The Justice Department contends that the Franklin, TN-based hospital company Community Health received a total of $27.5 million in improper payments at three of its New Mexico hospitals through June 2006. But Community Health representatives say the company did nothing wrong and violated no laws in the period under Justice department review.
Russian hospitals are understaffed, poorly equipped and rife with corruption, dragging down healthcare in an already unhealthy nation. The Russian government is pumping $6.4 billion into revamping healthcare, and much of that money is paying for the construction of eight high-tech medical centers across the country. The funds will also be used for new X-ray machines, electrocardiograms and ambulances at hospitals, and raises for family doctors.
Rhode Island lawmakers have proposed a system to investigate and track medical mistakes and so-called "near misses" after brain surgeons at Rhode Island Hospital operated on the wrong side of patients' heads on three separate occasions in 2007. New bills introduced in the House and Senate would create a Rhode Island Patient Safety Organization designed to determine the potential causes of medical errors and fix them at healthcare providers statewide before patients are hurt.
Additional cases of carbon monoxide poisoning might be caught if doctors began routinely testing emergency room patients for carbon monoxide exposure, a study suggests. Because the symptoms of carbon monoxide poisoning resemble those of other illnesses, hospitals may provide improper treatment and return the patient to the environment where the exposure occurred, said researchers from Brown University. A simple test, using a device clamped on one finger, could measure oxygen and carbon monoxide levels in the blood quickly and inexpensively, according to the researchers.
New York City Mayor Michael R. Bloomberg has announced that the city is ready to equip doctors with computer software that can track patients' medical records in order to provide better preventive care. The new system would let doctors do much more than is possible with paper charts by integrating a patient's medical history, lab results and current medications into one electronic interface. The system will also provide up-to-date information to doctors through a series of alerts, as well as share data with other doctors and provide information about the current best practices for treating illnesses.
U.S. healthcare spending will almost double to about $4.3 trillion by 2017, according to economists with the Centers for Medicare and Medicaid Services. CMS forecasts that healthcare spending will account for 19.5 percent of the U.S. gross domestic product by 2017, up from 16.3 percent in 2007. A key factor in the increase will be the entry in 2011 of the leading edge of the baby boom generation into Medicare, officials said.
Establishing rules around patient consent and privacy is one of the most difficult aspects of establishing a healthcare information exchange. That was the message delivered by Irene Koch, executive director of the budding Brooklyn Health Information Exchange, or BHIX, who spoke at HIMSS 2008.
Formed in 2006, BHIX is an effort to share data among several nursing homes and home care agencies with Maimonides Medical Center and Kingsbrook Jewish Medical Center. The presentation provided insight into why data exchanges often struggle. For example, BHIX initially had hoped for a "universal consent" process. In this model, having one provider in the exchange gain a patient's agreement to participate in the exchange would automatically enroll all other providers, and thus streamline sharing data among the multitude of potential participants.
However, after reviewing other exchanges, BHIX opted for a "provider-by-provider" consent process. In this method, the provider gaining patient consent would be able to view information generated by other providers.
There were other difficulties encountered beyond the logistics of gaining informed consent, however. For example, Koch pointed out how the lack of a standard clinical vocabulary makes interpreting shared records difficult. Pertaining to medications, "start date" and "effective date" mean different things at different organizations.
The Brooklyn project is among some nearly 400 similar ventures underway in the U.S., according to HIMSS Analytics. Maimonides won a New York state grant in 2006, which sparked the formation of the now-independent BHIX. It has a joint governing model, representing three home care agencies and four nursing homes. The data exchange will enable the sharing of both discrete electronic data and scanned images, such as advance directives. Data sharing is expected to begin later this year.
Partners Community Healthcare faced a common problem with its physician members. Beyond the members of Partners' academic medical center group practice, adoption of EMR technology was low. The AMC members used the Boston-based healthcare organization's own homegrown system, but primary care physicians lagged in technology adoption throughout the vast community setting Partners encompasses.
Yet, through a combination of carrots and sticks, Partners is on course for 100 percent EMR adoption by its 6,000 affiliated physicians by the end of 2009. Partners CIO Cynthia Bero told hundreds of participants at the HIMSS conference that although physicians understand the benefits of clinical automation, giving them an option about which software to use was a major boost to the effort.
To facilitate physician participation, Partners negotiated pay-for-performance incentives from three managed care plans. The payers agreed to pool money from one year to the next, in the event a practice took longer than anticipated to implement. Partners also provided a "total cost of ownership" analysis to its community physicians. The fiscal analysis was tailored to individual practices. By demonstrating the long-term ROI of an IT investment, the organization helped allay physician fears, Bero observed. Leaning on local and regional physician leaders also helped.
In 2007, Partners added a stick to the various payer carrots it had dangled. It mandated EMR use by any new physician group joining its network, and later expanded the mandate to include all physicians. But physician acceptance has played out better than expected. Only 16 physicians out of some 1,100 primary care physicians opted to leave the network.
Bero's presentation was part of the 2008 HIMSS conference, which is taking place in Orlando this week.
Plans for a new hospital campus hang like a shadow over New Orleans residents in the Tulane-Gravier neighborhood who were largely resigned to their neighborhood's fate. Residents pulled together to rebuild after Katrina--meeting on the neutral ground when there were no habitable buildings--and now stand to lose both their houses and their newfound sense of solidarity. The city, state and federal governments have announced their intention to demolish the neighborhood and build two teaching hospitals, which will be shared by Louisiana State University and the U.S. Department of Veterans Affairs, in its place. The hospitals are to act as a means to revive the crippled healthcare system, reverse the exodus of doctors and inaugurate a new economy based on medical research and education.
Florida regulators have ordered Northside Hospital in St. Petersburg to stop giving dialysis treatments and have threatened to suspend hospital operations if safety problems aren't fixed. According to the regulators, the Northside's board and administration knew about problems with its dialysis unit but did nothing to fix them.
