April 13th, 2011 by BobDoherty in Health Policy, Opinion, Primary Care Wednesdays
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When I talk to internal medicine audiences around the country about the latest health policy flavor of the day – accountable care organizations (ACOs) – a typical reaction is skepticism trending toward cynicism. Many don’t quite get what ACOs are all about and certainly don’t want to be lectured about how they need to re-invent their practices. And they don’t buy the idea that ACOs will somehow save internal medicine primary care. The same can be said, perhaps to a lesser extent, about their reactions to PCMHs (Patient-Centered Medical Homes), P4P ( pay-for-performance), HIT (health information technology), MU (meaningful use), and the whole alphabet soup of other reforms being proposed to reform health care delivery and payment systems.
And who can blame them? Older internists have seen this all before, and the word has gone out from them to medical students and younger doctors not to trust policy prescriptions that promise to save primary care. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
April 4th, 2011 by RyanDuBosar in News, Research
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Improving handoffs from the emergency room back to the primary care physician will require changing how electronic health records are used, better reimbursement to both the hospital and ambulatory doctors, and malpractice reform, according to a study. The rising use of hospitalists and larger primary care practice sizes has contributed to the difficulties faced when an ER doctors tries to reach a physician who best knows the patient.
Haphazard communication and poor coordination can undermine effective care, according to a new research conducted by the Center for Studying Health System Change. Researchers conducted 42 telephone interviews between April and October 2010 with 21 pairs of emergency department and primary care physicians, who were case-matched to hospitals so the perspective of both specialties working with the same hospital could be represented.
Among the findings in the report, telephone communication was essential in some cases, but particularly time-consuming. Both emergency and primary care physicians reported successful completion of each telephone call often required multiple pages and lengthy waits for callbacks. While placing and receiving telephone calls might seem straightforward and quick, providers said each small action multiplied across dozens of patients can become a daunting burden, with little immediate reward or reimbursement. Read more »
*This blog post was originally published at ACP Hospitalist*
March 17th, 2011 by DavidHarlow in Health Policy, Opinion
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HealthNet either lost, or had stolen from it, computer hard drives with PHI of 1.9 million subscribers that had been in a California facility. This latest HealthNet data security breach, which may have included names, Social Security numbers, addresses, health information and financial information comes a little over a year after a widely-reported data security breach by HealthNet in Connecticut which resulted in the first state Attorney General action under the HIPAA amendments contained in the HITECH Act. HealthNet is notifying affected individuals and is offering two years of no-cost credit monitoring and fraud resolution services, and credit restoration and identify theft insurance as needed.
It’s both surprising and unsurprising that this has happened again to HealthNet. In these cases, and in recent cases in Massachusetts (Mass General Hospital HIPAA settlement) and Maryland (Cignet HIPAA violations and CMPs), we have seen examples, collectively, of individual sloppiness, of ineffective corporate policies and procedures, and possibly of gross neglect/fraud/incompetence. The question arises: Is HIPAA the right instrument to address all three sorts of problems? Since it seems that it is not having an effect on any of them, I would suggest that the answer is no. Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
December 10th, 2010 by DavidHarlow in Better Health Network, Health Policy, News, Opinion
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I’ve seen at least half a dozen links to the op-ed coauthored by Newt Gingrich and neurosurgeon Kamal Thapar about how the doctor used information on Facebook to save a woman’s life. (It was published by AOL News. Really.)
In brief, a woman who had been to see a number of different health care providers without getting a clear diagnosis showed up in an emergency room, went into a coma and nearly died. She was saved by a doctor’s review of the detailed notes she kept about her symptoms, etc., which she posted on Facebook. The story is vague on the details, but apparently her son facilitated getting the doc access to her Facebook page, and the details posted there allowed him to diagnose and treat her condition. She recovered fully.
Newt and Dr. Thapar wax rhapsodic about how Facebook saved a life, and sing the praises of social media’s role in modern medicine. (I’m not sure how this really fits in with Newt’s stance on health reform, within his 12-step program to achieve the total replacement of the Left…but, hey, nobody has the patience these days for so many details anyway.)
Regular readers of HealthBlawg know that I would perhaps be the last to challenge the proposition that social media has a role to play in health care. However, I think Newt got it wrong here. Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
February 3rd, 2010 by DrRob in Better Health Network, Health Policy, Opinion
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I was talking to a fellow physician about a mutual patient. I had information that would help him in their care and he was taking the unusual step of asking me for my information. I was impressed.
“Could you fax me those documents?” he asked. ”Here’s my fax number.”
I scrambled to get a pen to write down his number. Then I had a thought: “I could email you those documents much easier. Do you have an email address?”
Silence.
After a long pause, he hesitantly responded, “I would rather you just fax it.” He said no more. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
