CMS launches Data Element Library to advance EHR interoperability
The Centers for Medicare & Medicaid Services (CMS) announced the launch of the Data Element Library (DEL), a free, centralized database to support the interoperability of electronic health records (EHRs). The public can use DEL to view specific data that long-term and post-acute care facilities are required to collect as part of patient health assessments. DEL includes information technology standards that support the collection of health information, which CMS says will allow for easier integration and data sharing In addition, many of these data elements, including demographics, medical problems, and other types of health evaluations, are standardized. “Integrating these data elements into EHRs will ultimately allow health information to flow more easily from one provider to another,” CMS said in a press release.
House of Representatives passes most expansive opioid legislation to date
On Friday, the U.S. House of Representatives passed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. The legislation, which is a package of smaller bills, is designed to help healthcare providers stem the opioid crisis. It includes the following:
expanding the use of telehealth services for substance use disorder
providing improved care for infants with neonatal abstinence syndrome
increasing the types and capacity of providers offering medication-assisted treatment
allowing Medicaid funding for inpatient stays in mental health and behavioral health facilities
covering screening for addiction as part of Medicare beneficiaries’ first physical examination
The legislation will head to the Senate, where multiple committees are working on their own bills. It is expected that some form of opioid legislation will be signed into law before the end of the year.
Head of corporate health plan says surgery is the biggest U.S. healthcare cost
Atul Gawande, MD, MPH, the newly appointed head of the Amazon-Berkshire Hathaway-JPMorgan Chase healthcare venture, says surgery is the single biggest cost to the U.S. healthcare system. During a presentation at America’s Health Insurance Plans annual meeting, Dr. Gawande discussed the need to better track treatments to determine the most optimal care. The three large employers announced the joint venture earlier this year, noting that healthcare costs were rising too quickly and saying they would use big-data analysis and other high-tech tools to improve care and reduce unnecessary costs.
Study: Intra-articular hematoma block for analgesia in closed reduction of ankle fractures
Intra-articular hematoma block (IAHB) may be as effective as procedural sedation (PS) as an analgesic in closed reduction of ankle fractures, according to a study published online in Foot & Ankle International. Researchers conducted a retrospective chart review of ankle fractures requiring reduction in patients who visited a trauma center between 2005 and 2016. A total of 221 patients underwent IAHB and 114 underwent PS. Researchers observed faster reduction and associated tibiotalar joint subluxation in those who received IAHB. Patients with a tibiotalar fracture dislocation who received PS more often had successful reduction after the first attempt than those who received IAHB.
Study: Reoperation rates for intramedullary nailing versus arthroplasty for proximal femur fractures
A study published in The Journal of Arthroplasty appeared to show that intramedullary nailing and endoprosthetic reconstruction yield similar reoperation rates for patients with proximal femur metastatic lesions. Researchers conducted a systematic review of 16 nonrandomized, retrospective studies that included 1,414 patients. Studies selected were performed within the last 20 years and focused on treatment of proximal femur metastatic lesions via either intramedullary nailing or endoprosthetic reconstruction, as well as reoperation rates. The pooled estimated reoperation was 9 percent for intramedullary nailing and 7 percent for endoprosthetic reconstruction. However, the researchers noted there were inconsistencies in follow-up and study designs.
Trends in carpal tunnel syndrome management continue to evolve
Carpal tunnel syndrome (CTS) remains the most common compressive neuropathy An article in AAOS Now reviewed recent trends in the preoperative evaluation, anesthesia, surgical approaches, and opioid prescribing patterns for patients with CTS.
Apply for Adult Spine Evaluation Committee member position
The AAOS International Committee has an open member position, a three-year term that runs from March 18, 2019, to March 25, 2022. The committee prepares the Adult Spine Self-Assessment Examination every two years and acts as a resource as requested for providing examination questions for other AAOS educational programs. The last day to submit an application is Aug. 3.
