Nursing homes that offer after-hours telemedicine services to their residents significantly reduce hospitalization rates, which could save Medicare hundreds of thousands of dollars per year, according to a study published in the journal Health Affairs, Clinical Innovation & Technology reports. Continue reading
Mass. General Hospital records reflect changes in costs, patient mortality
No one questions whether or not health care costs have risen, and risen dramatically, in recent decades. But beyond questions of cost alone is a bigger question: how has the value of health care changed or, in other words, is the health care system getting what it pays for in terms of improved patient health?
Any answer to Continue reading
Some people with depression symptoms may not tell their family doctor about it — often out of worry they will be placed on an antidepressant, a new study suggests.
In a survey of more than 1,000 California adults, researchers found that 43 percent had at least some misgivings about telling their primary care doctor about any depression symptoms.
Their top concern was the possibility that their doctor would prescribe an antidepressant — a worry voiced by 23 percent of the whole study group.
Another 16 percent thought it was not their doctor’s job to “deal with emotional issues.” And a similar percentage worried that someone — like an employer — Continue reading
Heath care is expensive. Costs continue to mount despite recent efforts at health care “reform.”
Sally C. Pipes, the president, CEO and Taube Fellow in Health Care Studies at the Pacific Research Institute, argues in Forbes Magazine this week that the best way to lower costs is through expensive “medical innovation” (technology). Pipes claims that innovation alone will “minimize doctor visits, specialist referrals, round-the-clock care, trial-and-error surgeries” and other procedures in order “to deliver more value for less money in the long term.”
It is true that less use of the health care system in general will reduce costs. But does that mean we’ll actually be “healthy”? Innovation cannot make us healthier. The only way to achieve that Continue reading
It’s bad enough that the U.S. honeybee population has dropped precipitously in the past few years, threatening the existence of all pollinated crops (that’s one-third of American agriculture). Now an epidemic may be hitting the country’s bats–and it has the potential to further threaten agriculture.
Bats are the unsung heroes of organic farming, consuming massive amounts of pests on a daily basis. The little brown bat, Montana’s most common bat species, gobbles up 1,200 insects per hour and in one 2006 study, bats in South-Central Texas were shown to have an annual pest control value of over $740,000 (29% of the value of the area’s cotton crop). For organic farms, this is key, since pest control is hard enough with chemicals. Continue reading
This month’s newsletter is part 2 of a three-part series examining the new healthcare law’s impact on the technology sector. This month, we focus on the health insurer side. In the final Issue, we will look into the medical device industry to analyze its exposure and upside under the new health law.
The Patient Protection and Affordable Care Act (“Affordable Care Act”), passed in the spring of 2010, has some favorable provisions for health insurers. The law, after its full enactment in 2014, will require near universal coverage, Continue reading
People used to have to be very obese to qualify for LAP-BAND surgery, a weight loss operation in which an inflatable silicon ring is wrapped around the stomach to create a small pouch, drastically limiting food consumption. Until recently, the procedure was only approved for those with a body mass index (BMI) of 40 or above, or patients with a BMI of 35 or above, plus a severe obesity-related illness, such as heart disease or diabetes. Now the FDA has expanded the criteria to include people who have a BMI of 30, along with an obesity-related disorder.
That means 37 million more Americans are Continue reading
What It Costs to Start-Up an Electronic Health Electronic health records (EHRs) broaden access to patient data and provide the platform for pushing evidence-based decision support to clinicians at the point-of-care. This promotes optimal care for patients, reduces medical errors, optimizes the use of labor, reduces duplication of tests, and by the way, improves patient outcomes. When done in aggregate across all health providers, a team from McKinsey estimates that $40 billion of costs could be saved in the U.S. health system.
Reforming hospitals with IT investment in the McKinsey Quarterly talks about the American Reinvestment and Recovery Act’s (ARRA) $20+ billion worth of stimulus funding under the HITECH Act and estimates that 80% of existing hospital IT applications will be affected by the regulation. Hospitals will be spending about $120 billion to meet the adoption and meaningful use provisions of the Act. This equates to $80,000 to $100,000 per hospital bed. ARRA incentive payments will cover roughly 20% of this cash outlay, meaning that $60-80K won’t to covered.
But McKinsey says, “Hold on!” There are ways to recoup the spending gap between HITECH incentives and cash-out-of-the-hospitals-budget. McKinsey’s research calculates that optimizing labor, reducing adverse drug events and duplicate tests, and adopting revenue cycle management can help the average hospital save $25,000 to $44,000 per bed each year. That gets to the $40 billion in annual savings when multiplied across all hospital beds in the U.S.
In operational terms, the savings accrue through:
* Managing inpatient beds more efficiently using equipment-scheduling software
* Optimizing the use of clinical equipment
* Determining optimal staffing
* Reducing administrative waste
* Reducing adverse drug reactions through computerized-physician-order-entry (CPOE) which cost $8,000 to $15,000 per bed each year (up to $3 million for a 200 bed hospital)
* Managing the revenue cycle by billing unbilled services, equivalent to 0.4% of hospital services, or $4,000 per bed.
Jane’s Hot Points: The McKinsey team rightly points to three critical success factors for maximizing health IT investments that the most wired, effective hospital-adopters have learned: get critical buy-in among clinicians and hospital execs early in the HIT adoption process; ‘radically’ simplify health IT architecture; and, elegantly plan and execute.
It’s the implementation phase in health IT adoption that so often gets short-shrift. McKinsey notes that Canada’s hospital system devoted 30% of its entire budget to change management. That’s a big number, but it’s also where rubber meets road: a capital outlay of $N million is the easy part of HIT adoption. The follow-on implementation resources, both in terms of sheer dollar volume and labor/staffing, along with disruption of clinical workflow, is the hard part. But getting to meaningful use will require no small amount of implementation effort in the form of evangelism, education and training, and ongoing assistance and support.
Free software is secure, creators say
Researchers at Hamilton’s McMaster University say they have devised an electronic medical records system that can be implemented by physicians across Ontario for two per cent of the money the provincial government has spent on eHealth Ontario.
The web-based program, dubbed OSCAR, organizes medical records and can be set up on any computer system with a browser. It was first created in 2001, and has attracted more users each year.
Around 600 doctors across the country — including 450 family physicians in Ontario — currently use the software.
The software is open-source, which means users are allowed access to its basic code. Users are free to add to or modify the software without fear of legal repercussions, as long they abide by the conditions of the General Public Licence, which stipulates that the program must remain open and sharable.
Because it’s open-source, OSCAR is free. The costs to set it up come in the form of servers, hardware and support staff.
“In Ontario, there are approximately 8,000 family physicians that are not using electronic medical record systems. All these physicians could have OSCAR implemented within the next 24 months, and the cost would be less than $20 million,” Dr. David Price, chair of family medicine at McMaster’s medical school, said in a release.
While the software would be able to cover all the family physicians in Ontario, it is not as comprehensive in scope as eHealth, which is charged with linking all healthcare facilities, including hospitals and clinics, not just family doctors.
$1B spent already
Yet it can still help in digitizing Ontario’s medical records, said Dr. David Chan, who developed the software.
He said Ontario’s approach to building a health-record system is wrong. The province spent some $1 billion commissioning eHealth Ontario to produce an electronic medical database.
But in a report released Wednesday, Ontario Auditor General Jim McCarter said the province had wasted that investment and eHealth had little to show for its work.
We really don’t need to spend that kind of money. I think the government’s paranoia about building … a secure network is hugely expensive,” Chan said Friday.
People often get concerned about the security risks of open-source software, but Chan said it has passed stringent provincial security tests. It is no more vulnerable to hackers than more expensive proprietary software, he said.