This document discusses the intersection of chronic condition documentation and coding with data-driven reimbursement, patient satisfaction, and cost. It proposes an integrative population health approach using evidence-based integrative health practices to improve chronic illness management, health promotion, self-care, and patient engagement. Data analytics can
This presentation tells us about what are the medication errors and how we differentiate between them as per the National Accreditation Board for Hospital & Healthcare Providers standard for hospitals 5th Edition.
Presentation contains detailing details of medication error.
Some GIFs may not be seen.
Medication therapy is becoming increasingly more complex as new drugs are developed and more therapeutic targets are elucidated. In addition, polypharmacy (≥5 scheduled medications) has become exceedingly common in geriatric patients and in patients with chronic disease states. As the complexity of drug therapy and the number of medications increase, patients are at a high risk for medication errors and adverse drug events (ADEs), or injuries resulting from medication. The type of adverse events may be associated with professional practices, healthcare products, procedures, and systems including prescription, communication through instructions, drug labeling, packaging and nomenclature, reformulation, dissolution, distribution, administration, education, monitoring, and use. Classification and evaluation of medication errors according to their importance may constitute an important factor for process improvement in order to render the administration of medicines as safe as possible. In hospitals, medication errors occur at a rate of about one per patient per day. A dispensing error is one made by pharmacy staff when distributing medications to nursing units or directly to patients in an ambulatory-care pharmacy; the error rates for doses dispensed via the cart-filling process range from 0.87% to 2.9%. Technology has grown to be a constituent part of medicine these days. A few advantages that technology can supply are categorized as follows: the assisting of communication between clinicians; enhancing medication safety; decreasing potential medical errors and adverse events; rising access to medical information and encouraging patient-centered healthcare. The aim of this article is to provide a compendious literature review regarding Medication errors
Background: The Food and Drug Administration relies on adverse event reports linked with health risks to remove potentially harmful dietary supplements from the market. Many emergency medicine physicians encounter suspected adverse events related to
dietary supplement use but we do not know what proportion of those adverse events are reported to the Food and Drug Administration. The objective of the study was to determine emergency medicine physicians’ practices regarding adverse event reporting and knowledge of dietary supplements.
Methods: A prospective, cross-sectional study was conducted across five medical centers around the U.S: three military and two civilian. A web-based survey was distributed to emergency medicine attending physicians and emergency medicine residents. The questionnaire was created and administered using Lime Survey software. An administrator at each site communicated study details to emergency medicine physicians and residents via email. The survey was kept open for fi ve months. To preserve participant anonymity,
neither email domains, email addresses, Internet Protocol addresses, nor any other personally identifi able or demographic information were collected.
Team Lift: Predicting Medication AdherenceNeil Ryan
Medication adherence is a growing public health concern in the US. It is the extent to which patients are taking medications as prescribed by their healthcare providers. Simply put, are patients eating their pills on time?
We looked at patient data from Medicare part D program released by Centers for Medicare & Medicaid services. We built a prediction model to ascertain whether a patient would be adherent based on a variety of social, economic and behavioral aspects.
Presentation by Avella Specialty Pharmacy & mScripts at Armada 2015 on improving medication adherence through mobile app technology. Learn about how Avella meets the challenges of medication non-adherence: http://www.avella.com/medication-adherence
This presentation tells us about what are the medication errors and how we differentiate between them as per the National Accreditation Board for Hospital & Healthcare Providers standard for hospitals 5th Edition.
Presentation contains detailing details of medication error.
Some GIFs may not be seen.
Medication therapy is becoming increasingly more complex as new drugs are developed and more therapeutic targets are elucidated. In addition, polypharmacy (≥5 scheduled medications) has become exceedingly common in geriatric patients and in patients with chronic disease states. As the complexity of drug therapy and the number of medications increase, patients are at a high risk for medication errors and adverse drug events (ADEs), or injuries resulting from medication. The type of adverse events may be associated with professional practices, healthcare products, procedures, and systems including prescription, communication through instructions, drug labeling, packaging and nomenclature, reformulation, dissolution, distribution, administration, education, monitoring, and use. Classification and evaluation of medication errors according to their importance may constitute an important factor for process improvement in order to render the administration of medicines as safe as possible. In hospitals, medication errors occur at a rate of about one per patient per day. A dispensing error is one made by pharmacy staff when distributing medications to nursing units or directly to patients in an ambulatory-care pharmacy; the error rates for doses dispensed via the cart-filling process range from 0.87% to 2.9%. Technology has grown to be a constituent part of medicine these days. A few advantages that technology can supply are categorized as follows: the assisting of communication between clinicians; enhancing medication safety; decreasing potential medical errors and adverse events; rising access to medical information and encouraging patient-centered healthcare. The aim of this article is to provide a compendious literature review regarding Medication errors
Background: The Food and Drug Administration relies on adverse event reports linked with health risks to remove potentially harmful dietary supplements from the market. Many emergency medicine physicians encounter suspected adverse events related to
dietary supplement use but we do not know what proportion of those adverse events are reported to the Food and Drug Administration. The objective of the study was to determine emergency medicine physicians’ practices regarding adverse event reporting and knowledge of dietary supplements.
Methods: A prospective, cross-sectional study was conducted across five medical centers around the U.S: three military and two civilian. A web-based survey was distributed to emergency medicine attending physicians and emergency medicine residents. The questionnaire was created and administered using Lime Survey software. An administrator at each site communicated study details to emergency medicine physicians and residents via email. The survey was kept open for fi ve months. To preserve participant anonymity,
neither email domains, email addresses, Internet Protocol addresses, nor any other personally identifi able or demographic information were collected.
Team Lift: Predicting Medication AdherenceNeil Ryan
Medication adherence is a growing public health concern in the US. It is the extent to which patients are taking medications as prescribed by their healthcare providers. Simply put, are patients eating their pills on time?
We looked at patient data from Medicare part D program released by Centers for Medicare & Medicaid services. We built a prediction model to ascertain whether a patient would be adherent based on a variety of social, economic and behavioral aspects.
Presentation by Avella Specialty Pharmacy & mScripts at Armada 2015 on improving medication adherence through mobile app technology. Learn about how Avella meets the challenges of medication non-adherence: http://www.avella.com/medication-adherence
Medication non-adherence is a growing concern, as it is increasingly associated with negative health outcomes and higher cost of care. Tackling the burden of non-adherence requires a collaborative, patient-centric approach that considers individual patient needs and results in intelligent interventions that combine high-tech with high-touch.
Medication non-adherence is a growing concern, as it is increasingly associated with negative health outcomes and higher cost of care. Tackling the burden of non-adherence requires a collaborative, patient-centric approach that considers individual patient needs and results in intelligent interventions that combine high-tech with high-touch.
Polestar Oncology is the all-in-one product to assess and connect cancer patients to the psychosocial support they need, while exceeding new accreditation requirements set forth by the Commission on Cancer. With Polestar Oncology, the multidisciplinary cancer care team can efficiently navigate patients’ psychosocial needs in the context of their medical progress.
Population health management real time state-of-health analysispscisolutions
To lower health costs, physician networks and medical homes must employ a closed loop population management program that focus on patient SOH stratification, chronic disease management, care coordination and incentive management. This approach will enable them to consistently reduce ER and inpatient admissions, which are the greatest expenditures in health care today.
Medication non-adherence is a growing concern, as it is increasingly associated with negative health outcomes and higher cost of care. Tackling the burden of non-adherence requires a collaborative, patient-centric approach that considers individual patient needs and results in intelligent interventions that combine high-tech with high-touch.
Medication non-adherence is a growing concern, as it is increasingly associated with negative health outcomes and higher cost of care. Tackling the burden of non-adherence requires a collaborative, patient-centric approach that considers individual patient needs and results in intelligent interventions that combine high-tech with high-touch.
Polestar Oncology is the all-in-one product to assess and connect cancer patients to the psychosocial support they need, while exceeding new accreditation requirements set forth by the Commission on Cancer. With Polestar Oncology, the multidisciplinary cancer care team can efficiently navigate patients’ psychosocial needs in the context of their medical progress.
Population health management real time state-of-health analysispscisolutions
To lower health costs, physician networks and medical homes must employ a closed loop population management program that focus on patient SOH stratification, chronic disease management, care coordination and incentive management. This approach will enable them to consistently reduce ER and inpatient admissions, which are the greatest expenditures in health care today.
BRP Pharmaceuticals is a leader in physician dispensing services that provides instant medication to patients located in Burbank, CA. Visit: http://www.brppharma.com/
Partners’ Care Management Strategy: A 10-Year JourneyHealth Catalyst
Chronic diseases are responsible for seven out of 10 deaths each year, killing more than 1.7 million Americans annually. Additionally, 133 million Americans—approximately 45 percent of the population—have at least one chronic disease. Partners HealthCare believes that chronically ill patients with multiple medical conditions often need the most help coordinating their care, which is why this well-respected health system has spent the last 10 years perfecting an integrated care management program (iCMP).
Key elements of the iCMP at Partners include access to specialized resources (e.g., mental health, palliative care), involvement through the continuum of care, patient self-management, IT-enabled systems to improve care coordination, data-driven analytics to support strategic decision making, a payer-blind approach, and ongoing support and training for its teams and staff.
Attendees will learn how to:
Identify the essential elements of an effective care management program for chronically ill patients
Recognize how care management plays a key role in an effective population health management strategy
Determine how to use information to identify and effectively manage complex, chronically ill patients
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
V O L U M E 3 4 - N U M B E R 4 - F A L L 2 0 1 6 187FEATURE ART.docxkdennis3
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Nurse Practitioner Perceptions of a Diabetes Risk Assessment Tool in the Retail Clinic Setting Kristen L. Marjama, JoAnn S. Oliver, and Jennifer Hayes
Diabetes is the seventh leading cause of death in the United States, burdening society with
high costs for treatment and placing increased demand on the health care system (1). According to the 2014 National Diabetes Statistics Report, an estimated 29.1 million people in the United States have diabetes, and 8.1 million of them are undiagnosed (2). The lack of screening for early identification of patients at risk for type 2 diabetes is a significant clin- ical problem. Health care providers (HCPs) need to be aware of the in- creasing diabetes burden and to pri- oritize the screening of patients who may be at risk. Screening for risk can aid in both efforts to prevent the development of diabetes and early management of the disease to reduce complications. Clinical trials have demonstrated that type 2 diabetes can be delayed or prevented through life- style modification or pharmacother- apy for people at increased risk (3).
In order to reduce risk for those at risk of developing diabetes, screen- ing is a priority that will raise patient
awareness. Many patients are not aware of their risk for type 2 dia- betes until they receive a confirmed diagnosis from their HCP. There are numerous health care settings in which screenings can be imple- mented, including but not limited to primary care practices, urgent care centers, hospital emergency depart- ments, and retail health clinics.
Retail clinics are located in retail supermarket and pharmacy chains to provide high-quality, affordable, and easily accessible health care services for communities. A true measure of quality in retail clinics is their degree of adherence to several measures iden- tified in the Healthcare Effectiveness Data and Information Set (4). Services in this type of setting may include treatment of acute episodic conditions, physical examinations, vaccinations, health screenings, and prevention and management of chronic conditions (5). Retail clinics provide services to patients with or without insurance or a primary care “home.†Patients’ visits to a retail clinic afford the opportunity to assess
■IN BRIEF This article describes a study to gain insight into the utility and perceived feasibility of the American Diabetes Association’s Diabetes Risk Test (DRT) implemented by nurse practitioners (NPs) in the retail clinic setting. The DRT is intended for those without a known risk for diabetes. Researchers invited 1,097 NPs working in the retail clinics of a nationwide company to participate voluntarily in an online questionnaire. Of the 248 NPs who sent in complete responses, 114 (46%) indicated that they used the DRT in the clinic. Overall mean responses from these NPs indicated that they perceive the DRT as a feasible tool in the retail cli.
The Affordable Care Act of 2010 (ACA) opens the door to a wealth of opportunities for hospitals and physician groups. They are beginning to adapt to the new pay-for-performance and bundled payment systems and develop population-based care management programs. While the goal of ACA is to hold hospitals and physicians jointly responsible for quality and cost of care, the new payment models span the entire care continuum, including primary care physicians (PCPs), specialists, hospitals, post-acute care, and re-admissions. The biggest winners will be those who can improve quality of care while driving down costs. Those that focus first on preventive care for top chronic illnesses will be the first to cross the finish line.
Real world Evidence and Precision medicine bridging the gapClinosolIndia
Real-world evidence and precision medicine represent complementary forces reshaping the healthcare landscape. The synergy between these realms offers a pathway to more personalized, effective, and patient-centered care. As technology, data analytics, and collaborative initiatives advance, the integration of real-world evidence into precision medicine practices holds the promise of revolutionizing how healthcare is delivered, ensuring that treatments are not only scientifically sound but also tailored to the unique characteristics and experiences of individual patients.
Predictive Risk Stratification: Using Analytics to Empower Change with Action...Health Catalyst
Effective population health initiatives are challenging to implement for a variety of reasons. Care teams are already overburdened, and healthcare data is challenging to aggregate and analyze. These factors make it difficult to accurately identify patients who are high-risk or have rising risk for poor outcomes and provide appropriate intervention. To manage patient populations effectively and efficiently, healthcare organizations must be able to automate predictive risk stratification based on claims data, clinical data, and social determinants of health. When care teams know which patients need the most help, which patients have rising risk, and which patients are healthy, they can focus their valuable time where it’s needed most. In this webinar, Dr. Welch shares best practice strategies for utilizing analytics that empower change with actionable workflows, like patient engagement, to ensure that clinically integrated entities can manage high-risk populations appropriately, while also caring for those with rising risk, and engaging with healthy populations mapped to the right targeted interventions.
Community Pharmacists and Medication Therapy ManagementDownlLynellBull52
Community Pharmacists and Medication Therapy Management
Download the strategy pdf icon[PDF - 775 KB].
Medication therapy management (MTM) is a distinct service or group of services provided by health care providers, including pharmacists, to ensure the best therapeutic outcomes for patients. MTM includes five core elements: medication therapy review, a personal medication record, a medication-related action plan, intervention or referral, and documentation and follow-up.
Within the context of cardiovascular disease (CVD) prevention, MTM can include a broad range of services, often centering on the following:
· Identifying uncontrolled hypertension
· Educating patients on CVD and medication therapies
· Advising patients on health behaviors and lifestyle modifications for better health outcomes
MTM is especially effective for patients with multiple chronic conditions, complex medication therapies, high prescription costs, and multiple prescribers. MTM can be performed by pharmacists with or without a collaborative practice agreement (CPA), and it is a strategy that can be considered to straddle Domain 3 (health care system interventions) and Domain 4 (community-clinical links).
· Evidence of Effectiveness
· Evidence of Impact
· Implementation Considerations
Strong evidence exists that the use of MTM by pharmacists is effective. Although the exact combination of MTM activities tends to vary between settings, studies examining MTM have generally found it to be effective and to have strong internal and external validity. MTM trials have been replicated in many different contexts with positive results. Implementation guidance on MTM is available from several sources, including the guidance provided under Medicare Part D.
MTM at Ohio Department of Health
In 2014, the Ohio Department of Health (ODH) teamed up with three Federally Qualified Health Center (FQHC) sites to assess the effect of MTM counseling sessions on patients with hypertension. This effort involved collaboration among the Ohio State University College of Pharmacy, Ohio Pharmacists Association, Ohio Association of Community Health Centers, and the Health Services Advisory Group. These partners helped plan and develop the assessment. Pharmacists administered MTM to 500 patients with hypertension who were receiving care at one of the three FQHC sites. After 6 months, assessments found that hypertension control had increased to 68.6% among these patients. There were key components related to the project’s achievement, which included maintaining relevant partnerships, implementing the pilot in one type of pharmacy setting, allowing FQHC sites to develop their own protocols for patient enrollment, using effective dissemination processes, and selecting data points that align with current pharmacy practices. Challenges included finding champions for the MTM model.
For more information:
Jen Rodis, Assistant Dean for Outreach and Engagement
Ohio State University College of Pharma ...
12. Integrative
Health
Practice
Tobacco
Use HBP Obesity Inactivity Anxiety Depression DM Pain
Meditation X X X X X X X
Imagery X X X X X X X
Biofeedback X X X X X X X
Yoga X X X X X X X X
Acupressure X X X X X X X
Qi Gong X X X X X X X
6 Evidence Based IH Interventions for
8 Common Chronic Conditions1
12
1From: Russo, Stitcher, & Diener. (2014). The low risk and high return of integrative health services. Journal of Healthcare Financial Management.
14. Intervention Anxiety Depression Stress Response to pain
Acupuncture X X X X
Biofeedback X X X X
PMR X X X X
Yoga X X X X
Hypnosis X X X X
Massage X X X X
Imagery X X X X
Meditation X X X X
Qi Gong X X X X
Evidence-Based IH Interventions for
Stage 3 + 4 Symptoms of Chronic Pain
19. • Treat the whole population, not just individuals actively seeking care
• Use data and analytics to make informed decisions for high utilizers
• Employ best available evidence to guide treatments
• Engage in actionable care management with condition-specific
registries.
1Sources: CMS, SAMSHA, CDC, AHRQ
Population Health:
Providers, Payors, or Public Health?
31. The Root of All Chronic Disease: Stress + Life Style “Choices”• Do we even have valid ICD-10 codes for:
– The effects of stress?
– Lifestyle choices?
– Precursors to stress?
• If we do, are clinicians documenting & diagnosing patients with it?
• Are providers prescribing anything for these patients (besides
medications)?
• If yes [such as the SMART Program] are we coding this? Do codes
even exist for such interventions?
• Do we have ANY reliable data around SMART & Lifestyle
Management programs?
Relevance to the Health Information
Professional
42. Population Health Analytics
Target High Utilizers: Multiple Chronic Conditions
42
# of Chronic
Conditions
for Patient
Unique
Patients
Total
Cases
Total
Charges
Average
Charge per
Patient
8 12 72 $696,816 $58,068
7 63 292 $2,159,642 $34,280
6 154 628 $4,517,694 $29,336
5 268 908 $6,888,829 $25,705
4 412 1,278 $7,660,776 $18,594
3 537 1,556 $7,718,457 $14,373
2 592 1,661 $6,635,607 $11,209
1 428 1,259 $4,379,734 $10,233
Chronic Total 2,466 7,654
$40,657,55
5
$16,487
Of the 2,717 High Utilizers:
§ 91% of patients (2,466) have at
least 1 Chronic Condition
§ 91% of cases and 96% of charges
are associated with patients with
Chronic Conditions
§ 75% of patients (2,038) have at
§ > 2 different Chronic Conditions
Population Health Analytics
Target High Utilizers: Multiple Chronic Conditions
48. EHR Optimization: Sample Patient Action Plan
48
Action What should I do next? Why is this important?
You are due for
your
cholesterol
blood test
Please go to any XYZ system lab for a
blood draw. You do not need to fast
UNLESS your provider instructed you to
do so. You do not need an appointment
for this test.
A cholesterol test measures the fats in your
blood and helps assess the health of your
heart, blood vessels and risk for heart
attack or stroke. It can also show if
medication you are taking is working
You are due for
a blood
pressure check
Go to an XYZ system primary care
department for a walk in no cost blood
pressure check. No appointment needed.
Monitoring your blood pressure is
important to your heart health.
You are due for
a Tdap vaccine.
Go to your XYZ medical office and as for a
“walk-in” immunization visit or you can
get this at your next scheduled visit.
The Tdap vaccine protects against tetanus,
diptheria and whooping cough.
You are invited
to participate
in an
integrative
Skills group
There is no costs to attend. Call 888-212-
2222 to register for the healthy skills
group nearest you. You can also register
for the group using this link. Click here to
find out more about healthy skills groups
and how attendance can benefit you.
Learning and practicing the healthy skills
can help you manage the symptoms of your
high blood pressure. It can also help you
manage stress, chronic pain, anxiety, weight
gain, and depression.
EHR Optimization: Sample Patient Action Plan