SMARTMD Monthly Newsletter- A Timely Summary of Your IT News

Physician Study Reveals Startling News about the Workplace

According to a recent study published by the New England Journal of Medicine in regard to evaluating electronic health records, it found that primary care physicians spend a significant amount of time answering e-mails and performing other tasks that provide them with limited reimbursement.

The reports had Richard Baron, an internist in a five-provider practice in Philadelphia with roughly 8,500 patients conduct a yearlong study using his practice's EHR system to track the average daily workload of a primary care physician. On an average workday, he found each primary care provider in his practice:

Saw 18.1 patients; Handled 23.7 phone calls; Answered 16.8 e-mails, mostly dealing with test result interpretations; Dealt with 19.5 lab reports, 11.1 imaging reports and 13.9 consult reports; and Issued 12.1 prescription refills, excluding those issued during patient visits

The doctor also said the results show the need for a new payment method that accurately reimburses primary care physicians for the amount of care they provide. In USA Today, their April 29th edition, Dr. Baron acknowledged that reimbursing for each phone call or e-mail a physician handles would be impractical, but he suggested that adopting capitation -- in which physicians would receive an annual lump sum per patient -- would better cover the amount of time primary care physicians actually spend on patients.

The above news piece is from an excellent I.T. health news source and I extremely recommend their site. Go online at to www.ihealthbeat.org

TeleHealth on Goal with Chronic Illness

In an article written by Marianne Kolbasuk McGee, April 29, 2010 in www.informationweek.com, she writes that several recent studies highlight the importance and challenges of utilizing IT to help manage chronic illnesses. The article reports that in a recent report released this week by the Asthma Regional Council of New England found that New England has the highest rate of asthma in the nation. The disease is poorly controlled, resulting in scary and costly trips to the E.R., as well as other health complications, such as sleep deprivation and lost time on the job.

For some of these asthma patients, the assistance of remote monitoring by clinicians might help address some of the behavioral and other issues that factor into disease management by asthma patients, as well as the complications faced by patients with other chronic diseases, such as diabetes, hypertension or heart failure. The author has researched wonderfully that there are TeleHealth applications in the fight against asthma that allow patients to use peak flow meters at home, having the readings electronically sent via the web to remote clinicians who can watch for low measurements that could indicate an impending flare up.

Another interesting fact the article brings to light is that children with chronic illnesses today are statistically a prime target user for TeleHealth programs if you assume younger people are more comfortable using computer technologies than older patients, and assuming the kids' families can afford web access from home.

To read more from this author, go to www.informationweek.com

California Leads Country in Adoption of PHR

Although the number of U.S. residents using personal health records has more than doubled since 2008, usage rates remain relatively low at 7%, according to a survey released Tuesday by the California HealthCare Foundation, the San Francisco Chronicle reports. CHCF is the publisher of California Healthline. Lake Research Partners conducted the survey of about 1,850 U.S. residents in December and January. The findings were as follows:

The survey found that California leads the country in PHR adoption with a usage rate of 15%. Overall, people who lived in western states were more likely to report using PHR tools. California's PHR adoption rates could be partially attributed to the high percentage of residents who are members of Kaiser Permanente, which offers patient Web portals and other consumer health tools (Colliver, San Francisco Chronicle, 4/13). When asked about the most useful elements of PHRs, researchers found that:

• 64% of respondents said they appreciate the ability to check whether their health data is correct;
• 57% said they like using PHRs to look at test results; and
• 50% said they value the ability to contact their health care providers.

Characteristics of PHR Users
The survey found that younger, highly educated individuals with higher incomes are more likely to use PHRs. However, researchers noted that low-income people with less education and multiple chronic conditions are likely to reap greater benefits from the technology (Mearian, ComputerWorld, 4/13).

The above article was published in www.californiahealthline.org

EMR, Chaos or Streamline- You Make The Call!

The New York Times recently wrote a fascinating piece by author Pauline W. Chen, M.D. Here's a brief portion but to read it in its entirety, go online to www.nytimes.com their April 22, 2010 edition. The author, a medical physician herself notes of an interesting experience that has evolved with use of an EMR solution in a hospital in which she see's patients. Dr. Chen writes the following: " One afternoon several years ago, I found myself faced with an unexpected challenge while seeing patients in clinic. The hospital had just put in effect an electronic medical records system, or EMR, and along with the dozens of shiny new computer terminals installed in nursing stations on every ward came the promise of fewer missing charts, streamlined information and efficient work-flow patterns for all. By the time the first computers were finally installed in exam rooms, my colleagues and I were already fluent enough in the systems software that we were creating and trading order sets, progress note templates and clinical checklists like kids exchanging baseball cards and CDs. For someone who likes to imagine herself as tech savvy, it was a heady moment.

But that afternoon as I settled in to see my first clinic patient, I realized I had no idea where to sit. The new computer was perched atop a desk in one corner of the room; the patient sat on the exam table on the other side of the room. In order to use the computer, I had to turn my back to the patient as I spoke to him. I tried to compensate by sitting on a rolling stool but soon found myself spending more time spinning and wheeling back and forth between patient and computer than I did sitting still and listening. And when my patient did talk, his story came only in spurts because every time I turned my back to him to type, the room fell silent. My vision of an interaction marked by the seamless flow of conversation and capture of information vanished. Instead, I was spinning my wheels- Literally " .

Any of the above sound familiar to you?

To read the rest of this article, go to www.nytimes.com, their April 22, 2010 issue.

Medicare Advantage Landscape- Changes Ahead?

The federal government's chief Medicare actuary, Richard Foster, suggests that MA plans will reduce benefit packages due to approximately $136 billion in reimbursement cuts, resulting in a massive 50 percent fall-off in enrollment by 2017, according to the New York Times. However, early indications from around the industry support the continued survival of Medicare Advantage plans despite the reimbursement cuts included in the Patient Protection and Affordable Care Act, reports Bloomberg BusinessWeek.

Not only did Kathleen Sebelius, secretary of the Department of Health and Human Services, recently tell a House Appropriations subcommittee that Medicare beneficiaries should have "a robust array of choices," but key players in the MA market have started 2010 in a strong position.

Payment cuts won't stop Minneapolis based UnitedHealth Group Inc., from competing with the traditional fee-for-service Medicare program, said President/CEO Stephen Hemsley during a conference call last week to report the firm's first-quarter 2010 results. UnitedHealth added 215,000 new MA enrollees in first-quarter 2010 and 310,000 over the past 12 months (an 18 percent year-over-year gain).

Louisville, Ky.-based Humana Inc., posted similar gains, adding 273,400 members in first-quarter 2010 (a 19 percent gain) compared to first-quarter 2009. Since Dec. 31, 2009, the insurer has added 233,800 MA members, representing a 16 percent increase.
The key will be how well MA plans are able to rein in enrollee costs while providing better benefits. "We have said for some time now that our Medicare Advantage business must ultimately be able to perform better than fee-for-service Medicare on a comparable-benefits basis and with care quality considered," said Hemsley. "We believe we can achieve and sustain that standard in the majority of our local markets."

The PPACA payment cuts should be taken seriously, but the health reform law also offers MA plans some opportunities, noted Robert A. Berenson, a former Medicare official now at the Urban Institute research foundation in Washington, D.C. For example, in 2014, MA plans will be eligible for 5 percent bonus payments if they implement programs that improve enrollee health or care-delivery efficiency
Read more: http://www.fiercehealthpayer. com/story /medicare-advantage- plans-look- strong-now-questions -loom/ 2010-04-26#ix zz0m VyS 83Q1