given the complexity of the health care environment, it’s no surprise that many consumers are confused about simple health terms," says HLI's Chief Content Director Aracely Rosales. "Having good health literacy -- understanding basic health information, and how to read, act on, and follow information -- is crucial for America’s consumers, especially those new to health care via the Affordable Care Act. HLI’s Health Literacy Advisor, a comprehensive health literacy software tool, can help health care providers to explain simple health terms while creating industry standardization.

Read more: http://www.digitaljournal.com/pr/1789381#ixzz2waporwsv

Humana deal to help Medicare members

If you’re one of Humana’s 41,000 Medicare Advantage members in Franklin, Fairfield, Licking and Delaware counties, you can expect your family doctor to know far more about which specialists you're seeing and how often you see them.

Humana officials expect that increased awareness to translate into better coordination of care, meant to improve members’ health at a lower cost.

The health insurer reached the new “pay-for-value” agreement with Health4, a health-care delivery model co-owned by the OhioHealth hospital system and the Medical Group of Ohio. The three-year deal, which took effect on Jan. 1, was disclosed this week.

Medicare Advantage patients “are going to see the same outcomes that we’ve demonstrated ... in the commercial population,” said Dr. John Schmeling, the Medical Group of Ohio’s CEO.

Since its creation in 2010, MGO officials said the organization has improved rates for breast, cervical and colorectal cancer screening, as well as for preventive visits and diabetes management.

As part of the deal with Humana, emphasis also will be placed on prescribing generic medications and avoiding X-rays on a patient’s initial visit for back pain, Schmeling said.

Humana has established similar partnerships in Cincinnati and northeastern Ohio, said Larry Costello, the insurer’s president for senior markets in Ohio.

Doctors have incentives to meet certain quality measures. A spokesman declined to specify how large the incentives would be, saying only that the payments would be a “needle-mover in terms of enabling proactive, integrated care delivery.”

Officials also declined to say how much improvement must be seen for specific health conditions in order for physicians to be rewarded monetarily.

Costello said the partnership is one of the first and largest such partnerships involving Medicare patients in central Ohio.

Such “accountable-care” deals are becoming common across the state. In October, for example, UnitedHealthcare and Mount Carmel Health Partners embarked on a similar three-year deal meant to improve the health of 20,000 patients.

http://www.dispatch.com/content/stories/local/2014/03/20/humana-deal-to-help-medicare-members.html

Welltok acquires Seattle mobile health company Mindbloom

Welltok Inc., a Denver health-optimization company, continued its growth Thursday by acquiring Mindbloom, a Seattle mobile health company that it believes will help it to deliver more interactive mobile experiences.

Officials from Welltok did not disclose what they paid for Mindbloom, a builder of apps such as Bloom for inspiration and Life Game for life improvement. 

But they said they will use the company’s expertise and resources to expand Welltok’s CafeWell Health Optimization Platform that it offers to engage people more in their own health, working with insurers and health systems to promote its products.

“To profoundly change consumers’ health-related awareness, actions and behaviors for the better, we need an effective and practical platform to become ingrained in their daily lives,” said Jeff Margolis, Welltok chairman and CEO. “We were impressed by the Mindbloom team’s ability to integrate behavioral science and user-centered design principles with health-related content to deliver a superior consumer experience.”

The acquisition comes slightly more than one month after Welltok received $22.1 million in new funding, including the first investment from IBM’s newly created Watson Group.

http://www.bizjournals.com/denver/news/2014/03/20/welltok-acquires-seattle-mobile-health-company.html

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Health providers may experience information and financial loss during transition to ICD-10

Health providers may experience information and financial loss during the mandated conversion from the current International Classification of Diseases to its new and improved version, report researchers at the University of Illinois at Chicago.

The study, appearing in the March issue of the Journal of Oncology Practice, looked at coding ambiguity for hematology-oncology diagnoses to anticipate challenges all providers may face during the transition from ICD-9-CM to ICD-10-CM.

The researchers chose to look at hematology-oncology because prior research suggested that, compared to other sub-specialties, it would have a simpler transition, due to fewer ICD-10 codes and less convoluted mappings.

The nation's health care system is scheduled to fully implement ICD-10 on Oct. 1, and many doctors and hospitals are still preparing for the transition. The system is used to classify and code all diagnoses, symptoms and procedures for reference in managing all aspects of health care - from insurance reimbursement to staffing decisions to supply procurement.

The ICD-10-CM includes more than 68,000 diagnostic codes, compared to 14,000 in ICD-9-CM. The Centers for Medicare and Medicaid Services provides a general equivalent mapping (GEM) code translation system, but it's complex and often difficult even for billers and coders to interpret, according to the researchers.

Codes often do not map one-to-one or one-to-many, says Andrew Boyd, UIC assistant professor in biomedical and health information sciences and one of the study's co-authors. A cluster of codes might map to several ICD-10 codes, which might then map back to different ICD-9 codes, he said.

In the study, the researchers used 2010 Illinois Medicaid data to identify ICD-9-CM outpatient codes and the associated reimbursements used by hematology-oncology physicians. The researchers identified 120 codes with the highest reimbursement for analysis.

They also looked at ICD-9-CM outpatient diagnosis codes and associated billing charges used by University of Illinois Cancer Center physicians from 2010 to 2012 and selected the 100 most-used codes.

Using a web-based tool developed at UIC, the researchers input the ICD-9 codes and translated them into ICD-10 codes. They looked at whether the translation made sense; whether a loss of clinical information occurred; and whether a loss of information had financial implications.

"What we found was the transition from ICD-9 to ICD-10 led to significant information loss, affecting about 8 percent of the Medicaid codes and 1 percent of the codes in our cancer clinic," said Dr. Neeta Venepalli, UIC assistant professor of hematology/oncology and first author of the study.

In looking at the financial implications, the researchers found that 39 ICD-9-CM codes with information loss accounted for 2.9 percent of total Medicaid reimbursements and 5.3 percent of UI Cancer Center billing charges.

The report highlights the 39 codes "to help identify that there might be trouble with reimbursement for these codes," said Boyd.

http://www.medicalnewstoday.com/releases/273992.php

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Traditionally, physicians have used their power of their influence or the strength of their relationship to encourage healthier habits in patients.

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