Should self-insured employers have to follow state laws on reporting healthcare costs -- including how much they pay providers? That question is at the crux of a case recently argued before the Supreme Court.
A national campaign for electronic health records is driving business for at least 20 companies with thousands of workers ready to help stressed doctors log the details of their patients' care — for a price. Nearly 1 in 5 physicians now employ medical scribes, many provided by a vendor, who join doctors and patients in examination rooms. They enter relevant information about patients' ailments and doctors' advice into a computer, the preferred successor to jotting notes on a clipboard as doctors universally once did. The U.S. has 15,000 scribes today and their numbers will reach 100,000 by 2020, estimates ScribeAmerica, the largest competitor in the business. After buying three rivals this year, it employs 10,000 scribes working in 1,200 locations.
Can machines outperform doctors? Not yet. But in some areas of medicine, they can make the care doctors deliver better. Humans repeatedly fail where computers — or humans behaving a little bit more like computers — can help. Even doctors, some of the smartest and best-trained professionals, can be forgetful, fallible and prone to distraction. These statistics might be disquieting for anyone scheduled for surgery: One in about 100,000 operations is on the wrong body part. In one in 10,000, a foreign object — like a surgical tool — is accidentally left inside the body.
Simply put, security control considerations were "not really part of some of these early medical devices," said Kevin Fu, associate professor of electrical engineering and computer science at University of Michigan. But many of those very medical devices are still in wide use at hospitals across the U.S. Fu has been a longtime researcher into device security. He routinely sees potentially dangerous faults in implants and bedside devices, he said Wednesday at Healthcare IT News' Privacy & Security Forum in Boston. By way of example, he pointed to one local hospital that had "600 Windows XP boxes in deployment." To his astonishment, he was told by one hospital staffer that many were unpatched.
Community Health Systems Inc. figures its patients don't always want to go to one of its almost 200 hospitals when they're feeling ill. The hospital system has struck a deal with American Well Corp. to offer online doctor visits for patients with colds or other minor ailments. The agreement is the latest piece of Community Health's strategy to add more ways for its customers to see a physician, in addition to urgent-care clinics and doctors' offices. "We've been seeing that shift, as everyone has, from inpatient care to other points of care," said Lynn Simon, Community Health's president of clinical services and chief quality officer. "People are really moving towards convenience and easy access."
Doctors who entered data into computerized health records during patients' appointments did less positive communicating, and patients rated their care excellent less often, in a recent study. "Many clinicians worry that electronic health records keep them from connecting with their patients," said Dr. Neda Ratanawongsa of the University of California, San Francisco, who co-authored the research letter. "So it's not surprising that we found differences in the way clinicians and patients talk to each other," she said. But doctors who used the computer more also spent more time correcting or disagreeing with patients, she told Reuters Health by email.