Post-hospital home visits were provided to 332 high-risk patients referred after discharge from WakeMed Health in North Carolina to reduce readmissions. 299 patients participated in an average of 2.2 home visits in the first 30 days, and the readmission rate of 7.7% was significantly lower than the hospital's Medicare readmission rate of 12%. This suggests that home visits after discharge can help prevent readmissions and reduce healthcare costs compared to usual care alone.
Validation studies are essential to accurately assess the sensitivity, specificity, and predictive values of point prevalence surveys (PPS) of healthcare-associated infections (HAI). Previous validation studies of PPS have shown varied results, underscoring the need for formal evaluations. Without validation, true HAI prevalence is unknown and differences between locations cannot be properly investigated. International organizations can help support national validation efforts to improve HAI surveillance.
Cadth 2015 c6 symposiuml semchuk the rqhr perspectiveCADTH Symposium
This document discusses opportunities for increased collaboration across formularies in Saskatchewan's health regions. It provides context on the current decision-making processes and formularies within the Regina Qu'Appelle Health Region. Challenges include differences in coverage of drugs between regions that can impact patients who transfer between facilities. Greater alignment is needed, as demonstrated by a successful example of a provincial working group that aligned ticagrelor coverage based on clinical evidence. Overall, the speaker argues that formalizing collaboration through initiatives like joint evidence reviews and policy consultation can help standardize practices across regions to improve patient care continuity.
The document outlines recommendations to improve the discharge process at Valley Medical Center (VMC) by focusing on communication, prioritization, and standardization. Key stakeholders identified common barriers including waiting for ancillary services, transportation, and discharge orders. The top five recommendations were prioritized based on cost, effectiveness, and feasibility to streamline the discharge process and help VMC better fulfill its mission.
Comparative effectiveness randomized trial to improve stroke care delivery c...Marilyn Mann
A Vanderbilt University Medical Center study comparing the current way stroke care is delivered with a redesigned model that better integrates rehabilitation and skilled nursing facilities as well as lay health educators who make home visits. A pilot project suggests this new model can decrease hospital length of stay and readmissions, recurrence rates, and lower cost.
Novel Approaches to Antiretroviral Therapy DistributionJSI
JSI experts Nikki Davis, Melissa Sharer, and Sabrina Eagan presented on Novel Approaches to Antiretroviral Therapy Distribution at the 2017 American Evaluation Conference. The presentation was based on JSI's learnings through the AIDSFree project.
1) A patient with familial hypercholesterolemia (FH) on PCSK9 inhibitors described facing step therapy requirements and high copays to access the drug, with an initial $1000 copay and $400 monthly copay.
2) A study found that only 30.9% of patients prescribed PCSK9 inhibitors ever received the therapy due to prior authorization denials and high copays, with prescription abandonment rates over 75% for copays over $350.
3) Medicare Part D plans have annual out-of-pocket costs for PCSK9 inhibitors and statins of nearly $5000 on average.
Post-hospital home visits were provided to 332 high-risk patients referred after discharge from WakeMed Health in North Carolina to reduce readmissions. 299 patients participated in an average of 2.2 home visits in the first 30 days, and the readmission rate of 7.7% was significantly lower than the hospital's Medicare readmission rate of 12%. This suggests that home visits after discharge can help prevent readmissions and reduce healthcare costs compared to usual care alone.
Validation studies are essential to accurately assess the sensitivity, specificity, and predictive values of point prevalence surveys (PPS) of healthcare-associated infections (HAI). Previous validation studies of PPS have shown varied results, underscoring the need for formal evaluations. Without validation, true HAI prevalence is unknown and differences between locations cannot be properly investigated. International organizations can help support national validation efforts to improve HAI surveillance.
Cadth 2015 c6 symposiuml semchuk the rqhr perspectiveCADTH Symposium
This document discusses opportunities for increased collaboration across formularies in Saskatchewan's health regions. It provides context on the current decision-making processes and formularies within the Regina Qu'Appelle Health Region. Challenges include differences in coverage of drugs between regions that can impact patients who transfer between facilities. Greater alignment is needed, as demonstrated by a successful example of a provincial working group that aligned ticagrelor coverage based on clinical evidence. Overall, the speaker argues that formalizing collaboration through initiatives like joint evidence reviews and policy consultation can help standardize practices across regions to improve patient care continuity.
The document outlines recommendations to improve the discharge process at Valley Medical Center (VMC) by focusing on communication, prioritization, and standardization. Key stakeholders identified common barriers including waiting for ancillary services, transportation, and discharge orders. The top five recommendations were prioritized based on cost, effectiveness, and feasibility to streamline the discharge process and help VMC better fulfill its mission.
Comparative effectiveness randomized trial to improve stroke care delivery c...Marilyn Mann
A Vanderbilt University Medical Center study comparing the current way stroke care is delivered with a redesigned model that better integrates rehabilitation and skilled nursing facilities as well as lay health educators who make home visits. A pilot project suggests this new model can decrease hospital length of stay and readmissions, recurrence rates, and lower cost.
Novel Approaches to Antiretroviral Therapy DistributionJSI
JSI experts Nikki Davis, Melissa Sharer, and Sabrina Eagan presented on Novel Approaches to Antiretroviral Therapy Distribution at the 2017 American Evaluation Conference. The presentation was based on JSI's learnings through the AIDSFree project.
1) A patient with familial hypercholesterolemia (FH) on PCSK9 inhibitors described facing step therapy requirements and high copays to access the drug, with an initial $1000 copay and $400 monthly copay.
2) A study found that only 30.9% of patients prescribed PCSK9 inhibitors ever received the therapy due to prior authorization denials and high copays, with prescription abandonment rates over 75% for copays over $350.
3) Medicare Part D plans have annual out-of-pocket costs for PCSK9 inhibitors and statins of nearly $5000 on average.
Sarah Reed presented on the feasibility of moving Drake Center's medical documentation to an electronic system. Currently, paper records are used but regulations from CMS require improvements to documentation. Electronic records could help by decreasing paperwork, increasing productivity and staff satisfaction compared to paper records. Sarah chose this topic because as a child of a nurse, she witnessed how outdated documentation systems led to errors and how moving to electronic records could help hospitals modernize and improve quality of care.
Outcomes research tests evidence-based interventions to see how they impact individuals, groups, and populations. It examines the effects on both patients and healthcare providers. The Patient Protection and Affordable Care Act, Accountable Care Organizations, Center for Medicare and Medicaid Services, Agency for Healthcare Research and Quality, and Patient Centered Outcomes Research Institute all play roles in outcomes research. Outcomes research can help improve patient care by identifying effective interventions and understanding different treatment outcomes. However, outcomes may differ based on patient demographics and reported data could be skewed.
Alabama Pharmacy Association Mid Winter Conf. 2014Samantha Haas
Telehealth has the potential to provide clinical care, consultations, and remote patient monitoring anytime and anywhere. It uses telecommunications and information technology to provide healthcare services across distances. The Alabama Partnership for Telehealth is a nonprofit focused on increasing access to care through innovative technology. It provides telehealth liaison services, credentialing support, a scheduling system, and imaging support to partner organizations. The main drivers for expanding telehealth are improving rural healthcare and decreasing costs while improving efficiency. Barriers include reimbursement issues, physician adoption, costs, and resistance to change. However, studies show telehealth can reduce medical errors and potential adverse events while improving satisfaction.
Anne Bracken Univ of South AL - aco rural healthSamantha Haas
1) Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other care providers who come together voluntarily to give coordinated high quality care to their patients.
2) ACOs aim to improve care and lower costs through improved care coordination and preventative care. They are paid for keeping their patients healthy instead of paying for each test and procedure.
3) For ACOs to be successful, providers need organizational capabilities like managing risk, using electronic health records, tracking performance measures, and engaging patients in self-care.
Training medical policy program final version 3Emily Barton
UCare's Medical Policy Program establishes evidence-based guidelines to determine health care coverage. The program aims to improve health outcomes while meeting regulatory requirements. Medical policies are developed through a multistep process including literature review and approval by clinical committees. Finalized policies are integrated into coverage determinations and published for providers and members. Utilization is then measured and policies updated based on feedback to enhance the program over time.
The document summarizes research on physician assistants' use of clinical information for patient care decision-making. It provides background on physician assistants as a profession and describes two studies examining how clinical librarians and literature searching impacted physicians' and other practitioners' patient care. The document also outlines preliminary results of a current study surveying physician assistants, nurses and physicians at rural hospitals on their information needs and use of resources for clinical decision-making. Key findings suggest rural practitioners want improved access to online journals and databases to inform direct patient care and education.
This study analyzed patient admission and occupancy data from a large children's hospital to determine patterns and variability over time. It found that scheduled admissions contributed more variability than emergent admissions, with peak occupancy mid-week. Scheduled patients admitted on Mondays had longer average lengths of stay. The variability in scheduled admissions generated uneven patient hours and mid-week crowding, suggesting opportunities to optimize patient flow.
This document provides an overview of TRICARE, including eligibility requirements, covered and non-covered services, network and non-network provider reimbursement, and participating and non-participating provider charges and reimbursement. Eligible individuals include uniformed service members, spouses, unmarried children, and reserve and national guard members. Covered services include ambulatory surgery, diagnostic testing, durable medical equipment, and prescription drugs. Non-covered services include cosmetic procedures and routine physical exams for foot care. Network providers are reimbursed at contracted rates while non-network providers are reimbursed at 115% of allowable amounts.
This document summarizes a quality improvement project at Hunterdon Healthcare that assessed factors contributing to patient readmissions. The project administered a 15-question survey to 57 recently readmitted patients to understand their knowledge of their disease and discharge instructions. The survey found that most common factors for readmission were an inability to obtain follow-up appointments, lack of transportation, and inability to identify the cause of readmission. Providing more education to patients and caregivers on diet and self-care may help reduce readmissions and the associated penalties from CMS. Hunterdon will monitor readmission data monthly to evaluate if interventions are successful in lowering readmission rates.
Telemedicine allows for remote monitoring and consultation of ICU patients using technology. It has historical roots in addressing gaps in intensivist coverage. Key terms include telemedicine, tele-physician, and tele-nurse. Current applications include ICU consultations, monitoring patients with conditions like CHF, and providing care to remote or underserved populations. Telemedicine monitoring involves teams of tele-nurses and physicians overseeing multiple ICU beds using virtual patient records and monitoring equipment. Studies show benefits to patient outcomes and safety, though some clinicians note potential disadvantages like loss of bedside experience.
Terry Cannestra is a registered nurse in Wisconsin with over 35 years of clinical experience. She has held roles as a clinical research nurse, data specialist, case coordinator, and bedside nurse. Her skills include research coordination, project management, data entry, clinical skills such as phlebotomy and IV placement, and strong computer and communication abilities. She is certified as a clinical research coordinator and in basic life support.
This document discusses using linked health data to identify problems and improve patient outcomes and efficiency. It describes an example where data on epilepsy patients was analyzed across multiple hospitals, finding wide variability in referrals to seizure clinics and follow-up care. A simple pathway was then implemented at three sites to ensure epilepsy patients seen in the emergency department received a neurology appointment within two weeks. Individual reports were provided to hospitals, and the document suggests this approach could also be applied to issues around alcohol use and COPD.
The document summarizes key themes from a webinar on developing medical policies and coverage guidelines for next generation sequencing in oncology. It discusses the challenges of evaluating genomic tests and gaining insurance coverage. Recommendations include requiring laboratories to obtain accreditation for analytic validity, covering small gene panels when clinical utility is established, and facilitating data collection to support coverage of larger tests and off-label drug use. The webinar included perspectives from various stakeholders on addressing these issues.
The document discusses the implementation and evaluation of a Memory Disorders Clinic (MDC) at Boston Medical Center using a mixed methods approach guided by the PARiHS framework. The MDC aims to improve care for the growing elderly population experiencing memory loss. Qualitative and quantitative data were collected from clinic providers, referring providers, interpreters, patient and caregiver surveys, and medical charts. Preliminary results found high satisfaction among referring providers and patients/caregivers with the MDC's services, family-centered approach, and cultural competency in addressing the needs of English and non-English speaking populations. The evaluation seeks to identify best practices to ensure the MDC's feasibility, sustainability, and quality of care.
The role of patients and healthcare providers in translational medicinejangeissler
The role of patients and healthcare providers in translational medicine, presented by Jan Geissler at the European Commission's Personalized Medicine Conference 2016 on 1 June 2016 in Brussels
The document discusses the importance of global health information systems and challenges in building sustainable systems in resource-constrained countries. It highlights issues such as lack of integrated interventions and siloed disease-specific systems. It also outlines opportunities for librarians and universities to help address gaps through educational programs, research, and training the next generation of health informatics professionals.
Soraya Ghebleh - Variation in Healthcare DeliverySoraya Ghebleh
This is a presentation by Soraya Ghebleh that discusses some of the main points in unwarranted variation in healthcare and strategies that can potentially reduce it.
Dr. Craig J. Lenz - School of Osteopathic MedSamantha Haas
This document discusses barriers to telehealth and opportunities to integrate medical education and telehealth. It describes an early telehealth program in San Bernardino County, California that helped address barriers to care from distance. The document also discusses piloting the use of video conferencing units at a medical school to help deliver certain specialties and clinical education remotely, as well as the potential for students on international clerkships to participate in morning report back at the medical school via laptop or iPad.
Physician age and outcomes in elderly patients in hospial in the US: observat...Akshay Mehta
- This study examined the relationship between physician age and patient outcomes among elderly Medicare beneficiaries admitted to hospitals in the US from 2011-2014.
- The study found that patients treated by older hospitalists had higher 30-day mortality rates compared to patients treated by younger hospitalists, except for those treated by hospitalists with high patient volumes.
- Readmission rates did not meaningfully vary with physician age, while costs of care were slightly higher among older physicians. The results suggest that differences in practice patterns or quality measures between physicians of varying experience levels could influence patient outcomes.
Strengthening Acute to Post Acute-Care Connection: Cohesively Manage CareCentralPAHEF
WellSpan Health is a large integrated health system in central Pennsylvania serving over 1 million people. It operates 6 hospitals, a medical group with over 1200 physicians, and provides various post-acute services including home health, rehabilitation, and long-term care. WellSpan is working to strengthen connections between acute and post-acute care by standardizing care, improving care coordination and transitions, and developing preferred partnerships with post-acute providers. The goal is to improve patient outcomes and experiences while decreasing healthcare costs through more cohesive management of care across settings.
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 24, 2013
John E. Wennberg, The Dartmouth Institute
Sarah Reed presented on the feasibility of moving Drake Center's medical documentation to an electronic system. Currently, paper records are used but regulations from CMS require improvements to documentation. Electronic records could help by decreasing paperwork, increasing productivity and staff satisfaction compared to paper records. Sarah chose this topic because as a child of a nurse, she witnessed how outdated documentation systems led to errors and how moving to electronic records could help hospitals modernize and improve quality of care.
Outcomes research tests evidence-based interventions to see how they impact individuals, groups, and populations. It examines the effects on both patients and healthcare providers. The Patient Protection and Affordable Care Act, Accountable Care Organizations, Center for Medicare and Medicaid Services, Agency for Healthcare Research and Quality, and Patient Centered Outcomes Research Institute all play roles in outcomes research. Outcomes research can help improve patient care by identifying effective interventions and understanding different treatment outcomes. However, outcomes may differ based on patient demographics and reported data could be skewed.
Alabama Pharmacy Association Mid Winter Conf. 2014Samantha Haas
Telehealth has the potential to provide clinical care, consultations, and remote patient monitoring anytime and anywhere. It uses telecommunications and information technology to provide healthcare services across distances. The Alabama Partnership for Telehealth is a nonprofit focused on increasing access to care through innovative technology. It provides telehealth liaison services, credentialing support, a scheduling system, and imaging support to partner organizations. The main drivers for expanding telehealth are improving rural healthcare and decreasing costs while improving efficiency. Barriers include reimbursement issues, physician adoption, costs, and resistance to change. However, studies show telehealth can reduce medical errors and potential adverse events while improving satisfaction.
Anne Bracken Univ of South AL - aco rural healthSamantha Haas
1) Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other care providers who come together voluntarily to give coordinated high quality care to their patients.
2) ACOs aim to improve care and lower costs through improved care coordination and preventative care. They are paid for keeping their patients healthy instead of paying for each test and procedure.
3) For ACOs to be successful, providers need organizational capabilities like managing risk, using electronic health records, tracking performance measures, and engaging patients in self-care.
Training medical policy program final version 3Emily Barton
UCare's Medical Policy Program establishes evidence-based guidelines to determine health care coverage. The program aims to improve health outcomes while meeting regulatory requirements. Medical policies are developed through a multistep process including literature review and approval by clinical committees. Finalized policies are integrated into coverage determinations and published for providers and members. Utilization is then measured and policies updated based on feedback to enhance the program over time.
The document summarizes research on physician assistants' use of clinical information for patient care decision-making. It provides background on physician assistants as a profession and describes two studies examining how clinical librarians and literature searching impacted physicians' and other practitioners' patient care. The document also outlines preliminary results of a current study surveying physician assistants, nurses and physicians at rural hospitals on their information needs and use of resources for clinical decision-making. Key findings suggest rural practitioners want improved access to online journals and databases to inform direct patient care and education.
This study analyzed patient admission and occupancy data from a large children's hospital to determine patterns and variability over time. It found that scheduled admissions contributed more variability than emergent admissions, with peak occupancy mid-week. Scheduled patients admitted on Mondays had longer average lengths of stay. The variability in scheduled admissions generated uneven patient hours and mid-week crowding, suggesting opportunities to optimize patient flow.
This document provides an overview of TRICARE, including eligibility requirements, covered and non-covered services, network and non-network provider reimbursement, and participating and non-participating provider charges and reimbursement. Eligible individuals include uniformed service members, spouses, unmarried children, and reserve and national guard members. Covered services include ambulatory surgery, diagnostic testing, durable medical equipment, and prescription drugs. Non-covered services include cosmetic procedures and routine physical exams for foot care. Network providers are reimbursed at contracted rates while non-network providers are reimbursed at 115% of allowable amounts.
This document summarizes a quality improvement project at Hunterdon Healthcare that assessed factors contributing to patient readmissions. The project administered a 15-question survey to 57 recently readmitted patients to understand their knowledge of their disease and discharge instructions. The survey found that most common factors for readmission were an inability to obtain follow-up appointments, lack of transportation, and inability to identify the cause of readmission. Providing more education to patients and caregivers on diet and self-care may help reduce readmissions and the associated penalties from CMS. Hunterdon will monitor readmission data monthly to evaluate if interventions are successful in lowering readmission rates.
Telemedicine allows for remote monitoring and consultation of ICU patients using technology. It has historical roots in addressing gaps in intensivist coverage. Key terms include telemedicine, tele-physician, and tele-nurse. Current applications include ICU consultations, monitoring patients with conditions like CHF, and providing care to remote or underserved populations. Telemedicine monitoring involves teams of tele-nurses and physicians overseeing multiple ICU beds using virtual patient records and monitoring equipment. Studies show benefits to patient outcomes and safety, though some clinicians note potential disadvantages like loss of bedside experience.
Terry Cannestra is a registered nurse in Wisconsin with over 35 years of clinical experience. She has held roles as a clinical research nurse, data specialist, case coordinator, and bedside nurse. Her skills include research coordination, project management, data entry, clinical skills such as phlebotomy and IV placement, and strong computer and communication abilities. She is certified as a clinical research coordinator and in basic life support.
This document discusses using linked health data to identify problems and improve patient outcomes and efficiency. It describes an example where data on epilepsy patients was analyzed across multiple hospitals, finding wide variability in referrals to seizure clinics and follow-up care. A simple pathway was then implemented at three sites to ensure epilepsy patients seen in the emergency department received a neurology appointment within two weeks. Individual reports were provided to hospitals, and the document suggests this approach could also be applied to issues around alcohol use and COPD.
The document summarizes key themes from a webinar on developing medical policies and coverage guidelines for next generation sequencing in oncology. It discusses the challenges of evaluating genomic tests and gaining insurance coverage. Recommendations include requiring laboratories to obtain accreditation for analytic validity, covering small gene panels when clinical utility is established, and facilitating data collection to support coverage of larger tests and off-label drug use. The webinar included perspectives from various stakeholders on addressing these issues.
The document discusses the implementation and evaluation of a Memory Disorders Clinic (MDC) at Boston Medical Center using a mixed methods approach guided by the PARiHS framework. The MDC aims to improve care for the growing elderly population experiencing memory loss. Qualitative and quantitative data were collected from clinic providers, referring providers, interpreters, patient and caregiver surveys, and medical charts. Preliminary results found high satisfaction among referring providers and patients/caregivers with the MDC's services, family-centered approach, and cultural competency in addressing the needs of English and non-English speaking populations. The evaluation seeks to identify best practices to ensure the MDC's feasibility, sustainability, and quality of care.
The role of patients and healthcare providers in translational medicinejangeissler
The role of patients and healthcare providers in translational medicine, presented by Jan Geissler at the European Commission's Personalized Medicine Conference 2016 on 1 June 2016 in Brussels
The document discusses the importance of global health information systems and challenges in building sustainable systems in resource-constrained countries. It highlights issues such as lack of integrated interventions and siloed disease-specific systems. It also outlines opportunities for librarians and universities to help address gaps through educational programs, research, and training the next generation of health informatics professionals.
Soraya Ghebleh - Variation in Healthcare DeliverySoraya Ghebleh
This is a presentation by Soraya Ghebleh that discusses some of the main points in unwarranted variation in healthcare and strategies that can potentially reduce it.
Dr. Craig J. Lenz - School of Osteopathic MedSamantha Haas
This document discusses barriers to telehealth and opportunities to integrate medical education and telehealth. It describes an early telehealth program in San Bernardino County, California that helped address barriers to care from distance. The document also discusses piloting the use of video conferencing units at a medical school to help deliver certain specialties and clinical education remotely, as well as the potential for students on international clerkships to participate in morning report back at the medical school via laptop or iPad.
Physician age and outcomes in elderly patients in hospial in the US: observat...Akshay Mehta
- This study examined the relationship between physician age and patient outcomes among elderly Medicare beneficiaries admitted to hospitals in the US from 2011-2014.
- The study found that patients treated by older hospitalists had higher 30-day mortality rates compared to patients treated by younger hospitalists, except for those treated by hospitalists with high patient volumes.
- Readmission rates did not meaningfully vary with physician age, while costs of care were slightly higher among older physicians. The results suggest that differences in practice patterns or quality measures between physicians of varying experience levels could influence patient outcomes.
Strengthening Acute to Post Acute-Care Connection: Cohesively Manage CareCentralPAHEF
WellSpan Health is a large integrated health system in central Pennsylvania serving over 1 million people. It operates 6 hospitals, a medical group with over 1200 physicians, and provides various post-acute services including home health, rehabilitation, and long-term care. WellSpan is working to strengthen connections between acute and post-acute care by standardizing care, improving care coordination and transitions, and developing preferred partnerships with post-acute providers. The goal is to improve patient outcomes and experiences while decreasing healthcare costs through more cohesive management of care across settings.
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 24, 2013
John E. Wennberg, The Dartmouth Institute
This study analyzed data from 84,421 patients discharged between 2014-2019 from a university hospital in Yemen to determine average length of stay (ALOS) and factors affecting length of stay (LOS). The total mean hospital stay was 3.11 days. Female patients had a shorter mean stay of 2.89 days compared to 3.37 days for males. Factors found to influence LOS included patient's state at discharge, hospital department, number of admissions, sex, and day of admission. Patients transferred to other hospitals had the longest stay of 4.30 days on average. This study provides data on LOS that can help optimize hospital resource use and efficiency.
For more information contact: Slideshare@marcusevans.com
Presentation delivered by Donna Medina, Regional Director,OSF Hospice and Homecare Foundation at the marcus evans Home Care Leadership Summit held on July 13 & 14 2015 in Palm Beach FL.
1) The study examined whether increased ICU occupancy on the day of patient admission was associated with increased inpatient mortality.
2) Using data from over 198,000 patients admitted to 108 ICUs, the study found no significant relationship between ICU census on the day of admission and inpatient mortality or discharge destination.
3) The results suggest that ICUs are able to maintain consistent patient outcomes even during periods of high occupancy, functioning as "high-reliability organizations."
Case Study "Using Real Time Clinical Data To Support Patient Risk Stratification in The Clinical Care Setting"
HealthInfoNet operates the statewide health information exchange in Maine. The exchange currently manages clinical and patient care encounter information on 97 percent of the residents of the State of Maine. The information is gathered in real time, standardized, and aggregated at a patient specific level to support treatment. For the past three years, HealthInfoNet has worked with HBI Solutions, Inc of Palo Alto, CA to utilize this real time clinical and encounter data to support the development of predictive analytic tools that risk stratify patient populations and individual patients for future incidence of disease, cost, and both inpatient and ambulatory care encounters. These real time predictive models have now been used in clinical care settings for a year. The presentation will cover both lessons learned to date from implementing and optimizing real time predictive analytic tools and the early finding of the impact that the use of these tools is having on patient care management, utilization and outcome.
Devore Culver
Executive Director & CEO
HealthInfoNet
Multispecialty Physician Networks: Improved Quality and Accountability - The ...EvidenceNetwork.ca
Multispecialty Physician Networks: Improved Quality and Accountability - The “Health Care Neighbourhood”
by Thérèse A. Stukel, Rick Glazier, Sue Schultz, Jun Guan Institute for Clinical Evaluative Sciences Toronto
Funded by: CIHR Emerging Team Grant in Applied Health Services and Policy Research
Public Reporting as a Catalyst for Better Consumer DecisionsATLAS Conference
Greater efficiency in the process of matching patients to appropriate providers is vital to achieving the Triple Aim. As patients research and choose among appropriate providers, sound decision-making will depend on the accessibility of high-quality data that enables them to make meaningful, actionable comparisons. Online public-reporting tools, such as those published by U.S. News, CMS and others, serve as venues for consumer decision-making. Driven by current trends in data transparency, rapid advances in public reporting can be anticipated. This presentation will outline several recent and expected future developments in the evolution of key public-reporting tools, and discuss their role in facilitating patient engagement and access to appropriate care.
Reducing Readmissions and Length of Stay | VITAS HealthcareVITAS Healthcare
Hospice can help reduce hospital readmissions and lengths of stay for patients with serious illnesses like heart failure. By providing comprehensive care, including nursing support 24 hours a day, palliative care physician support, medications, equipment, and targeted programs for conditions like CHF, hospice can help meet patient goals of comfort and avoiding inappropriate hospitalizations. For the patient with heart failure described in the case study, hospice could help prevent readmissions and allow the patient to focus on quality of life rather than further medical interventions by providing end-of-life care in their home.
Closing the Loop: Strategies to Extend Care in the EDEngagingPatients
This HIMSS15 presentation discusses the challenges faced in hospital emergency departments and offers insights for implementing a process to follow up with discharged ED patients to enhance outcomes and satisfaction,while optimizing utilization and reducing risk.
Aveline Casey, Director of Nursing National Acute Medicine ProgrammeInvestnet
The document discusses the redesign of Ireland's acute hospital system including the establishment of hospital groups. It focuses on the importance and role of Model 2 and 3 hospitals as smaller hospitals that act as hubs providing integrated primary and hospital care. They aim to treat patients at the lowest level of complexity safely and close to home. The document outlines opportunities and challenges for Model 2 and 3 hospitals in improving patient flow, expanding ambulatory and day surgery services, collaboration, workforce development, and meeting national targets for patient length of stay and discharge.
Comparing psychiatric re-hospitalization rates across countries by using rout...THL
This document discusses a study comparing psychiatric re-hospitalization rates across countries using routine health care data. The study, called CEPHOS-LINK, analyzed data from six European countries to identify predictors of re-hospitalization and compare rates. Ensuring the data was interoperable between countries with different health systems and data collection practices was challenging. The study found re-hospitalization rates varied between countries and psychosis was a consistent predictor of higher rates. Continuity of outpatient care after discharge also impacted rates. However, differences in health systems, data quality, and definitions of variables like hospital discharge limited full comparability.
1) The study aims to analyze patient flow patterns and morbidity at KEM Hospital in Mumbai, a large public hospital, to understand how to decongest tertiary care facilities by strengthening primary care.
2) Preliminary findings show the hospital is overcrowded with 71% of patients presenting conditions that could be managed at primary care centers. Referral pathways also demonstrate patients bypass available primary care.
3) Recommendations include zoning the hospital, limiting daily registrations, issuing color-coded referral cards, and deputing specialists to peripheral centers to strengthen primary care and reduce overreliance on tertiary hospitals.
AHRQ Quality and Disparities Report, May 2015Joe Soler
The document is a presentation from the National Healthcare Quality and Disparities Report Chartbook on Care Coordination from May 2015. It discusses trends in care coordination measures from the report and provides data on various measures of care coordination, including rates of patients receiving discharge instructions, hospital readmission rates, and preventable emergency department visits. The goal is to assess quality of care coordination and identify areas for improvement, particularly in reducing disparities. Several charts display care coordination measure results over time and differences between demographic groups to examine health equity.
The Healthcare Team as the Healthcare Provider: A Different View of the Patie...guesta14581
Presentation to the Ohio State Society of Medical Assistant's annual convention about the Patient Centered Medical Home and the role of the medical assistant
Improving ruli district hospital's patient referral system, final, 4.12.11Wendy_Leonard
Presentation by team of MBA students from Ross School of Business at University of Michigan. Describes recommendations for improving the referral process for rural health centers to the district hospital in rural Rwanda.
This document summarizes the benefits of highly organized primary care and medical homes. It discusses how organizing primary care into teams that focus on population health, care coordination, planned care for chronic conditions, and quality improvement can improve health outcomes, reduce costs, and enhance the patient experience. The document provides examples from Cambridge Health Alliance that show improved quality metrics, decreased hospital and emergency room use, and reduced costs after implementing a primary care reform model centered around medical homes and accountable care.
Similar to Discussion on Health Information Exchange and Length of Stay-WHITE 2014 (20)
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International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
2024 HIPAA Compliance Training Guide to the Compliance OfficersConference Panel
Join us for a comprehensive 90-minute lesson designed specifically for Compliance Officers and Practice/Business Managers. This 2024 HIPAA Training session will guide you through the critical steps needed to ensure your practice is fully prepared for upcoming audits. Key updates and significant changes under the Omnibus Rule will be covered, along with the latest applicable updates for 2024.
Key Areas Covered:
Texting and Email Communication: Understand the compliance requirements for electronic communication.
Encryption Standards: Learn what is necessary and what is overhyped.
Medical Messaging and Voice Data: Ensure secure handling of sensitive information.
IT Risk Factors: Identify and mitigate risks related to your IT infrastructure.
Why Attend:
Expert Instructor: Brian Tuttle, with over 20 years in Health IT and Compliance Consulting, brings invaluable experience and knowledge, including insights from over 1000 risk assessments and direct dealings with Office of Civil Rights HIPAA auditors.
Actionable Insights: Receive practical advice on preparing for audits and avoiding common mistakes.
Clarity on Compliance: Clear up misconceptions and understand the reality of HIPAA regulations.
Ensure your compliance strategy is up-to-date and effective. Enroll now and be prepared for the 2024 HIPAA audits.
Enroll Now to secure your spot in this crucial training session and ensure your HIPAA compliance is robust and audit-ready.
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About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
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PrudentRx: A Resource for Patient Education and Engagement
Discussion on Health Information Exchange and Length of Stay-WHITE 2014
1. Does Health Information
Exchange Move Patients Through
Emergency Departments Faster?
Discussant: Peiyin Hung
(University of Minnesota)
Workshop on Health IT and Economics 2014
Alexandria, VA
October 10, 2014
2. Summary-Variables
Key Variables
Outcome Length of stay defined as duration
between admission and discharge
Treatment Health information exchange in a
given year 2009,2010, 2011
Compared to patients in hospitals
without HIE in all years
Crowdedness Hourly dummy variable indicating
above or below 75% of annual census
Severity Dummy variable indicating 2 or
higher Charlson Comorbidity Index
2
3. Summary-Identification
Main Model: Difference-in-difference model to
evaluate average treatment effects on means of LOS
Hierarchical model with the patient-visit as
unit of analysis
3
4. Primary Questions
Q1: How patients flow in ED?
Q2: Which clinical conditions matter?
Q3: How was patient clustering in a
hospital addressed?
Q4: Is it possible that high-efficiency
hospitals are more amenable to HIE
adoptions?
Q5: Year of HIE adoption vs. Number of
years adopted
4
5. Patient Flows in Emergency
Departments
Registratio
n/Check in
Triage
Handover/
Assessment
Examination
Inpatient
Admission
Referral/
Discharge
Treatment
5
6. Length of Stay
by Clinical Condition and Severity
Average Length of Stay in Emergency
Department (2010)
Hours)
(12
Stays of Length Obstetric Patients Chest Pain Patients 18
5.1
8.2
Low-risk
(Vaginal
Delivery)
High-risk
(Cesarean
Delivery)
Low-risk High-risk
6
8. Reminder of
Identification Method
Main Model: Difference-in-difference model to
evaluate average treatment effects on means of LOS
Hierarchical model with the patient-visit as
unit of analysis
8
9. Other Identification
Suggestions
• HIE implementers by number of years
adopted
• Ordinal Severity Scores
– AHRQ’s Emergency Severity Index
• Patients visits nested in a patient and
clustered in a hospital
– Generalized Estimating Equations
• Multicollinearity between covariates
– E.g. Community income and patient
income
• Stratify by clinical conditions
– Which condition would need more information? 9
10. Future Extensions
• Distinct treatment effects on LOS
– Lagged effects (how many years would
significant effects in place? By how much?)
– Hospital inpatient and ED integration
– Effects by exchangeability of scope
• Within and outside of hospital systems
• Ambulatory providers in and outside of a system
– Effects by discharged vs. admitted patients
• Other intermediate effects
– Simultaneous effects of HIE on quality and
volume on efficiency
10