Despite indications that e-mail access to physicians increases patient satisfaction, only 6.7% of office-based physicians routinely use e-mail to communicate with their patients, according to a report from the Center for Studying Health System Change. The report is based on a 2008 survey of 4,258 physicians (anesthesiologists, pathologists, radiologists, and residents and fellows were excluded).
Only 34.5% of survey respondents said their office was equipped to handle electronic communication about clinical issues with patients, and among them, only 19.5% reported e-mailing with patients routinely.
Barriers to using e-mail included lack of reimbursement and concerns about increased workload, maintaining data privacy and security, and avoiding increased medical liability. (A representative from the America’s Health Insurance Plan trade group was not available for comment.)
Avoiding e-mail did not necessarily correspond with an avoidance of information technology. The survey also found that 76.6% of physicians had electronic access to lab, radiology or other diagnostic tests, with 61.8% using that application routinely; 56.8% had electronic access to patient notes, medication lists or “problem lists”; and 42.2% had access to electronic prescribing tools.
Source: HITS
If you would like to explore using email as a form of communication within your practice, please feel free to contact us.
The Office of the National Coordinator for Health IT has published an online list of complete and modular electronic health record products that have been certified as meeting the first stage of federal “meaningful use” rules, Government Health IT reports (Mosquera, Government Health IT, 10/6).
ONC-designated authorized testing and certification bodies approved the products under a temporary certification program for EHRs (iHealthBeat, 10/4).
Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs can qualify for Medicare and Medicaid incentive payments.
List Details
The list shows:
The directory includes four certified EHR products from the Drummond Group.
However, the list does not yet include the more than 30 ambulatory and inpatient complete and modular EHRs that the Certification Commission for Health IT has certified (Goedert, Health Data Management, 10/6).
According to ONC, only those EHR products on the list will be given a reporting number used by CMS for verification in the incentive program (Conn, Modern Healthcare, 10/6).
The list will be updated as more products are certified and validated, AHA News reports (AHA News, 10/6).
Source: iHealthBeat
A majority of health care CIOs believe a shortage in health IT workers will have an adverse effect on their organizations, according to a recent survey from the College of Healthcare Information Management Executives, Health Data Management reports.
The survey was conducted in early September and included responses from 182 member CIOs of CHIME.
Survey Results
According to the survey, more than 70% of CIOs said their organizations had inadequate IT staff to implement clinical application software, while 51% said that such staffing issues may affect their ability to implement electronic health record systems and qualify for “meaningful use” incentive payments through Medicare and Medicaid.
Ten percent of respondents said the health IT work force shortage would definitely have a negative effect.
The survey also found that:
CIOs from smaller hospitals had the lowest percentage of vacant health IT support positions, while larger hospitals had a higher percentage of open positions, the survey found.
The most vacancies were for positions related to clinical software implementation and support staff, including:
Addressing the Issues
More than one-third of respondents said they plan to use third-party consultants to address immediate staffing needs.
CIOs also said they intend to provide health IT training to staff from within their organization (CMIO, 10/7).
Many groups also plan to try other ways to retain staff, such as setting up professional development or telecommuting programs (Health Data Management, 10/6).
Source: iHealthBeat
The American Medical Association recently announced the release of the Practice Analysis Tools for Healthcare, a computer program designed to serve as an online consultant to physicians and help their clinical staff track and revise their offices’ fee schedules, American Medical News reports.
Users of PATH will have access to three modules capable of:
In addition, PATH allows physicians to:
Users can transfer their fee schedules from a spreadsheet or practice management software or enter it directly into PATH.
Practice management consultants say the tool might appeal to practices that cannot afford to hire a consultant and also help practices monitor national statistics (Berry, American Medical News, 10/6).
Source: iHealthBeat
The Panel Support Tool developed by Kaiser Permanente allows physicians to provide better care for patients with diabetes and heart disease, as well as enhanced preventive care, according to two separate studies, Healthcare IT News reports.
The online tool is designed to extract information from electronic health records to assist physicians in managing care for individuals and groups of patients. The tool compares the care patients are receiving with what is recommended by national guidelines.
First Study
The first study — published Oct. 4 in the American Journal of Managed Care — tracked for three years 204 primary care teams using the PST to manage care for 48,344 patients with heart disease and/or diabetes.
The study found that the percentage of care recommendations met every month increased:
Second Study
The second study — published Oct. 1 in Population Health Management — examined 207 primary care teams using the PST to manage care for 263,509 patients. The study involved 13 different care recommendations.
After 20 months, the online tool improved performance from 72.9% to an average of 80%.
The researchers said a statistically significant increase in delivering care recommendations was noted every four months during the first year of using the PST.
Additional Results
According to researchers, physicians using the tool were able to:
Adrianne Feldstein — lead author of the first study and a senior investigator at Kaiser Permanente’s Center for Health Research — said using the tool in combination with EHRs “can provide patients with more of the care they are supposed to receive” (Cardiovascular Business, 10/4).
Source: iHealthBeat
Payment challenges and a lack of connectivity between mobile technology and electronic health record systems are hindering widespread adoption of smartphones among physician practices, American Medical News reports.
Reimbursement Issues
Most doctors do not receive reimbursement for electronic communication with patients.
According to a PwC Health Research Institute report released last month, only about half of patients are willing to pay for a mobile health technology device, with most saying they would prefer to spend less than $10 monthly for the service.
Connectivity Challenges
The majority of physicians who use smartphones in their practice are unable to connect the devices to an EHR system because of a lack of bandwidth. Therefore, physicians generally are unable to use mobile devices for patient monitoring and other purposes.
According to the PwC report, many doctors say that a portion of their office visits could be eliminated if they had the ability to use smartphones for mobile patient monitoring (Dolan, American Medical News, 10/4).
Source: iHealthBeat
Early results from a pilot study suggest that telemedicine-based care could help improve treatment for geriatric depression, according to a presentation at the annual meeting of the National Association of Home Care and Hospice, Healthcare IT News reports.
Thomas Sheeran, a clinical psychiatrist at Rhode Island Hospital, led the study and presented its findings.
Study Methodology
The project integrated evidence-based depression care with existing telehealth programs in Florida, New York and Vermont.
Researchers started the study at the Cornell Homecare Research Project at Weill Cornell Medical College and completed the project at Rhode Island Hospital in collaboration with the University of Vermont’s Telemedicine Program.
Project Findings
When the study began, 19 patients met the full criteria for major depression with a mean depression severity score in the “markedly severe” range, Sheeran said. He added that during the follow-up to the study, mean depression severity scores were in the “mild” range.
Sheeran said that most of the elderly patients involved in the study reported that they:
Source: iHealthBeat
A new comprehensive resource is now available to help family caregivers of older adults cope with issues often faced when caring for a senior loved one. The Home Instead Senior Care® network has launched “Caring for Your Parents: Education for the Family CaregiverSM.”
This family caregiver support series addresses senior resistance to care and features 17 topics of interest to caregivers such as identifying the signs that care is needed, selecting an in-home care provider, communicating with seniors and healthcare providers, and providing at-home care in a recession. Materials including workbooks and videos are available at www.caregiverstress.com.
Individuals also will find tips on coping with caregiver stress and a handy “stress meter” to help gauge stress levels. In a survey on the website, 58 percent of family caregivers responded they are getting ill more frequently than they did four years ago. Additionally, 81 percent said their loved ones’ needs are becoming overwhelming compared with 73 percent who thought so just four years earlier.
The support series was developed in cooperation with Amy D’Aprix, PhD, CSA, who has an extensive background working with seniors and their caregiving families, as well as educating professionals about the needs of caregiving and aging.
Source: Nashville Medical News
Although it took a little longer to close than originally anticipated, LifePoint Hospitals Inc. completed the deal to acquire Sumner Regional Health System (SRHS) on Sept. 1.
The financially ailing, private, not-for-profit health system with hospitals in Sumner, Trousdale and Smith counties filed for Chapter 11 bankruptcy at the end of April. Simultaneous to the filing, system officials announced the decision to sell to LifePoint after reviewing bids from 10 suitors. The Brentwood-based, public hospital management company made an offer to purchase the system for $145 million plus working capital in the range of $10 million and a promise to infuse another $60 million in capital investments into the four hospitals over the coming decade. The purchase would add Sumner Regional Medical Center in Gallatin, Riverview Regional Medical Centers North and South in Carthage and Trousdale Medical Center in Hartsville into the LifePoint fold increasing the company’s operational reach to 52 hospital campuses in 17 states. In addition to the four hospitals, SRHS included medical offices, outpatient facilities, a family physician group, and home health and hospice care.
“The system in many ways consists of several communities that fit in what I call ‘our sweet spot,'” noted Jeff Seraphine, Delta Division chief operating officer for LifePoint. “We continue to build a company that focuses on community hospitals and on being the best at running them. That’s our goal.”
What was seen as a love match between the administration and medical staff of the affected facilities and the company with expertise in operating non-urban hospitals ran into a glitch when officials in Sumner County raised objections to the transaction. The marriage planned for the end of June turned into a slightly prolonged engagement as the county’s concerns were addressed. The points of contention were not aimed at LifePoint as an owner/operator but were instead rooted in terms outlined in 2004 when the county sold Sumner Regional Medical Center to the SRHS healthcare organization.
Due to the bankruptcy proceedings, Seraphine noted LifePoint’s contact with county officials was restricted. “It wasn’t that we couldn’t reach agreement, we just couldn’t have the conversation,” he pointed out. However, it became clear the main sticking points centered around inmate and charity care and the county’s right to retrieve assets if Sumner Regional was closed or sold. Indigent care became a “non-issue” according to Seraphine when officials reviewed LifePoint’s record in other Tennessee markets and found the company to exceed the county’s baseline expectations. While Seraphine readily recognized the prisoner care stipulation has “the opportunity to be a very expensive proposition,” he said ultimately LifePoint “agreed that we would fulfill the obligations in the previous agreement with the hospital” and extend care to that patient population until 2034.
In late July, Sumner County commissioners were satisfied the outstanding issues had been settled and voted unanimously to approve the transaction. After review and approval by the State Attorney General (as is required in Tennessee when a tax-exempt hospital is sold to a for-profit company), the deal was finally consummated. By the beginning of last month, the hospitals and allied facilities serving 11 counties along the Highland Rim were set to begin the next chapter in care delivery under the LifePoint umbrella.
With the finalization of the sale, the system was promptly renamed HighPoint Health System (HHS), and veteran healthcare executive Mary Jo Lewis, FACHE, was quickly tapped to become the system’s new chief executive officer. Lewis has been with LifePoint since the company’s inception in 1999 and has served as CEO of LifePoint’s acute care hospital Jackson Purchase Medical Center in Mayfield, Ky.
“All of the hospitals are positioned for growth,” Lewis noted of the new challenge. “The opportunity to work with these people and get the system back on solid ground was very exciting,” she continued, adding with a laugh that it didn’t hurt that she has four grandchildren in nearby Nashville.
Seraphine said Lewis is working with key stakeholders at the two acute care and two critical access hospitals to assess needs and create a strategic plan to move forward. Of the $60 million investment committed to capital improvements, he said much of that expenditure would be predicated by the strategic plans. However, he added, some immediate investments would be needed to address physical plant issues in Carthage and Hartsville. Recent additions to Sumner Regional clearly benefited the flagship facility but also added to the system’s financial woes. “They made a significant investment in the new tower … it also stretched their balance sheet beyond the limit,” he said.
With the financial distress came a freeze in spending. “There are equipment needs in all the facilities,” Seraphine continued. In addition to purchasing both minor and major equipment, Seraphine said LifePoint’s strong balance sheet has afforded the company the opportunity to buy out leases on some equipment already in use.
Lewis said she has already begun the process of open communication with the facilities. She stressed that staffing would stay the same but said a key operational difference would be the emphasis on teamwork between the medical staff, larger medical community, employees and administration. She added, “I think they will see all the facilities be more involved in civic activities. We look forward to getting back to the community.”
Despite the hiccup in closing the deal, Seraphine noted the reaction to the sale has been positive. “There’s a great deal of community support,” he said. “It’s one of the things we think is a key ingredient to make those hospitals successful.” He added that LifePoint isn’t a completely new presence in Smith County. The company was the previous owner of the 63-bed Riverview Regional Medical Center – North in Carthage (previously Smith County Memorial Hospital) and actually sold the facility to SRHS so there is a sense of coming full circle with that hospital. “We always felt the hospitals should work together more,” Seraphine noted. “The opportunity to go back to a community and work with a single focus in a consolidated manner is really exciting to us.”
For the hospitals, having access to the depth and breadth of resources of a large, financially stable corporate entity improves functionality on a variety of levels ranging from benchmarking to physician recruitment to increased leverage and group purchasing power to assistance with regulatory compliance issues. “All of a sudden, you’re not alone anymore,” said Seraphine. “We can help them meet and rise to the challenges of whatever is coming their way.”
Lewis concurred. Having led a hospital similar in size to Sumner Regional, she has had first-hand experience in the benefits of being able to tap into a larger system of analytics to inform decision-making. “Healthcare is a very complicated industry these days,” she said. “You can’t know everything about everything. I think the hospitals will learn quickly they have a lot of resources at their fingertips.” Lewis added, HighPoint Health Services has the benefit of being in the corporate headquarters’ backyard, which she believes will enable HHS to move faster when it comes to ramping up services.
“We’ve spent a long time looking at these communities,” concluded Seraphine. “We feel that we have an opportunity to make a difference. We think we can work together to grow their hospitals and their medical communities. I think as we work through this, LifePoint and these three communities are going to have a great story to share.”
Source: Nashville Medical News
In June, the Medical Group Management Association released the results of its third annual member survey on the professional issues that challenge them the most. In this edition of Practice Makes Perfect, we address No. 27 on the list: Implementing social media tools to engage patients.
Lots of medical groups are launching Twitter accounts, creating Facebook pages and YouTube channels as a free way to strengthen relationships and engage patients outside the visit. Unfortunately, you can’t just “set it and forget it” like a phone system. Social media requires frequent updates and effort to get patients involved.
Follow these five tips to go social and have your patients interacting in no time:
No matter which social network you choose, know that creating interaction online takes time, but it will happen as long as you’re willing to put in the effort.
Source: Modern Physician
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
