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Bob Wachter Puts Forward Spin on Patient Safety, Quality of Care at HM13
Most hospitalists have heard the adage “If you’ve seen one hospitalist group, you’ve seen one hospitalist group.” Another HM truism is “If you’ve seen one SHM annual meeting, then you’ve seen Bob Wachter, MD, MHM.”
Dr. Wachter, professor, chief of the division of hospital medicine, and chief of the medical service at the University of California at San Francisco Medical Center, is to HM conventions as warfarin is to anticoagulation. His keynote address is the finale to the yearly confab, and HM13’s version is scheduled for noon May 19 at the Gaylord National Harbor Resort & Convention Center in National Harbor, Md.
This year’s address is titled “Quality, Safety, and IT: A Decade of Successes, Failures, Surprises, and Epiphanies.” Dr. Wachter spoke recently with The Hospitalist about his annual tradition.
Question: With your interest in the intersection between healthcare and politics, to be back in D.C. has to be something enjoyable for you to write and talk about.
Answer: It’s a very interesting time in the life of healthcare, in that now that everybody knows that the [Affordable Care Act] is real and not going away, and we’re actually beginning to implement parts of it, you can kind of see what the future is going to look like, and everybody’s responding. And there are parts of that that are very exciting, because they’re forcing us to think about value in new ways. [And] there are parts of it that are somewhat frustrating.
Q: Does that give the hospitalist community the chance to ride herd on more global issues?
A: I think that’s the most optimistic interpretation—that we stick to our knitting, that we continue to be the leaders in improvement, and eventually all of the deals will be done, lawyers will be dismissed, and people will turn back to focusing on performance and say to us, “Thank goodness you’ve been doing this work, because now we realize that it’s not just about contracts; it’s about how we deliver care, and you’re the ones that have been leading the way.”
Q: What’s the most realistic interpretation?
A: This work gets less attention and less support than it needs. … I think we’re going to go through three to five years where we’re continuing to do the work. It’s really important—in many ways, it’s as important as growing—but as its importance is growing, the importance of other things that require more tending-to by the senior leadership is growing even faster. The risk is that there will be a disconnect.
Q: When you see the literature that suggests just how difficult the nuts and bolts implementation of reform is, what message do you want to get across to the people who are going to be listening, in terms of actually implementing all of this?
A: The message I don’t want to get across is “frustration, burnout, and it’s not worth it.” The endgame is worth it. The endgame is not even elective. We have to get to a place where we’re delivering higher-quality, safer, more satisfying care to patients at a lower cost. We’re in a unique position to deliver on that promise. … This is really tough stuff, and it takes time and it takes learning.
Check out our 6-minute feature video: "Five Reasons You Should Attend HM13"
Richard Quinn is a freelance writer in New Jersey.
Most hospitalists have heard the adage “If you’ve seen one hospitalist group, you’ve seen one hospitalist group.” Another HM truism is “If you’ve seen one SHM annual meeting, then you’ve seen Bob Wachter, MD, MHM.”
Dr. Wachter, professor, chief of the division of hospital medicine, and chief of the medical service at the University of California at San Francisco Medical Center, is to HM conventions as warfarin is to anticoagulation. His keynote address is the finale to the yearly confab, and HM13’s version is scheduled for noon May 19 at the Gaylord National Harbor Resort & Convention Center in National Harbor, Md.
This year’s address is titled “Quality, Safety, and IT: A Decade of Successes, Failures, Surprises, and Epiphanies.” Dr. Wachter spoke recently with The Hospitalist about his annual tradition.
Question: With your interest in the intersection between healthcare and politics, to be back in D.C. has to be something enjoyable for you to write and talk about.
Answer: It’s a very interesting time in the life of healthcare, in that now that everybody knows that the [Affordable Care Act] is real and not going away, and we’re actually beginning to implement parts of it, you can kind of see what the future is going to look like, and everybody’s responding. And there are parts of that that are very exciting, because they’re forcing us to think about value in new ways. [And] there are parts of it that are somewhat frustrating.
Q: Does that give the hospitalist community the chance to ride herd on more global issues?
A: I think that’s the most optimistic interpretation—that we stick to our knitting, that we continue to be the leaders in improvement, and eventually all of the deals will be done, lawyers will be dismissed, and people will turn back to focusing on performance and say to us, “Thank goodness you’ve been doing this work, because now we realize that it’s not just about contracts; it’s about how we deliver care, and you’re the ones that have been leading the way.”
Q: What’s the most realistic interpretation?
A: This work gets less attention and less support than it needs. … I think we’re going to go through three to five years where we’re continuing to do the work. It’s really important—in many ways, it’s as important as growing—but as its importance is growing, the importance of other things that require more tending-to by the senior leadership is growing even faster. The risk is that there will be a disconnect.
Q: When you see the literature that suggests just how difficult the nuts and bolts implementation of reform is, what message do you want to get across to the people who are going to be listening, in terms of actually implementing all of this?
A: The message I don’t want to get across is “frustration, burnout, and it’s not worth it.” The endgame is worth it. The endgame is not even elective. We have to get to a place where we’re delivering higher-quality, safer, more satisfying care to patients at a lower cost. We’re in a unique position to deliver on that promise. … This is really tough stuff, and it takes time and it takes learning.
Check out our 6-minute feature video: "Five Reasons You Should Attend HM13"
Richard Quinn is a freelance writer in New Jersey.
Most hospitalists have heard the adage “If you’ve seen one hospitalist group, you’ve seen one hospitalist group.” Another HM truism is “If you’ve seen one SHM annual meeting, then you’ve seen Bob Wachter, MD, MHM.”
Dr. Wachter, professor, chief of the division of hospital medicine, and chief of the medical service at the University of California at San Francisco Medical Center, is to HM conventions as warfarin is to anticoagulation. His keynote address is the finale to the yearly confab, and HM13’s version is scheduled for noon May 19 at the Gaylord National Harbor Resort & Convention Center in National Harbor, Md.
This year’s address is titled “Quality, Safety, and IT: A Decade of Successes, Failures, Surprises, and Epiphanies.” Dr. Wachter spoke recently with The Hospitalist about his annual tradition.
Question: With your interest in the intersection between healthcare and politics, to be back in D.C. has to be something enjoyable for you to write and talk about.
Answer: It’s a very interesting time in the life of healthcare, in that now that everybody knows that the [Affordable Care Act] is real and not going away, and we’re actually beginning to implement parts of it, you can kind of see what the future is going to look like, and everybody’s responding. And there are parts of that that are very exciting, because they’re forcing us to think about value in new ways. [And] there are parts of it that are somewhat frustrating.
Q: Does that give the hospitalist community the chance to ride herd on more global issues?
A: I think that’s the most optimistic interpretation—that we stick to our knitting, that we continue to be the leaders in improvement, and eventually all of the deals will be done, lawyers will be dismissed, and people will turn back to focusing on performance and say to us, “Thank goodness you’ve been doing this work, because now we realize that it’s not just about contracts; it’s about how we deliver care, and you’re the ones that have been leading the way.”
Q: What’s the most realistic interpretation?
A: This work gets less attention and less support than it needs. … I think we’re going to go through three to five years where we’re continuing to do the work. It’s really important—in many ways, it’s as important as growing—but as its importance is growing, the importance of other things that require more tending-to by the senior leadership is growing even faster. The risk is that there will be a disconnect.
Q: When you see the literature that suggests just how difficult the nuts and bolts implementation of reform is, what message do you want to get across to the people who are going to be listening, in terms of actually implementing all of this?
A: The message I don’t want to get across is “frustration, burnout, and it’s not worth it.” The endgame is worth it. The endgame is not even elective. We have to get to a place where we’re delivering higher-quality, safer, more satisfying care to patients at a lower cost. We’re in a unique position to deliver on that promise. … This is really tough stuff, and it takes time and it takes learning.
Check out our 6-minute feature video: "Five Reasons You Should Attend HM13"
Richard Quinn is a freelance writer in New Jersey.
SHM Sections Adds Global Health and Human Rights Category
SHM Sections offer opportunities for members to connect with communities of their peers who share specialties or interests. At present, SHM Sections include:
- Med-Peds
- International
- Global Health and Human Rights
- Rural Hospitalists
- Practice Administrators
SHM Section of the Month
Seeing as how the focused-practice pathway for hospitalists is a first of its kind for physician credentialing boards, the ABIM is planning a “fairly significant” research effort tracking participants’ experience, Dr. Holmboe says.
Global Health and Human Rights is one of the newest SHM Sections, and represents a growing passion among hospitalists as increasing numbers of internal-medicine physicians express interest in overseas placements in resource-limited settings. SHM also recognizes the need for mentored training in global health.
Over the last decade, interest in global health has grown significantly amongst trainees, faculty, and staff. Current priorities for global health include: health-system strengthening, workforce training, QI and patient safety. These priorities align to core strengths of hospital medicine, which is therefore well suited to meet these global health challenges.
For more information about this and other Sections, visit www.hospitalmedicine.org/membership.
SHM Sections offer opportunities for members to connect with communities of their peers who share specialties or interests. At present, SHM Sections include:
- Med-Peds
- International
- Global Health and Human Rights
- Rural Hospitalists
- Practice Administrators
SHM Section of the Month
Seeing as how the focused-practice pathway for hospitalists is a first of its kind for physician credentialing boards, the ABIM is planning a “fairly significant” research effort tracking participants’ experience, Dr. Holmboe says.
Global Health and Human Rights is one of the newest SHM Sections, and represents a growing passion among hospitalists as increasing numbers of internal-medicine physicians express interest in overseas placements in resource-limited settings. SHM also recognizes the need for mentored training in global health.
Over the last decade, interest in global health has grown significantly amongst trainees, faculty, and staff. Current priorities for global health include: health-system strengthening, workforce training, QI and patient safety. These priorities align to core strengths of hospital medicine, which is therefore well suited to meet these global health challenges.
For more information about this and other Sections, visit www.hospitalmedicine.org/membership.
SHM Sections offer opportunities for members to connect with communities of their peers who share specialties or interests. At present, SHM Sections include:
- Med-Peds
- International
- Global Health and Human Rights
- Rural Hospitalists
- Practice Administrators
SHM Section of the Month
Seeing as how the focused-practice pathway for hospitalists is a first of its kind for physician credentialing boards, the ABIM is planning a “fairly significant” research effort tracking participants’ experience, Dr. Holmboe says.
Global Health and Human Rights is one of the newest SHM Sections, and represents a growing passion among hospitalists as increasing numbers of internal-medicine physicians express interest in overseas placements in resource-limited settings. SHM also recognizes the need for mentored training in global health.
Over the last decade, interest in global health has grown significantly amongst trainees, faculty, and staff. Current priorities for global health include: health-system strengthening, workforce training, QI and patient safety. These priorities align to core strengths of hospital medicine, which is therefore well suited to meet these global health challenges.
For more information about this and other Sections, visit www.hospitalmedicine.org/membership.
Robotic Vaporizers Reduce Hospital Bacterial Infections
Paired, robotlike devices that disperse a bleaching disinfectant into the air of hospital rooms, then detoxify the disinfecting chemical, were found to be highly effective at killing and preventing the spread of “superbug” bacteria, according to research from Johns Hopkins Hospital published in Clinical Infectious Diseases.5 Hydrogen peroxide vaporizers were first deployed in Singapore hospitals in 2002 during an outbreak of severe acute respiratory syndrome (SARS).
Almost half of a study group of 6,350 patients in and out of 180 hospital rooms over a two-and-a-half-year period received the enhanced cleaning technology, while the others received routine cleaning only. Manufactured by Bioquell Inc. of Horsham, Pa. (www.bioquell.com), each device is about the size of a washing machine. They were deployed in hospital rooms with sealed vents, dispersing a thin film of hydrogen peroxide across all exposed surfaces, equipment, floors, and walls. This approach reduced by 64% the number of patients who later became contaminated with any of the most common drug-resistant organisms, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, Clostridium difficile, and Acinetobacter baumannii.
Spreading the bleaching vapor this way “represents a major technological advance in preventing the spread of dangerous bacteria inside hospital rooms,” says senior investigator Trish Perl, MD, MSc, professor of medicine and an infectious disease specialist at Johns Hopkins. The hospital announced in December that it would begin decontaminating isolation rooms with these devices as standard practice starting in January.
Reference
Paired, robotlike devices that disperse a bleaching disinfectant into the air of hospital rooms, then detoxify the disinfecting chemical, were found to be highly effective at killing and preventing the spread of “superbug” bacteria, according to research from Johns Hopkins Hospital published in Clinical Infectious Diseases.5 Hydrogen peroxide vaporizers were first deployed in Singapore hospitals in 2002 during an outbreak of severe acute respiratory syndrome (SARS).
Almost half of a study group of 6,350 patients in and out of 180 hospital rooms over a two-and-a-half-year period received the enhanced cleaning technology, while the others received routine cleaning only. Manufactured by Bioquell Inc. of Horsham, Pa. (www.bioquell.com), each device is about the size of a washing machine. They were deployed in hospital rooms with sealed vents, dispersing a thin film of hydrogen peroxide across all exposed surfaces, equipment, floors, and walls. This approach reduced by 64% the number of patients who later became contaminated with any of the most common drug-resistant organisms, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, Clostridium difficile, and Acinetobacter baumannii.
Spreading the bleaching vapor this way “represents a major technological advance in preventing the spread of dangerous bacteria inside hospital rooms,” says senior investigator Trish Perl, MD, MSc, professor of medicine and an infectious disease specialist at Johns Hopkins. The hospital announced in December that it would begin decontaminating isolation rooms with these devices as standard practice starting in January.
Reference
Paired, robotlike devices that disperse a bleaching disinfectant into the air of hospital rooms, then detoxify the disinfecting chemical, were found to be highly effective at killing and preventing the spread of “superbug” bacteria, according to research from Johns Hopkins Hospital published in Clinical Infectious Diseases.5 Hydrogen peroxide vaporizers were first deployed in Singapore hospitals in 2002 during an outbreak of severe acute respiratory syndrome (SARS).
Almost half of a study group of 6,350 patients in and out of 180 hospital rooms over a two-and-a-half-year period received the enhanced cleaning technology, while the others received routine cleaning only. Manufactured by Bioquell Inc. of Horsham, Pa. (www.bioquell.com), each device is about the size of a washing machine. They were deployed in hospital rooms with sealed vents, dispersing a thin film of hydrogen peroxide across all exposed surfaces, equipment, floors, and walls. This approach reduced by 64% the number of patients who later became contaminated with any of the most common drug-resistant organisms, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, Clostridium difficile, and Acinetobacter baumannii.
Spreading the bleaching vapor this way “represents a major technological advance in preventing the spread of dangerous bacteria inside hospital rooms,” says senior investigator Trish Perl, MD, MSc, professor of medicine and an infectious disease specialist at Johns Hopkins. The hospital announced in December that it would begin decontaminating isolation rooms with these devices as standard practice starting in January.
Reference
Digital Diagnostic Tools Unpopular with Patients, Study Finds
A recent study from the University of Missouri to explore how patients react to physicians’ use of computerized clinical decision support systems finds that these devices could leave patients feeling ignored and dissatisfied with their medical care, potentially increasing noncompliance with treatment while distracting physicians from the patient encounter.1
“Patients may be concerned that the decision aids reduce their face-to-face time with physicians,” says lead author Victoria Shaffer, PhD, assistant professor of health and psychological sciences at the University of Missouri. She recommends incorporating computerized systems as teaching tools to engage patients and help them understand their diagnoses and recommendations. “Anything physicians or nurses can do to humanize the process may make patients more comfortable,” she says.
The study presented participants with written descriptions of hypothetical physician-patient encounters, with the physician using unaided judgment, pursuing advice from a medical expert, or using computerized clinical decision support. Physicians using the latter were viewed as less capable, but participants also were less likely to assign those physicians responsibility for negative outcomes.
A concurrent study from Missouri, part of a $14 million project funded by the Centers for Medicare & Medicaid Services (CMS) to reduce avoidable rehospitalizations of nursing home residents, suggests that sophisticated information technology (IT) can lead to more robust and integrated communication strategies among clinical staff, as well as better-coordinated care.2 Nursing informatics expert Gregory Alexander found that nursing homes with IT used it to help make clinical decisions, electronically track patient care, and securely relay medical information.
References
- Shaffer VA, Probst CA, Merkle EC, Arkes HR, Mitchell AM. Why do patients derogate physicians who use a computer-based diagnostic support system? Med Decis Making. 2013;33(1):108-118.
- Alexander GL, Steege LM, Pasupathy KS, Wise K. Case studies of IT sophistication in nursing homes: a mixed method approach to examine communication strategies about pressure ulcer prevention practices. SciVerse website. Available at: http://www.sciencedirect.com/science/article/pii/S0169814112001229. Accessed March 10, 2013.
A recent study from the University of Missouri to explore how patients react to physicians’ use of computerized clinical decision support systems finds that these devices could leave patients feeling ignored and dissatisfied with their medical care, potentially increasing noncompliance with treatment while distracting physicians from the patient encounter.1
“Patients may be concerned that the decision aids reduce their face-to-face time with physicians,” says lead author Victoria Shaffer, PhD, assistant professor of health and psychological sciences at the University of Missouri. She recommends incorporating computerized systems as teaching tools to engage patients and help them understand their diagnoses and recommendations. “Anything physicians or nurses can do to humanize the process may make patients more comfortable,” she says.
The study presented participants with written descriptions of hypothetical physician-patient encounters, with the physician using unaided judgment, pursuing advice from a medical expert, or using computerized clinical decision support. Physicians using the latter were viewed as less capable, but participants also were less likely to assign those physicians responsibility for negative outcomes.
A concurrent study from Missouri, part of a $14 million project funded by the Centers for Medicare & Medicaid Services (CMS) to reduce avoidable rehospitalizations of nursing home residents, suggests that sophisticated information technology (IT) can lead to more robust and integrated communication strategies among clinical staff, as well as better-coordinated care.2 Nursing informatics expert Gregory Alexander found that nursing homes with IT used it to help make clinical decisions, electronically track patient care, and securely relay medical information.
References
- Shaffer VA, Probst CA, Merkle EC, Arkes HR, Mitchell AM. Why do patients derogate physicians who use a computer-based diagnostic support system? Med Decis Making. 2013;33(1):108-118.
- Alexander GL, Steege LM, Pasupathy KS, Wise K. Case studies of IT sophistication in nursing homes: a mixed method approach to examine communication strategies about pressure ulcer prevention practices. SciVerse website. Available at: http://www.sciencedirect.com/science/article/pii/S0169814112001229. Accessed March 10, 2013.
A recent study from the University of Missouri to explore how patients react to physicians’ use of computerized clinical decision support systems finds that these devices could leave patients feeling ignored and dissatisfied with their medical care, potentially increasing noncompliance with treatment while distracting physicians from the patient encounter.1
“Patients may be concerned that the decision aids reduce their face-to-face time with physicians,” says lead author Victoria Shaffer, PhD, assistant professor of health and psychological sciences at the University of Missouri. She recommends incorporating computerized systems as teaching tools to engage patients and help them understand their diagnoses and recommendations. “Anything physicians or nurses can do to humanize the process may make patients more comfortable,” she says.
The study presented participants with written descriptions of hypothetical physician-patient encounters, with the physician using unaided judgment, pursuing advice from a medical expert, or using computerized clinical decision support. Physicians using the latter were viewed as less capable, but participants also were less likely to assign those physicians responsibility for negative outcomes.
A concurrent study from Missouri, part of a $14 million project funded by the Centers for Medicare & Medicaid Services (CMS) to reduce avoidable rehospitalizations of nursing home residents, suggests that sophisticated information technology (IT) can lead to more robust and integrated communication strategies among clinical staff, as well as better-coordinated care.2 Nursing informatics expert Gregory Alexander found that nursing homes with IT used it to help make clinical decisions, electronically track patient care, and securely relay medical information.
References
- Shaffer VA, Probst CA, Merkle EC, Arkes HR, Mitchell AM. Why do patients derogate physicians who use a computer-based diagnostic support system? Med Decis Making. 2013;33(1):108-118.
- Alexander GL, Steege LM, Pasupathy KS, Wise K. Case studies of IT sophistication in nursing homes: a mixed method approach to examine communication strategies about pressure ulcer prevention practices. SciVerse website. Available at: http://www.sciencedirect.com/science/article/pii/S0169814112001229. Accessed March 10, 2013.
Society of Hospital Medicine Launches Online Training Program for Hospitalists
Hospitalists play an increasingly pivotal role in ensuring the highest quality and safety for patients in hospitals. The implementation of healthcare reform has only heightened the importance of hospital quality and patient safety for hospitalists. To enable education and advancement of quality improvement (QI), SHM has developed the Hospital Quality & Patient Safety (HQPS) Online Academy (http://www.hospitalmedicine.org/hqps).
The HQPS Online Academy consists of Internet-based modules that provide training not included in traditional medical education. These modules bridge the gap between the conceptualization and practice of quality in hospitals, helping hospitalists to prepare and lead quality initiatives to improve patient outcomes. The modules allow healthcare providers to explore and evaluate current quality initiatives and practices, as well as reflect on ways to improve core measures within their hospital.
Each module focuses on a core principle of QI and patient safety, and provides three AMA PRA Category 1 credits.
SHM members who are insured with The Doctors Company can earn a 5% risk-management credit by completing the first five HQPS modules (see below). Eligible members also enjoy premium savings through a 5% program discount and a claims-free credit of up to 25%.
HQPS Online Academy modules
- Quality measurement and stakeholder interests
- Teamwork and communication
- Organizational knowledge and leadership skills
- Patient safety principles
- Quality and safety improvement methods and skills (RCA and FMEA)
Hospitalists play an increasingly pivotal role in ensuring the highest quality and safety for patients in hospitals. The implementation of healthcare reform has only heightened the importance of hospital quality and patient safety for hospitalists. To enable education and advancement of quality improvement (QI), SHM has developed the Hospital Quality & Patient Safety (HQPS) Online Academy (http://www.hospitalmedicine.org/hqps).
The HQPS Online Academy consists of Internet-based modules that provide training not included in traditional medical education. These modules bridge the gap between the conceptualization and practice of quality in hospitals, helping hospitalists to prepare and lead quality initiatives to improve patient outcomes. The modules allow healthcare providers to explore and evaluate current quality initiatives and practices, as well as reflect on ways to improve core measures within their hospital.
Each module focuses on a core principle of QI and patient safety, and provides three AMA PRA Category 1 credits.
SHM members who are insured with The Doctors Company can earn a 5% risk-management credit by completing the first five HQPS modules (see below). Eligible members also enjoy premium savings through a 5% program discount and a claims-free credit of up to 25%.
HQPS Online Academy modules
- Quality measurement and stakeholder interests
- Teamwork and communication
- Organizational knowledge and leadership skills
- Patient safety principles
- Quality and safety improvement methods and skills (RCA and FMEA)
Hospitalists play an increasingly pivotal role in ensuring the highest quality and safety for patients in hospitals. The implementation of healthcare reform has only heightened the importance of hospital quality and patient safety for hospitalists. To enable education and advancement of quality improvement (QI), SHM has developed the Hospital Quality & Patient Safety (HQPS) Online Academy (http://www.hospitalmedicine.org/hqps).
The HQPS Online Academy consists of Internet-based modules that provide training not included in traditional medical education. These modules bridge the gap between the conceptualization and practice of quality in hospitals, helping hospitalists to prepare and lead quality initiatives to improve patient outcomes. The modules allow healthcare providers to explore and evaluate current quality initiatives and practices, as well as reflect on ways to improve core measures within their hospital.
Each module focuses on a core principle of QI and patient safety, and provides three AMA PRA Category 1 credits.
SHM members who are insured with The Doctors Company can earn a 5% risk-management credit by completing the first five HQPS modules (see below). Eligible members also enjoy premium savings through a 5% program discount and a claims-free credit of up to 25%.
HQPS Online Academy modules
- Quality measurement and stakeholder interests
- Teamwork and communication
- Organizational knowledge and leadership skills
- Patient safety principles
- Quality and safety improvement methods and skills (RCA and FMEA)
HMX Term of the Month: Achievement Points
Awarded to a hospital by comparing an individual hospital’s performance measure rates during a certain period with all hospitals’ rates during the baseline period.
Awarded to a hospital by comparing an individual hospital’s performance measure rates during a certain period with all hospitals’ rates during the baseline period.
Awarded to a hospital by comparing an individual hospital’s performance measure rates during a certain period with all hospitals’ rates during the baseline period.
Houston Hospitalists Create Direct-Admit System
Two hospitalists in the greater Houston area have developed a computer application that streamlines the hospital admission process—a major frustration for busy, office-based primary-care physicians (PCPs).
Mujtaba Ali-Khan, DO, who has practiced at Conroe Regional Medical Center since 2009, is president of Streamlined Medical Solutions (www.streamlinedmedical.com), a company incorporated in July 2011 to market the Direct Admit System for Hospitals, or DASH.1 DASH allows referring physicians to access and submit a direct-admit form, upload medical records, and order preliminary medications and tests for the patient. Once the on-call hospitalist accepts the submitted referral, a “boarding pass” with assigned hospitalist and room number is generated for the patient to take to the hospital’s admissions department. Patients bypass the ED and avoid duplicative medical tests. The process also sends a confirmation to the PCP.
With the support of Hospital Corporation of America (HCA), Dr. Ali-Khan and his business partner, hospitalist Ali Bhuriwala, MD, piloted DASH at two HCA hospitals in Texas. It’s now on the market and has been implemented or is in the works at several others.
“When we started using DASH, we found ourselves getting all sorts of data: Who are the referring physicians, the patients’ ZIP codes, how long do admissions take?” says Dr. Ali-Khan, who adds plans are under way to expand the software’s capacity to allow PCPs to upload tests and place medical orders from the field. “We’re also developing a full suite of hospitalist communication and coordination functions on a dashboard, accessible from smartphones and text alerts, dispensing with pagers entirely.”
Watch a video about DASH at www.youtube.com/watch?v=HUG_vQgKvE0.
Reference
Two hospitalists in the greater Houston area have developed a computer application that streamlines the hospital admission process—a major frustration for busy, office-based primary-care physicians (PCPs).
Mujtaba Ali-Khan, DO, who has practiced at Conroe Regional Medical Center since 2009, is president of Streamlined Medical Solutions (www.streamlinedmedical.com), a company incorporated in July 2011 to market the Direct Admit System for Hospitals, or DASH.1 DASH allows referring physicians to access and submit a direct-admit form, upload medical records, and order preliminary medications and tests for the patient. Once the on-call hospitalist accepts the submitted referral, a “boarding pass” with assigned hospitalist and room number is generated for the patient to take to the hospital’s admissions department. Patients bypass the ED and avoid duplicative medical tests. The process also sends a confirmation to the PCP.
With the support of Hospital Corporation of America (HCA), Dr. Ali-Khan and his business partner, hospitalist Ali Bhuriwala, MD, piloted DASH at two HCA hospitals in Texas. It’s now on the market and has been implemented or is in the works at several others.
“When we started using DASH, we found ourselves getting all sorts of data: Who are the referring physicians, the patients’ ZIP codes, how long do admissions take?” says Dr. Ali-Khan, who adds plans are under way to expand the software’s capacity to allow PCPs to upload tests and place medical orders from the field. “We’re also developing a full suite of hospitalist communication and coordination functions on a dashboard, accessible from smartphones and text alerts, dispensing with pagers entirely.”
Watch a video about DASH at www.youtube.com/watch?v=HUG_vQgKvE0.
Reference
Two hospitalists in the greater Houston area have developed a computer application that streamlines the hospital admission process—a major frustration for busy, office-based primary-care physicians (PCPs).
Mujtaba Ali-Khan, DO, who has practiced at Conroe Regional Medical Center since 2009, is president of Streamlined Medical Solutions (www.streamlinedmedical.com), a company incorporated in July 2011 to market the Direct Admit System for Hospitals, or DASH.1 DASH allows referring physicians to access and submit a direct-admit form, upload medical records, and order preliminary medications and tests for the patient. Once the on-call hospitalist accepts the submitted referral, a “boarding pass” with assigned hospitalist and room number is generated for the patient to take to the hospital’s admissions department. Patients bypass the ED and avoid duplicative medical tests. The process also sends a confirmation to the PCP.
With the support of Hospital Corporation of America (HCA), Dr. Ali-Khan and his business partner, hospitalist Ali Bhuriwala, MD, piloted DASH at two HCA hospitals in Texas. It’s now on the market and has been implemented or is in the works at several others.
“When we started using DASH, we found ourselves getting all sorts of data: Who are the referring physicians, the patients’ ZIP codes, how long do admissions take?” says Dr. Ali-Khan, who adds plans are under way to expand the software’s capacity to allow PCPs to upload tests and place medical orders from the field. “We’re also developing a full suite of hospitalist communication and coordination functions on a dashboard, accessible from smartphones and text alerts, dispensing with pagers entirely.”
Watch a video about DASH at www.youtube.com/watch?v=HUG_vQgKvE0.
Reference
Well-Designed IT Systems Essential to Healthcare Integration
David Lawrence, MD, retired head of the Kaiser Foundation health plan, says in a recent Information Week article that it will be “nearly impossible” to achieve the goals of healthcare integration without the connectivity of a well-designed health IT system.4 Dr. Lawrence was a member of a committee that authored the recent report Order from Chaos: Accelerating Care Integration for the Lucian Leape Institute at the National Patient Care Safety Foundation. Failures of coordination most often happen during the crucial information transfers that happen during care transitions, but there has not been enough attention to how important information technology could be to these transfers, Dr. Lawrence told the magazine. “It’s the really complex stuff where this becomes particularly critical,” he said.
The federal Office of Inspector General (OIG) took the Centers for Medicare & Medicaid Services (CMS) to task in a November report for not having adequate oversight or safeguards for its EHR meaningful-use program.5 As a result, OIG described Medicare as “vulnerable” to fraud and abuse of incentive payments made to hospitals and health professionals, according to OIG. OIG recommends that CMS request and review supporting documentation for selected providers and issue guidance with specific examples of appropriate documentation. As of September 2012, CMS had paid out $4 billion in meaningful-use incentives to 1,400 hospitals and 82,000 professionals.
References
- Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
- The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
- Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
- Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
- Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.
David Lawrence, MD, retired head of the Kaiser Foundation health plan, says in a recent Information Week article that it will be “nearly impossible” to achieve the goals of healthcare integration without the connectivity of a well-designed health IT system.4 Dr. Lawrence was a member of a committee that authored the recent report Order from Chaos: Accelerating Care Integration for the Lucian Leape Institute at the National Patient Care Safety Foundation. Failures of coordination most often happen during the crucial information transfers that happen during care transitions, but there has not been enough attention to how important information technology could be to these transfers, Dr. Lawrence told the magazine. “It’s the really complex stuff where this becomes particularly critical,” he said.
The federal Office of Inspector General (OIG) took the Centers for Medicare & Medicaid Services (CMS) to task in a November report for not having adequate oversight or safeguards for its EHR meaningful-use program.5 As a result, OIG described Medicare as “vulnerable” to fraud and abuse of incentive payments made to hospitals and health professionals, according to OIG. OIG recommends that CMS request and review supporting documentation for selected providers and issue guidance with specific examples of appropriate documentation. As of September 2012, CMS had paid out $4 billion in meaningful-use incentives to 1,400 hospitals and 82,000 professionals.
References
- Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
- The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
- Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
- Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
- Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.
David Lawrence, MD, retired head of the Kaiser Foundation health plan, says in a recent Information Week article that it will be “nearly impossible” to achieve the goals of healthcare integration without the connectivity of a well-designed health IT system.4 Dr. Lawrence was a member of a committee that authored the recent report Order from Chaos: Accelerating Care Integration for the Lucian Leape Institute at the National Patient Care Safety Foundation. Failures of coordination most often happen during the crucial information transfers that happen during care transitions, but there has not been enough attention to how important information technology could be to these transfers, Dr. Lawrence told the magazine. “It’s the really complex stuff where this becomes particularly critical,” he said.
The federal Office of Inspector General (OIG) took the Centers for Medicare & Medicaid Services (CMS) to task in a November report for not having adequate oversight or safeguards for its EHR meaningful-use program.5 As a result, OIG described Medicare as “vulnerable” to fraud and abuse of incentive payments made to hospitals and health professionals, according to OIG. OIG recommends that CMS request and review supporting documentation for selected providers and issue guidance with specific examples of appropriate documentation. As of September 2012, CMS had paid out $4 billion in meaningful-use incentives to 1,400 hospitals and 82,000 professionals.
References
- Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
- The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
- Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
- Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
- Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.
HMX Term of the Month: CMS 1500
Medical claim form established by CMS to submit paper claims to Medicare and Medicaid. Most commercial insurance carriers also require paper claims be submitted on CMS 1500s. The form is distinguished by its red ink.
Medical claim form established by CMS to submit paper claims to Medicare and Medicaid. Most commercial insurance carriers also require paper claims be submitted on CMS 1500s. The form is distinguished by its red ink.
Medical claim form established by CMS to submit paper claims to Medicare and Medicaid. Most commercial insurance carriers also require paper claims be submitted on CMS 1500s. The form is distinguished by its red ink.
Quality Improvement Project Helps Hospital Patients Get Needed Prescriptions
A quality-improvement (QI) project to give high-risk patients ready access to prescribed medications at the time of hospital discharge achieved an 86% success rate, according to an abstract poster presented at HM12 in San Diego last April.1
Lead author Elizabeth Le, MD, then a resident at the University of California at San Francisco Medical Center (UCSF) and now a practicing hospitalist at the Veterans Administration Medical Center in Palo Alto, Calif., says the multidisciplinary “brown bag medications” project involved training house staff to recognize patients at risk. Staff meetings and rounds were used to identify appropriate candidates—those with limited mobility or cognitive issues, lacking insurance coverage or financial resources, a history of medication noncompliance, or leaving the hospital against medical advice—as well as those prescribed medications with a greater urgency for administration on schedule, such as anticoagulants or antibiotics.
About one-quarter of patients on the unit where this approach was first tested were found to need the service, which involved faxing prescriptions to an outpatient pharmacy across the street from the hospital for either pick-up by the family or delivery to the patient’s hospital room. For those with financial impediments, hospital social workers and case managers explored other options, including the social work department’s discretionary use fund, to pay for the drugs.
Dr. Le believes the project could be replicated in other facilities that lack access to in-house pharmacy services at discharge. She recommends involving social workers and case managers in the planning.
At UCSF, recent EHR implementation has automated the ordering of medications, but the challenge of recognizing who could benefit from extra help in obtaining their discharge medications remains a critical issue for hospitals trying to bring readmissions under control.
For more information about the brown bag medications program, contact Dr. Le at [email protected].
References
A quality-improvement (QI) project to give high-risk patients ready access to prescribed medications at the time of hospital discharge achieved an 86% success rate, according to an abstract poster presented at HM12 in San Diego last April.1
Lead author Elizabeth Le, MD, then a resident at the University of California at San Francisco Medical Center (UCSF) and now a practicing hospitalist at the Veterans Administration Medical Center in Palo Alto, Calif., says the multidisciplinary “brown bag medications” project involved training house staff to recognize patients at risk. Staff meetings and rounds were used to identify appropriate candidates—those with limited mobility or cognitive issues, lacking insurance coverage or financial resources, a history of medication noncompliance, or leaving the hospital against medical advice—as well as those prescribed medications with a greater urgency for administration on schedule, such as anticoagulants or antibiotics.
About one-quarter of patients on the unit where this approach was first tested were found to need the service, which involved faxing prescriptions to an outpatient pharmacy across the street from the hospital for either pick-up by the family or delivery to the patient’s hospital room. For those with financial impediments, hospital social workers and case managers explored other options, including the social work department’s discretionary use fund, to pay for the drugs.
Dr. Le believes the project could be replicated in other facilities that lack access to in-house pharmacy services at discharge. She recommends involving social workers and case managers in the planning.
At UCSF, recent EHR implementation has automated the ordering of medications, but the challenge of recognizing who could benefit from extra help in obtaining their discharge medications remains a critical issue for hospitals trying to bring readmissions under control.
For more information about the brown bag medications program, contact Dr. Le at [email protected].
References
A quality-improvement (QI) project to give high-risk patients ready access to prescribed medications at the time of hospital discharge achieved an 86% success rate, according to an abstract poster presented at HM12 in San Diego last April.1
Lead author Elizabeth Le, MD, then a resident at the University of California at San Francisco Medical Center (UCSF) and now a practicing hospitalist at the Veterans Administration Medical Center in Palo Alto, Calif., says the multidisciplinary “brown bag medications” project involved training house staff to recognize patients at risk. Staff meetings and rounds were used to identify appropriate candidates—those with limited mobility or cognitive issues, lacking insurance coverage or financial resources, a history of medication noncompliance, or leaving the hospital against medical advice—as well as those prescribed medications with a greater urgency for administration on schedule, such as anticoagulants or antibiotics.
About one-quarter of patients on the unit where this approach was first tested were found to need the service, which involved faxing prescriptions to an outpatient pharmacy across the street from the hospital for either pick-up by the family or delivery to the patient’s hospital room. For those with financial impediments, hospital social workers and case managers explored other options, including the social work department’s discretionary use fund, to pay for the drugs.
Dr. Le believes the project could be replicated in other facilities that lack access to in-house pharmacy services at discharge. She recommends involving social workers and case managers in the planning.
At UCSF, recent EHR implementation has automated the ordering of medications, but the challenge of recognizing who could benefit from extra help in obtaining their discharge medications remains a critical issue for hospitals trying to bring readmissions under control.
For more information about the brown bag medications program, contact Dr. Le at [email protected].