Posts in Category: health IT

Are You Ready for the New Cardiac Bundled-Payment Program? 

Heart hospital across the country are preparing for the new mandatory bundled-payment program for cardiac care. Set to begin this July, the program makes hospitals in certain markets accountable for the quality and cost of care for bypass and heart attack patients until 90 days after discharge.

CMS predicts that the program-which also covers knee and hip replacements-will save the federal government as much as $159 million between now and 2021. In 2014, the CMS said, heart attack treatment for 200,000 patients cost Medicare more than $6 billion. From one hospital to another, the cost of treating heart attack patients varies by as much as 50 percent, according to Modern Healthcare.

The bundled-payment model allows hospitals to keep the savings they achieve if they spend less than a target price for an episode of care. However, hospitals that exceed the target price must repay Medicare. Target prices will be determined retrospectively.

LUMEDX offers a path to meeting or beating those targets. Our Cardiovascular Performance Program helps facilities gather the consolidated CV data they need to see and manage quality and cost of care in real time. The program helps CV service lines analyze their data, identify higher-risk patients and act to ensure they are performing at or better than national targets so they can keep any savings they have realized-and avoid repaying Medicare. 

Inpatient costs are likely to account for most of the cost of the 90-day bundled-payment period, and LUMEDX is uniquely positioned to help providers reduce those expenses. Our Cardiovascular Performance Program can help CV service lines contain costs while improving outcomes by reducing:

  • Door-to-balloon time
  • Door-to-Troponin-testing time
  • PCI and CABG complications
  • PCI and CABG cost-per-case variation

These are just a few of the many ways LUMEDX solutions can help heart hospitals demonstrate best-quality, best-value care delivery-and uncover the solutions to radical improvement. 

How will the bundled-payment program impact your CV service line? Share your thoughts in our comment section, below. 

3 New Clients Join LUMEDX Family 

Hospitals in Alabama, Massachusetts and Texas begin CVIS implementation

LUMEDX is happy to welcome to our family three new clients: Marshall Medical Centers; Holyoke Medical Center; and Baylor Scott & White Health, the largest not-for-profit healthcare organization in Texas.

The first Baylor Scott & White location to implement the LUMEDX solution is Baylor Jack and Jane Hamilton Heart and Vascular Hospital in Dallas. LUMEDX is providing the hospital with comprehensive cardiovascular data management that:

  • Connects isolated data sources,
  • Integrates with the enterprise electronic health record (EHR), and
  • Eliminates redundant data collection.

Holyoke Medical Center has gone live with our PACS with Echo Workflow software. After all phases of the CVIS deployment are completed, the secure, cloud-delivered software-as-a-service (SaaS) solution will provide the medical center-located in Holyoke, Massachusetts-with comprehensive management of its Echo, Nuclear, ECG, Holter and Stress workflows, and will offer remote access for physicians, allowing them to access data and complete reports from any location.

The deployment for Marshall Medical Centers is taking place at two hospitals: Marshall Medical North in Guntersville, Alabama; and Marshall Medical South in Boaz, Alabama. Both hospitals have implemented Echo Workflow and ECG-Holter software, which will help them improve performance and quality of care while containing costs and minimizing inefficiency.

We look forward to long and productive relationships with our new partners!

 

Latest Healthcare Cyberattack Highlights Need for Prevention 

How would you like to have to tell 34,000 patients that their data had been hacked? That’s the situation that Quest Diagnostics found itself in recently after hackers stole health information including names, birth dates, telephone numbers and lab results.

The clinical laboratory services company is just the latest victim in a long string of cyberattacks targeting protected health information. One in 13 patients stand to have their records stolen because of a healthcare provider breach, according to Accenture, an industry consulting firm. Healthcare organizations that have been the recent target of cybercriminals include:
Hollywood Presbyterian Medical Center, which paid a $17,000 ransom in bitcoin to regain control of its computer systems after a hack.
Anthem Inc., the second-largest U.S. health insurer, which had the records of nearly 80 million customers stolen.
MedStar Health, where hackers encrypted data from 10 hospitals, causing widespread confusion and delays in treatment because providers were unable to access records.
What can healthcare providers do to protect against such cyberattacks? We’ve collected a number of articles offering advice.
Tips for protecting hospitals from ransomware as cyberattacks surge
Hospitals Battle Data Breaches With a Cybersecurity SOS
Protecting a vulnerable industry against cyber attacks
5 Ways Providers Can Prevent Patient Data Breaches

What is your organization doing to protect itself from hackers? Share your strategies in our comments section below.

Parts of Obama's Healthcare Legacy Will Likely Continue Under Trump 

President-elect cites popular provisions he'd like to keep

As the dust settles after the presidential election, it appears that Donald Trump is already softening some of his positions, especially his position on Obamacare. Media outlets have speculated that President Obama pushed hard for the continuance of his signature healthcare program when he met with Trump at the White House following the election.

During the presidential campaign, Trump disparaged the Affordable Care Act and called for its repeal, although he didn't spell out what he would put in its place. A wholesale repeal of the ACA could leave as many as 22 million people without health insurance--a prospect that industry insiders consider unlikely.

Healthcare attorney Michael P. Strazzella told FierceHealthcare that Trump will focus on the ACA on the first day of his presidency, but that he doesn't expect anything dramatic to happen immediately. (Strazzella is co-head of Buchanan, Ingersoll & Rooney's District of Columbia office.)

"Repeal is good campaign language, but it's a 2,000-plus page bill and not everything can be repealed," Strazzella pointed out. To actually repeal all of Obamacare would require a 60-vote Senate supermajority, which Trump could not get unless some Democrats crossed party lines.
Other factors to consider:

  • The Republican Party is far from united under Trump, whom some GOP leaders have distanced themselves from, so the new president may not be able to count on the party's backing his every move.
  • Republicans may be wary of taking away well-liked provisions of Obamacare, especially if that doesn't play well with their constituencies.
  • The ACA's mandate that patients must not be denied coverage due to pre-existing conditions is very popular with voters, as is the act's provision for young people to be kept on their parents' insurance plans till age 26.*

What other aspects of healthcare might change under the Trump presidency? The future of pilot programs such as the Accountable Care Organizations under the Medicare Shared Savings Programs--like so many other Obama administration healthcare provisions--is murky. But many in the healthcare industry maintain that value-based care is here to stay. 

The credit ratings and research company Fitch Ratings issued this prediction: "The shift toward linking pricing to patient outcomes will continue as patients and health insurers grapple with the growing burden of healthcare costs over the longer term." 

*UPDATE: Trump recently told "60 Minutes" that he is in favor of keeping at least two provisions of Obamacare: the requirement that insurance companies accept patients with pre-existing conditions, and the provision that allows young adults to stay on their parents' health insurance plans until they reach the age of 26. He also signaled that he would not end Obamacare without having some other program in place.

Will the election of Trump impact your organization? Share your thoughts in our comment section below.

Leapfrog List Puts Focus on Patient Safety 

Patient safety is once again in the news with the recent release of the Leapfrog Group's Fall 2016 Hospital Safety Grade List. Almost all the hospitals on the list received a passing grade. Of the 2,633 hospitals evaluated, 844 earned an "A," 658 earned a "B," 954 earned a "C," 157 earned a "D" and 20 earned an "F."

Leapfrog's biannual program assigns A, B, C, D and F letter grades to the hospitals surveyed. When compared to previous lists, several states showed significant improvement this time. North Carolina, for example, climbed to No. 5 in this fall's list, up from No. 19 in spring 2013.

Hawaii ranked No. 1 for the first time, while Alaska, Delaware, and North Dakota, along with Washington, D.C., brought up the rear. None of the bottom-ranked states had a hospital that earned an A grade.

Improving patient safety is, of course, a major priority for healthcare providers. Research published in The Journal of Health Care Finance found that medical errors cost the United States $19.5 billion in 2008 alone. A 2016 study estimated that these mistakes cause 251,000 deaths a year in the U.S., where they are the third-leading cause of death (after heart disease and cancer). 

For more information on the Leapfrog list, including a full description of the data and methodology used, click here.
 

 

Posted by Tuesday, November 01, 2016 10:03:00 AM Categories: health IT healthcare reform healthcare today HIT hospitals patient experience of care patient satisfaction

Early Reaction to MACRA Rule Mostly Positive 

Last weekend was a busy one for those trying to parse the new MACRA rule released on Friday. At 2,202 pages, the Medicare Access and CHIP Reauthorization Act rule wasn't exactly beach reading, and it gave the health IT community plenty to talk about on social media and in policy statements.

The dust is still settling, but it appears that early reaction to the rule was mostly positive. Healthcare organizations praised the CMS for being responsive to concerns they had raised during the comment period leading up to the rule's finalization. In fact, about 80 percent of the 2,000+ pages are comments CMS received and its responses.
The American Medical Association was pleased with the permanent elimination of the Sustainable Growth Rate (SGR) formula. "The new law," according to the AMA's press release, "gives many physicians the opportunity to be rewarded for the improvements they make to their practices and for delivering high-quality, high-value care to Medicare patients."
Other features that drew favorable reactions included:

  • The rule's overarching theme that improving the organization and payment models for medical care must stress quality over quantity.
  • Greater reporting flexibility for clinicians, as well as support for innovation in the delivery of care.
  • The formal adoption of a transition year during 2017, which makes major changes to the Quality Payment Program (QPP) reporting requirements, and provides a longer time frame for those transitioning to the QPP.
  • Emphasis on helping clinicians educate themselves about the rule.
  • Easing of the policy defining the Advanced Alternative Payment Model (APM), which will allow additional programs to quality.

But the rule is not without its detractors. "It's disappointing that the flexibility provided for quality reporting in 2017 largely disappears in 2018 and beyond," the Medical Group Management Association said in a policy statement.
Other organizations complained that the nominal risk standard defining the Advanced APM remains too high.

Want to know more? Healthcare Dive has a great breakdown of the rule changes you need to know. And for even more information on the new rule, click here. 
What's your take on the final MACRA rule? Share your thoughts in our comment section below.

Clinician mobile device use increasing as healthcare organizations struggle to protect data 

The number of clinicians who use smartphones and other mobile devices on the job is rising rapidly, and so is the number of facilities that have created mobile device management strategies to cope. "Organizations with a documented mobility strategy have nearly doubled, and in-house use of pagers has increased slightly during the past two years," according to Health Data Management.

Almost 90 percent of physicians surveyed reported using smartphones, while about half of nurses and other staff members use them. In response, more than 60 percent of hospitals surveyed have a documented mobile device strategy. (The survey, by mobile messaging service vendor Spok, included responses from about 550 hospitals.)
The leading mobile devices used in hospitals are:

  • Smartphones (78 percent)
  • In-house pagers (71 percent)
  • Wi-Fi phones (69 percent)
  • Wide-area pagers (57 percent)
  • Tablets (52 percent)

Security and privacy, of course, are huge concerns for those setting mobile device policy, leading some organizations to forbid clinicians to use personal devices for work-related communication. About 80 percent of surveyed hospitals with such policies cited fear of data breaches as the reason behind their rules. 

Click here to download the survey.
What's the mobile device policy at your organization? Share your thoughts with the LUMEDX community by commenting below. 

Healthcare Cybersecurity Failings Draw the Ire of Accountability Office 

GAO Recommends Corrective Action by Department of Health and Human Services

More than 113 million electronic health records were breached in 2015, a year that saw a total of 56 cybersecurity attacks in healthcare alone. That's a 13-fold increase from 2006 to 2015.
The Government Accountability Office isn't going to let those cybersecurity failures go unremarked upon. The GAO last week came down hard on the Department of Health and Human Services, pointing out a number of weaknesses in efforts by HHS to help health plans and other providers protect data.
"HHS has established an oversight program for compliance with privacy and security regulations, but its actions did not always fully verify that the regulations were implemented," wrote the GAO in a report released Sept. 26. The report also called out HHS for giving technical assistance "that was not pertinent to identified problems" in cybersecurity, and for failing to follow up on cases it investigated. 
In short, the GAO found, loss or misuse of health information is not being adequately addressed by HHS. To help healthcare organizations comply with HIPAA and prevent further data breaches, the Office said, HHS should take the following corrective actions:

  • Update its guidance for protecting electronic health information to address key security elements.
  • Improve technical assistance it provides to covered entities.
  • Follow up on corrective actions.
  • Establish metrics for gauging the effectiveness of its audit program. 

HHS generally concurred with the recommendations and stated it would take actions to implement them.

UPDATE: On Oct. 4, HHS announced that it had awarded funding to help protect the health sector against cyber threats. Learn who received the funding, and how it is intended to help healthcare organizations.

Heart Attack Patients Get Faster Care When Medical Teams Use Smartphone Social Network System 

18-month study tracked 114 STEMI patients

New research shows that patients in need of a hospital transfer were treated 27 minutes faster when their medical teams used a smartphone app-based social network system (SNS) to set up the transfer, compared to medical teams who didn’t use the smartphone technology.

The research, published in the Journal of the American College of Cardiology, monitored the time that patients with ST-elevated myocardial infarction (STEMI) suffered from ischemia (reduction in blood supply) while they waited to have a procedure opening their blocked arteries. On nights and weekends, the treatment time reduction was even greater than during the regular work week.

One of the study’s senior researchers, Jin Joo Park, M.D., pointed out that there is a higher risk of death for patients who get to a hospital during off hours—a worldwide trend.

“Transferred STEMI patients rarely achieve timely reperfusion due to delays in the transfer process, especially when transferred during off-hours,” Park told Dicardiology.com. “The use of a smartphone SNS (Social Network System) can help to achieve timely reperfusion for transferred STEMI patients with rapid, seamless communication among healthcare providers.”

Over a period of 18 months, the study enrolled 114 STEMI patients who were transferred to Seoul National University Bundang Hospital. The transfers for 50 of the patients were completed using the SNS app, while the remaining patient transfers used a non-smartphone-based STEMI hotline. The transit times for both groups of patients were similar.

Click here to read the research letter.

 

Enhancing the EHR 

Why Department-Level Systems Remain Critical to Quality 

The need for Electronic Health Records (EHRs) has become widely accepted, and methods to accelerate hospital adoption are proving to be successful, albeit resource-and cost-intensive. While EHRs are highly useful tools for collecting certain kinds of information and making that information available widely across services, cardiovascular care is complex; the data generated by this care is equally complex; and therefore cardiovascular service lines require systems that can match this complexity.


 

Chris Winquist, LUMEDX President and COO, explains how the CVIS augments the EHR to provide CV services with the deep data needed for clinical and business excellence.

Publicly Reported Measures & the Need for Deep Data

Even with the rapid pace of innovations in treatments and technologies, cardiovascular disease is the leading cause of death in the United States.(1) Unsurprisingly, today a large percentage of publicly reported quality measures are CV measures. Further, new value-based payment models are making up-to-date tracking and managing of performance ever more critical. Demonstrating quality of care delivered has never been more central to cardiac and vascular departments. 

How can a hospital best report, monitor internally and improve quality performance in key measures like Mortality, Complications, and Appropriate Use? With discrete, queryable data. This data must be:

  • Acquired at the point of care so workflow is efficient and data is of high quality 
  • Made accessible to providers across the care continuum so they can make fully informed treatment decisions
  • Reported to the registries
Getting Actionable Information

It's not enough to report to the registries once a quarter and then hope for the best. A high-performing facility must monitor and drill-down into its own data to investigate any problems and take action-as quickly as possible. For this, service lines need systems that can capture information as queryable data elements. And these systems need to integrate with all the devices and clinical systems at work in the service line (ECGs, Stress, Holters, cardiac ultrasounds, hemodynamic systems--to name just a few). 

A dedicated departmental system-one that integrates with clinical-modality systems and the EHR, and offers automated registry data collection and submission to the full suite of cardiac and vascular registries-is the only way for complex environments like cardiac and vascular services to get the data they need to measure and improve performance (clinical, operational) in a substantive way.   

LUMEDX HealthView CVIS Enhances the EHR and Supports Operational Efficiency

With more than 30,000 discrete, queryable data points, HealthView CVIS offers the depth cardiac and vascular departments need for optimal clinical and business excellence. We've developed a powerful data engine that brings insight to every aspect of CV suite operations by drilling into details and reporting on both trending and outlier situations. 

The HealthView CVIS also accepts and transmits relevant data from and to the EHR, so that the enterprise and the service line can operate at the highest levels of efficiency, facilitating best-quality care, improved performance and cost savings.

(1) Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics-2014 update: a report from the American Heart Association. Circulation. 2014;129(3):e28-e292.

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