View the original article here
This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.
Friday, 20 September 2013
Public Health Update 09/19/13
Sorry, I could not read the content fromt this page.Sorry, I could not read the content fromt this page.
This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.
This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.
Wednesday, 18 September 2013
Alert: 5 cases of H.Flu invasive disease in Minnesota
The CDC reported this week that five cases of H. flu invasive disease have appeared in children in Minnesota. There have been no reports of similar disease in Massachusetts thus far.
One of the five children reported to the Minnesota Department of Health with invasive Haemophilus influenzae type b (Hib) disease died. Only one of the children had completed the primary Hib immunization series; three had received no doses of Hib-containing vaccine, according to the CDC. “The five Hib cases are the largest number among children aged <5 years reported from Minnesota since 1992. The cases occurred during a Hib vaccine recall and continuing nationwide shortage that began in December 2007," said the CDC.
An American Academy of Pediatrics (AAP) alert on the same date reminds pediatricians and family practitioners that it is “critically important” for all infants to complete the primary three dose series of a Hib-containing vaccine on schedule.
“Given the vaccine shortage, prolonged booster deferral, and reduced compliance with the primary series coverage, the increase in the number of Hib cases in Minnesota likely reflects a weakening of herd immunity — that is, the percentage of immunized children in the population has dropped below a certain critical level,” said the AAP.
The AAP said, “The recent cases of Hib invasive disease serve as a reminder that serious vaccine-preventable diseases do occur if infants and children are not vaccinated. Physicians also should remember to review immunization status when evaluating a child with fever since evaluation of unimmunized children with fever and/or lethargy may differ.”
Prior to widespread Hib vaccination, H. Influenzae b was a frequent cause of bacterial meningitis and epiglottitis in infants and young children.
The Massachusetts Department of Public Health has also distributed an alert, reminding practitioners to vaccinate infants against H. influenza. Providers who do not have adequate supplies of Hib containing vaccine to support a 3-dose series for healthy children (or 4 doses for high risk children) should contact the Mass. DPH vaccine unit immediately at 
617-983-6828
.
Carole Allen, MD
President, Massachusetts Chapter, American Academy of Pediatrics
Vice President, Middlesex District, MMS
Annual Education Program: How Technology Is Improving Patient Care
From electronic health records to medical devices to the latest in research, technology is continuing to push into new frontiers in medicine, and that bodes well for patient care.
In introducing the 2013 Annual Education Program, Navigating the Currents of Change: Integrating Innovative Technologies Into Your Clinical Practice, MMS President Richard Aghababian, M.D. said “Incorporating technology into our approaches to patient care is one of the biggest challenges we face as physicians today. The tools and data we now have at our disposal are truly amazing. But we must balance the machines with the humans side of medicine.”
The educational program on Friday, May 10 included four distinguished clinicians and scientists who addressed concrete examples of how the latest technologies have made advances in the surveillance, diagnosis and management of disease, and how those technologies are being incorporated into patient care.
Dr. Robert L. Jesse, Principal Under Secretary of Health at the Department of Veterans Administration, discussed health information technology and how it affects patient care.
Dr. Marc Semigran, Medical Director of the Massachusetts General Hospital Heart Failure and Cardiac Transplant Program, talked about how technology and the latest medical devices are improving and extending the lives of patients with heart disease.
Dr. Suzanne Topalian, Professor of Surgery and Oncology at Johns Hopkins School of Medicine, examined how nanotechnology and targeted immunotherapy are making progress in the battle against various forms of cancer.
Dr. John Moore, of MIT’s Media Lab, discussed the application of technology for patient empowerment within the medical home model.
The participants’ presentations, along with their biographical information, are available for viewing here.
Filed under: Electronic health records, Health IT, medical homesNew England CMS Director Says Physicians Must Adapt
The “dizzying” pace of change in our health care system requires physicians to adapt quickly to this new world, says chief medical office of CMS’ New England Region, Dr. William Kassler.
Speaking at the Massachusetts Medical Society’s health IT conference on Friday, Dr. Kassler began his remarks by outlining the impressive breadth of innovation occurring at the national level.
He then told physicians in the audience that the only way to take advantage of these innovations is to embrace information technology.
Later, in response to a question about whether physicians should wait to adopt EHRs until interoperable health information exchanges become a reality, Dr. Kassler said, “I reject the idea that you need a fully functional EHR to get the benefits.” He said the benefits from the decision-support tools in a freestanding EHR is “reason enough to invest.”
Filed under: Electronic health records, Electronic Medical Records, Health ITDavid Blumenthal: Physician Professionalism and Health IT
Dr. David Blumenthal, the leader of the federal government’s health IT initiative, keynoted the MMS’ health IT conference with remarks today asserting that adoption of health IT is a professional imperative for physicians.
“Information and its management is a core competency for the profession,” he said. “Can we be technically competent if we don’t manage information using the most capable and available technology?”
Dr. Blumenthal also extolled explosion of innovation in the EHR industry, and that every major electronics company is trying to build a better EHR. He said a “tidal wave of change” is coming, and predicted there won’t be another opportunity in our lifetime to have the government subsidize the implementation of EHRs.
Filed under: Electronic health records, Electronic Medical Records, Health ITKey Similarities and Differences Between the House and Senate Payment Reform Bills
After two years of discussion and debate, the Massachusetts Legislature must now deal with two huge pieces of payment reform and cost control legislation.
Earlier this week, the House passed its legislation by a wide margin, following eight hours of deciding which of 275 amendments it would accept. The Senate passed a separate bill on May 17.
During the House debate this week, the MMS sought to protect most small and medium physician groups from the House’s very rigorous reporting requirements. The original House bill exempted groups with fewer than 10 physicians. Due to MMS advocacy, the House agreed to increase the exemption to 25, which we will try to increase further during the conference committee’s deliberations.
When the members of the conference committee are appointed, they will have until adjournment on July 31 to agree on a single bill and get it passed by both chambers.
Despite their many similarities, reconciliation and consolidation of the bills is not expected to be an easy task.
Key Similarities
Cost containment: Each bill states that overall health care costs should rise in concert with the growth in the state’s economy. (Differences noted below.)State oversight: Each creates a new state agency to certify provider groups, and collect volumes of information on quality measures and costs. The House agency is placed inside the executive branch, under the Executive Office of Health and Human Services. The Senate agency is an independent entity.Market power: Both bills require payers to negotiate separate contracts for each hospital facility, with some exceptions.Alternative payment models: The bills define ACOs and their requirements. They provide a 2 percent bonus in Medicaid payments to providers starting in July 2013, if they move to alternative payment methodologies.Electronic Health Records: Each requires physicians to be proficient in the use of electronic medical records. (Differences noted below.)Medical liability: Both mandate waiting periods for civil suits brought against health care providers. They require disclosure of case information to patients and providers; protect statements of apology from being admissible as evidence; provide for early payments to patients without prejudice. They reduce the prejudgment interest rate in malpractice cases from 4 percent to 2 percent. No contract may prohibit a physician from serving as an expert witness.Determination of Need: They expand the Determination of Need process to include more new technologies, transfers of ownership and site expansions.Administrative simplification: Both bills require standards forms for utilization review.Peer review: Both bills expand the peer review statute. The House specifically provides ACOs with peer review protection; the Senate provides such protections to any provider group that conducts peer review activities.Charitable immunity: They raise the charitable immunity cap from $20,000 to $100,000 (affects most hospitals in Massachusetts).Physician assistants and nurse practitioners: Each bill provides more independence to physician assistants and nurse practitioners.Limited service clinics: Both bills eliminate some existing regulations for the operation limited service clinics, such as those located in pharmacies; however their approaches differ.Key Differences
Cost Containment
The House’s benchmark is 3.6 percent for 2012 and 2013. In 2014 and 2015, it would be equal to the growth rate projected in the Governor’s budget submissions. From 2016 to 2026, it would be equal to a half percentage point below the Gross State Product (GSP) from 2016 to 2026, and equal to one point above GSP after 2027.The Senate’s cost benchmark is a half point above GSP through 2015, and equal to GSP from 2016 to 2026.The House imposes a penalty on providers who costs are 20 percent higher than the benchmark. It establishes rate setting for governmental units. The House gives the state the ability to force providers to reopen contracts that it considers contributing to excessive spending. The House gives the attorney general to block unreasonable increases in rates, and block changes that adversely affect patient access and the quality of care. In the Senate bill, groups that exceed the benchmark must file improvement plans.Market power
The House subjects provider groups of 10 or more physicians to a market impact review. The Senate gives the attorney general the power to prevent excess consolidation and collusion.Certification
The House requires any physician group with 25 or more physicians to be certified by the Department of Public Health. The Senate requires certification for all providers entering into alternative contracts. It exempts groups with less than $500,000 in annual net patient service revenue and fewer than five affiliated physicians, if the group does not accept risk.Electronic Health Records
The House requires providers to adopt EHRs that are fully interoperable and connect to the statewide health information exchange.The Senate updates existing the requirement for EHR proficiency by 2015 by requiring physicians must demonstrate the skills to comply with the federal government’s meaningful use requirements. It creates an institute to facilitate the implementation of interoperable records statewide, and promote the use of other health information technologies.Filed under: Accountable Care Organizations, Defensive medicine, Electronic health records, Electronic Medical Records, Health IT, Health Reform, Malpractice, Mass. Legislature, medical liability reform, Payment ReformTuesday, 17 September 2013
State Seeking Input on How to Spend Health IT Funds
The Massachusetts Health Information Technology Council has scheduled five hearings to hear suggestions how it should implement electronic health records (EHRs) and health information exchanges (HIE) for physicians and hospitals across the state.
Depending on who's doing the estimating, Massachusetts will get between $40 million and $70 million over the next year from the federal stimulus bill to promote EHRs and HIEs. What should we spend it on? The council wants to hear suggestions.
The hearings will be held at five locations from April 13 to April 28.April 136:00 – 8:00 pm
Massachusetts Medical Society
860 Winter St.
Waltham, MA
April 14
10:30 am – 12:30 pm
Baystate Educational Center (up to 75 people)
361 Whitney Avenue
Holyoke, MA
April 22
10:30 am – 12:30 pm
Plymouth South Middle School
488 Long Pond Rd
Plymouth
10:00 am – 12:00 pm Boston
1 Ashburton Place
21st floor, Conference Rooms 2 & 3
Boston
(This hearing will focus specifically on issues pertaining to public health)
April 28
10:00 am – 12:00 pm
Worcester City Hall
Levi Lincoln Chamber
455 Main Street
Worcester
Here are the questions that the council says it wants to explore:
What are the greatest barriers and challenges facing physicians and hospitals in implementing EHRs/HIEs that will qualify for Medicare and Medicaid incentive payments?Are there different types of barriers for Primary Care, Specialists or different specialties?What implementation strategies should the Commonwealth pursue to assist hospitals, physicians, health centers, and others to qualify for federal incentive payments to adopt and implement Electronic Health Records (EHRs) with a Health Information Exchange (HIE)?
Should we prioritize by provider types?
Should HIE be a high priority where there is substantial penetration of EHRs?What types of financing strategies, should the Commonwealth consider to assist hospitals and physicians to implement EHRs and HIEs?
How should the State prioritize using its limited funds?What other kinds of assistance do physicians and hospitals require to adopt these technologies?Under the Federal Stimulus bill, there are significant changes to the Privacy rules/HIPAA which create conflicts between HIE and privacy. How should information be exchanged or shared without compromising the security of the data, and the privacy of the patient?What are the major challenges that Public Health Hospitals and community health centers will encounter and how can stimulus funds assist them?How can the state best ensure that EHR/HIE implementation will enhance population health and allow local communities and the state to enhance public health reporting and surveillance?What outcomes should the federal government and the state track to document the benefit of EHR/CPOE on health care quality?What experiences have you had with EHRs or HIE? What lessons have you learned from this experience? What lessons learned from North Adams, Newburyport and Brockton should the state take into account while developing and implementing a statewide plan?What can the role of the state be to enhance the position of local HIT companies for a national role?Does the availability of federal stimulus funding in the form of Medicaid/Medicare incentive payments change your views on the adoption and use of EHRs? Why or why not?Have you already received assistance from a hospital, independent practice association, non profit or government organization in the implementation or use of an electronic health record? If so, has the assistance been effective?What are the aspects of EHR/HIE that are most important to consumers? (e.g., patient portal, clinical decision support, privacy)How can the private sector help to accelerate HIT implementation?Filed under: Health IT
MMS on Meaningful Use Criteria: “Too Much, Too Soon”
The MMS told the Centers for Medicare and Medicaid Services today that its proposed rules for a national electronic health record incentive program are too aggressive, and would deter many physicians from participating in the program.
The MMS said the program “asks for too much, too soon” from many physicians, especially those in small practices. Read the MMS letter here. (.pdf, 6 pages)
The comments were a response to the federal government’s proposed definition of “meaningful use,” the criteria that would determine whether physicians can recoup more than $40,000 of Medicare or Medicaid subsidies per person for installing an EHR. Today was the deadline to submit comments on the widely anticipated rulemaking.
Among the proposal’s shortcomings, according to the MMS:
Not enough representation from small practices on its advisory committeePediatricians are disadvantaged because few would meet the minimum 20% Medicaid patient panel to qualifySpecialists are disadvantaged because the criteria are focused on primary care physiciansThe high administrative burden on small practices, who must redesign their workflow to implement an EHRHospital based physicians who also practice in outpatient clinics are unfairly excluded from the programThe MMS recommendations include:
Lengthen the schedule for adoption and complianceReduce the number of required criteriaProvide partial reimbursement for partial completion of the criteriaCreate a separate track for those who do not yet have full health IT capabilitiesThe American Medical Association’s comments today were similar. In a document co-signed by 94 state and specialty medical societies (including the MMS), the AMA said it worries that physicians who install an EHR will find the requirements “overly complex and unattainable.”
The American Hospital Association called for a “rational timeline,” and criticized the lack of clarity in several sections of the proposed rules.
Filed under: Health IT, meaningful use, MedicareData Tracking and Analytics: No Longer Avoidable in Physician Practices
In an age where the federal government has settled on a total of 33 quality metrics in its final rule for accountable care organizations, figuring out how to track data and meet quality and performance benchmarks is becoming a critical part of a physician’s role in providing quality care to patients.
More practices in Massachusetts are focusing on data and analytics, because where risk-based contracts and accountable care delivery models are becoming increasingly prevalent. Understanding practice level and physician level data is a key to success, starting at the point of payer contract negotiation.
Many practices are challenged by where to start, which is not surprising given the alphabet soup that exists in terms of recognized metrics, HEDIS, NQF, NCQA, PQRI, PCPI to name only a few.
The good news is that while many are just beginning on this path, several practices have been operating in the data and analytics space for many years, and they are happy to share their lessons learned as well as the upside and downside of their experiences.
One such practice, South East Texas Medical Associates (SETMA), under the leadership of Dr. Larry Holly, has worked to hone its data analytic capabilities to successfully manage their patient population, and has demonstrated success in improving metrics in areas such as diabetes management.
Of course, this is the result of years of evolution and a level of comfort with the metrics that are being tracked. That being said, SETMA has demonstrated success in working with the plans in risk based contracts as a result of their efforts.
Again, it took years for SETMA to perfect its strategy. One should not fear data tracking and analysis but embrace the initiative by starting with a few metrics that are important to the practice. There is plenty of opportunity to tweak, improve and revise your processes over time.
As experienced practices such as SETMA will tell you, it’s about starting somewhere and perfecting your process over time. On that note, why not start now?
If you’d like to learn more about how to approach data and how organizations like SETMA were able to successfully use data, join us at MMS on March 30th for the program titled “The Importance of Data in Physician Practice”. Visit http://www.massmed.org/DataAnalytics2012Filed under: Accountable Care Organizations, Electronic health records, Health IT, meaningful use
CMS to Delay ICD-10 Implementation
The acting administrator of the Centers for Medicare and Medicaid Services said today her agency may delay adoption of a complex new insurance coding system.
Speaking at a conference of the American Medical Association on Tuesday, Marilyn Tavenner (right) said CMS is considering giving the nation’s doctors more time to switch to the ICD-10 systems. Currently, the law requires implementation by October 2013.
(UPDATE: On Feb. 16, the CMS formally announced an indefinite postponement of the deadline to comply with the ICD-10 system.)
“I’m committing today to work with you to reexamine the pace at which we implement ICD-10,” Tavenner said to loud applause from hundreds of physicians. “I want to work together to ensure that we implement ICD-10 in a way that (meets its) goals while recognizing your concerns.”
Proponents say the switch from ICD-9 to ICD-10 will bring the U.S. medical system in line with much of the rest of the world, while allowing health officials to better track the nation’s health and monitor diseases. The new system has some 68,000 codes, five times the amount under the current system.
The AMA and other physician groups say switching to ICD-10 coding will cost medical practices anywhere between $83,290 and more than $2.7 million, and that the pressure is too much while physicians are also coping with complex new electronic health record requirement mandates.
Lynda Young, M.D., president of the Massachusetts Medical Society, praised Tavenner’s openness to delaying ICD-10 implementation.
“This is a good thing, and it will give us more time to get ready,” said Dr. Young. “There are serious time and cost issues for practices trying to implement all of these changes at once. We want to give people a chance to take care of the other changes first.”
Tavenner said her office would formally announce its intention to craft new regulations within the next few days.
More on the CMS announcement:
–Erica Noonan
Filed under: Electronic Medical Records, Health ITState Steps Up EHR Support Services for Physicians
The state agency charged with helping physicians and hospitals implement electronic health records has released its list of 18 certified “implementation organizations” to act as consultants to practices during the implementation process.
They range from hospitals and health care systems, to private consulting firms, to even a few EHR vendors themselves.
The state also unveiled a list of 10 certified vendors of EHR software, and said that it’s made arrangements through Webster Bank to provide loans to physicians to help them purchase and install the software.
In addition, Dr. JudyAnn Bigby (pictured), secretary of the state Executive Office of Health and Human Services, issued an open letter today to all physicians inviting them to take advantage of the state’s support services. (.pdf)
She wrote, “As a physician, I understand that making the transition to electronic health records is challenging, but the Patrick Administration and the team of professionals at the Regional Extension Center will help you every step of the way.”
She invited physicians to become members of the state’s Regional Extension Center, which will provide direct support services to practices worth $4,500, upon payment of a registration fee up $600 to $800. The application form is available here. (.pdf)
General information about EHRs from the Massachusetts eHealth Institute is available to anyone, regardless of whether they’ve joined the Regional Extension Center.
Filed under: Electronic health records, Electronic Medical Records, Health IT, meaningful usePublic Health Update 09/05/13
Sorry, I could not read the content fromt this page.Sorry, I could not read the content fromt this page.
Benefits of Magnetic Therapy
Avoid suffering from all the pain and agony with the help of magnetic therapy. It helps in instant and long lasting pain relief. Numerous cases have proved that the therapy can help relieve a pulled back muscle, a sprained knee, a sinus inflammation, a carpel tunnel syndrome, a swelling, an ulcer treatment or even a recurring head ache
Celebrity Makeup Tips
Celebrities suffer from bad skin, dark circles and puffiness too, which is why professional makeup artists like to apply cream concealer to affected areas with a fluffy eye-shadow brush. Brushes are great for the initial application of concealer, go over it lightly with a fingertip to ensure the product has been well-blended.
How to Deal with a Selfish Spouse
If your spouse is acting selfish, it means he/she is unconsciously hinting at something. Try to talk with them to find out if there is actually something bothering them. You both have to respect each others feeling and decisions.
Effects of Crack
Many addicts shell out exorbitant amounts of money to buy and use crack cocaine. They are only harming their health in return for their huge expenses. Crack has several debilitating short-term and long-term effects. In this article, we detail the effects of crack which may persuade you to never use this dangerous drug again.
Crack creates a short-lived and intense high which is followed by edginess, intense depression and craving. Crack addicts find it difficult to sleep or eat properly. They could experience convulsions, muscle spasms and increased heart rate. Some users can become anxious, hostile, angry and paranoid.
Crack addicts are at higher risk of breathing failure, seizure, stroke and heart attack, which can cause sudden death.
These include bleeding, lung damage, shortness of breath and respiratory problems like coughing. Addicts can suffer severe damage to the kidneys, liver and heart. They can become more vulnerable to infectious diseases. Continued addiction can cause loss of appetite and sleep deprivation. Appetite loss can lead to malnutrition. Smoking crack can also make the addict prone to paranoid and aggressive behavior. As the addict’s brain get used to the crack, they need more and more amounts of the drug just to feel normal.
Because of the high price of crack, the addict may even kill to get their hands on the drug. And if they can’t get the drug, they may even commit suicide.
Seizures, convulsions and even death if the dose is highPsychosis and painIntense craving for the drugDepressionParanoia and anxietyIntense euphoriaIrritability, hyper-excitability and hallucinationsErratic, bizarre and violent behaviorHyper-stimulationNauseaDisturbed sleepDilated pupilsIncreased breathing rateContracted blood vesselsIncreased body temperature, blood pressure and heart rateLoss of appetiteTolerance to the drug and addiction, sometimes after just one useSevere depressionPsychosis or deliriumMood disturbances and irritabilityConfused exhaustion, apathy and disorientationInfertility, reproductive damage and sexual problemsHallucinationsSevere tooth decayWeight loss and malnutritionAbscesses and infectious diseases if injectedRespiratory failureSevere chest painLung, kidney and liver damageIncreased risk of high blood pressure, strokes and heart attacksResource: http://www.drugfreeworld.org/drugfacts/crackcocaine/effects-of-crack-cocaine.html
To learn more about the effects of crack, please watch this video:
Makeup to Hide Scars
Scars are a source of shame, pain, and embarrassment for most people. Many people try their best to hide their scars by using a scarf or extra clothing. However, make up can do wonders by hiding your scars. So, read onto know how to hide and cover up scars with makeup.
Magnetic Bracelets for Joint Pain
It is noticed that the pressure and warmth received from the bracelet have been very relieving experience, magnets helps in restoring proper balance in human cells and promote healing by stimulating cell growth in healthy patterns.
Magnetic Therapy Products for Injuries
Knee pain is considered to be a very common problem nowadays in many sports such as football, hockey, tennis, golf and cycling. Knee wraps are an excellent product, as they work to pain reliever.
The Benefits of Titanium Bracelets
Titanium bracelets are fashionable accessories, but it is more effective in the form of magnetic therapy as it functions like a relieving agent for most of the pains. They are very safe and easy to wear, and helps in reducing the symptoms of back pain.
Tips and Tricks To Apply Make Up
Sharing make-up products leads to transfer of bacteria from one person to another, especially eye makeup. If you are prone to allergies on the skin, use latex free makeup. This minimizes the risk of formation of allergies
Yoga for Stress Relief
Inhale and lift your tail bone, get your back in arched position, and gently look up. Exhale and return to the previous move. Repeat this for several breaths and perform the Cow’s pose as you inhale and Cat’
On an inhale, lift your tailbone, arch your back, and gently look up. Then exhale and return to Cat, the previous move. Repeat for several breaths, performing Cow as you inhale, and Cat as you exhale.
Yoga Poses That Make You Happy
This is another excellent pose for relieving stress, which plagues your mind and body. It invites inner peace. All you need to do is extend the arms forward and the feet into the air. You can bend your legs but remember do not hunch.
Yoga Postures – The Types!
These poses can be helpful to anyone and they involve the waist, arms and legs. Few standing postures include sun salutation, mountain pose, side-angle pose, side stretch pose and warrior pose. These can be done to increase your stamina and for various other purposes.
Subscribe to:
Posts (Atom)