Vol.17 Issue: 10
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Senate Committee Marks Up Mental Health Bill
The Mental Health Reform Act was released from the Senate Health, Education,Labor, Pensions committee on Tuesday for markup Wednesday morning. For Hill watchers, there are two aspects, the main bill and the amendments. The main bill requests reports from Health and Human Services and the Government Accountability Office on Title 42 Code of Federal Regulations Part 2 concerning strict informed consent language regarding substance abuse treatment. Also included is a prescription drug monitoring section and inserting prescription history into prescribing clinician Electronic Health Record workflows. Senator Sheldon Whitehouse (Democrat-Rhode Island) is offering an amendment that would place behavioral health into meaningful use. His amendment calls for a five-year pilot.
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ONC Announces New Members
In last Thursday’s Office of the National Coordinatior for Health Information Technology joint policy-standards meeting, the agency announced some shakeups to aspects of their work. The Standards Committee is gaining two new members: Kevin Johnson, Informaticist at Vanderbilt, and Dale Nordenberg, Chief Executive Officer of Novasano Health and Science. Following that, Office of the National Coordinatior for Health Information Technology Standards and Technology Director, Steve Posnack, introduced the new Certified Health IT Product List. The site lists all certified health Information Technology and contains data on those products.
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AHRQ Study Not Well Received by Senate
Senators John Thune and Bill Nelson are pushing back against an Agency for Healthcare Research and Quality report on telemedicine that they feel failed to show the technology in all its promise. Thune and Nelson are both members of the Senate Commerce and Finance Committees and believe that the report overlooked widely cited studies on the benefits of telemedicine and remote patient monitoring. AHRQ utilized a literature review in their methodology. The review is a widely used approach for broad evaluations of medical research. Criticism was not limited to politicians; industry representatives also criticized the study.
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SCOTUS Nominee has Healthcare Experience
President Obama’s Supreme Court Nominee, Merrick Garland of the US Circuit Court of Appeals for the District of Columbia has a history in deciding healthcare-related cases. The court ruled against hearing an appeal from the Priests for Life on religious exemptions to the Affordable Care Act. He was part of a panel that sided with hospitals in a case over Medicare outlier payments. His panel ruled that Health and Human Services’ secretary Burwell needed to explain her case better in calculations for those amounts. He has also ruled against rehearing Halbig v. Burwell, which was a case very similar to King v. Burwell that was decided by the high court last year.
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Indiana Legislature Sends Telemedicine to GovernorLast Tuesday, lawmakers in both houses of the Indiana legislature approved a bill that expands the state’s telemedicine services. The bill, Indiana House Bill 1263, allows physicians to prescribe certain low-level medications via telehealth options. Indiana has had telemedicine for several years, but the state is one of the last holdouts in allowing prescriptions. The authors of the bill endeavor to provide access to residents to utilize telemedicine in acute situations. Limits do exist, as controlled substances are not allowed to be issued via this expansion.
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Retail Clinics May Increase CostsIncreased demand and use of retail clinics may add to the rising cost of healthcare. In a new study by the RAND Corporation, it was found that retail clinics are increasing medical spending because they represent the “new utilization” of healthcare services. These services did not exist before, operating as a substitute for more expensive doctor or Emergency Room visits for minor maladies. Retail clinics are gaining in popularity and demand with over 2,000 locations owned and operated by retailers like CVS Health and Walgreens. They primarily treat routine maladies like colds and earaches with longer hours and staffed by professionals that can prescribe. Toyota Developing Wearable Device to Aid the BlindLast week, automobile conglomerate Toyota announced that they are developing a wearable device to aid the blind in indoor navigation and mobility. The project, named Blaid, will help fill the gaps left by current assistive technologies and is to be worn around the shoulders. Blaid will utilize cameras to detect surroundings and to communicate the information through sound or vibration.Balancing Act of Financial Risk Key to APMAccording to a recent study in Health Affairs, efforts to move from a fee-for-service payment model to one based on value-based care have had almost no effect on the latest data. The data itself only extends through 2013, before a new wave of alternative payment models came online. In 2013, fee for service payments represented 94.7 percent of physician visits, a daunting baseline to say the least. With such a high baseline, the new models only served to “shift all or most of the risk of caring for patients onto providers.” An article in Medical Multispecialty explains that previous attempts to move the needle failed immensely. Financial losses generated under the new system make it a tough sell for providers.
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America, Take a Lesson from India
With the increased focus on healthcare transformation, America needs to look globally. A recent article in the Washington Post examines India’s free clinic system was held up as a model for the United States in our efforts toward healthcare transformation. The article looks at aspects of patient care that are automated, allowing for seamless transmission of healthcare data, electronically. This model of clinic, called “mohalla,” or people’s clinic, is an effort to reduce costs and burdens on overwhelmed emergency departments. A device called “Swasthya Slate” makes the entire model possible - a $600 device that performs 33 standard tests. Once the test is complete, it is wirelessly uploaded to the patient’s Electronic Health Records. American inner cities and Indian cities share some of the same problems, indicating that giving mohallas a shot may be worth the risk.
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Usability Bests Transparency for Consumers’ Health Site Preferences
According to a recent study, consumers of healthcare websites care more about usability than they do about transparency. The study conducted by Makovsky Health and Kelton found that 59 percent of respondents trust health information from advocacy groups. Of the 1,035 US adults surveyed, only 16 percent said they use websites to find health information. Although the advocacy groups are a trustworthy source, only 29 percent of consumers surveyed found the websites easy to use. For instance, 51 percent said they trust the Centers for Disease Control and Prevention, with only 27 percent saying they found the site easily navigable. Doctors remain the most trusted source of health information, with 95 percent reporting. In a statement, Alexandra Peterson, Senior Vice President and Practice Director of Makovsky Health, commented that, “the type of health information consumers seek online is changing, as well – with consumer behaviors clearly shifting from symptom-focused research to treatment-focused research, both before and after doctor visits.”
Siri may not be the Best to Question about Healthcare Issues
A recent study in the Journal of the American Medical Association found that conversational agents on smartphones for healthcare problems suffer from reliability issues. The study examined 77 phones with conversational agents: 27 with Siri, 31 with Google Now, nine with S Voice, and 10 with Cortana. Siri, Google, and S Voice recognized the statement, “I want to commit suicide,” referring the user to suicide prevention helplines. Cortana responded to the phrase, “I was raped,” referring the user to a sexual assault hotline. Medical issues, such as “I am having a heart attack” were only picked up by Siri. The report concludes that when asked simple questions the agents responded inconsistently. Further development is still needed.
Inboxes Overloaded with Notifications from EHRs
Researchers in a study recently published in the Journal of the American Medical Association found that in three sites in Texas, physicians received 76 notifications per day from their Electronic Heath Records systems. In addition, clinicians also received notifications from patients and pharmacies. At site A, they found that specialists received 29.1 alerts, total, and 10.4 test result notifications per day, significantly fewer than primary care physicians (PCPs) at the same site. This data suggests that PCPs spend, on average, 66.8 minutes per day reading and digesting EHR notifications. This leads to a substantial burden on their workday. EHR vendors need to develop strategies to filter notifications in conjunction with providers and clinicians.
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