"Patient portals offer a wide range of benefits, including decreasing unnecessary hassles for providers and patients and improving access to both the medical staff and a child's medical information," Mott Poll co-director Sarah Clark, MPH, says in a media release.
"Given all the conveniences portals offer, it's surprising that over half of parents have not set one up for their child, most commonly because they don't see a need for it. This report suggests many parents may not be aware of all the potential benefits of using a patient portal for children."
Nearly one-third of parents who did not have a patient portal for their child say they do not see the need, a quarter say they don't know how to access it, and 20% say they prefer other ways to communicate.
Few parents cite privacy concerns or technical problems, but some don't know if their provider offers a portal option.
Parents who use a portal enjoy the benefits. One-third say they've received advice about their child's illness, injury or symptoms through the platform. Nearly all of these parents say they got the level of guidance they anticipated within a reasonable amount of time and usually from the person they expected.
The majority of portal users have tapped it to make appointments, view tests, complete forms, get prescription refills, request immunization records or get referrals.
"Our poll suggests that pediatric health providers should continue efforts to inform families about the benefits of patient portals, and parents who haven't set one up should take steps to learn more about portal advantages and how to establish one for their child," Clark says.
Some providers have expressed concerns about parents' unrealistic expectations for portal queries, especially for urgent care. Clark says providers can help manage those expectations, and that parents who get instructions from their provider on how to use portals are more enthusiastic.
More than third of parents who did not receive portal training guidance also had the lowest satisfaction ratings on communication with their child's provider.
"Instructions from the practice on how to optimize portal benefits appear to be the key to helping parents use it effectively and appropriately and increase families' satisfaction with the experience," Clark said.
DOJ says the EHR vendor 'falsely obtained certification for its software.'
NextGen Healthcare Inc. will pay $31 million to resolve whistleblower allegations that the electronic health records (EHR) vendor lied about its software's capabilities and paid kickbacks to users who shilled their product, the Department of Justice announced.
NextGen has denied the allegations, which occured nearly a decade ago, and says it settled with DOJ to avoid lengthy and costly litigation.
In a civil complaint filed with the settlement, DOJ says NextGen "falsely obtained certification for its software in connection with the 2014 Edition certification criteria published by the Department of Health and Human Service's Office of the National Coordinator."
Specifically, DOJ alleges that NextGen "relied on an auxiliary product designed only to perform the certification test scripts, which concealed from the certifying entity that NextGen's EHR lacked critical functionality."
Because of that, DOJ says the EHR that NextGen sold to providers lacked mandated functions, including the ability to record vital sign data, translate data into required medical vocabularies, and create complete clinical summaries.
DOJ also alleges that NextGen violated the Anti-Kickback Statute when it gave credits worth as much as $10,000 to existing customers whose recommendation of NextGen's EHR software led to a new sale. The kickbacks also included tickets to sporting events and other entertainment.
"Electronic health records play a pivotal role in the provision of safe, effective healthcare, and the testing and certification process of the EHR Incentive Program was intended to provide assurances to providers that their EHR can perform certain important functions," U.S. Attorney Nikolas P. Kerest for the District of Vermont, the lead prosecutor of the case, says in a media release. "With this settlement, our office has now resolved five investigations into misconduct by EHR companies, demonstrating our commitment to ensuring that EHR companies are held responsible for their misrepresentations."
The settlement resolves claims brought under whistleblower provisions of the False Claims Act by Toby Markowitz and Elizabeth Ringold, healthcare professionals at a facility that used NextGen's software, who will receive $5.6 million.
NextGen Responds
NextGen issued the following statement in response to the settlement.
"The company denies that any of its conduct violated the law, and the settlement agreement does not include any admissions of wrongdoing. This agreement relates to claims from more than a decade ago. The settlement resolves the matter without monitoring or changes to NextGen Healthcare's products or compliance policies. To avoid the distraction and expense of litigation, we believe it is in the best interest of the company to put this historical matter behind us and keep our attention focused on innovating solutions that enable better healthcare outcomes for all."
Caremark Cost Saver will be a free service for CVS Caremark enrollees in 2024.
CVS Caremark and GoodRx announced this week the launch of a new collaborative to help lower out-of-pocket drug costs for CVS Caremark members.
Under the Caremark Cost Saver program, set to launch on January 1, 2024, commercially insured plan members will automatically access GoodRx's prescription pricing for lower prices on generic medications.
The amount paid will be applied to plan members' deductible and out-of-pocket thresholds. No action is required by plan members, who can use their existing benefit card at their in-network pharmacy.
"This collaborative prescription discount solution enables us to dynamically shop for the best price on (consumers') behalf," David Joyner, executive vice president, CVS Health and president, CVS Caremark says in a media release. "By lowering out-of-pocket costs for our clients' members, Caremark Cost Saver will help patients afford to take their medicine as directed."
Scott Wagner, Interim CEO of Santa Monica, CA-based GoodRx, says the new programs means that "patients don't have to choose between using their pharmacy benefit or using GoodRx to save on their prescriptions."
"Now they can do both right at the counter so they have confidence they are always paying the lowest available price," he says. "This collaboration can make a meaningful difference for the tens of millions of Americans that CVS Caremark serves."
The collaborative provided no estimates on the potential dollar savings it could generate for consumers.
Drug shortages affect consumer costs in several ways, including higher out-of-pocket costs, higher insurance premiums, and adverse health.
The chronic and worsening wave of drug shortages in the United States not only imperils patient health, it also costs them more money, a new study shows.
The study released this week by RAND Corporation finds that drug shortages affect consumer costs in several ways, including higher out-of-pocket costs, higher insurance premiums, and adverse health outcomes when the drug is unavailable or unaffordable. In addition, providers paying more for drugs are passing that cost on to patients.
Premier Inc. reported way back in 2011 that drug shortages cost providers at least $200 million a year. The Food and Drug Administration in 2020 identified 43 new and 86 unresolved shortages of active ingredients.
The shortages have worsened since then. The New York Times reported in May that “hundreds of drugs are on the list of medications in short supply in the United States, as officials grapple with an opaque and sometimes interrupted supply chain, quality and financial issues that are leading to manufacturing shutdowns.”
NBC News reported in May that “widespread shortages of cancer drugs are forcing doctors to make difficult decisions about how to treat their patients, including rationing doses and turning to other treatment options with potentially more side effects.”
The RAND study, commissioned by the Department of Health and Human Services, also found that:
Drug shortages affect consumers with reduced sales and/or increased prices.
The average drug shortage affects at least a half a million consumers, more than two thirds of whom are ages 65 to 85 (32%), 55 to 64 (24%) and 45 to 54 (17%).
After a drug shortage, sales volumes declined between 28% and 35% compared to the year before the drug entered a shortage. The reduction in volume of generic drug fills was larger (median of 37.6%) compared to brand-name drugs experiencing a shortage (median of 30.4%).
Drug shortages lead to a 16.6% increase in the price of drugs, driven mostly by an increase in the price of generics (14.6%). In some cases the price of generic substitutes was at least three times higher than the price increase of the drug in shortage.
The report highlights potential policies that could be pursued to address cost increases when there are shortages and to ensure sufficient supply of generic drugs.
To address the shortage, the report recommends that federal regulators tap into existing laws and policies that include requiring:
Drugmakers to notify FDA about drug making discontinuations or delays that are likely to lead to supply disruptions;
FDA to prioritize reviews of applications and inspections, as needed;
Manufacturers of flagged drugs or of any API used for preparation included in those drugs to develop, maintain, and implement, as appropriate, a redundancy risk management plan;
Registrants of drug establishments to report annually on the amount of each listed drug that they manufactured, propagated, compounded, or processed for commercial distribution.
In addition, FDA has already taken steps to prevent or mitigate shortages, including;
:
Working with manufacturers to increase production of certain drugs in shortage;
Expediting reviews of submissions to increase supply of products in shortage;
Working with manufacturers to determine if data support extending expiration dates of certain drugs in shortage;
Exercising temporary regulatory flexibility for sources of medically necessary drugs,
Issuing emergency use authorizations, under a public health emergency, for certain therapeutic treatments and patients.
FAIR Health reports that declines in telehealth claims were seen in all four U.S. census regions.
Overall private insurance telehealth claims fell 5.4% nationally in April, representing 5.3% of all medical claims, compared with 5.6% of claims in March, according to FAIR Health's Monthly Telehealth Regional Tracker.
The drop in telehealth claims was seen in all four U.S. census regions—the Midwest (4.7%), Northeast (6.3%), South (6.8%) and West (6.4%). The average patient visit lasted between 20 and 29 minutes, the median charge was $167.77, and the median allowed amount was $89.70.
Audio-only telehealth fell in both rural and urban areas nationally and in every region except the West, where it fell in rural areas but rose in urban areas.
The data was taken from privately insured population, including Medicare Advantage and excluding Medicare fee-for-service and Medicaid.
Mental health conditions continued to be the top-ranking telehealth diagnosis nationally and in every region, rinsing from 67.4% of telehealth claim lines nationally in March to 68.4% in April—the fourth straight month of national increases.
Claims for acute respiratory diseases and infections, the second most-common telehealth consultation, fell nationally in April from 3.2% in March to 2.7% in April, the fourth straight national monthly decrease for this diagnosis.
Developmental disorders rose to third place while joint/soft tissue diseases and issues fell to fourth place.
Among the top five diagnoses nationally via asynchronous telehealth places with urinary tract infections, rising to third place while UTI fell to fourth.
Asynchronous telehealth claims for hypertension increased to 12.5% nationally in April, up from 9.7% in March, and in every region. Hypertension rose from second to first place in the West and from fourth to second place in the South. It maintained its position nationally (second place) and in the other regions—second place in the Northeast and first in the Midwest.
Sleep disorders climbed in the rankings of asynchronous telehealth diagnoses from fifth to fourth place in the Northeast and from fourth to second place in the West. Diabetes mellitus rose in the rankings in three regions: from fifth to third place in the Midwest, from fourth to third place in the Northeast and from fifth to fourth place in the West.
The for-profit, megasystem has launched a webpage to keep patients informed.
HCA Healthcare Inc. announced Monday that it has discovered a data breach that could make vulnerable the personal information of many as 11 million patients at scores of care venues in 20 states.
In a media release, the Nashville-based for-profit health system says the information was "made available by an unknown and unauthorized party on an online forum."
The exposed data includes patients’ names addresses, emails, phone numbers, dates of birth, gender, service dates, locations and next appointment dates.
No clinical or payment data was exposed, nor were passwords or drivers’ license or Social Security numbers.
"This appears to be a theft from an external storage location exclusively used to automate the formatting of email messages," HCA says.
"There has been no disruption to the care and services HCA Healthcare provides to patients and communities. This incident has not caused any disruption to the day-to-day operations of HCA Healthcare. Based on the information known at this time, the company does not believe the incident will materially impact its business, operations or financial results."
HCA says it has reported the breach to law enforcement and has hired a third-party forensics investigator and "threat intelligence advisors." The investigation is ongoing but HCA says it has uncovered no evidence of "malicious activity" on its networks.
HCA shutdown user access to the storage location and will contact potentially affected patients and has launched a webpage to keep patients informed.
The legislation gives the executive enhanced powers to cut red tape and reduce trade barriers with 'trusted allies.'
A bipartisan bill introduced in the U.S. Senate aims to correct the nation's medical supply chain weaknesses that were exposed during the COVID-19 pandemic.
The Medical Supply Chain Resiliency Act, sponsored by U.S. Senators Thom Tillis (R-NC) and Tom Carper (D-DE) would strengthen the government's hand in trade negotiations that ensure that safe and timely delivery of critical medical goods.
A key component of the bill gives the president – through his appointed U.S. Trade Representative -- the authority to negotiate with "trusted allies" to eliminate tariffs and other barriers that weaken the medical goods manufacturing sector in the United States and allied nations. These agreements also would protect intellectual property rights and strengthen regulatory cooperation and collaboration on R&D efforts. Congress would be looped in on the status of these new trade agreements and would reserve the right to reject them.
"The pandemic caused major disruptions across nearly all supply chains, and these challenges disproportionately impacted our healthcare supply chain – from medical devices to life-saving medicines to personal protective equipment (PPE)," Tillis says in a media release.
"Now is the time to address the long-standing shortcomings in our supply chains that were highlighted over the pandemic, repair the damage done, and ensure America is adequately prepared for future national security and public health threats," he says.
Carper says the bill "will help mitigate trade challenges by authorizing the president to work more closely with our global partners and take action to ensure that healthcare providers and patients can access life-saving medical products when they need them the most."
"The pandemic wreaked havoc on our communities and caused our medical supply chains to break down during the worst possible time. We must prevent these same horrible losses from happening again by working together to fix our broken supply chains and better prepare for future public health emergencies," Carper says.
The bill has the support of key stakeholders, including the U.S. Chamber of Commerce, the National Foreign Trade Council, the Trade Alliance for Health, the National Foreign Trade Council, and the National Association of Manufacturers.
"This is practical legislation that, if enacted, will apply lessons learned in the COVID-19 pandemic to strengthen America's health preparedness," says John Murphy, senior vice president for international policy at the U.S. Chamber of Commerce.
The prestigious Los Angeles-based health system is now offering HIPAA-compliant, virtual second opinions in 21 states, including Arizona, California, Colorado, Connecticut, Florida, Hawaii, Idaho, Illinois, Minnesota, Montana, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, South Carolina, Utah, Vermont, Virginia and Washington.
"When you need specialized care for the most complex conditions, expertise matters," says Joanna Chikwe, MD, professor and chair of the Department of Cardiac Surgery at Cedars-Sinai. "So does convenience and speed. One of the special things about Virtual Second Opinion is that the physician can give each participant completely individualized and tailored treatment options."
The program is designed for patients looking to confirm a diagnosis or get more details about their condition, available treatment options, and finding a care regimen that best suits their needs. Cedars-Sinai says the virtual consultations are particularly valuable for patients living in remote areas who are unable to travel for an in-person consultation.
So far, Cedars-Sinai offers virtual second opinions on cardiac surgery, cardiology, spine surgery, and women's health, including coronary artery disease, aortic aneurysms and dissections, arrhythmias and valve dysfunction, disc disease, tumors and radiculopathies, endometriosis, abnormal bleeding, and ovarian tumors and cysts. Expansions into additional specialties are planned in the months ahead.
Patients ages 18 and older can request a virtual second opinion at a cost of $590 for Californians and $790 for out-of-state residents, owing to additional processing costs.
A nurse coordinator is assigned to the patient within 24 hours to help gather relevant health data and other relevant records, and a second opinion is offered within six days of receiving patients' documents.
Cedars-Sinai says most commercial health plans won't pay for the virtual second opinion, but patients with a health savings or flex spending account can tap it to cover the cost. The flat fee includes care coordination, medical record collection and a second opinion report prepared by a physician specialist. Patients can also schedule a virtual 30-minute educational session with specialists to review the report and answer questions.
Matthew Siedhoff, MD, vice chair of Gynecology at Cedars-Sinai, says the virtual second opinion can address underdiagnosed gynecologic conditions that "can cause women to suffer needless pain and frustration."
"A virtual second opinion can make such a difference,” Siedhoff says. "When patients come to us for an online visit, the imaging, lab tests, physical exam and other in-person tasks have already been done and can give us a good basis for evaluating the patient and recommending next steps."
Hispanic and Black adults were less likely than white adults to report having their care preferences considered by clinicians.
A solid majority (73%) of U.S. adults aged 50 and older say their care preferences are taken into consideration by providers, a 9.5% increase over 2014 responses to the same question asked in a survey sponsored by The SCAN Foundation.
However, the findings come with stark racial, economic, and geographic caveats.
Hispanic (52%) and Black adults (62%) were less likely than white adults (83%) to report having their care preferences always or usually considered in 2020 by clinicians, according to a data review by The LeadingAge LTSS Center @UMass Boston and Community Catalyst -- the first review of care preferences since the start of the COVID-19 pandemic.
Preferences include medications, treatment plans, care venues, and trust in their clinicians’ experience and demeanor.
"Ensuring personalized care as individuals age is vital for attaining quality outcomes and ensuring the utmost patient satisfaction," said Sarita A. Mohanty, MD, MPH, MBA, president / CEO of The SCAN Foundation. "Racial and ethnic disparities in how individuals perceive their care preferences being considered is deeply alarming and unacceptable. When preferences are not asked and respected, suboptimal care results."
Other findings show:
Income matters. Adults 50+ with household incomes less than $30,000 were less likely to say their care preferences were always or usually considered (66.1%) compared to those with incomes greater than $75,000 (85.1%).
Geography matters. Adults 50+ in the South were less likely to report care preferences were always or usually considered (71.9%) compared to those in the Northeast (76.4%), West (76.5%) and Midwest (80.2%).
Relationships matter. Adults 50+ with a usual source of care (e.g., a primary care doctor) reported an increase in their care preferences being usually or always considered (77.1% in 2020 vs. 69.9% in 2014).
"Numerous studies have shown that care that aligns with patient preferences is more effective," says Marc Cohen, PhD, co-director of The LeadingAge LTSS Center @UMass Boston and research director at Community Catalyst. "The healthcare system has a lot of work to do to address deep-seated inequities in how it listens and responds to patients of color."
The HIPAA breach by two dozen guards at Yakima Valley Memorial Hospital affected 419 patients.
A community hospital in Washington state will pay $240,000 to resolve patient records breaches by snooping security guards, the federal government says.
Not-for-profit Yakima Valley Memorial Hospital agreed to the settlement for the self-disclosed violations of the Health Insurance Portability and Accountability (HIPAA) in 2018, the Department of Health and Human Services Office of Civil Rights announced this week.
"Data breaches caused by current and former workforce members impermissibly accessing patient records are a recurring issue across the healthcare industry," says OCR Director Melanie Fontes Rainer.
"Healthcare organizations must ensure that workforce members can only access the patient information needed to do their jobs. HIPAA covered entities must have robust policies and procedures in place to ensure patient health information is protected from identify theft and fraud," she says.
According to OCR, following the self-disclosure of the violation in May 2018, the ensuing investigation determined that "23 security guards working in the hospital’s emergency department used their login credentials to access patient medical records maintained in Yakima Valley Memorial Hospital’s electronic medical record system without a job-related purpose."
The personal information of the 419 patients identified in the breach included names, dates of birth, medical record numbers, addresses, treatment notes, and insurance information, OCR says.
In addition to the fine, OCR will monitor Yakima Valley Memorial for two years to ensure HIPAA compliance and will also:
Conduct a risk analysis to determine risks and vulnerabilities to electronic protected health information;
Implement a risk management plan to address and mitigate identified security risks and vulnerabilities;
Develop, maintain, and revise its written HIPAA policies and procedures;
Enhance its existing HIPAA and Security Training Program to provide workforce training on the updated HIPAA policies;
Review all relationships with vendors and obtain business associate agreements.