Quality and Safety

Truven Health Analytics prides itself on, well, analyzing data. So when it came to picking this year’s top 15 hospitals, Truven analysts turned to crunching numbers. The winning health systems are those who showed higher survival rates and fewer errors at a lower overall treatment cost than any of the other health systems across the country. Overall mortality rates were 14.7 percent lower than non-winning peer group hospitals Complication rates were 15.1 percent lower ED wait times were 12.3 percent lower. The 15 health systems also lowered cost per episode by 5 percent, discharged patients from the hospital a half-day sooner than non-winners. Moreover, they showed y percent higher Patient Satisfaction Scores compared with the non-winning hospitals. The 2016 edition of 15 Top Health Systems evaluated 338 health systems and 2,912 member hospitals to identify the systems with the highest overall achievement on a balanced scorecard. Here are the winners: Large Health Systems (operating expense of more than $1.75 billion) Mayo Foundation – Rochester, Minn. Mercy – Chesterfield, Missouri Spectrum Health – Grand Rapids, Michigan Sutter Health – Sacramento, California Sutter Health Valley Division – Sacramento, California Medium Health Systems (operating expense between $750 million and $1.75 billion) Kettering Health Network – Dayton, Ohio Scripps Health – San Diego, California St. Luke's Health System – Boise, Idaho St. Vincent Health – Indianapolis TriHealth – Cincinnati, Ohio Small Health Systems (operating expense of less than $750 million) Asante – Medford, Oregon Lovelace Health System – Albuquerque, New Mexico MidMichigan Health – Midland, Michigan

An estimated 33,439 lives could be saved each year if all hospitals had the same performance as those receiving an A grade, according to Leapfrog and the Johns Hopkins Medicine’s Armstrong Institute for Patient Safety and Quality.

Intermountain Healthcare and the Stanford Genome Technology Center will work together on research aimed at developing advances in precision health.

New York's Mount Sinai Health System is joining other high-profile health systems across the nation in embracing OpenNotes, an initiative that gives patients access to their care provider's notes in their medical records. The notes are available for the first time in the health system's online electronic health record portal, called MyMountSinaiChart. Users can now read details of their office visit from the convenience of their personal computer, tablet or smartphone. MyMountSinaiChart, launched in 2012, also enables patients to communicate with their doctor, access test results, request prescription refills and manage appointments. The goal of OpenNotes is to improve transparency, communication and trust between patients and physicians – and it's working, Mount Sinai officials say. [Also: OpenNotes: 'This is not a software package, this is a movement'] "When patients can access their physicians' notes, they can better understand their medical issues and treatment plan as active partners in their care," said Sandra Myerson, chief patient experience officer at the Joseph F. Cullman, Jr. Institute for Patient Experience at Mount Sinai. "This can ultimately lead to improved patient engagement, patient empowerment, and communication between patient and physician." "Patients expect and deserve to have full access to their medical records and the Mount Sinai Health System is committed to meeting this expectation," Jeremy Boal, MD, chief medical officer at Mount Sinai Health Systems, said in a statement. Four Mount Sinai physicians in various clinical practices conducted the initial OpenNotes pilot beginning in December 2015. Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

Theranos, the embattled blood testing startup, is now under investigation by the U.S. Securities and Exchange Commission, as well as the U.S. Attorney's Office for the Northern District of California, according to Bloomberg. The investigation is the latest in a series of hardships for the once-vaunted company, coming on the heels of a recommendation by the Centers for Medicare and Medicaid Services that founder Elizabeth Holmes be banned from the blood testing business for a two-year period. In March, a study in the Journal of Clinical Investigation found that cholesterol test results obtained through Theranos – which are drawn from small finger pricks – were much different than those from large laboratory companies, implying that doctors' medical decisions could be thrown off by results acquired through Theranos technology. [Also: Theranos results differed from Quest, LabCorp enough to impact care decisions, study finds] In all, Theranos' results for total cholesterol were found to be an average 9.3 percent lower than those obtained through clinical laboratories Quest and LabCorp, according to the March study. This has lead researchers to surmise that in some instances, doctors may inappropriately begin, or fail to begin, statin therapy, a drug-based regimen that aims to prevent heart disease. The investigation by the SEC, which ensures companies give accurate information to investors, was one of several described in a memo from Theranos (once valued at $9 billion) obtained by Bloomberg. The memo was originally furnished to Theranos' partners including Walgreen's, which has reportedly been looking to cut ties with the startup. "The company continues to work closely with regulators and is cooperating fully with all investigations," Theranos officials said. Before the federal investigations were announced Monday, Holmes appeared on NBC's Today show to say she was "devastated" that her lab did not discover its deficiencies. Holmes also said Theranos would rebuild its lab from scratch to avoid future problems. In addition to suggesting that Holmes be temporarily banned from the industry, CMS has proposed a number of other sanctions, including revocation of Theranos' Clinical Laboratory Improvement Amendments of 1988 certificate – or, alternatively, a civil monetary penalty of $10,000 per day for each day of non-compliance. Theranos could delay the effective date of the sanctions by filing an appeal. Twitter: @JELagasse Like Healthcare IT News on Facebook and LinkedIn

Care coordination, quality measurement, patient engagement and population health management strategies are routinely used by physicians with electronic health records who participate in accountable care organizations or patient-centered medical homes, according to a new study published in the American Journal of Managed Care. Aiming to find out whether doctors using health IT and working within new reimbursement models were actually employing improved care processes, researchers Jennifer King, Vaishali Patel, Eric Jamoom and Catherine DesRoches examined cross-sectional data on office-based physicians from the 2012 National Ambulatory Medical Care Survey Physician Workflow Survey. "Early indicators suggest strong physician participation in initiatives to support health IT adoption and to reform healthcare payment and delivery," they said. "However, evidence on whether provider participation in these initiatives has translated to better care delivery is just beginning to emerge. "Although studies prior to HITECH and the ACA found health IT and external reporting or payment incentives to be associated with a higher likelihood of performing these care processes," they added, "they are performed at low rates even when these factors are in place." [Also: 4 surprising benefits of PCMH] King et al. examined how ACO and PCMH docs used their EHRs for 14 specific processes in four categories: population management, quality measurement, patient communication and care coordination. They found that those factors were independently associated with better processes: "Physicians who were using EHRs in combination with participation in ACO or PCMH initiatives had the highest likelihood of routinely performing the care processes." Indeed, those docs "were between 6 and 22 percentage points more likely to routinely perform the care processes than physicians with EHRs alone." While fewer than half (44 percent) reported routinely doing quality measurement, substantial majorities of docs said they routinely engage in care coordination (89 percent), patient communication (69 percent), and population management (67 percent). "Given the cross-sectional nature of this study, these results do not establish a causal relationship between payment reform, EHR use, and these care processes," researchers said. "Nonetheless, this finding is consistent with other research that shows that healthcare providers are most likely to perform these care processes when practicing in a payment environment that incentivizes and supports such care." Moreover, many U.S. physicians are still "not performing these processes routinely," researchers said. "Our analysis highlights several specific areas – including population management processes that require the aggregation and analysis of individual patient data and communication with patients and other care team members – where additional technology and policy supports may be important to facilitate wider adoption of these activities." Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

Starting in 2019, Centers for Medicare & Medicaid Services, will change how they pay physicians in a profound way. Unfortunately, the details are complicated and confusing, and many of the particulars have yet to be worked out, which has led many healthcare leaders to glaze over the details and focus on more immediate concerns.

The Centers for Medicare and Medicaid Services has warned Theranos founder Elizabeth Holmes that the company could face serious sanctions after the startup failed to address numerous problems with its technology and practices.

In his first year at the helm of Geisinger Health System, David Feinberg, MD, has continued to hone the longtime population health leader's intense focus on evidence-based care and improved patient experience.

Multi-agency collaboration aim to help app developers stay aware of consumer privacy and safety protections, while still enabling innovation, officials say.