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Health Management Technology News
  February 11, 2014
In this issue:
 

 Physician outcry on EHR functionality, cost will shake the health information technology sector

  Obamacare rules tweaked amid complaints about plan flexibility

 How to avoid digital eyestrain

 First assessment of national telemedicine service finds efforts appear to expand access to acute medical care


Physician outcry on EHR functionality, cost will shake the health information technology sector

Despite the government’s bribe of nearly $27 billion to digitize patient records, nearly 70% of physicians say electronic health record (EHR) systems have not been worth it. It’s a sobering statistic backed by newly released data from marketing and research firm MPI Group and Medical Economics that suggest nearly two-thirds of doctors would not purchase their current EHR system again because of poor functionality and high costs.

In a surprise finding, nearly 45% of physicians from the national survey report spending more than $100,000 on an EHR. About 77% of the largest practices spent nearly $200,000 on their systems.

While physicians can receive $44,000 through the Medicare EHR Meaningful Use (MU) incentive program, and $63,750 through Medicaid’s MU program, some physicians say it’s not nearly enough to cover the increasing costs of implementation, training, annual licensing fees, hardware and associated services. But the most dramatic unanticipated costs were associated with the need to increase staff, coupled with a loss in physician productivity.

“We used to see 32 patients a day with one tech, and now we struggle to see 24 patients a day with four techs. And we provide worse care,” said one survey respondent.

While some physicians cited benefits of accessing patient data, availability of practice metrics, and e-prescribing conveniences for patients, most physicians do not believe these systems come close to creating new efficiencies or sharing data with multiple providers or improving patient care.

In fact, when doctors were asked if their EHR investment was worth the effort, resources and cost, “no” was the reply given by nearly 79% of respondents in practices with more than 10 physicians.

Medical Economics’ survey results, based on responses from nearly 1,000 physicians, were corroborated by the findings of a January 2013 RAND Corp. study, detailed in Health Affairs, The New York Times, USA Today, and other national media organizations, criticizing the usability and interconnectedness of current EHR systems.

“The failure of health information technology to quickly deliver on its promise is not caused by its lack of potential, but rather because of the shortcomings in the design of the IT systems that are currently in place,” says  Art Kellermann, MD, MPH, the study’s senior author and the Paul O’Neill Alcoa Chair in Policy Analysis at RAND.

Read the full Medical Economics article here

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Obamacare rules tweaked amid complaints about plan flexibility

To address concerns among some Obamacare enrollees who lost access to their old doctors or found themselves unable to add a new dependent or spouse, President Obama’s administration has tweaked the law’s regulations to provide added flexibility for consumers, CBS News confirms. “We are committed to ensuring that consumers have continuity of coverage if they experience a life circumstance such as a birth of a new child or a marriage,” explained Health and Human Services spokeswoman Joanne Peters. “As of this week, consumers are able to report these life events and change or update their coverage directly through the Marketplace. We continue to work closely with issuers to ensure that consumers are able to use this new functionality make changes to their coverage.”

The change, which was unveiled in a memo distributed on Thursday to participating insurers, was first reported by the Washington Post.

Under the new rules, consumers who have already enrolled in a plan may switch to a different plan before the open enrollment period closes at the end of March, provided they stay with the same insurer and opt for roughly the same level of coverage.

The administration also rolled out a new “Report a Life Change” feature on healthcare.gov, the website that governs the federal insurance exchange for 36 states. The new feature will allow consumers to adjust their plans in accordance with changing circumstances like a new baby, a marriage, a relocation, or another life event.

Read the full CBS News article here

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How to avoid digital eyestrain

Our lives have increasingly become more digital today. While some may see this as a benefit, others are finding that it can literally be a pain in the eye.

Digital eyestrain is now a common problem. Eye and vision problems are reported in 70 to 75% of computer workers, according to the American Optometric Association.

Headaches, eye pain, redness, watering, double vision and loss of focus are all associated with digital eyestrain.

The good news is there are numerous things you can do to help avoid the condition, including:

Take a break. Take frequent 15 minute breaks and focus your eyes on a distant object across the room. This will give the focusing muscle a chance to relax.

Try palming. This is essentially meditation for the eyes. To do this, you will close your eyes and place the centers of your palms over your eyes. Take deep slow breaths and relax your eye muscles.

This is a wonderful way to rejuvenate your eyes during those long computer projects. Keep your shoulders and neck relaxed. Tension in this area will cause a tension in your eyes. An occasional neck and shoulder massage will also work wonders.

Blink frequently. When doing demanding digital work, your blink rate decreases. A conscious effort should be made to blink lightly every 10 to 15 seconds. This will coat the cornea, or front part of the eye, to nourish your eye with oxygen and nutrients -- and the coating of tears will also sharpen your vision.

Wear computer glasses. Use a pair of computer glasses and work at the proper distance -- 20 to 28 inches, depending on the focal point of the eye. Computer glasses have a different focal point than reading glasses. This will reduce the effort of focusing and putting a strain on your eyes. The extra effort to focus will cause tension in the eye muscles, which in addition to causing eye discomfort can lead to an increase in eye pressure.

Keep your monitor bright. This will reduce the flicker rate of the computer and reduce fatigue. Flickering can lead to eyestrain and headaches. A bright monitor causes the pupil to constrict and a greater range of focus will result. This will reduce the need for your eye to accommodate and enable you to work longer with more comfort.

Reduce blue light at night. A Harvard study revealed that blue light at night negatively reduces melatonin levels, which have a serious adverse health effect. It is associated with an increased incidence of diabetes, obesity and cancer. Reduce computer time at night or wear blue blocking glasses. These will block out the harmful blue spectrum light at night.

Take vitamins and minerals. Considering that the eyes have one of the highest energy requirements in the body, it is important that they get proper amounts of vitamins and minerals. It is important to opt for a vitamin that offers key antioxidants and ingredients that will help improve the health of the eye and reduce eyestrain. Those can include vitamins A, C, and E with a B complex and zinc.

Homeopathy. Speak with a practitioner to find a level of therapy that will work for your individual circumstances. One of the most common homeopathic remedies to treat eyestrain is Ruta Graveolens, a common ornamental plant found in gardens that is used to treat strains of tendons. This remedy can greatly reduce the symptoms of eyestrain during prolonged computer use.

Read the full CNN article here

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First assessment of national telemedicine service finds efforts appear to expand access to acute medical care

People who are younger, more affluent and do not have established health care relationships are more likely to use a telemedicine program that allows patients to get medical help — including prescriptions — by talking to a doctor over the telephone, according to a new RAND Corporation study.

Patients who used the service suffered from a wide assortment of acute medical problems such as respiratory illnesses and skin problems, and researchers found little evidence of misdiagnosis or treatment failure among those who used the service.

The findings, published in the February edition of the journal Health Affairs, are from the first assessment of a telemedicine program offered to a large, diverse group of patients across the United States.

“Telemedicine services such as the one we studied that directly links physicians and patients via telephone or Internet have the potential to expand access to care and lower costs,” said Lori Uscher-Pines, lead author of the study and a policy researcher at RAND, a nonprofit research organization. “However, little is known about how these services are being used and whether they provide good quality care. Our study provides a first step to better understand this growing health care trend.”

Interest has grown in telemedicine programs because of the shortage of primary care physicians, which will likely worsen as more Americans acquire medical coverage under the Affordable Care Act. Telemedicine is one of the alternatives touted as a way to better provide primary health care without greatly expanding the number of doctors.

Uscher-Pines and co-author Dr. Ateev Mehrotra studied 3,701 patient “visits” provided from April 2012 to February 2013 by Teladoc, one of the nation's largest providers of telemedicine services.

Teladoc is different from most other telemedicine efforts that connect patients to providers for specialty visits or connect providers to other providers for consults for in-hospital care.

Read the full Rand Corporation article here

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