Today, a new set of rules goes into effect, limiting first-year residents, also called interns, to 16-hour shifts. The rules, put in place by the private nonprofit Accreditation Council for Graduate Medical Education, are intended to prevent medical errors resulting from sleep deprivation. Second- and third-year residents will still be permitted to work 28 hours at a time. But in the last four hours, they can't take on new patients. Debate has been raging for years over this issue--and the new rules haven't ended it. Supporters of long shifts say residents gain invaluable experience through longer hours and managing the fatigue that inevitably comes with practicing medicine. They say patients are protected because residents, who make up almost a quarter of physicians working in hospitals, are closely supervised. Critics, however, cite research showing that doctors become so tired during long shifts that their performance deteriorates. They are no different in that respect from workers in other industries, according to decades of studies linking exhaustion to accidents and errors.
Some health IT advocates are bracing for a new anti-technology backlash after a major newspaper called the safety of safety of electronic medical records into question with a front-page story about a premature infant who died from a medication error that stemmed from a data-entry gaffe. The lead story in Monday's Chicago Tribune chronicled the death of Genesis Burkett, a baby boy administered a fatal overdose of intravenous sodium chloride at Advocate Lutheran General Hospital in Park Ridge, IL last October. The child reportedly had received more than 60 times the dosage a physician ordered. An attorney for the Burkett family also blamed a mislabeled IV bag. The incident has thrust the issue of EMR and electronic health record safety back into the spotlight. "While many people think that EHR usability is focused solely on user satisfaction, there are other key factors, such as patient safety, that are impacted by the usability of an EHR. The means by which patient data is accessed and displayed in an EHR system will ultimately affect the decisions of healthcare providers and the potential for medical errors," Booz Allen Hamilton senior VP Kristine Martin Anderson said.
The Centers for Medicare and Medicaid Services has released an interim final rule that describes the standard set of information for two electronic health transactions, one for inquiring about a patient's insurance eligibility and the other on the status of a healthcare claim submitted to an insurer. CMS portrayed the rule as common-sense measures that will save money for doctors, patients and insurers. The health reform law called for the measures to cut paperwork. The new operating rules will provide greater uniformity of information and transmission formats so that physicians and other healthcare providers can use one type of information request for all insurers rather than being required to use multiple systems. It will also make it easier to automate the transactions, CMS said in an announcement June 30.
It's estimated as many as 96,000 people die every year from an infection or a medical mistake they experience after going into the hospital. And almost all of those deaths are preventable. But the chances of that happening at Denver Health are much lower than they were just a few years ago, because this safety net hospital for the poor and uninsured now has the lowest mortality rate of any academic medical center in the country.
CMS rule to streamline data for insurance eligibility, claim status inquiries
A Sugar Land brain cancer patient was transferred from Texas Children's Hospital to a long-term acute-care facility on Thursday, beating the pediatric hospital's plan to remove his life support by five days. In the latest conflict involving the state law that allows hospitals to discontinue life-sustaining treatment of patients they deem futile, Jordan Allen arrived at Atrium Medical Center Thursday night after a fight between his parents and Texas Children's doctors and ethicists. "We're greatly relieved," said Samuel Allen. "We knew we were up against the clock." Allen said he and his wife want to give Jordan, 14, "a fighting chance," even though they know he faces long odds. He has inoperable glioblastoma, a particularly lethal cancer, and is currently on a ventilator and comatose.
Several state legislatures are passing laws that prohibit municipalities and other local governments from adopting regulations aimed at curbing rising obesity and improving public health, such as requiring restaurants to provide nutritional information on menus or to eliminate trans fats from the foods they serve. In some cases, lawmakers are responding to complaints from business owners who are weary of playing whack-a-mole with varying regulations from one city to the next. Legislators have decided to sponsor state laws to designate authority for the rules that individual restaurants have to live by. Florida and Alabama recently adopted such limits, while Georgia, Tennessee and Utah have older statutes on their books. Earlier this year, Arizona prohibited local governments from forbidding the marketing of fast food using "consumer incentives" like toys. And this week, Ohio Gov. John Kasich signed the state budget, which contains sweeping limitations on local government control over restaurants.