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https://www.readbyqxmd.com/read/28162990/effects-of-electronic-psychiatric-consultations-on-primary-care-provider-perceptions-of-mental-health-care-survey-results-from-a-randomized-evaluation
#1
Ezra Golberstein, Sarah Kolvenbach, Hilary Carruthers, Benjamin Druss, Paul Goering
BACKGROUND: Primary care is the main point-of-entry for identifying and treating mental health problems. This research examines the effect of a new model of supporting primary care providers (PCPs) treating mental health disorders, the electronic consultation (eConsults), a standard process for communication between PCPs and psychiatrists through an electronic health records system. METHODS: A cluster-randomized evaluation of the psychiatric eConsults model, as implemented in a large integrated delivery system...
February 2, 2017: Healthcare
https://www.readbyqxmd.com/read/28117243/patient-perceptions-of-integrated-care-and-their-relationship-to-utilization-of-emergency-inpatient-and-outpatient-services
#2
Ashley-Kay Fryer, Mark W Friedberg, Ryan W Thompson, Sara J Singer
BACKGROUND: Patients with multiple chronic conditions have garnered particular attention from policymakers and health service researchers because these patients utilize more services and contribute disproportionally to rising health care expenses. The growing prevalence of patients with multiple chronic conditions has increased the importance of achieving better health care integration for this patient population. Patients may be well positioned to assess integration of their care, but the relationship between patients' perceptions of care integration and use of health services has not been studied...
January 21, 2017: Healthcare
https://www.readbyqxmd.com/read/28065558/the-availability-of-community-health-center-services-and-access-to-medical-care
#3
James B Kirby, Ravi Sharma
BACKGROUND: Community Health Centers (CHCs) funded by Section 330 of the Public Health Service Act are an essential part of the health care safety net in the US. The Patient Protection and Affordable Care Act expanded the program significantly, but the extent to which the availability of CHCs improve access to care in general is not clear. In this paper, we examine the associations between the availability of CHC services in communities and two key measures of ambulatory care access - having a usual source of care and having any office-based medical visits over a one year period...
January 5, 2017: Healthcare
https://www.readbyqxmd.com/read/28063837/leveraging-lean-principles-in-creating-a-comprehensive-quality-program-the-ucla-health-readmission-reduction-initiative
#4
Nasim Afsar-Manesh, Sarah Lonowski, Aram A Namavar
INTRODUCTION: UCLA Health embarked to transform care by integrating lean methodology in a key clinical project, Readmission Reduction Initiative (RRI). METHODS: The first step focused on assembling a leadership team to articulate system-wide priorities for quality improvement. The lean principle of creating a culture of change and accountability was established by: 1) engaging stakeholders, 2) managing the process with performance accountability, and, 3) delivering patient-centered care...
January 4, 2017: Healthcare
https://www.readbyqxmd.com/read/28065392/mapping-the-process-of-emergency-care-at-a-teaching-hospital-in-ghana
#5
Emily Aaronson, Elizabeth Mort, Samara Soghoian
Emergency Department (ED) overcrowding has become a global concern as the number of countries with formalized emergency care systems has expanded, and the burden of trauma and non-communicable diseases in low and middle-income countries increased. In light of this, the international Emergency Medicine literature has outlined the need for operational projects in low and middle income countries which focus on the process of care. Despite this, there is limited published literature describing these types of projects...
January 3, 2017: Healthcare
https://www.readbyqxmd.com/read/28043807/on-the-ground-floor-looking-up-managing-trainees-uncertainty-at-the-end-of-life
#6
Ravi B Parikh, Dhruv Khullar
Recent US healthcare policy changes set the stage for integrating palliative and end-of-life care into routine medicine. However, these changes may not affect the daily practice of medical trainees-fellows, residents, and medical students-who as front-line care providers are not always equipped with the skills needed to treat terminally ill patients. We review evidence on trainees' discomfort with end-of-life care and highlight limitations of recent policy changes. Key barriers to proficiency include inadequate conversational training, prognostic uncertainty, and unfamiliarity with hospice and palliative care...
December 30, 2016: Healthcare
https://www.readbyqxmd.com/read/28039014/what-can-five-high-cost-patients-teach-us-about-healthcare-spending
#7
Ishani Ganguli, Ryan W Thompson, Timothy G Ferris
The highest cost patients account for a disproportionately large share of American healthcare costs and are increasingly the focus of research and policy efforts to stem the rapid growth of these costs. These patients tend to be medically complex and frail, but we know little about how such characteristics influence healthcare spending from the perspectives of the patients and their caregivers. Therefore, we examined five of the highest cost patients at an academic medical center in a case series. We interviewed the patients, their family members, and their clinicians and analyzed their claims data and medical charts to explore how patient and health system characteristics influenced their health costs...
December 27, 2016: Healthcare
https://www.readbyqxmd.com/read/27986416/interview-with-robert-k-kraft
#8
Brian Powers
No abstract text is available yet for this article.
December 13, 2016: Healthcare
https://www.readbyqxmd.com/read/27939170/advancing-medical-device-innovation-through-collaboration-and-coordination-of-structured-data-capture-pilots-report-from-the-medical-device-epidemiology-network-mdepinet-specific-measurable-achievable-results-oriented-time-bound-smart-think-tank
#9
Terrie L Reed, Joseph P Drozda, Kevin M Baskin, James Tcheng, Karen Conway, Natalia Wilson, Danica Marinac-Dabic, Theodore Heise, Mitchell W Krucoff
The Medical Device Epidemiology Network (MDEpiNet) is a public private partnership (PPP) that provides a platform for collaboration on medical device evaluation and depth of expertise for supporting pilots to capture, exchange and use device information for improving device safety and protecting public health. The MDEpiNet SMART Think Tank, held in February, 2013, sought to engage expert stakeholders who were committed to improving the capture of device data, including Unique Device Identification (UDI), in key electronic health information...
December 6, 2016: Healthcare
https://www.readbyqxmd.com/read/27939169/overcoming-barriers-to-diabetic-polyneuropathy-management-in-primary-care
#10
Alyce S Adams, Brian Callaghan, Richard W Grant
Diabetic polyneuropathy is a highly prevalent and costly complication of diabetes that is frequently underdiagnosed and undertreated in primary care settings. In this article, we discuss challenges in the management of diabetic polyneuropathy symptoms, including diagnostic complexity, the limited efficacy and high side effect rates associated with available treatments and the time constrained primary care visit. We call for the development of novel patient-centric, system-level strategies that engage patients between physician visits in order to facilitate timely communication of symptoms and treatment response and to promote patient-centered care...
December 6, 2016: Healthcare
https://www.readbyqxmd.com/read/27932264/physician-attitudes-toward-participating-in-a-financial-incentive-program-for-ldl-reduction-are-associated-with-patient-outcomes
#11
Tianyu Liu, David A Asch, Kevin G Volpp, Jingsan Zhu, Wenli Wang, Andrea B Troxel, Aderinola Adejare, Darra D Finnerty, Karen Hoffer, Judy A Shea
No abstract text is available yet for this article.
December 5, 2016: Healthcare
https://www.readbyqxmd.com/read/27932263/long-term-disease-and-economic-outcomes-of-prior-authorization-criteria-for-hepatitis-c-treatment-in-pennsylvania-medicaid
#12
Mina Kabiri, Jagpreet Chhatwal, Julie M Donohue, Mark S Roberts, A Everette James, Michael A Dunn, Walid F Gellad
BACKGROUND: Several highly effective but costly therapies for hepatitis C virus (HCV) are available. As a consequence of their high price, 36 state Medicaid programs limited treatment coverage to patients with more advanced HCV stages. States have only limited information available to predict the long-term impact of these decisions. METHODS: We adapted a validated hepatitis C microsimulation model to the Pennsylvania Medicaid population to estimate the existing HCV prevalence in Pennsylvania Medicaid and estimate the impact of various HCV drug coverage policies on disease outcomes and costs...
December 5, 2016: Healthcare
https://www.readbyqxmd.com/read/27932261/does-adding-clinical-data-to-administrative-data-improve-agreement-among-hospital-quality-measures
#13
Amresh D Hanchate, Kelly L Stolzmann, Amy K Rosen, Aaron S Fink, Michael Shwartz, Arlene S Ash, Hassen Abdulkerim, Mary Jo V Pugh, Priti Shokeen, Ann Borzecki
BACKGROUND: Hospital performance measures based on patient mortality and readmission have indicated modest rates of agreement. We examined if combining clinical data on laboratory tests and vital signs with administrative data leads to improved agreement with each other, and with other measures of hospital performance in the nation's largest integrated health care system. METHODS: We used patient-level administrative and clinical data, and hospital-level data on quality indicators, for 2007-2010 from the Veterans Health Administration (VA)...
December 5, 2016: Healthcare
https://www.readbyqxmd.com/read/28007228/using-active-choice-within-the-electronic-health-record-to-increase-physician-ordering-and-patient-completion-of-high-value-cancer-screening-tests
#14
Mitesh S Patel, Kevin G Volpp, Dylan S Small, Craig Wynn, Jingsan Zhu, Lin Yang, Steven Honeywell, Susan C Day
BACKGROUND: High value screening tests such as colonoscopy and mammography can improve early cancer detection but are often underutilized. METHODS: We evaluated an active choice intervention using the electronic health record (EHR) to confirm patient eligibility for colonoscopy or mammography during the patient's clinic visit and prompt the physician and his/her medical assistant to actively choose to "accept" or "cancel" an order for it. We fit multivariate logistic regression models using a difference-in-differences approach to evaluate changes in physician ordering and patient completion of colonoscopy and mammography at the intervention practice compared to two control practices, adjusting for time trends, patient and clinic visit characteristics...
December 2016: Healthcare
https://www.readbyqxmd.com/read/28007227/the-perioperative-surgical-home-model-facilitates-change-implementation-in-anesthetic-technique-within-a-clinical-pathway-for-total-knee-arthroplasty
#15
Seshadri C Mudumbai, Tessa L Walters, Steven K Howard, T Edward Kim, Gregory Milo Lochbaum, Stavros G Memtsoudis, Zeev N Kain, Alex Kou, Robert King, Edward R Mariano
BACKGROUND: The challenge of knowledge translation in medical settings is well known, and implementing change in clinical practice can take years. For the increasing number total knee arthroplasty (TKA) patients annually, there is ample evidence to endorse neuraxial anesthesia over general anesthesia. The rate of adoption of this practice, however, is slow at the current time. We hypothesized that a Perioperative Surgical Home (PSH) model facilitates rapid change implementation in anesthesia...
December 2016: Healthcare
https://www.readbyqxmd.com/read/28007226/role-expansion-on-interprofessional-primary-care-teams-barriers-of-role-self-efficacy-among-clinical-associates
#16
Karleen F Giannitrapani, Lynn Soban, Alison B Hamilton, Hector Rodriguez, Alexis Huynh, Susan Stockdale, Elizabeth M Yano, Lisa V Rubenstein
BACKGROUND: Interprofessional team-based models of primary care that expand the role of clinical associates (CAs) are increasingly adopted in primary care practices. In this study we query team members of a newly implemented patient centered medical home (PCMH) to identify facilitators and barriers of occupational role self-efficacy, a belief of possessing the capacity to execute their new team based role effectively. METHODS: 79 key informants, members of primary care teams at six Veterans Health Administration (VA) clinics, were interviewed to assess their experiences with implementing expanded roles for CAs...
December 2016: Healthcare
https://www.readbyqxmd.com/read/28007225/essentials-for-improving-service-quality-in-cancer-care
#17
Leonard L Berry, Kedar S Mate
No abstract text is available yet for this article.
December 2016: Healthcare
https://www.readbyqxmd.com/read/28007224/efficacy-of-surgical-safety-checklist-assessing-orthopaedic-surgical-implant-readiness
#18
Benjamin G Thomasson, David Fuller, John Mansour, Robert Marburger, Erin Pukenas
INTRODUCTION: Our institution employs a Surgical Universal Protocol Preoperative Checklist in accordance with World Health Organization guidelines to promote patient safety. It is used in part to evaluate orthopaedic surgical equipment and implant readiness prior to the initiation of each surgical case. Our goal is to measure the preoperative checklist's efficacy in assessing orthopaedic equipment readiness preoperatively and its ability to prevent orthopaedic equipment failures (OEF)...
December 2016: Healthcare
https://www.readbyqxmd.com/read/28007223/a-hidden-opportunity-within-surgery-in-low-and-middle-income-countries
#19
Allison Silverstein, Sristi Sharma, Swagoto Mukhopadhyay, Salim Afshar
No abstract text is available yet for this article.
December 2016: Healthcare
https://www.readbyqxmd.com/read/28007222/faster-cancer-treatment-using-timestamp-data-to-improve-patient-journeys
#20
C G Walker, M J O'Sullivan, I Ziedins, N Furian
This paper presents a case study of research conducted to improve the delivery of treatment to high priority cancer patients. The authors present a modelling framework that uses time-stamp data collected by the North Shore Hospital IT systems as "business as usual", to describe the patient journey through the cancer-care process. A simulation process is developed that uses this data to estimate the service's performance under current operating practices, and enables "what-if" analysis to identify where changes to current practice can most effectively be applied, ensuring the investment of additional resource can be targeted at the steps of the patient pathway where it can result in the greatest improvement...
December 2016: Healthcare
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