According to a new report from AMN Healthcare, a healthcare staffing firm, 78 percent of hospital executives believe there is a shortage of physicians nationwide, 66 percent believe there is a shortage of nurses, and 50 percent believe there is a shortage of advanced practitioners. The survey also indicates that the vacancy rate for physicians at hospitals approaches 18 percent, while the vacancy rate for nurses is 17 percent, considerably higher than when AMN Healthcare conducted a similar survey in 2009.
“Change in healthcare is a continuous evolution, but the one constant is people,” said AMN president Susan Salka. “No matter what models of care are in place, it takes physicians, nurses and other clinicians to provide quality patient care, and the fact is we simply do not have enough of them.”
AMN Healthcare’s 2013 Clinical Workforce Survey asked hospital executives nationwide to comment on clinical staffing trends affecting their facilities. More than 70 percent rated the staffing of physicians, nurses, nurse practitioners and physician assistants as a high priority in 2013, compared to only 24 percent of hospital executives who rated staffing these professionals as a high priority in AMN Healthcare’s 2009 workforce survey.
Guest post by Jonathan Zimmerman vice president and general manager, Clinical Business Solutions, GE Healthcare IT.
With key deadlines looming, 2014 will be a critical year for the healthcare industry, one marked by important industry milestones and advances. As ICD-10 implementation and meaningful use Stage 2 attestation approach, many are saying we have reached healthcare’s tipping point – where first of its kind opportunities for collaboration and innovation intersect with challenging regulatory standards and population health demands. In order to better facilitate these updates and solve potential market challenges, healthcare providers will need to blend innovative technological solutions with current operational systems.
As the industry evolves, we anticipate three key opportunities for 2014.
#1: Smarter Collaborations
New industry partnerships and alliances are being created to collectively address standardization and implementation. Healthcare IT organizations are working to adopt common standards and protocols to provide sustainable, cost-effective, trusted access to patient data. Payers and providers are coming together to ensure healthcare providers are setup up for success. Regulatory agencies, manufacturers and providers are working diligently to approve more devices, streamline communications and update payment codes in time for ICD-10 implementation. We are also seeing CIOs/CTOs work closer than ever before with physicians in order to reap the benefits of incentive driven initiatives like meaningful use Stage 2.
Guest post by Scott Parker, senior marketing analyst, CureMD.
Healthcare needs to be efficient in delivering care to the patient. What if iPad and iPhone apps provide the services healthcare professionals need? Wouldn’t that be a dream come true? The mobile healthcare market is talk of the town in healthcare circuits. The amazing thing is, mostly mobile EHRs are free. Soon to be launched CureMD’s app Avalon will be free too. It is free because you only pay for the services you use.
Medical history on fingertips: Healthcare professionals only dreamt about a day, when the ease of access in terms of patient data could take a step further, and somehow make them get off their boring computer screens. All of patient’s data is just a few taps away with mobile EHR. Providers can access an up-to-date list of current and past diagnoses of the patient; along with list of medications the patient has been formally prescribed.
Empowering patients: Mobile EHRs are not just for care providers. They are for patients as well. Patients can use mobile EHR to view their test results along with clinical summaries of their visit to the practice. They can keep track of their vaccinations, making it convenient for the providers and staff to arrange an appointment. If providers are able to empower patients through mobile EHR they are essentially empowering themselves.
Accurate sharing of patient information: Mobile EHRs provides a coordinated system of care through its function of interoperability. It allows for secure exchange of data among multiple providers, practices and healthcare facilities in real-time. This will provide a better support structure for informed clinical decisions. All in all, it reduces manual medical errors caused by humans trying to provide information through lethargic channels.
Given the spirit of #mHealth13, I thought the following infographic was appropriate: mHealth stas: mobile apps, devices and solutions. Created by xcube labs, a mobile apps developer, it details the current use of mobile apps in healthcare by patients. Since mobile health, #mHealth, is now more than a $1.3 billion industry and it’s expected to grow to more than $20 billion by 2018, according to mhealthshare.
Not surprising, the use of smartphones is the most prominent device of physicians in the care setting, and an estimated 62 percent of physicians using tablets. Likewise, 72 percent of nurses and other caregivers are using smartphones in the care setting.
From a patient perspective, almost every person in the US – 247 million – have downloaded a healthcare app for their personal use, and there are more than 40,000 apps available for use by patients.
The sector is clearly burgeoning. For example, Becker’s Hospital Review recently reported that the vast majority of clinicians use mobile devices in their day-to-day practice. About four in five clinicians currently use smartphones every day, a rate which will increase to nine in the 10 next years.
Additionally, more than half of physicians use tablets daily. “Half of clinicians are ‘digital omnivores’ who routinely use a smartphone, tablet and computer currently, and 82 percent plan to within the next 12 months. Tablet and smartphone usage accounts for more than 40 percent of clinicians’ at-work digital time.”
Top uses for smartphones are using generic search functions (46 percent), accessing professional resources (38 percent) and communicating with colleagues (38 percent).
Guest post by Bill Walker, chief technology officer, Aegis Health Group.
Fo r the last several years, there has been an increasing emphasis by the federal government on digitizing the healthcare industry. The allocation of meaningful use dollars to physician practices for converting to electronic health records was only the beginning. The Affordable Care Act (ACA) was the seminal event that demonstrated without a doubt that electronic management of patient information was going to be an absolute if hospitals and health systems are to survive.
The ACA puts healthcare organizations at financial risk for duplication of services, lapses in care coordination and questionable patient safety practices. Population health management demands that electronic patient records be accessible for planning, managing and tracking care coordination. But the fact is fully managing the continuum of care for a patient cannot be achieved without data collection both inside and outside the hospital’s walls. This is a trend that will take on increased importance as healthcare reform rolls out in 2014.
Health systems with forward-thinking HIT executives saw the writing on the wall after the ACA became law and began converting their organizations to electronic medical records. Systems that are considering becoming accountable care organizations (ACOs) – and accepting value-based reimbursement, which will become the predominant reimbursement model – need to find ways to track the health status of individuals in their community before they become patients. How? By embracing the use of technology that closes the healthcare loop before people even know they need those services.
The Centers for Medicare & Medicaid Services announces a delay of meaningful use, and on Dec. 6, 2013, proposed an extension of Stage 2 through 2016 and beginning Stage 3 in 2017 for those providers that have competed at least two years in Stage 2.
In a post on its site, Robert Tagalicod, CMS’ director of Office of E-Health Standards and Services and Jacob Reider, MD, acting national coordinator for Health Information Technology of ONC, the goal of the change is two-fold: “First, to allow CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2; and second, to utilize data from Stage 2 participation to inform policy decisions for Stage 3.
“The phased approach to program participation helps providers move from creating information in Stage 1, to exchanging health information in Stage 2, to focusing on improved outcomes in Stage 3. This approach has allowed us to support an aggressive yet smart transition for providers.”
The two also point out that the timeline allows for enhanced program analysis of Stage 2 data to inform to the improvements in care delivery outcomes in Stage 3, the primary goal of the extension, to give all involved more time to prepare for the future of the reform.
This is the time of year for speculation regarding which teams will play in the various college football bowl games, but also, unfortunately, whether Congress will finally pass a permanent repeal of the unpopular Medicare Sustainable Growth Rate, which once again threatens to impose a sharp decrease to the physician fee schedule, reportedly 24.4 percent on Jan. 1, 2014.
Just as most every college football team had a sense of optimism when the season began, throughout the summer and fall it seemed like politicians on both sides of the aisle were, to switch metaphors, singing from the same hymnal, railing against the Medicare Sustainable Growth Rate and arguing for a permanent “doc fix.” And, of course, physician groups provided supportive background vocals.
But here’s the problem: A permanent solution will be costly, very costly. According to the latest estimate by the Congressional Budget Office (from May), freezing (i.e., holding flat) all Medicare physician rates for 10 years would cost $139 billion, and proposals that are more generous to physicians would obviously cost more. The Medicare Sustainable Growth Rate remains the elephant in the room of deficit reduction. As for temporary patches, I’ve seen ballpark estimates of $18 billion for a one-year doc fix and $36 billion for a two-year freezing of rates, but both of those solutions would simply “kick the can down the road” yet again.
Why is the challenge of meeting meaningful use Stage 2 much more difficult, and why are many finding it to be a more rigorous certification process? To start, the requirements are more complex, and vendors are facing challenges in building solutions that are truly interoperable – which is the goal that all EMR/EHR vendors are pursuing as they upgrade their software to meet MU2 requirements.
While MU1 required that patient data be shared with patients or other healthcare professionals, MU2 has more in-depth requirements for sharing that data using advanced document architecture. EHR software needs to electronically connect and securely share data with patients, other practices, laboratories, hospitals, etc. Challenges arise for vendors when trying to build software that will easily integrate with other proprietary clinical systems. This means working with those other entities on their time frame. Because of the large number of EMR systems that need access to these entities, prioritization of these interface requests have led to long wait times and in turn, further delay certification progress.
Given the spirit of #mHealth13, I thought the following infographic was appropriate: mHealth stas: mobile apps, devices and solutions. Created by 
