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eNews - July 2007 •

No Free Lunch

by Mike McBrideHealth Management Technology

As predicted, healthcare technology and universal coverage are top issues in the presidential debates. In addition, Congress is scrambling to push through health spending bills designed to incentivize providers toward nationwide adoption of EMRs/EHRs, RHIOs and the NHIN. You could say that this is good, that it is as it should be.

Read the full editorial

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The Future Looks Bright for HIT Careers
AHIMA launches first-of-its-kind Web site to attract potential new talent into the field of health information management.
(more)


Boarding a Critical Challenge, Say Studies
Study reveals one in four physicians have personally experienced the loss of a patient due to the practice of emergency department (ED) boarding.
 (more)


“Please, Anywhere But There”
Study reveals hospital inpatients prefer to be boarded outside of the ED and in inpatient hallways by a margin of three to two.
(more)


HHS Advisory Body Transitions to Private Sector
AHIC establishes timeline for its own retirement and hires firms to create successor organization. (more)


Private Drug Plan Woes
Medicare Rights Center testimony before House subcommittee suggests consumer protection is lacking for older and disabled Americans.  
(more)


The Future Looks Bright for HIT Careers

According to the U.S. Bureau of Labor Statistics, the field of computer and information systems managers that includes professions in health information technology (HIT) and technology management are forecast to grow faster than the average for all occupations through the year 2014. In response to this robust growth trend in demand for HIT-professionals, American Health Information Management Association (AHIMA) launched HealthInformationCareers.com, which, according to AHIMA, is the first Web site of its kind. The site is geared toward high school students or others considering a career change, and aims to recruit talent and bring more qualified and trained people into the fields of health information management (HIM). Featuring a clean, elegant design, the easy to navigate site offers information about the HIM field, academic pathways to various careers within HIM, a useful FAQ section, advice on how to finance education opportunities and more to assist those considering a HIM career to make an informed decision.

Click here to access the site.



Boarding a Critical Challenge, Say Studies

One in four: That’s the number of physicians in some cases who have personally experienced the loss of a patient due to the practice of emergency department (ED) boarding, according to one study by the American College of Emergency Physicians. The organization surveyed 2,821 of its members in Connecticut, New Jersey and New York, who responded that boarding patients in hospital hallways because of overcrowded EDs is a worsening issue, often resulting in tragic consequences. According to “Emergency Department Crowding: A Point in Time,” published in the August 2003 Annals of Emergency Medicine, boarding exacerbates the dilemma by perpetuating a type of negative feedback loop where the symptoms worsen the condition.

The study found that the practice of boarding itself, as well as a shortage of on-call physicians, is a primary trigger of overcrowding in EDs and also of ambulance diversion, and further reveals that overcrowding is a condition occurring throughout all regions of the country, in public hospitals and private, teaching hospitals and non-teaching. The study surveyed nearly 90 hospital EDs throughout the country and 73 percent of them reported boarding two or more inpatients. Boarding contributes to further crowding because these often critically ill patients waiting for a bed in the ICU require emergency medical equipment and staff attention, which further reduces the ability of the ED to treat additional severely injured and sick patients.

Researchers found that ED-boarded patients also face a shortage of on-call specialists, another cause—and symptom—of the condition. Patients waiting for consultations by on-call physicians in EDs accounted for 7.6 percent of patients, and 36 percent of those EDs surveyed reported two or more patients waiting for consults, as well as an open bed.

Click here to read an abstract of the published study from the Annals of Emergency Medicine Web site.


“Please, Anywhere But There”

Conversely, a May 10, 2007, study published online in the Annals of Emergency Medicine entitled “Emergency Department Patient Preferences For Boarding Locations When Hospitals Are At Full Capacity” reveals that hospital inpatients would most likely prefer to be boarded outside of the emergency department (ED) and in inpatient hallways by a margin of three to two. Conducted over a period of four weeks at an urban teaching hospital, the study surveyed more than 431 admitted patients. Of those who expressed a specific boarding location (64 percent of the total), 59 percent preferred inpatient hallways and 41 percent preferred ED hallways. The median weekly ED boarding time recorded during the study ranged from 8.5 hours to just over 12 hours.

Patient preference is one reason the study gives for transferring admitted patients out of the ED. Other reasons include reducing ED crowding, locating patients geographically closer to their inpatient physician and allowing the patient’s care plan to be implemented more rapidly and effectively.

Click here to read an abstract of the published study from the Annals of Emergency Medicine Web site.


HHS Advisory Body Transitions to Private Sector

The American Health Information Community (AHIC), the federal advisory panel that supplies recommendations on rapid adoption of interoperable health information technology to the Secretary of the U.S. Department of Health and Human Services (HHS), recently established a timeline for its own retirement. During its fourteenth meeting, held in Washington on June 12, AHIC heard detailed presentations from three consulting firms it hired for approximately $100,000 each. The healthcare IT advisory group awarded the contracts to the firms to engineer an independent, voluntary, private sector-based AHIC Successor Organization (ASO) and to draw up a roadmap ensuring a smooth transition. AHIC’s charter outlines its own termination within two to five years of operation.

Consultants from Booz Allen Hamilton Inc., Avalere Health LLC and Alchemy LLC delivered business models for sustainability of the public/private entity, governance structures and transition plans. HHS’ Office of the National Coordinator of Health Information Technology says AHIC will implement a prototype from among the proposals later this summer that will incorporate public comment from the Federal Register given during a 3-week period. A final prototype for the ASO and transition plan will be introduced at AHIC’s September 18 meeting. The new ASO will begin operating alongside the current form of AHIC this November with an interim board in place by early 2008 and permanent board named by January 2009. The next AHIC meeting will be held on July 31, 2007.

Click here to read the consulting firm’s presentations to AHIC on the HHS Web site.


Private Drug Plan Woes

The Medicare Rights Center recently testified at the U.S. House of Representatives Committee on Ways and Means Subcommittee on Health that consumer protection is lacking for older and disabled Americans enrolled in Medicare private drug plans. Testimony from Deputy Policy Director Paul Precht included a number of concerns, such as computer system inadequacies, that cause problems for plan enrollment. The problems are many and varied, but involve lack of interaction between Medicare, private drug plans and Social Security. Precht also noted that victims of private plan marketing abuse are waiting months to have their coverage corrected in spite of systemic safeguards meant to address such problems. The Medicare Rights Center is generally and specifically drawing attention to the lack of oversight that allows these and other problems to result in unacceptable costs and stress to plan participants and those waiting to enroll.

Click here to download a PDF of Precht’s testimony and recommendations.


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