More hospitals earn good grades for LGBT-friendly policies

This year has seen a sharp rise in the number of hospitals adopting policies aimed at ensuring equality in the treatment of gay, lesbian, bisexual and transgender patients, physicians and other health professionals, according to a report issued in July.

A record 718 health care facilities, mostly hospitals, participated in the Human Rights Campaign Foundation’s “Healthcare Equality Index” in 2013, up from 407 facilities in 2012. The foundation is the nonpartisan arm of the Human Rights Campaign, a gay-rights advocacy group in Washington. There are 5,724 registered U.S. hospitals, according to the American Hospital Assn.

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Better patient safety is goal of confidential EHR error reports

The Dept. of Health and Human Services’ Office of the National Coordinator for Health Information Technology in July finalized a plan that aims to improve patient safety by enabling confidential reporting of IT-related adverse events.

“When implemented and used properly, health IT is an important tool in finding and avoiding medical errors and protecting patients,” said Farzad Mostashari, MD, the national coordinator for health IT. “This plan will help us make sure that these new technologies are used to make health care safer.”

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Patient location and condition signal odds of drug compliance

The degree to which Americans with chronic conditions take their medications as prescribed differs widely according to the state where they live, the conditions they have and their type of insurance coverage.

Those are the findings of a recent report based on 2012 data from the 60 million customers of CVS Caremark Corp.’s pharmacy benefit management program, which serves consumers covered by self-insured employers, private health plans and Medicare Part D. The CVS report breaks down drug adherence by state, condition and coverage on metrics such as medication possession ratio, which is based on dispensing records to show what percentage of a yearlong period patients had their prescriptions on hand to take.

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Emergency department relief? Keep doctor offices open late

Primary care physician practices that offer evening and weekend office hours can help patients avoid trips to the emergency department while cutting overall health system spending, suggests an emerging body of research.

A recent study in The Journal of Pediatrics examining the pediatric population confirms what earlier studies among adult patients have found: When patients with urgent health problems have the option to see their regular physician, they will skip ED visits that can involve long waits, big out-of-pocket costs and unneeded testing.

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AMA meeting: Low morale a problem at every physician career stage

Chicago The Council on Ethical and Judicial Affairs is exploring the ethical dimensions related to the American Medical Association’s strategic initiative aimed at improving physicians’ professional satisfaction.

As a first step in that process, the council’s open forum at the AMA Annual Meeting featured three presentations about factors driving the alarming rates of burnout and dissatisfaction among medical students, residents and physicians.

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AMA meeting: Medicaid organ transplants need federal money

Chicago The American Medical Association House of Delegates voted to support federal funding of organ transplants for patients on Medicaid.

The move came after a 2010 action in Arizona that cut funding for certain “optional services,” including some organ transplants. The policy affected nearly 100 Arizona patients on the organ wait list and was overturned in 2011 after intense pressure from transplant surgeons and the public.

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Facebook grapples with rules for patients seeking organ donors

Officials at Facebook are exploring how to help patients in need of organ transplants use the social networking service to ask for help.

The functionality, which could go live by the end of 2013, would involve a default format intended to make it easier for patients to raise awareness of their plight while avoiding any hint of coercion or financial exchange.

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Primary care case study: Quality at every step

Before he even walks into an exam room to greet a patient, Kimberly, Wis., family physician Montgomery “Monk” J. Elmer, MD, already has a good indication of how the patient’s health is holding up. On a rainy day this spring, he had good news for Jim DeBruin, a jovial 79-year-old patient with diabetes visiting for a routine follow-up visit.

“So you’re still passing,” Dr. Elmer said as a smile spread across his face. In his hand, he held a printout of DeBruin’s laboratory test results, showing his glycated hemoglobin reading of 7.6%.

“As long as we’re under eight, you’re OK,” Dr. Elmer added. DeBruin’s blood had been drawn only minutes earlier by a medical assistant at the clinic, which is part of the ThedaCare health system in Appleton, Wis. The sample was analyzed at a lab on site at the clinic.

This just-in-time approach to lab testing and patient care is a principal example of how physician leaders at ThedaCare have earned an outsized reputation within health care for their widespread implementation of the so-called lean-management methods that helped Toyota Motor Corp. become the world’s biggest automaker. Although taking a manufacturing approach to medicine is most commonly associated with hospitals, ThedaCare is implementing the idea aggressively in primary care.

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How med schools will spend innovation grants

Chicago Teaching medical students by using virtual electronic health records. Embedding students in clinical care from their first weeks in medical school. Training tomorrow’s physicians to be leaders of interprofessional teams and deliver safer, higher-quality care. Giving students pursuing primary care the opportunity to speed their path to practice and averting dire physician shortages.

These are among the ambitious goals set forth by the 11 medical schools that won approval from the American Medical Association’s expert advisory panel. The $1 million grants awarded to each recipient over five years will give the schools the time and resources to implement changes that the AMA, physicians and educators hope will spark the biggest transformation of U.S. medical education since Abraham Flexner’s 1910 report set the standard for modern physician training.

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