Accreditation Process Continues To Require Tweaks

December 7th, 2015

medical-organizationAfter nearly a decade of criticism about the hefty cost and questionable relevance of its evaluations, the Joint Commission on Accreditation of Healthcare Organizations is vowing to radically reformulate the accreditation process to spur meaningful measurement of patient care in place of rote compliance with lists of standards.

The declaration comes against a backdrop of simmering discontent from providers, declining survey volume and dozens of hospitals opting out of accreditation each year. In addition, providers are under increasing public pressure to show evidence of good clinical performance and patient-safety practices, not just good scores on surveys every three years.

But scenarios for substantial change and better attention to value have come from the Oakbrook Terrace, Ill.-based agency for more than 15 years in response to one criticism or another, starting in 1986 with the vaunted Agenda for Change initiative.

A spontaneous flare-up of provider criticism in 1994 resulted in another reform plan called Orion, which subsequently faded from view. Objections to JCAHO efforts to mandate the use of a homegrown performance measurement system led to the 1997 launch of the Oryx clinical-measure project, which handed off the development …

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Medicaid Cuts Continue To Hurt States

November 30th, 2015

medical-careCalifornia healthcare advocates have kicked off a campaign to block proposed cuts to the state’s Medicaid program, which they believe would have dire consequences for both patients and providers.

On Jan. 11, California Gov. Jerry Brown proposed eliminating $1.8 billion in state Medi-Cal funding-and sacrificing another $1.8 billion in federal matching funds-over the next 18 months as part of a sweeping effort to close the state’s $35 billion budget deficit.

But the reductions-half of which would come from cuts to provider reimbursements and half from new eligibility and benefit restrictions-would reverse many of the program’s most significant improvements since 1999 and wreak havoc on the state’s entire healthcare system, groups representing doctors, long-term-care providers, county welfare directors and the uninsured argued during a telephone conference held last week.

“Medi-Cal is the underpinning of our healthcare system,” said Mark Smith, president and chief executive officer of the California HealthCare Foundation, Oakland, which sponsored the discussion. “When you yank this much money out of the system, there will be a lot of unintended consequences.”

California is hardly alone. According to a study released last week by the Kaiser Commission …

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AMA Head Handles Many Issues

November 23rd, 2015

amaDonald Palmisano, president-elect of the American Medical Association, is a very busy man these days, fending off attacks that the doctors’ lobby is blackmailing the American public and taking its patients “hostage” in an increasingly aggressive fight against America’s trial lawyers. Luckily, Palmisano has a law degree-so at least he knows his enemy.

As point man for the AMA, Palmisano, a New Orleans surgeon, is engaged in a rapidly escalating war of words in the AMA’s effort to limit the amount of damages in malpractice lawsuits.

The most recent volley-and by far the most provocative-came from an influential law professor in Washington, who accused the doctors’ lobby of “medical terrorism” for using patients to try to force a change in tort laws.

Jonathan Turley, a law professor at George Washington Law School, denounced the actions of about 30 doctors who walked off their jobs at West Virginia hospitals earlier this month. That’s a form of blackmail, Turley suggested. “These latest walkouts are nothing short of hostage-taking: demanding huge benefits in exchange for basic medical care for captive patients,” Turley declared in a commentary published Jan. 6 in …

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Heathcare Prices Runaway In The US System: When Will The Gouging Stop?

November 16th, 2015

health-careUnleashed from the controls of managed care, hospitals hiked prices aggressively for the fourth straight year in 2002, according to government figures released last week. Industry consolidation and the easing of managed-care restrictions have allowed hospitals to pass on higher costs for labor, capital projects and technology to purchasers, analysts said.

Wholesale prices for general medical and surgical hospitals rose 3.4% in 2002, their biggest increase since 1995, according to the U.S. Bureau of Labor Statistics’ Producer Price Index. Meanwhile, wholesale prices for physician services didn’t budge after rising 2.8% in 2001 and 1.8% in 2000.

Another key inflationary gauge, the Consumer Price Index for medical care, rose 5% last year after a 4.7% increase in 2001. The increase largely reflected higher charges for hospital and related services, which were up 9.8% after a 7.1% increase in 2001, the bureau said. Stratospheric rate increases by hospitals contrasted with soft prices in most of the economy. The CPI, which reflects prices paid by urban consumers for all goods, rose 2.4%.

The figures bolster the case that hospitals are driving healthcare inflation. Earlier this month, the Centers for Medicare and …

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Stop Snoring, And Have A Good Morning!!!

November 15th, 2015

Are you waking up miserable and tired? Do you sleep next to someone who snores? Or are you the snoring culprit?

Believe it or not snoring is becoming a very common problem in most households. I have learned that many people are suffering silently with this deadly condition. I used to suffer as well. My ex-husband had sleep apnea, and while at some moments I wished he would stop breathing (I am kidding!) it was a completely miserable existence. He also had type 1 diabetes, a deadly combination.

I used to listen to him at night. It was fascinatingly sad. He would take a breath in, and then it wouldn’t come back out. As he would struggle to get the breath back out, it would wake him up and he would release the breath, take another and fall back asleep; only to start over again a few minutes later.

Shortly after, he began falling asleep on the job and pretty much hated his life, and everyone in it, including me. After he had lost his job, I decided it was time to take action. I researched methods to stop the snoring. We went through a plethora of pillows, neck straps and more. He was a proud man, and when his Doctor told him it was time for a sleep apnea machine, he refused to wear it, and ultimately I moved into our spare bedroom. I was sad to be no longer sleeping next to him but loved the new lease on life I had.

Shortly after this, I discovered The Good Morning Snore Solution at a trusted snoring product review site. I thought it was a weird concept, but what the heck, I was willing to try anything.

To fully understand how this awesome anti-snoring solution works, you must first understand the cause of snoring. When a person falls asleep, the muscles in their throat, neck and nasal area relax completely, and they are pulled backwards Read the rest of this entry »

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Maintaining Patient Health Is About Education

November 9th, 2015

mduThe risk of health problems decreases when patients take responsibility for their own lifestyle and existing disease.

The Groves Medical Centre in New Malden, Surrey – a finalist for the Medical Defence Union (MDU) risk management award – holds patient education evenings to encourage self-management and make contact with patients with undiagnosed conditions.

Rupert Lee, one of the MDU’s clinical risk managers, says: ‘This project is important because patients who have not seen their GP in a long time have been diagnosed.’

The judges were particularly impressed by the practice’s contribution to patient safety and their quality of care.

Six meetings are held each year and a variety of topics are covered.

‘We want to benefit as many patients in the practice as possible,’ says Dr Jeremy Harris, a GP at the practice.

‘We try to have at least one topic each for the elderly, women, men and children, and we also take on a clinical topic like hypertension or asthma.’

Topics are suggested by the practice’s patient participation group as well as the health professionals. Several of last year’s sessions addressed health promotion issues such as reducing …

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Five Medical Trends That Need To Go!

November 2nd, 2015

cosmetic-dentistyWanna play doctor? It’s easier than ever, thanks to the new walk-in labs and medical centers popping up in strip malls and on street corners. You can check your cholesterol and thyroid levels and rule out Lyme disease, among other things–all without a physician’s referral! And these clinics are perfectly legal in several states.

Some of the appeal, of course, is convenience: You just stroll into a lab–Quest Diagnostics is the leading provider of such services–no appointment needed. If there isn’t a walk-in lab nearby, you can go to Web sites such as www.healthcheckusa.com or www.directlabs.com. After perusing and ordering the tests you want, you’ll be directed to a lab in your area where you can have them done. For people who want to take their self-testing to a higher (and more expensive) level, imaging centers now offer total body scans–which take a 3-D image of internal organs–virtual colonoscopies, and more. These procedures are just a phone call away.

The quality of the facilities providing these services is not at issue; they must meet the same state standards as labs that don’t market directly to consumers. But …

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Modern Medicine Rocks!

October 29th, 2015

medicineNot long ago, my nephew needed a drug designed specifically to — get this — decrease the buildup of fluid behind his eyeball. Believe it or not, such a medicine exists and he got it. Not that anyone was really surprised. We’re starting to take miracle drugs like that for granted.

I’ve been known to make people run out of the room with my praise for health care in this country. It’s a known fact at our house that my kids would rather do math homework than hear me go on about it. But it’s true: Canada’s a great place to be sick.

I’m not alone. I have an ally, a physician who was quoted in the Toronto Star, saying the health-care system in this country … works darn well.” His name was Dr. Peter Carter. He was testifying at the Romanow Commission and I guess his comments were so unusual, they were news. As friends, colleagues and one spouse in particular added after they saw the story, “That is such a Peter Carter thing to say.”

So, naturally, I phoned him up. When I told him where …

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Ensuring That Surgery Is Accessible Is Easy To Do

October 26th, 2015

employment-dutyThe Disability Discrimination Act may seem like a minefield. Sarah Langton-Lockton thinks that an access audit may help

Two aspects of the Disability Discrimination Act 1995 (DDA) may be causing confusion for GPs. These are the employment duties contained in part 2 of the Act and the duties of service providers set out in part 3.

Confusion arises because of the differing nature of the duties and the timetables that apply. Most confusion is being generated by the duties to be met by October 2004.

These are being variously interpreted or misinterpreted to mean that GPs whose surgeries are not fully wheelchair accessible by this date will not be able to continue to practise in those premises.

Access rule changes

Part 2 of the DDA was introduced in December 1996. It currently applies to those employing 15 or more people in total, although they may work in several premises.

From 2004, the small-employer ceiling will be lifted and almost all employers will be covered by this part of the Act.

Part-2 duties relate to individuals – currently employed or being considered for employment – and any adjustments required …

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GPs Get It Happening

October 23rd, 2015

primary-care-teamAn RCGP quality scheme for practices is set to boost pay if GPs approve the new contract. Jennifer Taylor investigates

The RCGP launched its Quality Team Development (QTD) programme in April 2000. The aim of the programme is to assess the performance of primary health care teams (PHCTs) and identify areas for development.

GPs participating in the programme will also find that it gives them a head start on implementing the new GMS contract, if it is approved by the profession.

QTD is expected to be accredited as a way of earning points under the proposed quality framework and, in turn, extra income.

Since its launch, 45 PCTs in England have registered with the scheme and seven local health groups in Wales.

The programme was introduced in Powys with the support of the local health group. The first PHCTs to join the Powys programme were in Brecon and Presteigne.

Several steps are involved. A local group is set up within the primary care organisation (PCO) to co-ordinate the project locally and liaise with the RCGP. This group identifies local assessment teams, which usually include a GP, nurse and …

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