Clinical

IBM is making quantum computing available to the public, providing access to a platform from any desktop or mobile device via the IBM Cloud. It has implications for healthcare, where another supercomputer, IBMWatson, is already at work helping researchers and clinicians eradicate cancer, making sure the world’s population gets better sleep and sorting big data to boost genomics work and precision medicine. With IBM Quantum Experience, the new cloud-based platform unveiled today, users can create algorithms and run experiments, learn about quantum computing through tutorials and simulations and get inspired by the potential of a quantum computer. The goal, say IBM executives, is to make it easier for researchers and the scientific community to accelerate innovations. [See also: IBM Watson teams up with American Cancer Society to pit cognitive computing against cancer.] Today’s announcement comes days after Big Blue launched on April 29, secure blockchain services for healthcare, government and financial services on the IBM Cloud. Blockchain is the technology underpinning bitcoin, but IBM executives and others note that blockchain is much broader than bitcoin. "Clients tell us that one of the inhibitors of the adoption of blockchain is the concern about security," Jerry Cuomo, vice president, Blockchain, IBM, said in a statement. "While there’s a sense of urgency to pioneer blockchain for business, most organizations need help to define the ideal cloud environment that enables blockchain networks to run securely in the cloud." [See also: IBM Watson takes analytics prowess overseas: Supercomputer to work on big data and genomics in Italy.] Blockchain becomes more attractive wrapped in the new security framework IBM introduced on April 29 along with new blockchain services IBM’s quantum processor, IBM Quantum Experience, is housed at the IBM T.J. Watson Research Center in New York. A universal quantum computer can be programmed to perform any computing task and will be exponentially faster than classical computers for a number of important applications for science and business, according to IBM executives. “Quantum computing is becoming a reality and it will extend computation far beyond what is imaginable with today's computers," said Arvind Krishna, senior vice president and director, IBM Research, said in a statement. "This moment represents the birth of quantum cloud computing. By giving hands-on access to IBM's experimental quantum systems, the IBM Quantum Experience will make it easier for researchers and the scientific community to accelerate innovations in the quantum field, and help discover new applications for this technology." Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com      

The federal government paid bonuses to 231 hospitals with subpar quality because their patients tend to be less expensive for Medicare, new research shows. The bonuses are small, generally a fraction of a percent of their Medicare payments. Nonetheless, rewarding hospitals of mediocre quality was hardly the stated goal when the Affordable Care Act created financial incentives to encourage better medical care from hospitals, doctors and other health care providers. A study published Monday in the journal Health Affairs looked at the more than $1 billion in payments made last year in the Hospital Value-Based Purchasing program, which raises or lowers Medicare payments to hospitals based on the government’s assessment of their quality. Medicare primarily uses death and infection rates and patient surveys to judge hospitals, but it also evaluates how much each hospitals’ patients cost, both in treatment and recovery. The 231 hospitals the study identified had below average scores on quality measures but were awarded the bonuses because caring for their patients during their stays and in the 30 days following their discharge cost Medicare less than what it cost at half of hospitals evaluated in the program. The Centers for Medicare & Medicaid Services, or CMS, began measuring cost in October 2014 to encourage hospitals to provide care in the most efficient way possible. In the period examined in the study — the federal fiscal year that ended in September 2015 — spending counted for 20 percent of a hospital’s score in determining whether a hospital would get a bonus, penalty or regular payment. Under this formula, hospitals with Medicare spending below the median hospital were able to qualify for bonuses even though their quality measures were below the median, the study found. Patients at those 231 hospitals cost Medicare on average nearly $16,000, about $2,300 less than the average spending for the patients at other hospitals that received bonuses, according to the study’s lead author, Anup Das, a medical and health policy student at the University of Michigan. The average bonus for those lower quality hospitals was an 0.18 percent increase in Medicare payments for each patient stay during that fiscal year. Most of the 1,700 hospitals that received a bonus that year had higher than average quality ratings, and their patients in some cases were more costly to Medicare. [See also: 15 quality chiefs at best hospitals.] “High-quality low-spending hospitals received the greatest financial benefit from the program,” the study said. “In this respect, CMS achieved its goal with the new spending measure. However, some low-quality hospitals received bonuses because of their low spending.” In a statement, CMS said it would consider revising the program for future years so that hospitals scoring below the national median for quality would not receive a bonus. The statement also noted that this year, three-fourths of hospitals’ scores were based on quality measures. “We believe that there needs to be a balanced consideration between quality and cost, which is reflected in our scoring methodology,” the statement said. The study found the lower-quality hospitals that received bonuses in the last fiscal year had higher death rates for heart attacks, heart failure and pneumonia than half of the nation’s other hospitals evaluated in the program. These hospitals were also less likely to follow recommended procedures for care, like choosing the right antibiotic for patients or performing an angioplasty on a heart attack patient within 90 minutes of their arrival at the hospital. [See also: 1,700 hospitals win Medicare quality bonuses, but will never collect.] The 231 lower-quality hospitals with bonuses also received less enthusiastic ratings from patients about how well doctors and nurses communicated, responded to issues and managed pain, the study found. The study did not name the 231 hospitals. “It’s a small decrease in quality, but the differences are significant,” Das said in an interview. Other new federal quality payment programs created by the health law, such as accountable care organizations, deny bonuses to doctors or hospitals with substandard quality of care, no matter how efficiently they operate. The study suggested the government add a similar limitation to the Value-Based Purchasing program. The study did not look at the current federal fiscal year, which runs through this September. This year, Medicare gave bonuses to 1,705 hospitals, averaging 0.51 percent, and reduced payments to 1,375 hospitals by an average of 0.34 percent, according to a Kaiser Health News analysis. Along with spending, Medicare’s other criteria are: death and infection rates; how faithfully a hospital followed basic clinical guidelines; and how patients rated their experiences in surveys. Spending counts for a fourth of each hospitals’ scores, more than last year, and is scheduled to continue to do so for the next two years. The study’s lead author, Das, said in the interview that a preliminary analysis found some lower-quality hospitals again received bonuses.  

UMMC CHIO John Showalter, MD, describes what associative data lakes, honest brokers and more mean to becoming a learning health system.

IBM Watson said it will provide free storage to nonprofit organizations and academic medical center researchers using Apple’s ResearchKit. But developers looking to tap into the supercomputer's analytics will have to pay.

The funding will span more than 20 projects to address several of healthcare’s biggest burdens, according to the Patient-Centered Outcomes Research Institute.

The technology, seen as a potential move toward bionics, could one day enable wireless updates for corrective lens prescriptions, if it comes to fruition.

The health system credits clinical and financial improvements to a CDI initiative that resulted in more accurate coding and greater physician engagement. 

The sheer number and variety of providers that patients see after leaving a hospital make medical mistakes and poor transitions in care all too common today. 

By and large, population health measurement efforts are poorly developed and uncoordinated – and without effective measurement success will remain elusive, says Georgetown's Michael A. Stoto.

Geisinger Health System has enlisted 100,000 people for its genomic study and did so more quickly than expected. Attracting so many volunteers over two years has prompted program executives to raise the bar to 250,000 or more participants.