Today’s Top Story
Report highlights area of ongoing concern for patient safety, offers suggestions for improvement.
A report from the nonprofit National Patient Safety Foundation notes progress and areas for improvement in healthcare-associated patient injuries since the 1999 publication of the Institute of Medicine report: To Err Is Human: Building a Safer Health System. Recommendations in the report include:
- Ensuring that leaders establish and sustain a safety culture
- Centralized and coordinated oversight of patient safety
- A common set of safety metrics that reflect meaningful outcomes
- Increased funding for research in patient safety and implementation science
- Addressing safety across the entire care continuum
“Advancement in patient safety requires an overarching shift from reactive, piecemeal interventions to a total systems approach to safety,” the writers argue. Read more…(registration may be required)
Read the report, with related links…(registration may be required)
Other News
Tech companies ask U.S. Congress not to delay meaningful use unless interoperability issues are addressed.
In a letter to congressional leadership, nine technology companies have urged legislators to oppose any delays in the timing of Stage 3 of the Meaningful Use program “that do not also include reforms to improve the interoperable use of health information technology.” The writers state that the requirements and pace of the program have drawn time and resources away from addressing interoperability of electronic medical records systems. “Patients today have no guarantee that their health information will be accessible by their attending physician,” they write. “Vendors are spending so much time reacting to numerous, and sometimes conflicting, government regulations on or related to the program that they have little time to improve their products based upon their customers’ needs.” Read the letter (PDF)…
In a recent letter to both houses of the U.S. Congress, the American Association of Orthopaedic Surgeons (AAOS) and 110 other medical organizations asked legislators to reconsider plans to implement Stage 3 of the Meaningful Use program, arguing that Stage 2 implementation was largely a failure, and that future success of the program will require an increased focus on interoperability and innovation. Read the AAOS letter (PDF)…
AAOS and other organizations ask Congress to support bill that would increase opportunities to expand physician-owned hospitals.
In a letter to members of the U.S. Congress, the AAOS and 40 other medical organizations have asked legislators to support the Protecting Access, Competition, and Equity Act (H.R. 2513), which they say would provide “reasonable opportunities for expansion for high quality hospitals with physician ownership.” The organizations note that the Affordable Care Act prohibits new physician-owned hospitals from participating in Medicare and Medicaid, and prohibits existing physician-owned hospitals from expanding, unless they meet certain criteria. Read the letter (PDF)…
Read more in AAOS Advocacy Now…
Study: Parathyroid hormone may help stem cells migrate to assist with new bone formation.
A lab animal study published online in the journal Molecular Therapy suggests that parathyroid hormone (PTH) injections may complement intravenous mesenchymal stem cell (MSC) therapy in inducing fracture repair. The researchers used a rat model of osteoporotic vertebral bone defects to evaluate the efficacy of combination intravenous MSC and PTH therapy versus monotherapy and untreated controls. At 2-week follow-up, they found that the combination therapy was associated with significantly increased new bone formation versus monotherapy and control cohorts. The researchers noted that PTH significantly enhanced MSC migration to the lumbar region, where MSCs differentiated into bone-forming cells. Read more…
Read the abstract…
Study: Standardized patient-based intervention may not reduce ordering of “low-value” tests.
Findings from a study published in the Dec. 7 issue of the journal JAMA Internal Medicine suggest that use of a standardized patient (SP)-based intervention may not reduce the ordering of so-called “low-value” tests (based on primary care specialty societies’ “Choosing Wisely” lists). The research team conducted a randomized clinical trial of 61 general internal medicine or family medicine residents at 2 residency-affiliated primary care clinics. Of those, 31 participants received two simulated visits with SP instructors requesting spinal magnetic resonance imaging (MRI) for low back pain or screening dual-energy x-ray absorptiometry (DEXA), and all received three unannounced SP clinic visits over the next 3 to 12 months, with patients requesting spinal MRI, screening DEXA, or headache neuroimaging. Compared with the control group, residents in the intervention group had similar patient-centeredness and used a similar number of targeted techniques. The research team found no significant difference in the odds of test ordering among residents in the intervention cohort relative to those in the control cohort. However, the SP instructors rated visit satisfaction higher among intervention than control participants. Read the abstract…
Study: Depressive symptoms have increased among residents over the last 5 decades.
According to a study published in the Dec. 8 issue of The Journal of the American Medical Association, 20.9 percent to 43.2 percent of resident physicians report depression or depressive symptoms. The researchers conducted a systematic review of 31 cross-sectional studies (9,447 individuals) and 23 longitudinal studies (8,113 individuals) published between January 1963 and September 2015, and found the overall pooled prevalence of depression or depressive symptoms to be 28.8 percent (4,969 of 17,560). They noted an increased prevalence of symptoms as the calendar year progressed. Based on a secondary analysis of seven longitudinal studies, the researchers found that the median absolute increase in depressive symptoms with the onset of residency training was 15.8 percent. Read more…
Read the abstract…
An accompanying editorial notes that with the exception of work-hour limits, the basic features of the current system of graduate medical education have not changed in decades, and suggests that it may be time for “a national conversation on the fundamental structure and function of the graduate medical education system.” Read more…
Two SCOTUS cases address healthcare provider issues.
Modern Healthcare reports that the U.S. Supreme Court (SCOTUS) has announced that it will hear Universal Health Services v. United States ex rel Escobar, which could have ramifications for bringing False Claims Act (FCA) cases to court. In the relevant case, the Court will consider whether whistleblowers and the government may bring FCA cases under the theory of implied certification, in which providers may be held liable for not following certain regulations, even if the government never explicitly stated that following a regulation was a condition of payment, and if the provider never explicitly vouched compliance with the regulation. Read more…(registration may be required)
In a separate story, MedPage Today reports that a case recently argued before SCOTUS could determine whether self-insured employers must follow state laws on reporting healthcare costs, including information on provider reimbursement. A Vermont law requires all insurers in the state—including companies that self-insure their employees—to report healthcare cost data to a state-run database. Liberty Mutual employs workers in Vermont, has a self-insured health plan for them, and uses Blue Cross Blue Shield of Massachusetts to administer it. In the relevant case, the Vermont Banking, Insurance, Securities and Health Care Administration subpoenaed an insurer that administers a company’s self-insured health plan to obtain medical records and other information about company employees. The company argues that it is exempt from the law under provisions of the federal Employee Retirement Income Security Act. Read more…
Call for volunteers: ACSM Team Physician Consensus Conference.
AAOS seeks two members to represent the Academy at the 2016 American College of Sports Medicine (ACSM) Team Physician Consensus Conference. The proposed topic for review this year is “Psychological Issues in Athletes and the Team Physician: A Consensus Statement (2016 Update).” Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, and a letter of interest highlighting his or her expertise in the subject area and a statement that he or she is able to participate in full capacity. All supporting materials must be submitted by Sunday, Jan. 3, 2016 at 11:59 p.m. CT, to Kyle Shah at: shah@aaos.org
Learn more and submit your application…(member login required)
