The American College of Emergency Physicians (ACEP) and Florida College of Emergency Physicians (FCEP) have sent a formal response to Marilyn Tavenner, the Administrator and Chief Operating Officer of the Centers for Medicare & Medicaid Services (CMS), supporting CMS’ planned hearing to address Florida’s restriction of emergency department use to six visits per year for Medicaid beneficiaries which ACEP asserts is a violation of the prudent layperson standard. ACEP calls the hearing notice “a welcome commitment of federal oversight of beneficiary protections.”
Alex Rosenau, DO, FACEP, president of ACEP, and Michael Lozano, president of FCEP, issued a statement:
“Florida’s action is a violation of the prudent layperson standard that may result in serious and potentially deadly outcomes. Its use of the six-visit limit is yet another example of states using short-sighted approaches to saving money that can hurt the very people they are supposed to protect. As CMS itself has stated, Medicaid beneficiaries use the emergency department at an almost two-fold higher rate than the privately insured, but that is not inappropriate given their generally poorer health. At least two studies found that the majority of emergency visits by non-elderly Medicaid patients were for symptoms suggestive of urgent or emergent medical problems.
Guest post by Michelle Blackmer, director of marketing, healthcare, Informatica.
Several weeks into the New Year, our fitness resolutions are still top of mind. Whether tracking calories or steps, we are asking ourselves questions like “how many pounds have I lost?”, “how many calories did I eat?” and “how many steps did I take?” To take the guesswork out of it and to hold ourselves accountable, many of us put a Fitbit, Nike Fuel or Jawbone on our wish lists. Our physical fitness has become data-driven; these devices create data that provide insight, enable us to visualize patterns and generate millions of bytes of data, which helps account for the anticipated annual 40 percent growth in big data. However, this is only the tip of the iceberg for data-driven healthcare.
Health information leaders must continue to assess their business resolutions and take stock of their healthcare data fitness. This is especially important since an alarming 40 percent of healthcare executives gave their organizations a grade of “D” or “F” on their preparedness to manage the data deluge. What’s more is that none felt their organization deserved an “A.”
Successful transformation to value-driven care requires an investment in enterprise information management. However, healthcare organizations are tightening their belts and bracing for the hit to their bottom lines in response to the health reform law that took effect on January 1, 2014. Instead of scaling back, healthcare organizations must invest in the fitness of their data. After all, if the wrong data is analyzed (i.e., inaccurate, incomplete, missing or even unnecessary), organizations are going to make the wrong decisions. What is the cost of making the wrong decision?
Assess your data fitness. Ask yourself the following questions:
I received the following from Simione Healthcare Consultants and thought it actually quite provocative so thought I’d share. There are some really great organizational leadership insights here that are worth a look.
In a nutshell, integrated actions must be taken to create an environment where health organizations can achieve positive and sustainable results. Positive changes must be made from the inside out to achieve lasting financial gains without sacrificing quality, access or the level of patient satisfaction.
Take a look at the following. If nothing else, it’s an interesting read:
Ron Barrera
Congratulations, your business has reduced expenses. It must be a relief to finally be on track. Ron Barrera, director at Simione Healthcare Consultants, responds politely with, “Not so fast.” Given the complexities and requirements residing in all healthcare organizations, Barrera says that financial success today means thinking beyond simply cutting costs.
“Organizations must work intentionally to implement a wide range of integrated actions to thrive and achieve positive, sustainable financial results. When a hospital, home health agency or hospice eliminates or reduces an expense without consideration for the process behind it, the value of services may suffer. Positive changes must be made from the inside out to achieve lasting financial gains without sacrificing quality, access or the level of patient satisfaction,” Barrera explains.
The Atlanta-based Simione finance and operational expert suggests that home care and hospice agencies consider four strategies for operating at peak performance:
Maximize existing resources
Simplify processes
Evaluate clinical service delivery model
Leverage technology
In maximizing existing resources, Barrera suggests efforts to engage employees at all levels to build enthusiasm and a commitment to improving outcomes. “Any time you spend with your team communicating about the value of their work and discussing ways to improve will help productivity,” he says, “and special attention to your management team will develop more effective leaders to engage the hearts, hands and minds of staff.
Garth Graham, M.D., M.P.H., specializing in cardiology, is the current president of the Aetna Foundation and former deputy assistant secretary at the U.S. Department of Health and Human Services (HHS) during both the Bush and Obama administrations. Here he discusses the Aetna Foundation, improving quality of care, how the health IT community continues to change, how can it best be used as a positive tool for better health outcomes, even at the individual level.
Tell me about the Aetna Foundation and your role within the organization? How does the Foundation impact healthcare community?
The Aetna Foundation is the philanthropic arm of Aetna, Inc. funding a number of activities across the country that promote thought-leadership and community-based impact as well as research around improving health outcomes. As the Foundation’s president, I oversee the philanthropic work, including grant-making strategies aimed at improving the health of people from underserved communities.
Overall, at the Aetna Foundation we seek to impact the healthcare community by supporting research and organizations focused on improving the health and wellness of individuals throughout the United States.
How do you go about working to improve the health status and quality of care of the individual and community?
Our Digital Health Initiative is the most recent example of our efforts to fund both national and local programs that are striving to limit healthcare disparities among vulnerable populations, as well as increase positive health and wellness outcomes for individuals. Through this initiative, we are supporting technology that can empower individuals with the convenience and control to meet their personal health and wellness goals.
We hope that by arming individuals with the best possible tools to improve their health, we can ultimately build healthier communities.
Edison Nation Medical, a medical device incubator and healthcare innovation portal, is launching a global search to uncover innovative ideas for improving the design, packaging and administration of medications as a way to address the issue of accidental poisonings. This search coincides with National Poison Prevention Week, which takes place March 16 – 22.
Every 15 seconds, a Poison Control Center somewhere in the United States receives a call. According to the Centers for Disease Control and Prevention (CDC), there are approximately 2 million poison exposures in the United States every year—57 percent among children under the age of six.
In 2007, Dr. Daniel Budnitz, a scientist with the CDC’s Medication and Safety Program, started tracking children who were treated in emergency rooms after potentially toxic accidental pharmaceutical poisonings. At the conclusion of his tracking period in 2011, federal estimates put the number at around 74,000, which surpassed the number of children younger than six who needed emergency room treatment as a result of car crashes.
Poisoning from medication also affects the elderly; these poisonings are more likely to require hospitalization and to be fatal compared with younger individuals. Analgesics, cardiovascular medications, COPD and asthma preparations, antidepressants and other psychotropic medications are most commonly implicated in drug poisoning fatalities in elderly Americans. The primary reasons for unintentional drug poisonings in older patients include taking more than the prescribed dose, taking someone else’s medication, administering medication incorrectly and storing medication improperly.
According to the CDC, more than 41,000 people died as a result of poisoning in 2008 and more than 76 percent of those poisoning deaths were unintentional.
Guest post by Alexandra Sewell, executive director, emerging markets, Comcast Business.
As the healthcare industry moves through 2014 and begins planning for 2015, several trends continue to dominate the healthcare IT landscape. Healthcare organizations are grappling with the explosion of Big Data and implementing strategies to achieve varying stages of meaningful use. The industry is working toward interoperability, mobility and improving data security – all while looking to control costs and provide quality care.
New healthcare technologies hold great promise to improve both access to and quality of care, but they are in varying stages of adoption and federal approvals. This is leaving healthcare organizations and their IT directors searching for flexible solutions that can address current and future technologies.
Unfortunately, the industry’s approach to how technology is sourced, implemented and integrated as a business strategy is fractured. Many vendors offer different approaches to today’s healthcare technology challenges, but very few offer total solutions.
With that said, some technology is taking hold, such as digital hospital rooms, virtual medicine kiosks and mobile e-health devices, which allow physicians and other clinicians to monitor, diagnose and treat patients from remote locations. PACS imaging, electronic health records (EHR) and other data can now be shared within the entire healthcare ecosystem – from patients and clinicians to pharmacists and payers, and this is progress. But it’s been slow to take shape and there are still many questions to be answered.
Consumer health technology is attracting a lot of supporters on the business and medical ends of the spectrum because some of the more recent advances in this area are making it possible for people to be more proactive about their own health and initiate preventive measures. Awareness is a major component of effective prevention, and when consumers have the ability to discover any potential problems before they get out of hand, it can potentially save them a lot of money and improve their overall health status.
The question, then, is how companies can empower consumers to take responsibility for their own health through accurate and convenient information.
The resources that are scattered around the Internet would seem like the most obvious choice, but the problem there is that a consumer can just as easily base his or her decision on the large amount of misinformation that is circulating in and around the data that could really help them understand their condition.
A patient won’t prevent a thing if they misdiagnose their own problems. Even then, simply determining the potential problem doesn’t automatically suggest the appropriate answer or treatment. There have, however, been some technological advances that can address these concerns.
Making Reliable Technology Available
If the Internet isn’t the most reliable source, then, what other options are available? How can consumers find the best information and make sure they get an accurate diagnosis without actually going to the doctor?
Healthcare IT professionals’ greatest concern around mobile health technologies is the potential of a breach of patient data, according to a recent survey of HIMSS14 attendees conducted by Axway, a market leader in governing the flow of data.
Conducted at the HIMSS annual conference in Orlando, the poll found that 45 percent of individuals surveyed believe the greatest barrier to mobile health adoption is the risk of a data breach, followed by meeting regulatory and compliance requirements for the privacy and security of patient data.
Other key findings include:
44 percent of those surveyed believe the integration of disparate health IT systems is the most challenging IT issue facing healthcare organizations;
53 percent believe that improved access to healthcare information is the most important benefit driving mobile health adoption;
38 percent believe that the widespread adoption of mobile health services is one to three years away, and nearly 90 percent believe it will occur within five years.
The results demonstrate the rising trend of mobile health services and reflect growing concerns of healthcare professionals on the risks associated with new services.
“Mobile health is not only helping improve clinical outcomes and lower medical costs, it is also becoming a way to differentiate services and win over new customers as they are given more choices for insurance and providers,” said Rob Meyer, vice president of solutions, vertical marketing and management, Axway. “The risk of data breaches, HIPAA compliance, and reliability have been some of the biggest issues for the hundreds of payers and providers we’ve worked with. But they do not have to be a barrier. Together we have repeatedly been able to put in place the technology and processes needed to avoid breaches and ensure compliance in major mobile health initiatives.
The Axway poll was conducted at HIMSS14 Annual Conference & Exhibition in Orlando, Florida and includes responses from 39 healthcare IT and business professionals. Axway healthcare solutions enable organizations to securely integrate and exchange private healthcare, administrative and financial information across disparate platforms. For more information, visit: http://www.axway.com/industries-customers/industry/healthcare
About Axway
Axway (NYSE Euronext:AXW.PA), a market leader in governing the flow of data, is a global software company with more than 11,000 public- and private-sector customers in 100 countries. For more than a decade, Axway has empowered leading organizations around the world with proven solutions that help manage business-critical interactions through the exchange of data flowing across the enterprise, among B2B communities, cloud and mobile devices. Our award-winning solutions span business-to-business integration, managed file transfer, API and identity management, and email security– offered on premise and in the Cloud with professional and managed services.Axway is registered in France with headquarters in the United States and offices in 19 countries. www.axway.com