Just an occasional post when I come upon a few interesting reports and resources that are worth a download or browse. This week we have a few.
First we have:
Issue Date: September 2009
For All the Right Reasons
Approaching CPOE from a patient safety and care quality perspective is the first critical step toward success
by Mark Hagland
Yes, CPOE implementation is hard. It's very hard. What's more, it requires sustained commitment and cultural transformation in order to be truly successful. But the patient safety, care quality, and clinician workflow improvement gains that can be made are tremendous. Indeed, the whole initiative must be driven by patient safety and care quality goals, say the leaders of organizations that have successfully implemented CPOE and then built quality advances using its power. Call it the CPOE value proposition.
What's more, if a CPOE implementation requirement is embedded into the final draft of the ARRA-HITECH legislation's funding disbursement protocols (see “CPOE and Meaningful Use,” p. 42), the lessons learned will be all the more valuable. And what is the key to understanding CPOE success? It's about vision and process.
Much, much more here:
A report sized article that makes a lot of important points about how to get in-hospital electronic prescribing to work well. Must read!
Second we have:
Depressed people should get online counselling, study says
People suffering from depression should get counselling online to avoid long waiting times to see a doctor, according to new research.
Published: 7:00AM BST 21 Aug 2009
A study of almost 300 patients found that those given cognitive behavioural therapy (CBT) were two-and-a-half times more likely to recover from their mental health problems that those who received standard care from a GP.
One in six adults suffer from depression or chronic anxiety, and online CBT may offer an alternative to the growing problem.
.....
In the study, patients aged from eighteen into their 70s were recruited from Bristol, London and Warwickshire and 149 were given online CBT along with the usual care while 148 got the customary GP sessions.
After a four month follow up completed by 113 patients in the intervention group and 97 in the control group, almost two fifths of those who got the online CBT recovered from depression compared with one in four of those who did not. After eight months the proportion grew further, according to the findings published in The Lancet.
More here:
The paper is found here (log in for full paper):
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2961257-5/abstract
Good stuff to show how well this can work.
Third we have:
CMS issues new ICD-10 fact sheet
August 28, 2009 | Diana Manos, Senior Editor
WASHINGTON – The Centers for Medicare and Medicaid Services (CMS) have issued a new fact sheet on the ICD-10 coding system healthcare organizations will be required to use by Oct. 1, 2013.
According to CMS, the new classification system, used by hospitals and physicians both for classifying disease and for billing, will result in significant improvements over the ICD-9 system by providing greater detail and the ability to capture additional advancements in clinical medicine.
ICD-10-CM/PCS consists of two parts: the ICD-10-CM, the diagnosis classification developed by the Centers for Disease Control and Prevention for use in all U.S. healthcare treatment settings; and the ICD-10-PCS, the procedure classification system developed by CMS for use in the U.S. for inpatient hospital settings only.
More here:
http://www.healthcareitnews.com/news/cms-issues-new-icd-10-fact-sheet
The fact sheet is found here:
http://www.cms.hhs.gov/MLNProducts/downloads/ICD-10factsheet2009.pdf
It is amazing to think the UK went to this is 1995 and here in Australia in 1998! They are still trying to get there!
Fourth we have:
Report: Gov'ts Boosting I.T. Buying
HDM Breaking News, August 31, 2009
Health information technology investments by local and state governments will increase from $7.6 billion this year to $9.6 billion in 2014, according to a new report.
That's a compound annual growth rate of 4.6% spurred by health care reform and I.T. provisions of the American Recovery and Reinvestment Act, the report states.
.....
--Joseph Goedert
More here:
The cost of the report is $3,900. For more information, click here.
Seems like a considerable growth rate!
Fifth we have:
Electronic Health Information Exchange in the US: - New State Alliance for e-Health Report offers guidance
Date: 1 Sep 2009 - 14:31
Source: US National Governors' Association
As the national dialogue on health care reform continues, health information technology (IT) and health information exchange (HIE) have emerged as critical means to ensuring a health care system that is affordable, effective, safe and transparent. A new report from the State Alliance for e-Health, Preparing to Implement HITECH: A State Guide for Electronic Health Information Exchange, aims to help states lead the way in using health IT and HIE and guide them as they begin instituting the federal Health Information Technology for Economic and Clinical Health (HITECH) Act.
The State Alliance for e-Health, a consensus-based, executive-level body composed of governors, state legislators, attorney generals and state commissioners, was created by the NGA Center for Best Practices in 2006 to address the unique role states can play in facilitating adoption of health IT and HIE. The HITECH Act, enacted as part of the 2009 American Recovery and Reinvestment Act, expands the role of states in fostering health information exchange and adoption of electronic health records over the next five years.
More here:
http://www.egovmonitor.com/node/27565
For more information on the State Alliance, please visit www.nga.org/center/ehealth
Looks like a useful resource.
Sixth we have:
IOM pushes gathering of detailed ethnicity data
By Jennifer Lubell / HITS staff writer
Posted: September 1, 2009 - 11:00 am EDT
The Institute of Medicine has recommended that HHS make available to healthcare providers nationally standardized lists of narrowly defined ethnicity categories and spoken and written languages, as part of a larger effort to standardize collection of information on patient race, ethnicity and language.
By making this information available through electronic health records, it will be possible to “stratify quality performance metrics, combine data from various sources, and make comparisons across settings and payment mechanisms,” according to the IOM's new report Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement.
More here:
http://www.modernhealthcare.com/article/20090901/REG/309019953
The link to the brief is in the report. The same approach could sensibly be applied in Australia given our ethnic diversity and indigenous health problems.
Seventh we have:
Health IT contract failure part of VA mismanagement pattern, inspector says
By Mary Mosquera
Tuesday, September 01, 2009
The Veterans Affairs Department’s failure to manage a key element of its HealtheVet electronic health record system was part of a pattern of the mismanagement of complex information technology projects by the agency, its Inspector General said in a report.
The VA earlier this year canceled a contract for the Replacement Scheduling Application (RSA), a HealtheVet subsystem that would let veterans request and view medical appointments in their EHR accounts. RSA was expected to be the next major roll-out of HealtheVet.
Final testing of the seven-year RSA development project was to be completed this year for a January 2010 deployment. In March, however, VA terminated the contract because the code it developed did not work. Department-level IT management weaknesses led to its failure, the IG said.
“The failure of the RSA project is linked to larger systemic problems relating to the management and implementation of IT projects within VA,” according to the report published Aug. 26. Sen. Richard Burr (R-N.C.), the ranking member of the Senate Veterans Affairs Committee, requested the OIG review.
VA selected the Southwest Research Institute in 2002 to develop and deploy the RSA software. But VA managers continually changed the direction, requirements, management and timing of the project, the IG said, pointing to the lack of IT management experience as a factor in the failure of VA projects.
More here:
http://govhealthit.com/newsitem.aspx?nid=72040
The OIG report is located here.
Seems like there are some lessons to be learnt from this.
Lastly we have:
Study: Medical home model increases quality of care, reduces cost
September 01, 2009 | Kyle Hardy, Community Editor
SEATTLE – A study done by the Group Health Cooperative has demonstrated that a new care model coupled with the use of health information technology could serve as a solution to the nation’s primary care physician shortage.
The study results show that a “patient-centered medical home” model has many benefits to both patients and medical staff. This model gives patients more one-on-one time with the physician, improves caregiver cooperation, and provides more preventative care.
“A medical home is like an old-style family doctor’s office, but with a whole team of professionals,” explained evaluation leader Robert J. Reid, MD, an associate investigator at Group Health Center for Health Studies and Group Health’s associate medical director for preventive care. “Together, they make the most of modern knowledge and technology—including e-mail and electronic medical records—to give patients excellent care and reach out to help them stay healthy.”
The study suggests that this particular model empowers the patient and actively engages the patient in their health. A “medical home” approach is a way that is expected to improve health outcomes, control costs, and help deal with the growing shortage of primary care physicians.
In comparing a sample of 9,200 patients from Group Health’s medical home to a control group, after one year patient visits to emergency room decrease by 29 percent. The rate of hospitalizations dropped by 11 percent and the medical home had 6 percent fewer in-person visits.
By employing the use of technology such as email and mobile phones, physicians in the medical home were able to provide better care that included screening tests, management of chronic illnesses, and monitoring of their medications. Using these methods also helped physicians ease the workload and reported that only 10 percent of medical home doctors and staff felt “burnt out” or emotionally exhausted – a large contrast to the 30 percent reported from the control group.
Much more here:
http://www.healthcareitnews.com/news/study-medical-home-model-increases-quality-care-reduces-cost
See more here:
http://www.ghc.org/GettingCare/MedicalHome.jhtml
The article is here:
http://www.ajmc.com/articles/managed-care/AJMC_09sep_ReidWEbX_e71toe87
Shows what is possible with a bit of common sense and technology!
Enjoy!
David.
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