Today’s Top Story
AAOS, AMA, request CMS to move quickly to finalize 90-day reporting period for Meaningful Use.
In a letter to the acting administrator of the U.S. Centers for Medicare & Medicaid Services (CMS), the American Association of Orthopaedic Surgeons (AAOS), American Medical Association, and 19 other organizations have requested that the agency expeditiously move from full-year reporting to a 90-day reporting period for the 2016 Meaningful Use program. “Although a 90-day reporting period was granted for Meaningful Use program participants in 2015,” the writers note, “the policy was not finalized until after the start of the final reporting period so many providers were not able to take advantage of the additional flexibilities, and instead relied on hardship exemptions under the expanded authority established under the Patient Access and Medicare Protection Act.” The writers state that finalizing the 90-day reporting period as quickly as possible will reduce the number of providers who must rely on a hardship exemption during 2016.
Read the letter…
CDC report offers recommendations for sepsis management.
The U.S. Centers for Disease Control and Prevention (CDC) has released a Vital Signs report on sepsis. The report notes that sepsis begins outside of the hospital for nearly 80 percent of patients, and that recent data suggest that 7 in 10 patients with sepsis had recently used healthcare services or had chronic diseases requiring frequent medical care. The report offers the following recommendations for healthcare providers:
- Following infection control requirements such as handwashing
- Educating patients and their families regarding the need to prevent infections, manage chronic conditions, and if an infection is not improving, promptly seek care
- Understanding the signs and symptoms of sepsis to identify and treat patients earlier
- Acting quickly if sepsis is suspected
- Checking patient progress frequently and reassessing antibiotic therapy as needed
Study: FRAX tool effective, but intervention thresholds are country-specific.
A study published online in the journal Archives of Osteoporosis examines intervention thresholds for the World Health Organization Fracture Risk Assessment Tool (FRAX). The researchers conducted a systematic review of 82 guidelines or academic papers that incorporated FRAX. Of those, 58 recommended a fixed intervention threshold, 22 recommended an age-dependent threshold, and 2 adopted both fixed and age-dependent thresholds. The researchers found that fixed probability thresholds ranged from 4 percent to 20 percent for a major fracture and from 1.3 percent to 5 percent for hip fracture. Overall, 39 of 58 publications used a threshold probability of 20 percent for a major osteoporotic fracture, and many also mentioned a hip fracture probability of 3 percent as an alternative intervention threshold. The researchers state that, across various countries, fixed probability thresholds were determined to match the prevalence of osteoporosis or to align with pre-existing guidelines or reimbursement criteria. The researchers note that FRAX appears to be more effective overall than bone mineral density (BMD) for identifying individuals at high risk of osteoporosis; however, setting of intervention thresholds needs to be country-specific.
Read the abstract…
Study: Many patients with fragility fracture take drugs linked with increased risk of fracture.
According to a study published online in the journal JAMA Internal Medicine, many patients continue to take medications linked with increased fracture risk following a fragility fracture. The authors conducted a retrospective cohort study of 168,133 patients with a fragility fracture. They found that most patients were exposed to at least one nonopiate drug associated with increased fracture risk during the 4 months prior to fracture (77.1 percent of hip, 74.1 percent of wrist, and 75.9 percent of shoulder fracture patients). About 7 percent of such patients discontinued this drug exposure after the fracture, but this was offset by new users after fracture, leaving the proportion of the cohort exposed following fracture effectively unchanged. In addition, the authors note that less than 25 percent of patients used drugs to strengthen bone density both before and after fracture.
Read the abstract…
Some physicians receive consulting payments after being sanctioned.
An article in ProPublica notes that some physicians continue to receive consulting and other payments from pharmaceutical and medical device companies after sanctioning by state medical boards. The publication reviewed physicians disciplinary records for California, Texas, New York, Florida, and New Jersey, and identified at least 2,300 providers who received industry payments between August 2013 and December 2015, despite being sanctioned, including at least 40 physicians with revoked or surrendered medical licenses.
Study: TBI at young age linked to increased risk of later impairment.
A study conducted in Sweden and published online in the journal PLOS Medicine suggest a link between traumatic brain injury (TBI) in childhood and later impairments. The research team reviewed information on 104,290 Swedish individuals who sustained TBI up to age 25 years, and 68,268 unaffected siblings. They found that TBI exposure was associated with elevated risks of impaired adult functioning across all outcome measures, including disability pension, specialist diagnoses of psychiatric disorders and psychiatric inpatient hospitalization, premature mortality (before age 41 years), low educational attainment, and receiving means-tested welfare benefits. In addition, the research team observed a dose-response relationship with injury severity. Overall, they noted increased risks for all outcomes for individuals who had sustained their first injury at an older age.
Read the complete study…
Last call: Political Action Committee of the AAOS.
Aug. 26 is the last day to submit your application for a position on the Political Action Committee (PAC) of the American Association of Orthopaedic Surgeons (AAOS) (one member-at-large opening). The PAC is responsible for oversight over all activities relating to political fundraising and financial support for candidates for federal office. Applicants for this position must be active fellows, U.S. citizens, and have specific knowledge of the many research and health policy positions of the AAOS.
Learn more and submit your application…(member login required)