The organization that certifies electronic health records will soon search for a new chairman.
The Certification Commission for Health Information Technology announced today that Mark Leavitt, MD, PhD, is retiring from his position as chair of the commission on March 31, 2010.
"Having the privilege to launch and lead this volunteer-based, nonprofit organization has been one of the most rewarding and educational experiences of my life," said Leavitt.
CCHIT was founded five years ago and has been a federally recognized certifying body since 2006. It has certified more than 200 EHR products for doctors' offices, hospitals, and emergency rooms, which CCHIT said represents more than 85% of the market.
CCHIT opened applications for 2011 EHR certification in October that featured two pathways: maximum assurance of EHR capabilities for providers and one offering "maximum flexibility for technology innovations." CCHIT said it will announce the first products and technologies certified under the two new programs soon.
The CCHIT Board of Trustees said it will start a national search for a successor. CCHIT trustee Frank Trembulak, executive vice president and chief operating officer of Geisinger Health System, will chair the search committee, and a firm has been retained to conduct the search.
"The search for his successor will be open and transparent so we maintain the confidence of our many constituents," said H. Stephen Lieber, chair of the Board of Trustees.
Health insurers and employers may see chiropractic services as a nice addition on members' health plans, but a recent study suggests chiropractic care is also a way to reduce health costs and improve the value of health plans.
Mercer analyzed peer-reviewed scientific literature that valued the effectiveness of chiropractic treatments for U.S. patients with back and neck pain. The analysis found that chiropractic care is more effective than other modalities for treating low back and neck pain—and costs less than other care.
The analysts reported that the data show insurance coverage of chiropractic physician care for low back and neck pain for conditions other than fracture and malignancy would likely reduce total U.S. healthcare costs.
"Our findings in combination with existing U.S. studies published in peer-reviewed scientific journals suggest that chiropractic care for the treatment of low back and neck pain is likely to achieve equal or better health outcomes at a cost that compares very favorably to most therapies that are routinely covered in U.S. health benefit plans.
"As a result, the addition of chiropractic coverage for the treatment of low back and neck pain at prices typically payable in U.S. employer-sponsored health benefit plans will likely increase value-for-dollar by improving clinical outcomes and either reducing total spending (neck pain) or increasing total spending (low back pain) by a smaller percentage than clinical outcomes improve," wrote Mercer.
Gerard Clum, DC, president of Life Chiropractic College West and representative for the Foundation for Chiropractic Progress, says the report shows that chiropractic care can reduce cost and increase clinical effectiveness. The issue is that most health insurers see the services merely as an add-on rather than a way to control costs, he adds.
"More often than not, it's put in there as something to keep the employee happy rather than looking at the return to the plan and the value to the plan and the employer," he says.
Though most health insurers include chiropractic services and 46 states have mandates requiring insurers cover those services, Clum says insurers are not adequately promoting chiropractics as a care option. Insurers should market those services as a way to improve clinical effectiveness and cut costs. But that's quite different from the way insurers currently promote chiropractic services.
"That is a totally different orientation that we haven't seen on a broad-base level," he says.
Clum says insurers should rethink their thoughts about chiropractic services because that kind of care meshes with the belief that improved health doesn't come merely from a prescription pad or in a bottle.
"It's about how we're living our lives and taking responsibility for our lives. This is absolutely consistent with that emerging thinking," he says.
HealthLeaders Media '09: The Hospital of the Future Now
The hospital of the future is being built today. It's being built in board rooms and executive suites where long-term decisions are being made on strategies that will shape how hospitals plan for a market that is more dynamic, more efficient, more technologically intelligent, and more focused on the customer than ever before.
HealthLeaders Media '09: The Hospital of the Future Now brought those discussions out of the boardroom and into this unique, high-level leadership event-with access to thought-leaders only HealthLeaders Media, an award-winning healthcare strategy publisher can bring. More than a static gathering of lectures, HealthLeaders Media '09 provided an exclusive and interactive group experience.
Participants of this one-of-a-kind event worked together over two days to create cohesive plans for implementing progressive and actionable solutions for their organization.
Our annual gathering of top healthcare leaders featured exceptional executives with compelling stories to share. Throughout the two-day event in Chicago, leaders from successful healthcare organizations shared insights on becoming the hospital of the future now during panel discussions on leadership, design, culture, patient experience, outcomes, and talent.
You can find our complete coverage the HealthLeaders Media '09 keynote address, panel discussions and leadership luncheon here:
Healthcare in the Experience Economy. HealthLeaders Media Managing Editor Elyas Bakhtiari outlines how keynote speaker Joe Pine explained why healthcare is transitioning from a service-based economy to an experience-based economy.
Reinventing the Patient Experience. More than ever, healthcare organizations are trying to reinvent the patient experience—not just to see improvements to patient satisfaction scores, but also as a way of shifting the organizational culture to better meet quality and safety goals.
Audio Feature: Design for Digital Care. Greg Walton, chief information officer at El Camino Hospital in Mountain View, CA, shares strategies CIOs can use to survive the recession while designing for digital care. For example, organizations should factor in the amount of electricity the hospital of the future will need, as well as, the amount of heat all that electricity will generate.
Never-ending Quality Improvement. Four healthcare leaders offered a glimpse at how the best hospitals and payers in the industry are making progress on improving outcomes in a panel discussion.
Leadership During Disruptive Times. The HealthLeaders '09 conference closed with a leadership luncheon that focused on healthcare finances and the uncertain future of reform.
Welcome to the Future. In our November 2009 issue of HealthLeaders Magazine, Managing Editor Elyas Bakhtiari provided a comprehensive breakdown of each our HealthLeaders '09 panels.
The event also honored winners of the 2009 Top Leadership Teams in Healthcare Awards Program. In its sixth year, the Program recognized the best in senior leadership teamwork at small, medium, and large hospitals and health systems, health plans and medical group practices.
Dr. John Kenagy is a physician, healthcare executive, scholar, and advisor, who was once described by Forbes Magazine as "The Man Who Would Save Healthcare." He's written a book called Designed to Adapt: Leading Healthcare in Challenging Times. What's interesting about the book is that many of the lessons come from his personal experience surviving a critical hospital stay for a broken neck, where he came to the conclusion that most healthcare organizations can't manage the many small problems that affect each individual patient on a day-to-day basis, let alone the larger issues faced by the industry. I spoke with him recently and he's featured in this week's audio interview.
Healthcare reform is coming. Regardless of the specifics of the plan, the future will surely focus on informing the patient, will most certainly further constrain revenues, and will likely increase patient throughput. With all that said, leadership can expect significant challenges during the coming reform period.
In the current environment and the one to come, provider executives must continue to find the means to do more with less. Effective supply chain management working within an integrated care delivery context—one in which the quality a patient demands and the cost necessary to deliver on that expectation—is integral to both an organization’s economic success and the quality of patient care it is able to provide.
Supply chain expenditures comprise between 20% and 50% of the total cost of care budget. In our predominantly not-for-profit system, a high percentage of every dollar saved on supply acquisition will circulate directly back into patient care.
Supply channels tie up much-needed capital. Reductions in these areas fuel investments in facilities and patient care equipment.
Supply chain influences choices of patient care products and technologies.
Supply chain data systems hold the key to accurate identification of patient care supply utilization and are critical to the development of the next generation of cost management strategies.
Given the vital role of your organization's supply chain in influencing both the cost and quality of patient care, empowering supply chain management and having them apply supply chain processes in the clinical setting is essential. Your role is, quite simply, to enable and encourage supply chain managers to pursue educational opportunities that will enhance their tactical and leadership skills and forge a tighter connection with clinicians and their practices.
Determining whether your efforts are paying off is just as straightforward. Simply look at a patient record to learn whether it includes every significant—i.e., treatment-essential—product that was used to care for the patient. With this supply chain discipline in place, you’ll have tangible proof of your supply chain’s engagement in the clinical setting and your organization will be empowered to:
Ensure patient safety in product recall situations
Effectively study the impact of supplies on patient outcomes
Better understand and more clearly articulate the cost of goods for the services rendered
Identify cost/quality trade-offs
Whatever the future, empowered supply chain managers who can supply chain discipline in the clinical setting provide organizations with an invaluable opportunity to significantly affect the cost and quality of care they deliver. The time to access this opportunity is now.
Ed Hisscock is co-founder of Appleseed Healthcare Resources. He may be reached at ehisscock@appleseedhc.com For information on how you can contribute to HealthLeaders Media online, please read our Editorial Guidelines.
I was watching "CBS Sunday Morning" last weekend. Call me a fossil, (I'm only 38) but I love the music at the beginning, the sun motif, and Charles Osgood's voice and manner. Never mind that I usually watch it much later courtesy of the DVR.
Anyway, the stories are usually pretty soft—they had one on the 40th anniversary of Sesame Street, for example—and they're often pretty light on details, but a story this week on why people decline the swine flu vaccination was particularly interesting and alarming at the same time.
In the story, the reporter interviewed a couple of doctors who argued that getting a majority of people to get the vaccine is important to "herd immunity." This essentially means that it's more difficult for a disease to maintain a chain of infection when large numbers of a population are immune.
The doctors interviewed in the "Sunday Morning" piece said that irrational fear of the vaccine, thanks primarily to widespread speculation about the role of vaccinations in causing childhood autism (a link that has never been proven, by the way) is getting in the way of herd immunity across the globe.
Meanwhile, the spokesperson for a private group that counsels against getting the vaccine essentially said that people shouldn't be forced to get anything injected in their body. Never mind that no one's arguing that point—at least in this country.
But recent controversy about the safety of the vaccine has spread to people you'd think would know better, including healthcare workers themselves. These are people who are supposedly trained not only in treating patients for diseases and other maladies with which they're already afflicted, but who presumably have a working knowledge of how diseases are transmitted and how people can protect themselves.
Seeing something like this, it's no wonder we have such a problem with getting caregivers to consistently wash their hands. In fact, I'm only vaccinated against H1N1 myself because the initial 3,000 inoculations set aside for healthcare workers here in Nashville were so underutilized that you'd think they were giving away eye pokes and face slaps.
Only about 64 healthcare workers took advantage, so the local health department opened the remaining 2,936 doses to anyone who wanted one—my wife and I among them. One month later, and I'm still here. Not a sniffle.
I'm a big believer in vaccines. Why? My great-grandparents had a big family in rural Mississippi. By the time the so-called Spanish Flu pandemic finished its work between 1918-1920, they were both dead from it, as were three of their eight children. Between 50 million and 100 million people worldwide joined them in death from the disease. Do you think there would have been controversy about a vaccine that would prevent that disease if there had been one available at the time? Me neither.
Recently, a nurses' union in New York threatened to strike over a controversial requirement that said they must be vaccinated for H1N1 or lose their jobs. That requirement was soon rescinded. Nearly concurrently, a union in California threatened to strike because they didn't feel hospitals were doing enough to protect them from swine flu infection. Hello! How about getting the vaccine? I know these are different organizations, but what gives?
Many, many smart people have tried to find ways to convince people that the vaccine is not harmful and is important to protecting against a regional, national or global pandemic. Clearly, they've failed.
So how does a leader convey that getting the vaccine is important enough to overcome these irrational fears? How does a leader get buy-in from caregivers regarding any issue that is controversial? I'm not sure.
But I haven't seen the President or any of his cabinet holding a news conference at which they take the vaccination. In fairness, he's said he and the First Lady will wait until high-risk groups get the vaccine before getting it. I appreciate the gesture, but in this case, wouldn't it be better to go on the offensive against some of this irrational fear by getting the vaccine yourself?
I'd love to hear what great leaders have done to sell unpopular initiatives ranging from the importance of the H1N1 vaccine to the long-term wisdom of aligning with physicians through employment, for example. You can reach me at the email address below.
Note: You can sign up to receiveHealthLeaders Media Corner Office, a free weekly e-newsletter that reports on key management trends and strategies that affect healthcare CEOs and senior leaders.
The National Institutes of Health has given researchers at the University of Florida $1.6 million to determine if a new Medicare rule eliminating payment for the cost of treating in-hospital falls will lower the rate of falls among hospital patients.
Geriatricians are concerned that the preventative measure might have an unintended negative effect of increasing the use of physical restraints to keep people confined to beds or chairs.
"This is about how do we simultaneously cut healthcare costs and improve healthcare quality. It's where geriatrics, patient safety, and policy intersect," principal investigator Ronald Shorr, MD, a geriatric researcher who will lead the UF study, said in a media release announcing the funding.
In October 2008, as part of its pay-for-performance initiative, CMS stopped reimbursing hospitals for excess costs of treating eight hospital-acquired preventable conditions, including in-hospital falls. About 30% of falls in older adults result in injury and about 10% result in serious injury, according to the CDC. A separate study suggests that 20% of hospital falls can be prevented.
Patient safety advocates worry that fearing loss of revenue, some hospitals might resort to potentially harmful measures, such as tying patients down or otherwise restraining them.
"Our biggest concern is that the intervention used would be to keep people in bed—the end result would be a decline in mobility in hospitalized patients," said Cynthia J. Brown, MD, the coauthor of a New England Journal of Medicine paper on potential negative consequences of the Medicare rule change. Brown is not involved in the UF study.
Brown's research among older adults has shown that those who have the lowest levels of mobility during hospitalization were much more likely than others to have adverse outcomes, such as functional decline, requiring nursing home placement, and death.
Physical restraints do not protect patients from in-hospital falls, and are instead linked to increased rates of physical and psychological complications, such as loss of function, pressure sores, delirium, asphyxiation, and even death. Conditions that patients develop as a result of being bed-bound also cost extra to treat, Brown's study reported.
Meanwhile, Shorr's research found that up to five falls occur for every 1,000 patient-days in the acute-care setting.
"What's really more the point is that nobody to date has found anything that reduces injury from falls—and that's what costs us money," Brown said. "If a patient falls and breaks a hip that's what we're getting penalized for, but there is no evidence that there is anything that will reduce that. It's hard if you don't have evidence to say 'this is how to do it right.'"
The UF study hopes to identify which components of the regulation work and which do not, which can inform effective fall prevention policies and practices. Co-investigators from Methodist Health Care in Tennessee, Vanderbilt University, Louisiana State University, the University of Tennessee, and the University of Kansas will work with the UF team.
The research will have a three-tiered approach. An analysis will look at practices during the 27 months before the new payment rules went into effect, and during a period of corresponding length after the rule change. Using data from 3,000 nursing units at 1,000 hospitals that feed the National Database of Nursing Quality Indicators, the investigators will look at how many falls and related-injuries occurred, and how many hospital units used of physical restraints.
A more localized study will focus on similar outcomes for four adult hospitals in Memphis, TN. In addition, the team will conduct a case-control study comparing restraint use among people who fell while hospitalized to those who did not fall.
"We'd like to get a better understanding of how hospitals react or are able to react to policies that are set forth by regulatory agencies," said Lorraine Mion, RN, Independence Foundation Professor of Nursing at Vanderbilt University and co-investigator on the study. "Perhaps it will help us understand the ramifications policy has on us in terms of practices, patient outcomes, and cost."
The health bills passed through Senate committees would extend insurance to fewer people than the final bill passed through the House last week, and Senate leaders have been refining their bill to increase that number. Hospitals and insurance companies warn that if the final Senate bill doesn't cover more people than its earlier drafts, insurance prices will increase and industry pledges to cut costs could fall apart, the Wall Street Journal reports.
UnitedHealth Group, the nation's largest health insurance carrier, is urging its employees to lobby the Senate against reform proposals that would hurt the firm's bottom line. Minnesota-based UnitedHealth Group e-mailed its 75,000 employees asking them to write their senators and local newspapers in opposition to a public insurance option, alleging that "government-run healthcare" will force "millions of Americans" to drop their current coverage. Proposed form letters from the company also lay out opposition to cuts in the Medicare Advantage program and advocate higher financial penalties for individuals who do not buy health insurance. Consumer Watchdog, a California-based advocacy group, says the campaign amounts to intimidation of employees of UnitedHealth Group and its main operating division, UnitedHealthcare.
Democrats heralded a report from the Business Roundtable on healthcare costs, saying it showed their legislative efforts would reduce employers' costs in coming years. The Business Roundtable, which represents the chief executives of major U.S. companies, released a report that stated that without changes to the current U.S. healthcare system, costs would rise to $28,530 per employee. But the "right legislative reforms" would reduce those costs by more than $3,000 per employee, according to the report.
