Queue jumping, mainly from Canada and the United Kingdom, has become a big part of the medical tourism industry, but Canadians have long resisted anything that even suggests allowing faster care for those with the cash to pay. With queue jumping not allowed in Canada, the only option has traditionally been for the very rich to go south and have procedures done in expensive U.S. hospitals. But with India, the Philippines and other countries offering to do the work for as little as a tenth of the cost of American hospitals, jumping the queue is now possible for the middle class. Be sure to also check out Stuart Laidlaw's take on the Health Care Globalization Summit in Las Vegas.
One of the most frequently cited reasons for the underutilization of clinical IT by physician groups is that of mismatched economics. Spend the money, the thinking goes, and watch the benefits accrue to someone else. Several speakers at this year's TEPR conference turned that notion on its head. Representing a range of practice sizes from the tiny to the huge, these speakers detailed how their groups had trimmed expenses, enhanced revenues, and expanded productivity by judicious use of clinical IT and other technological tools.
The Medical Clinic of North Texas, for one, boosted average revenue per encounter some 7%, from $115 to $123, according to Steve Neorr, chief operating officer. The increase stemmed from a combination of more accurate charge capture and participation in pay-for-performance initiatives. Although this 100-plus physician group of internists and family physicians had deployed an EMR in 2001, it wasn't until they hired an outside firm to consolidate and analyze their data measures several years later that they began to see the real return on the technology. The group receives "patient recommendation reports" from its vendor, CINA, on a daily basis. The reports highlight, for example, which patients are overdue for an appointment, or which patients are overdue for a certain test related to their diabetes. In essence, by practicing better medicine, the group has been rewarded economically.
On the expense reduction side, other practices have put technology to work replacing traditional medical transcription services with voice recognition. The Lifetime Health Medical Group, a 150-physician group, had seen its transcription bills hit $1.25 million annually. Since deploying voice recognition, and enabling physicians to create their own notes, the group has seen its transcription expenses go down to about $200,000 annually. "Voice recognition is faster than typing, and helps transition to using documentation templates," noted Douglas Golding, MD, medical director. The voice recognition technology helped the practice overcome some of the flaws of an EMR, namely its ability to streamline capture of the patient history and physical. Such critical pieces of the chart, Golding said, do not lend themselves to documentation templates, as they contain too much unique detail for a pull-down menu to accommodate.
James Saul, MD, told me how his three-member internal medicine practice in suburban Cleveland has boosted its fiscal return by deploying EMR technology. In Saul's case, reduced transcription costs also figured into the equation. In addition, the practice is able to support a higher level of E&M coding for its services, and also reduce its support staff. The practice lost one medical assistant through attrition, finding it did not need to maintain extra labor to do chart pulls once it went to digital files.
Although these three practices improved their operations, they all took very different approaches to their deployments. Sometimes it is the smallest features—such as a lab interface that imported results directly—that provided the biggest selling points to the medical staff. As the industry compiles more and more case examples like these, we are sure to see additional medical groups take the plunge to electronic record keeping.
Gary Baldwin is technology editor of HealthLeaders magazine. He can be reached at gbaldwin@healthleadersmedia.com.
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The American Health Information Management Association has announced that Robert Kolodner, MD, head of the Office of the National Coordinator for Health Information Technology, will be the keynote speaker on the first day of the Long-Term Care Health Information Technology Summit, June 9-10. The title of Kolodner's presentation is "Aligning LTC with the National Vision for HIT."
As DICOM-compliant devices proliferate across a healthcare information system, their installation and monitoring becomes problematic for PACS administrators. This is because these devices are often located outside the radiology department, and in some cases are dispersed beyond the physical boundaries of the administrator's institution. DICOM devices also often require time-consuming, multi-vendor coordination and require a complex network of inter-dependency among the technologies, according to Harshad N. Puppalwar, a solutions architect and domain specialist at Sarasota, FL-based CitiusTech. Puppalwar has proposed a solution that collects data from currently available technologies and healthcare standards to achieve its goals.
Keane announced that it has signed a $1.5 million, five-year contract with Golden Living, a network of long-term care facilities that includes 331 skilled nursing facilities and 19 assisted living facilities in 22 states. As part of the agreement, Keane will install eCharting and ePrescribing components of its NetSolutions clinical application. The technology will give physicians at Golden Living access to patient information using a secure, browser-based connection at the point of service.
Despite HIPAA regulations, the push for more fungible and liquid health information is on, according to the the Center for Democracy and Technology. The CDT claims that medical and health data needs to flow freely if advances in research and development, as well as treatment, are to be realized. "CDT is urging Congress to hold hearings on a broad range of privacy and security issues in health IT, and we plan to informally gather together a group of diverse health IT stakeholders over the next several months to identify the issues that need to be addressed and possibly come up with some consensus solutions," said Deven McGraw, director of the Health Privacy Project that is under the auspices of the CDT.
An editorial published in the Washington Times recently urges adoption of health IT. The editorial cites the Rand study, which claims the industry can save $81 billion in healthcare costs by implementing clinical IT. The federal government can help support IT by establishing standards for the technology so systems can communicate with each other, providing incentives for health IT use, and using advanced technologies in its own health programs, the editorial states.
A community hospital in Colorado deploys a robot to simulate childbirth and train staff in delivering babies. The birth training using "Noelle" is videotaped so participants can later analyze their performance and discuss improvements. The robot is especially helpful to prepare for more rare problems that hospital staff won't often see in real life, and the simulation can also help promote teamwork, hospital officials said.
Scientists at the University of Pittsburgh have trained a group of monkeys to feed themselves marshmallows using a robot arm controlled by sensors implanted in their brains. The feat could one day help paralyzed people operate prosthetic limbs on their own, researchers said. Researchers added that they believe it won’t be long before the technology is tested in humans, but they predict it will be longer before the devices are used in actual patients with disabilities.
Lousiana's Charity hospitals will be forced to scale back services unless the state Legislature comes up with at least $35 million, Louisiana State University officials told a Senate panel. Although the Charity hospitals were spared from the $240 million in state and federal dollars the House cut from the budget bill, their financing remains short of what's needed to keep services at current levels and continue to expand offerings, said hospital officials.
