The CMS is reporting that the number of physicians and hospitals registering for the Medicare or Medicaid EHR incentive program continues to accelerate with over 20,000 new registrations in February. This brings total registrations for the program to 211,667. Total incentive payments issued during February were over $863 million bringing the total paid through February 2012 to over $3.85 billion.
According to a report available on the CMS website there were 9,207 Medicare Eligible Professionals and hospitals that signed up for the Medicare program with another 10,752 registering for the Medicaid program. 108 hospitals were registered for both programs bringing the total registrants in January to 20,067.
The breakdown of the $3.8 billion in incentive funds paid out so far is as follows:
The CMS reports these numbers a few days after the close of each month.
Source: EMR Daily News
On May 7, the Department of Veterans Affairs plans to eliminate copayments for veterans receiving in-home care via telehealth technology, Health Data Management reports.
Background
On March 6, VA published a proposed rule to waive copays for in-home telehealth services.
Also on March 6, VA published a direct final rule that is nearly identical to the proposed rule. The direct final rule calls for waiving the copays starting May 7 unless VA receives significant adverse comments on the proposal during a comment period that expired on April 5. Direct final rules are issued to speed rulemaking if a rule is expected to be noncontroversial.
If VA has received substantial negative comments on the proposed rule, it will publish a notice in the Federal Register indicating that it received the comments and will withdraw the direct final rule (Goedert, Health Data Management, 4/9).
VA’s Reasons for Proposing the Rule
VA said it proposed the elimination of copays for in-home telehealth services because it wants to improve access to care for veterans who have health conditions, are frail or face challenges traveling to clinics or hospitals.
The agency said it wants “to make the home a preferred place of care, whenever medically appropriate and possible.”
VA also said copays should be waived for in-home telehealth care because the technology “is not used to provide complex care and its use significantly reduces impact on VA resources compared to an in-person, outpatient visit” (Norman, CQ HealthBeat, 4/6).
Source: iHealthBeat
In the ongoing movement of health care reform, the most visible players have been lawmakers in Washington, DC, determining the outlook of American health care with two pieces of legislation — the final Health Care and Education Reconciliation Act of 2010 and the Patient Protection Affordable Care Act. Meanwhile, primary care physicians like Richard G. Roberts, M.D., J.D., are ensuring through international and national involvement and patient interaction that changes does not only come from the top down.
Dr. Roberts is a professor of family medicine at the University of Wisconsin School of Medicine and Public Health and a general family practitioner in Belleville, WI. He served as president of the Wisconsin Medical Society and the American Academy of Family Physicians (AAFP). Currently, Dr. Roberts is in his second year of a three-year term as president of the World Organization of Family Doctors (Wonca).
In his current role, Dr. Roberts acts as the voice of family medicine practitioners around the globe through representation at the World Health Organization’s assemblies and travels to approximately 40 countries every year. During his visits, he meets with presidents, ministers of health and physicians. He also spends time with young family doctors and medical school students and gathers information about their outlook on the country’s health care system, as well as shadows family medicine providers in their own practices.
“Serving with Wonca has presented a very interesting, informative and inspiring set of experiences, because you’re seeing it on the ground — often in the most difficult circumstances,” Dr. Roberts says. “That’s been a great joy of my professional career and a great insight — visiting people in the trenches and at the same time meeting with global leaders for discussions about health care and what health care systems should look like.”
Dr. Roberts reports that while no country has created the perfect model, telling details emerge in comparisons. The United States health care system ranks between 32 and 72 in global systems, its position dependent on the ranking’s specific measurements. However, the U.S. system costs $2.7 trillion, or 18% of the nation’s gross domestic product (GDP). Countries like Canada and Switzerland, which are continuously tied at the third ranking worldwide, spend 11% of the GDP on health care.
Dr. Roberts’ conversations with the global business community have also yielded revealing comparisons. According to Paul Grundy, M.D., M.P.H., Global Director of Healthcare for IBM, the company’s costs for employee benefits in Denmark are a fourth to a third less expensive than average U.S. employee benefits with better outcomes and patient satisfaction. As Dr. Roberts explains, 10 years ago, Denmark invested heavily in strengthening an already sizeable population of family medicine physicians. The move allowed the country to reduce its hospital beds by 50% and actually profit based on the cost savings in improved patient outcomes.
“We tend to think of health care as helping people, but that’s not really what effective health care is. Effective health care is built from relationships and having someone you know and trust,” Dr. Roberts says. “A lot of what we see in the U.S. health care system is what I call ‘stranger danger.’ Patients often bounce from one physician to another. These physicians are well-trained and well-motivated, but if a patient has a provider who knows them and whom they trust, the patient will do better.”
Based on his global and day-to-day patient care experiences, Dr. Roberts acknowledges that family physicians are not alone in their frustrations with the U.S. health care system, nor should they be the only voices in the discussion to improve the model.
“What I tell physicians is to take from the experiences of their practice. I think there is a range of places physicians can plug in,” Dr. Roberts says. “An individual physician’s degree of participation is going to be determined by his or her energy level.”
With the development of accountable care organizations, physicians can be instrumental at the local level through participation and leadership in these collaborative groups. State-level involvement is available through physicians’ organizations — such as medical societies — where contributions can be heard by those responsible for making statewide policy. Dr. Roberts notes that there has been a recent increase of state representatives and senators with medical backgrounds. Of the current Congress, 24 members entered public service from the health care industry, including 16 physicians.
“Physicians are and will always be very important in health care systems. We are leaders, and if we’re going to be good leaders, we need to understand what the priorities of the system are and how to help achieve those most effectively,” says Dr. Roberts. “We as doctors enjoy a privileged status because the public trusts that we are doing our best to look out for their interests. If that’s not our overarching goal, then we don’t deserve that trust.”
Source: MD News
Many patients say they would rather receive radiology results through an online portal than through more traditional notification methods, according to a study published in the Journal of the American College of Radiology, CMIO reports.
Study Details
For the study, researchers at Wake Forest School of Medicine in North Carolina invited adult outpatients to take an electronic survey. Fifty-three patients responded to the questionnaire.
The electronic survey exposed each respondent to three simulated medical situations in which radiology reports were described as normal, seriously abnormal or indeterminate. For each scenario, participants were asked to indicate how they would want to receive the radiology reports and what educational resources would help them better understand the results.
Study Findings
Overall, 80% of respondents said they would prefer to receive the radiology reports through an online portal instead of through traditional notification methods like phone calls, mail or in-person consultations.
Researchers also found that:
Respondents also cited interest in various educational resources that would help them better understand the radiology reports, such as conversations with physicians and Internet searches.
The study recommended that health care organizations using online portals provide links to reliable online medical information to help patients understand the results.
Study Limitations
Researchers noted that the study had certain limitations. For example:
Source: iHealthBeat
Physicians who can access patients’ prior test results through a health information exchange order fewer laboratory tests than doctors without such access, according to a study published in the Archives of Internal Medicine, Reuters reports.
Study Details
For the study, researchers examined care provided to 117,606 outpatients at Brigham and Women’s Hospital and Massachusetts General Hospital between January 1, 1999 and December 31, 2004. The two hospitals established a health information exchange in 2000.
Among the patients studied, 346 had received recent tests at the other hospital and 44 of those patients had received the tests before the data exchange was implemented.
Key Findings
In 1999 — before the data exchange was implemented — physicians ordered an average of seven lab tests per patient, according to Alexander Turchin, one of the study’s lead authors and an assistant professor at Harvard Medical School. In 2004, that number decreased to four lab tests per patient, Turchin noted.
When researchers looked only at patients who did not have prior lab tests available, they found that the amount of tests ordered increased slightly from five tests per patient in 1999 to six tests per patient in 2004.
When researchers looked only at patients who had prior lab tests available, the number of tests ordered decreased by about 49% after the implementation of the exchange. After accounting for factors such as age and gender, the number of tests ordered per patient with prior lab tests available decreased by about 53% after the exchange’s implementation.
Findings Appear To Conflict With Recent Study
The findings appear to conflict with a recent study published in the journal Health Affairs (Seaman, Reuters, 3/29).
The Health Affairs study — by the Cambridge Health Alliance — found that physicians with electronic access to patients’ previous imaging results ordered tests 40% more frequently than their peers using paper-based records (iHealthBeat, 3/13).
Danny McCormick — author of the Health Affairs study — said the results of the two studies could be different for several reasons, including the fact that researchers looked at different populations.
Turchin noted that the two studies had different methodology and that his study did not include imaging results like McCormick’s study (Reuters, 3/29).
Source: iHealthBeat
The global market for remote patient monitoring devices is expected to grow from $6.1 billion in 2010 to $8 billion in 2017, according to a report by GBI Research, MobiHealthNews reports (Dolan, MobiHealthNews, 3/26).
Report Findings
GBI estimated that the market will grow at a compound annual growth rate of 4%.
The report noted that China and India could be “potentially lucrative markets” for growth because of “huge patient bases and … underserved” populations (Bowman, FierceHealthIT, 2/27).
Reasons for Growth
According to the report, advancements in wireless and censor technology and increasing life expectancy are driving the need for remote patient monitoring devices.
According to the report, such devices can:
Source: iHealthBeat
Nearly 90% of surveyed physicians would like their patients to use mobile devices to monitor or track certain health indicators at home, according to a report from Float Mobile Learning, a mobile technology consulting firm, FierceMobileHealthcare reports (Jackson, FierceMobileHealthcare, 3/19).
The report is part of Float Mobile Learning’s comprehensive study of mobile usage in the health care industry.
Key Findings
The report found that:
Additional Findings
The survey also found that:
According to the survey, physicians are 250% more likely than other consumers to own a tablet computer (Murphy, Mashable, 3/12).
Implications
Gary Woodill — a senior analyst at Float Mobile Learning — said, “The looming demographic bulge of aging baby boomers and the rising costs of hospital care are driving a movement to providing medical care in a person’s own home, whenever possible.”
He added, “Mobile health and wellness applications can help relieve the burden of accelerating health care costs due to this demographic shift” (Float Mobile Learning release, 3/13).
Source: iHealthBeat
The majority of surveyed health care organizations say that managing patient data or electronic health record systems is their top health IT-related priority this year, according to a new report from InformationWeek Analytics, InformationWeek reports (Kolbasuk McGee, InformationWeek, 3/19).
Survey Details
For the report, InformationWeek Analytics conducted an online survey of business-technology officials in the North American health care industry, including those working at physician practices, hospitals, health plans, health centers, life science companies and pharmacies.
The report reflects responses from 579 participants (InformationWeek Analytics survey, 3/18).
Key Findings
The survey found that 64% of respondents said that managing patient data or EHR systems is their top health IT-related priority this year.
The report also found that:
The report also found that the top three health IT projects that respondents have completed or expect to complete in the next 24 months are those related to:
Source: iHealthBeat
The way that health information is presented online — particularly the order in which symptoms are displayed — can affect how patients diagnose themselves, according to a study published in the journal Psychological Science, Newsroom America reports (Newsroom America, 3/16).
Study Details
For the study, researchers from Arizona State University, the University of California-Irvine, Ono Academic College and the University of Warwick conducted two experiments.
In the first experiment, researchers presented students with lists of symptoms for a fictional type of cancer. The students were asked to check off the symptoms they had experienced and rate their likelihood of having the cancer.
The students were divided into three groups, which received either:
In the second experiment, researchers presented the students with lists of either six or 12 symptoms for meningioma, a real type of cancer. The students were divided into groups, which received one of the three types of symptom lists used in the first experiment (Association for Psychological Science release, 3/15).
Key Findings
In the experiment that looked at symptoms for the fictional type of cancer, participants who had received the list alternating between specific and general symptoms were less likely than participants receiving the other two types of lists to say that they could have cancer (Chan, “Healthy Living,” Huffington Post, 3/18).
Researchers wrote that when participants check off several symptoms in a row, “they perceive a higher personal risk of having that illness” (Newsroom America, 3/16).
In the experiment that looked at symptoms for the real cancer, researchers found that participants were less likely to think that having several symptoms in a row indicated that they could have cancer if they received the list of 12 symptoms instead of the list of six (“Healthy Living,” Huffington Post, 3/18).
Researchers wrote that the longer list of symptoms allowed several boxes to be left unchecked, which helped participants feel reassured that they did not have cancer (APS release, 3/15).
Implications
Virginia Kwan — a psychologist and the lead researcher of the study — said the findings could be useful for public health education. She said that health officials could encourage people to seek health screenings sooner by grouping common and mild symptoms together when describing a disease.
Kwan added that officials also could curb patient overreactions by listing rare symptoms first (Newsroom America, 3/16).
Source: iHealthBeat
On Tuesday, eight health care organizations released informational brochures aimed at promoting greater understanding and use of personal health records, Modern Healthcare reports (Robeznieks, Modern Healthcare, 3/14).
One set of brochures targets health care providers, and another set of brochures targets patients (Walsh, CMIO, 3/13).
The organizations that developed the brochures include the:
Brochure Details
The brochures contain information such as:
In their announcement, the groups said the brochures will “sho[w] consumers how they can use PHRs to store vital health information such as medical conditions, allergies, medications, and doctor or hospital visits in one convenient and secure place” (Modern Healthcare, 3/14).
Source: iHealthBeat
MGMA Supports ICD-10 Testing With Outside Organizations
July 30, 2013
Report: Many EHR Users Set To Replace Systems Within the Next Year
July 30, 2013
Providers, Vendors Urge Congress To Delay Meaningful Use Stage 2
July 30, 2013
Many Doctors May Find Meeting ‘Meaningful Use’ Requirements a Challenge
June 28, 2013
When it Comes to ICD-10 Physician Documentation: Collaborate and Educate
June 28, 2013
The Slow Crawl Toward Improved EHR Usability and Interoperability
June 28, 2013
Efficient Patient Communication and Engagement
June 13, 2013
ONC Issues Guidance on Stage 2 Transition of Care Requirements
May 31, 2013
Drugmakers Leverage Doctor, Patient Data To Market Their Products
May 31, 2013
Consumer Organizations Defend Meaningful Use Program
May 31, 2013
