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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Redesigning the patient experience for safer care

Amid growing financial pressure to improve scores on patient satisfaction surveys, some hospitals are looking beyond the potential ding associated with low grades. They are working to redraft their approach to care in an effort to ensure that patients not only have a positive experience but also get the right care at the right time while being spared from harm.

This involves a variety of approaches, from relatively ambitious moves such as creating a senior-level position charged with improving patient experience to something as seemingly simple as asking patients about their biggest hopes, fears or concerns about their care.

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Mentoring project aims to increase minorities in medicine

A Web-based mentoring service launched in August 2012 has attracted 400 active users in its effort to help underrepresented minorities pursue careers in medicine.

The project, DiverseMedicine Inc., allows users to request a personal mentor to answer questions through the website’s instant messaging or video chat functions. High school, college and medical students also use discussion forums to cover topics such as admissions testing and residency applications.

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Research uncovers formula for enhancing informed consent

Informed-consent documents that are shorter and use simpler language, bigger type and graphics lead to dramatically improved understanding of risks and benefits, said a study posted online May 13 in JAMA Pediatrics, formerly Archives of Pediatrics & Adolescent Medicine.

Researchers tested various types of forms — some long and complex, some shorter and simpler, some with graphics and some without — among 640 parents of children scheduled for elective surgery. The forms were designed to deliver the traditional elements of an informed consent-document for the clinical trial of a fictional pain-relieving drug called Painaway. The parents were quizzed after going through the informed-consent process to determine whether they understood what was presented about the risks and benefits of trial participation.

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Serious work put into making primary care fun again

Amid alarming rates of physician burnout, hundreds of clinics nationwide are redesigning their practices with a goal in mind beyond improving the quality of care. They are aiming to make life as a primary care doctor enjoyable once more.

Twenty-three of these clinics are profiled in a report in the May/June Annals of Family Medicine that describes practice innovations that can ease the chaos, administrative overload, miscommunication and computerized busy work that too often characterize primary care. These clinics find that planning visits ahead of time, delegating more tasks to nurses and medical assistants, holding daily meetings and using standing orders for recurring items not only improves patient satisfaction but also creates happier doctors.

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