Clinical

Where to start with an effective analytics program? A big staff and bigger budget are not prerequisites, says Karen Reff, manager of decision support at Union General Hospital.

Healthgrades published its ratings of hospitals across the country, and also launched its Risk IQ Tool to help consumers assess their personal risk to six common surgical procedures. It varies from region to region – even from city to city. And it depends what type of care or procedure you need. Some hospitals and physicians are better at some procedures than others. In other words: patient beware. Denver, Colo.-based Healthgrades bills itself as the leading online resource for comprehensive information about physicians and hospitals. It calls its Risk IQ Tool the first to help patients assess their personal risk as it relates to six common surgical procedures and also to help patients find the right hospital and physician for the procedure.  The Healthgrades report also takes into account patients’ risk for complications and mortality with common surgeries along with relative driving distance to hospitals in general, and to hospitals shown to have the best outcomes in a particular surgery or procedure. “The report shows that consumers need to educate themselves before any surgery and get the facts on their personal risk in order to improve the likelihood of a positive outcome,” Healthgrades Chief Strategy Officer Evan Marks said in a statement. [EHRs getting better? Readers rank vendors higher than last year in new survey] Making that happen, however, is complicated. The Healthgrades analysis found clinical and quality outcomes in hospitals vary drastically across the country. Its Report to the Nation evaluated the performance of nearly 4,500 short-term acute care hospitals nationwide, assessing hospital performance relative to each of 32 common conditions and procedures, as well as an evaluation of comparative outcomes in appendectomy and bariatric surgery using all-payer data provided by 18 states. The results showed wide gaps in outcomes: Healthgrades found patients treated from 2013-2015 at hospitals receiving a five-star rating have, on average, a 71 percent lower risk of dying and a 65 percent lower risk of experiencing one or more complications during a hospital stay than if they were treated at a hospital receiving a one-star rating in that procedure or condition. From 2013-2015, if all hospitals as a group performed similarly to hospitals receiving five-stars as a group, on average 223,412 lives could potentially have been saved and 162,215 complications could potentially have been avoided. Patients have varying relative risk for complications and mortality with common surgeries. Patients having surgery in hospitals rated five-stars will have a lower risk of experiencing a complication or dying than if they were treated in a hospital rated as one-star in six common surgical procedures. Patients having knee replacement in hospitals rated 5-stars have a 67 percent lower risk of experiencing a complication, or dying than if they were treated in hospitals rated 1-star. For hip replacement it was a 73 percent lower risk; pacemaker procedures, a 57 percent lower risk; CABG – Coronary artery bypass grafting – an 86 percent lower risk; hysterectomy, a 60 percent lower risk; and bariatric surgery, a 72 percent  lower risk. Healthgrades also took into account the patients relative driving distance to hospitals in general, and to hospitals demonstrating superior outcomes in a surgery or procedure and concluded outcomes can be dramatically different from city to city.   The HIMSS and Healthcare IT News Big Data & Analytics Forum takes place in Boston, Oct. 24-25. What to expect: ⇒ Charlotte hospitals analyze social determinants of health to cut ER visits ⇒ Big Data: Healthcare must move beyond the hype ⇒ Tips for reading Big Data results correctly ⇒ Small hospital makes minor investment in analytics and reaps big rewards  ⇒ MIT professor's quick primer on two types of machine learning for healthcare ⇒ Must-haves for machine learning to thrive in healthcare Based solely on clinical quality outcomes, Healthgrades 50 best hospitals for 2016 are in in the top 1 percent of hospitals in the nation for providing overall clinical excellence across a broad spectrum of conditions and procedures consistently for at least six consecutive years.  Here is the breakdown by U.S. State. Arizona Mayo Clinic, Phoenix California Cedars Sinai Medical Center, West Hollywood Hoag Memorial Hospital Presbyterian, Newport Beach Huntington, Memorial Hospital, Pasadena John Muir Medical Center, Walnut Creek Mills Peninsula Medical Center, including Mills Health Center, Burlingame Saddleback Memorial Medical Center, Laguna Hills Scripps Green Hospital, La Jolla Sutter Roseville Medical Center, Roseville Colorado Centura Health – Penrose Saint Francis Health Services, Colorado Springs St. Francis Medical Center, Colorado Springs North Colorado Medical Center. Greely Florida Delray Medical Center, Delray Beach Munroe Regional Medical Center, Ocala Georgia Northeast Georgia Medical Center, Gainsville Piedmont Fayette Hospital, Fayetteville Illinois Advocate Christ Hospital and Medical Center, Oak Lawn Advocate Good Samaritan Hospital, Downers Grove Alexian Brothers Medical Center Elk Grove Village Carle Foundation Hospital, Urbana Palos Community Hospital, Palos Heights Presence Resurrection Medical Center, Chicago St. Alexius Medical Center, Hoffman Estates Indiana Indiana University Health Methodist Hospital, including Indiana University Health, University Hospital, Indianapolis Iowa Mercy Medical Center – Cedar Rapids, Cedar Rapids Saint Luke’s Hospital, Cedar Rapids Kansas The University of Kansas Hospital, Kansas City Louisiana Ochsner Medical Center, New Orleans, including Oschner Health Center – Elmwood in New Orleans and Oschner Medical Center – West Bank Campus, Terrytown Maryland Medstar Franklin Square Medical Center, Baltimore Medstar Good Samaritan Hospital, Baltimore Medstar Harbor Hospital, Baltimore Massachusetts Baystate Medical Center, Springfield, Mass. Michigan Beaumont Health System, Beaumont-Troy Campus, Troy Holland Hospital, Holland  Providence-Providence Park Hospital, Southfield Campus, Southfield Spectrum Health Medical Center – Butterworth Hospital, including Spectrum Health – Blodgett Hospital, Grand Rapids, Mich. Minnesota North Memorial Medical Center, Robbinsdale Regions Hospital, St. Paul, Minn. New Jersey Morristown Medical Center, Morristown, N.J. New York New York Presbyterian-Weill Cornell Medical Center, New York New York Presbyterian/Columbia University Medical Center, New York New York Presbyterian/The Allen Hospital, New York North Carolina Mission Health, Asheville Pennsylvania Lancaster General Hospital, Lancaster Lehigh Valley Hospital Allentown South Carolina AnMed Health – Anmed Health Medical Center, Anderson Texas Houston Methodist Hospital, Houston, Texas Virginia Augusta Health, Fisherville Bon Secours Memorial Regional Medical Center, Mechanicsville Wisconsin Aurora Saint Lukes Medical Center, Milwaukee, including Aurora Sinai Medical Center, Milwaukee and Saint Lukes Medical Center, Cudahy Gunderson Lutheran Medical Center, La Crosse The following states had no hospital either in the top 100 (representing 2 percent of hospitals or in the top 50 (representing 1 percent of hospitals): Alabama Alaska, Arkansas, Connecticut, Delaware, District of Columbia, Hawaii, Kentucky, Maine, Mississippi, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Rhode Island, South Dakota, Tennessee, Utah, Vermont, West Virginia, and Wyoming.  Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

HealthPromise program aims to prevent readmissions and boost outcomes by identifying at-risk patients and enrolling them in connected health initiatives. 

The president, along with researchers and scientists, explored the ways technology will improve healthcare and other industries at the day-long conference on Thursday.

PCORI awarded UCLA and four other sites the money to kick off the Late-life Depression, Stress and Wellness Program to conduct stress, mood, cognitive, genetic, brain scanning assessments and clinical studies.

Executives said the center will house several institutes dedicated to improving healthcare across the country and around the world as well as research and leadership initiatives.

The system helps provide nurses with a comprehensive, single-source view of the factors most associated with driving nursing excellence – quality, patient experience and nursing engagement, the vendor said.

Recently, planners of an upcoming event asked me some questions and here are the answers: 1. How would you define the role/responsibilities of a “patient” advocate? The patient advocate can be defined in several ways. Sometimes this is an official staff member in a facility. They can operate as a patient navigator or customer service operative.  In the best scenario, their job is to help the patient understand the processes and options in care within the facility. In the worst scenarios, the patient advocate operates as a tool of damage control to damper litigious action of distraught family members. Sometimes the patient and family hire a patient advocate from a registry like the AdvoConnection. In this case the advocate may be a nurse, a doctor, or a trained and experienced caregiver who helps the patient while hospitalized or at home. They obtain medical records, ask questions, keep notes, help patients make their own difficult medical decisions, and review and negotiate medical bills. Often the patient advocate is a close friend or family member who is not paid for their service. This advocate provides many of the same services as a paid advocate, but often is learning on the job. Occasionally they have a background in medicine, and use that knowledge to great success helping the patient ask the right questions and get appropriate care at the correct time. Finally, there are patient advocates focused on policy. I am often classified among this category, although I prefer the term patient activist. A patient advocate focused on policy attends local, regional, state, and federal meetings to provide a patient perspective in policy decisions.  *(This is by no means meant to be an exhaustive definition of a patient advocate. Just how I define it in response to this question. There are several other resources out there to learn more http://pacboard.org/2016/03/09/patient-advocacy-vs-medical-advocacy-view-from-the-pacb/ is one.) ** (Additional edits were made on 10-5-16 to clarify the responsibilities of patient advocates in relation to the AdvoConnection.) 2. You do a number of these sorts of speaking engagements and presentations around the country. Are there some unifying themes- – clear trends – you see, common ideas that many people share about their worries or attitudes toward healthcare? Patient safety? Patient advocacy? I have been attending medical conferences and public meetings for the past seven years. In that time I have watched HITECH legislation morph and change. Patient access to data at stage one of meaningful use had budding teeth and at stage two it got poor fitting dentures. I have watched the ACA become the law of the land, only to see constant steps to repeal it.  I watched the concept of patient engagement grow from a demand in small healthcare meetings to a hashtag on twitter (#patientsincluded), to trend of conferences inviting patient speakers. I hoped that the next step was true partnership in decision-making and design. Sadly, of late I have often heard that “patient engagement” was out of fashion. We are now onto MIPS and MACRA and massive ACO’s.  I have watched patient safety advocates work for years with very little attention paid to their cause. I was happy to see alue Based Care begin to role out, as it addressed so many concerns of these advocates. I am saddened to hear how many attendees at conferences expound on their love for fee-for-service.  Or twist the intended purpose of reducing readmissions, by leaving patients in hallways for days to be “observed,” but not admitted after complications. The most apparent trend of the past seven years is that there are powerful lobbyists in this industry that will do anything to keep the status quo alive and well in healthcare. There are also amazing individuals, often on Twitter, (check out #hcldr), that will not stop fighting for the patient voice and the positive disruption that comes when data silos are leveled and technology is used appropriately. 3. Will patients ever be like consumers of other products? Outside of elective procedures or choosing a birthing place/option, how much real consumer choices do patients have in their healthcare? How would you like to see those avenues expanded or re-routed? I hate the word “consumer” when applied to healthcare; it assumes we take and never give. Partnership in care requires two-way communication. Care is always about choice. When we embrace price transparency, a patient can decide which facility has the most affordable MRI procedure. When we have medical record data transparency coupled with a clinical trials database, a cancer patient can decide the best personal path for their care. Which may include a hospice path, if that is their choice.  We have a choice right now. The difference in healthcare is that we have to fight for that choice, whereas in retail it is expected that the customer will decide which items to buy rather than the shopkeep.      4. How would you like to see healthcare systems and hospitals – particularly public and teaching systems – involve patients or their advocates in meaningful aspects of care best practices, policy making and priority-setting? Patients, caregivers, and patient advocates need to be present in meetings throughout the facility.  For far too long we have been forced into the role of lobby designers.  We ask that you invite us to take part and provide appropriate recompense for our time.  Or schedule the meeting after the workday is done at the facility.  That would be fine.  Then everyone at the table can be the unpaid volunteer that patients and family caregivers are so often asked to be.   You might want to make sure we can have those meetings next to a playroom though, so our children can play together while we work together to create new policy. Because whether you are a patient or a provider, childcare is expensive.   5. How would you describe your painting style and approach? My art looks like the work of the children’s book illustrator Garth Williams and the activist painter Diego Rivera fused. As a few people have told me over the years,  “Your work is often sweet and disturbing at the same time.” 6. Describe the healing benefits and/or the impact that making art that tells stories about health care can have on patients, survivors, care providers? As far as a healing benefit, the art process is a type of meditation and that can help soothe the soul.  It is a very nice feeling to be in the zone and at one with the cosmos. But the creation of art could feel like a nail ramming through my hand, and I would still create. I use art as a tool and the goal is to impact others. It is very easy to push aside someone’s story, if that story is only the bullet point on a slide or the footnote in an academic article.  It is much harder to look away at the painting on someone’s back, screaming at you like so many wheals and welts.  To know this image is someone’s story. To look at the painted eyes that look into yours and seem say, “I died, and it is all for naught if you do not act.”  7. Of all the art you’ve made--your Walking Gallery, the murals -- can you choose one piece and describe it and explain why it’s a piece that you especially want to share? My favorite piece is “Are you alright?”  In that painting, I captured my late husband Fred.  He stares at me from that painting like he is still with me.  Still alive on pigment covered canvas.  Still urging me to help him, a patient. And every day I do exactly that. This blog was originally published on Regina Holliday's Medical Advocacy Blog.

"The voices of regulation, defensive medicine, billing and quality measure reporting have been so loud that the primary reason for documentation has been ignored," said Peter Basch, MD, of MedStar Health in Washington.

Startup has developed imaging platform for gaining insight into cancer, infectious diseases, cognitive disorders and more.