U.S. hospitals have made major progress in adopting electronic health records systems over the past three years, according to a new report. The number of hospitals with a basic electronic health records (EHRs) system tripled from 2010 to 2012, with more than four of every 10 hospitals now equipped with the new health information technology, according to the report scheduled for Tuesday release by the Robert Wood Johnson Foundation. "Given the size of our country, that's amazing progress in a very short time period," said report co-author Dr. Ashish Jha, an associate professor with the Harvard School of Public Health.
Medicine has become a team sport—that's old news. Everyone knows that the team now includes residents, physician assistants, nurse practitioners, therapists, all taking over portions of the role that once belonged to the doctor alone. These colleagues slice and dice the doctor's time-honored obligations into fragments that can be difficult to reassemble. Residents routinely use my license number to write prescriptions; if the resident makes a big mistake, who is liable? Nurses inject medications per my orders; if I miscalculate a dose and disaster ensues, who pays?
With the advent of population health management and advances in mobile technology, remote patient monitoring and virtual visits are attracting a growing amount of attention in healthcare. A new report from consulting firm CSC provides a taxonomy of this burgeoning field, which it calls "teleservices."The four main branches of teleservices, the CSC report says, are: Telecare, Telehealth, Telecoaching, Telemedicine. According to an inMedica study cited by the authors, more than 300,000 patients are already being remotely monitored each year for congestive heart failure, COPD, diabetes, hypertension and mental illness. By 2017, it's projected, about 1.8 million patients worldwide will receive regular treatment through remote services.
Nearly three months after Richard Faircloth filed a class action lawsuit against Adventist Health System/Sunbelt, Inc. for violating the privacy rights of other patients at the Florida hospital, a federal judge has dismissed the case. More than 740,000 patients? data had been compromised and Adventist Health employees reportedly sold that data to outside individuals. Faircloth argued that though HIPAA doesn't allow private patients to sue healthcare organizations, a federal judge should determine whether Adventist was in the wrong because HIPAA's privacy language dictates how Florida state laws are interpreted.
Walk into a hospital intensive-care unit and hear the din. The sheer number—several hundred alarms per patient per day—can cause alarm fatigue. Nurses and other workers, overwhelmed or desensitized by the constant barrage, sometimes respond by turning down the volume on the devices, shutting them off or simply ignoring them—actions that can have serious, potentially fatal, consequences. Clinicians and patient-safety advocates have warned of alarm fatigue for years, but the issue is taking on greater urgency as hospitals invest in more-complex, often-noisy devices meant to save lives. Last month,the Joint Commission, which accredits hospitals, directed facilities to make alarm safety a top priority or risk losing their accreditation. The commission is requiring hospitals, starting in January, to identify the alarms that pose the biggest safety risks by unnecessarily adding noise or being ignored. By 2016, hospitals must decide who has the authority to turn off alarms.
Since 1992, the AMA has summoned this same committee three times a year. It's called the Specialty Society Relative Value Scale Update Committee (or RUC, pronounced "ruck"), and it's probably one of the most powerful committees in America that you've never heard of. The purpose of each of these triannual RUC meetings is always the same: it's the committee members' job to decide what Medicare should pay them and their colleagues for the medical procedures they perform. While these doctors always discuss the "value" of each procedure in terms of the amount of time, work, and overhead required of them to perform it, the implication of that "value" is not lost on anyone in the room: they are, essentially, haggling over what their own salaries should be.