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Health Management Technology News
  March 19, 2014
In this issue:

► (HMT Exclusive) Bundled payments: Quality measurement and the role of analytics

► (HMT Exclusive) Taming today's superbugs

► Are the government's "Meaningful Use" standards meaningful?

► Study explores text message health service

► Here's what will probably be in the GOP healthcare proposal

► Whistleblowers who raise concerns still at risk of losing their job

(HMT Exclusive) Bundled payments: Quality measurement and the role of analytics

In January 2013, CMS put its weight behind bundled payments by launching the Bundled Payments for Care Improvement (BPCI) initiative, subsequently enrolling more than 500 healthcare organizations into the program.

The widespread adoption of bundled payments has the potential to benefit multiple stakeholders within the healthcare system by shifting accountability and financial risk from the payer to the provider. However, in order to implement an effective bundled payment program, healthcare organizations will have to navigate multiple challenges, such as accurately defining care episodes, bundle pricing, aligning care team members and capturing information across all service levels. Both payer and provider infrastructure will also need to be modified to calculate claims based on the new reimbursement model. It will be necessary for an effective mechanism to distribute gains – based on performance and level of care provided – to different stakeholders in the care bundle.

Despite these challenges, hospitals are fast realizing that the benefits of a well-managed bundled payments program significantly outweigh the risks.

Read the full HMT article here ► 

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(HMT Exclusive) Taming today's superbugs

Antimicrobial resistance is a growing, worldwide issue. According to the World Health Organization, a high percentage of hospital-acquired infections (HAIs) are caused by highly drug resistant bacteria that can result from inappropriate use of antimicrobial medicines.

To address this issue, the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society of America (PIDS) issued a joint policy statement in 2007 recommending that clinicians improve antimicrobial stewardship through better coordination of interventions. The joint policy statement defines antimicrobial stewardship as “coordinated interventions designed to improve and measure the appropriate use of antimicrobial agents by promoting the selection of the optimal antimicrobial drug regimen including dosing, duration of therapy, and route of administration.”

Antimicrobial management can be both a complicated and costly undertaking for hospitals and caregivers — yet is an ever-increasing necessity for delivering quality patient care. Traditionally, antimicrobial stewardship programs have relied on manual management methods, including clinical oversight and intervention to monitor and contain HAIs. As healthcare digitizes and incorporates electronic health records (EHR), clinical decision support (CDS)is becoming an essential component for antimicrobial stewardship programs. CDS can greatly help alleviate clinicians’ pain points in managing infectious diseases.

Read the full HMT article here ► 

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Are the government's "Meaningful Use" standards meaningful?

I went down to Orlando, Florida a few weeks ago, joining about 35,000 of my closest friends to learn about the latest developments in healthcare related information technology. The convening authority was HIMSS, which stands for Healthcare Information & Management Systems Society. As you might imagine, it drew loads of savvy techies who work for hospitals and healthcare providers, and a fair number of vendors who desperately want to sell goods and services to them. As a neophyte, it was a bit intimidating to wade into an event of this scale and scope, but it was informative (pun intended) and there were some interesting developments that drew my attention.

One thing that is evident practice among healthcare IT aficionados is the extent to which they resort to the use of unhelpful hyperbole in describing their businesses. They appear well intentioned, and they may be accustomed to addressing audiences with limited background in technology, but there is an annoying reduction of ideas down to simple, if not simplistic, catch words and phrases that are utterly devoid of meaning.  For example:  “We apply sophisticated analytics.” “We leverage population health metrics.”  “We work with providers to enhance health care solutions for patients.” One of the highlights of the convention was an entire room devoted to firms whose business model focuses on the essentiality of “interoperability” . . .that sounds useful at first blush, but meaning what, exactly?

Read the full Forbes article here ► 

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Study explores text message health service

Across the country, the mobile health movement — mHealth — seeks to provide medical attention to communities with restricted access to health care. But the desirability of some of these mobile health care tools remains unknown, spurring researchers to examine the prevention of adolescent mental health issues through a new text messaging program.

Published last month in the Journal of Adolescent Health, the findings of a new study confirmed patient and public demand for a text messaging intervention program for at-risk teens.

The study, conducted by Megan Ranney, assistant professor of emergency medicine at Alpert Medical School, focused on adolescent females checked into the emergency department.

Previous interventions in mHealth — a field in its infancy — have successfully aided patients with smoking cessation, HIV/AIDS medication adherence and weight loss.

The suggested program, designed for teenagers at risk for depression, aims to prevent further development of mental health issues. Participants in the study were extremely enthusiastic about and receptive to the idea of being a part of a program that would send a regular text message to their cellphones, according to the study.

The study explored the optimal language, structure and regularity of the text message intervention, as well as the feasibility of such a program. Several participants in the study suggested that the message be individually tailored to how subscribers were feeling on a particular day, Ranney said.

Read the full The Brown Herald Daily article here ► 

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Here's what will probably be in the GOP healthcare proposal

House Republicans are finally putting their weight behind a single Obamacare alternative plan, according to The Washington Post. It looks really familiar — and voters in close Congressional districts will soon hear a lot about it.

Like the several plans hinted at and pitched before it, this one features conservative-friendly ideas on high-risk insurance pools, insurance sales across state lines and medical-malpractice regulations. And like all those past plans there are a lot of policies that would lead to reduced protections for consumers, especially those with pre-existing conditions.

This plan likely won't see the light of day until after the midterm elections (and then it will be killed by the Senate or President Obama). "Republican sources" say that House Majority Leader Eric Cantor hopes to at least create a plan to campaign on,according to The Washington Examiner, for reasons we explained earlier. But, to get a sense of what Republicans mean when they say healthcare reform, here's a breakdown of the key concepts that will definitely and possibly be included.

Read the full The Wire article here ► 

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Whistleblowers who raise concerns still at risk of losing their job

When a radiology manager with 27 years unblemished NHS service tells her trust that £250,000 appears to have been lost through moonlighting by medical consultants, you might expect her to be thanked, not suspended and sacked.

Sharmila Chowdhury, however, was suspended and dismissed. She went to tribunal and won, but then lost her job because her employer, who refused to reinstate her, restructured her job out of existence. All Chowdhury has to show for her public spiritedness is an apology from the trust, a P45, and compensation which went towards paying significant legal fees. Four years later Chowdhury is unemployed and fighting cancer which consultants say is probably linked to the stress of her treatment as a whistleblower.

"I still can't believe what happened", says Chowdhury. "I was the budget holder. I spotted large amounts of NHS money which appeared to be going into consultants' pockets rather than NHS patient care, yet I was the one suspended. I won an interim relief hearing. Watford employment tribunal took the unusual step of ordering the trust in effect to reinstate me on full salary and the judge told me: 'I have no hesitation in saying that you are probably going to win.' Yet my career is now in tatters, my health has paid a heavy price, and I am about to lose my home."

Read the full The Guardian article here ► 

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