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https://www.readbyqxmd.com/read/28099059/family-physician-readiness-for-value-based-payments-does-ownership-status-matter
#1
Heidy Robertson-Cooper, Bradley Neaderhiser, Laura E Happe, Roy A Beveridge
Value-based payments are rapidly replacing fee-for-service arrangements, necessitating advancements in physician practice capabilities and functions. The objective of this study was to examine potential differences among family physicians who are owners versus employed with respect to their readiness for value-based payment models. The authors surveyed more than 550 family physicians from the American Academy of Family Physician's membership; nearly 75% had made changes to participate in value-based payments...
January 18, 2017: Population Health Management
https://www.readbyqxmd.com/read/28098824/fabrication-of-a-miniature-multi-parameter-sensor-chip-for-water-quality-assessment
#2
Bo Zhou, Chao Bian, Jianhua Tong, Shanhong Xia
Water contamination is a main inducement of human diseases. It is an important step to monitor the water quality in the water distribution system. Due to the features of large size, high cost, and complicated structure of traditional water determination sensors and devices, it is difficult to realize real-time water monitoring on a large scale. In this paper, we present a multi-parameter sensor chip, which is miniature, low-cost, and robust, to detect the pH, conductivity, and temperature of water simultaneously...
January 14, 2017: Sensors
https://www.readbyqxmd.com/read/28092282/neonatal-palliative-care
#3
Elvira Parravicini
PURPOSE OF REVIEW: A significant number of newborns are affected by life-limiting or life-threatening conditions. When prolongation of survival is no longer a goal, or prognosis is uncertain, a plan of care focused on the infant's comfort is essential. The aim of this article is to review the most recent and relevant literature regarding neonatal palliative care (NPC). RECENT FINDINGS: A variety of perinatal and NPC programs are described, but most programs focus exclusively on end-of-life care...
January 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28087845/waking-eeg-cortical-markers-of-chronic-pain-and-sleepiness
#4
Danny Camfferman, G Lorimer Moseley, Kevin Gertz, Mark W Pettet, Mark P Jensen
OBJECTIVE: Spectral power analyses of EEG recordings are reported to distinguish the cortical activity of individuals with chronic pain from those of controls. Further study of these spectral patterns may provide a greater understanding of the processes associated with chronic pain, in addition to providing potential biometric markers of chronic pain for use in both clinical and research settings. However, sleep deprived groups have demonstrated similar characteristics in their spectral power characteristics, particularly in alpha bandwidth power activity...
January 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28080183/palliative-care-scorecard
#5
Sheri Kittelson, Read Pierce, Jeanie Youngwerth
BACKGROUND: In response to poor healthcare quality outcomes and rising costs, healthcare reform triple aim has increased requirements for providers to demonstrate value to payers, partners, and the public. OBJECTIVE: Electronically automating measurement of the meaningful impact of palliative care (PC) programs on clinical, operational, and financial systems over time is imperative to the success of the field and the goal of development of this automated PC scorecard...
January 12, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28074531/antibiotic-use-during-infectious-episodes-in-the-first-6-months-of-anticancer-treatment-a-swedish-cohort-study-of-children-aged-7-16-years
#6
M Af Sandeberg, E Johansson, L Wettergren, O Björk, O Hertting, A Nilsson
BACKGROUND: Children undergoing cancer therapy are at risk for infectious complications that require hospitalization and antimicrobial therapy. Host factors such as age and underlying disease may predict the risk of severe infections in these children. To describe the increased morbidity due to infections in children with cancer, we characterized the antibiotic use during the infectious complications in a national cohort of children 7-16 years of age with cancer. PROCEDURE: Data on infectious complications were prospectively collected from the medical records of all newly diagnosed children with cancer, aged 7-16 years, in Sweden between 2004 and 2006...
January 11, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28072793/merit-based-incentive-payment-system-meaningful-changes-in-the-final-rule-brings-cautious-optimism
#7
Laxmaiah Manchikanti, Standiford Helm Ii, Aaron K Calodney, Joshua A Hirsch
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) eliminated the flawed Sustainable Growth Rate (SGR) act formula - a longstanding crucial issue of concern for health care providers and Medicare beneficiaries. MACRA also included a quality improvement program entitled, "The Merit-Based Incentive Payment System, or MIPS." The proposed rule of MIPS sought to streamline existing federal quality efforts and therefore linked 4 distinct programs into one. Three existing programs, meaningful use (MU), Physician Quality Reporting System (PQRS), value-based payment (VBP) system were merged with the addition of Clinical Improvement Activity category...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28072666/outcomes-from-referrals-and-unscheduled-visits-from-community-emergency-departments-to-a-regional-pediatric-emergency-department-in-canada
#8
Ethan Reiner, Ardalan Ahmadi, Eric Grafstein, Quynh Doan
OBJECTIVES: Existing pediatric literature describing repeat visits to the emergency department (ED) for the same medical complaint has yet to report on patient flow patterns from general EDs (GEDs) to a pediatric ED (PED). We sought to characterize the population of patients who are treated in a GED and subsequently present to a PED for further care. METHODS: We conducted a retrospective cohort study reviewing all pediatric visits (age < 17 y) at 5 GEDs in Vancouver...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28069847/acos-serving-high-proportions-of-racial-and-ethnic-minorities-lag-in-quality-performance
#9
Valerie A Lewis, Taressa Fraze, Elliott S Fisher, Stephen M Shortell, Carrie H Colla
Accountable care organizations (ACOs) are intended, in part, to improve health care quality. However, little is known about how ACOs may affect disparities or how providers serving disadvantaged patients perform under Medicare ACO contracts. We analyzed racial and ethnic disparities in health care outcomes among ACOs to investigate the association between the share of an ACO's patients who are members of racial or ethnic minority groups and the ACO's performance on quality measures. Using data from Medicare and a national survey of ACOs, we found that having a higher proportion of minority patients was associated with worse scores on twenty-five of thirty-three Medicare quality performance measures, two disease composite measures, and an overall quality composite measure...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28062812/less-and-more-are-needed-to-assess-primary-care
#10
Rebecca S Etz, Martha M Gonzalez, E Marshall Brooks, Kurt C Stange
Significant federal investment is now being directed toward lessening the burden of clinical quality measurement; at the same time, there is growing recognition that current measures are inadequate to capture the domains of primary care that result in improved person and population health at sustainable cost. Our study reveals a significant gap between the universe of what is measured and those elements most critical to good quality primary care, indicating that the important efforts to reduce measurement burden must be accompanied by efforts to increase the relevance of measures to domains of care that affect patient-centered and community health outcomes...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28062809/new-core-quality-measures-only-a-beginning
#11
David Nowels, Douglas B Kamerow
A plethora of quality measures are used in health care for quality improvement, accountability (including reimbursement), and research. The Core Quality Measures Collaborative, with input from the American Association of Family Physicians, recently released several groups of reduced core measure sets, including one for primary care. The proposed measures are less helpful for the increasing proportion patients with multiple morbidities or advancing illness. Going forward, the development of quality measures that assess multidimensional patient experiences and how closely the health care patients receive matches their goals in the face of multiple morbidities and advancing illness should be the focus...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28062808/practice-innovation-for-care-integration-opioid-management-and-quality-measurement-in-family-medicine
#12
EDITORIAL
Anne Victoria Neale, Marjorie A Bowman, Dean A Seehusen
Ringing in the new year 2017! This may finally be the year of real practice improvement after many false starts. Research into practice transformation has informed both local work and national policy. Human factors and payment structures are key. And payment structures depend on how quality is measured. Large gaps between practicing physician recommendations for the most important quality measures and those currently imposed externally are exposed in this issue. Also see information on in-practice social work consultations and their outcomes and recommendations from innovators in integrated care, and for chronic opioid therapy management based on visits to many family medicine offices...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28061325/integrative-review-of-factors-and-interventions-that-influence-early-father-infant-bonding
#13
REVIEW
Ashley Renee Scism, Robin Lynn Cobb
OBJECTIVE: To report on the current state of research analyzing early father-infant bonding, including influential factors and interventions, to identify gaps in the literature. DATA SOURCES: CINAHL, MEDLINE, PubMed, and PsychInfo computerized databases were searched using the keywords bonding, paternal, father, infant, relationship, engrossment, and postpartum. STUDY SELECTION: Twenty-eight articles were compiled on the basis of key inclusion criteria...
January 3, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28059941/adenoma-detection-rates-for-screening-colonoscopies-in-smokers-and-obese-adults-data-from-the-new-hampshire-colonoscopy-registry
#14
Joseph C Anderson, Julia E Weiss, Christina M Robinson, Lynn F Butterly
GOAL: To examine screening adenoma detection rates (ADR) and serrated detection rates (SDR) among smokers and obese adults in the New Hampshire Colonoscopy Registry. BACKGROUND: ADR, a quality measure for screening colonoscopies, is associated with protection from interval colorectal cancer. Currently, only sex-specific ADR benchmarks are reported. However, obesity and smoking ≥20 pack-years are strong predictors for colorectal neoplasia, as highlighted by the 2009 American College of Gastroenterology CRC Screening Guidelines...
January 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28052756/small-rna-sequencing-of-cryopreserved-semen-from-single-bull-revealed-altered-mirnas-and-pirnas-expression-between-high-and-low-motile-sperm-populations
#15
E Capra, F Turri, B Lazzari, P Cremonesi, T M Gliozzi, I Fojadelli, A Stella, F Pizzi
BACKGROUND: Small RNAs present in bovine ejaculate can be linked to sperm abnormalities and fertility disorders. At present, quality parameters routinely used in semen evaluation are not fully reliable to predict bull fertility. In order to provide additional quality measurements for cryopreserved semen used for breeding, a method based on deep sequencing of sperm microRNA (miRNA) and Piwi-interacting RNA (piRNA) from individual bulls was developed. To validate our method, two populations of spermatozoa isolated from high and low motile fractions separated by Percoll were sequenced, and their small RNAs content characterized...
January 4, 2017: BMC Genomics
https://www.readbyqxmd.com/read/28050715/workflow-lexicons-in-healthcare-validation-of-the-swim-lexicon
#16
Chris Meenan, Bradley Erickson, Nancy Knight, Jewel Fossett, Elizabeth Olsen, Prerna Mohod, Joseph Chen, Steve G Langer
For clinical departments seeking to successfully navigate the challenges of modern health reform, obtaining access to operational and clinical data to establish and sustain goals for improving quality is essential. More broadly, health delivery organizations are also seeking to understand performance across multiple facilities and often across multiple electronic medical record (EMR) systems. Interpreting operational data across multiple vendor systems can be challenging, as various manufacturers may describe different departmental workflow steps in different ways and sometimes even within a single vendor's installed customer base...
January 3, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28047449/su-g-206-01-a-fully-automated-ct-tool-to-facilitate-phantom-image-qa-for-quantitative-imaging-in-clinical-trials
#17
M Wahi-Anwar, P Lo, H Kim, M Brown, M McNitt-Gray
PURPOSE: The use of Quantitative Imaging (QI) methods in Clinical Trials requires both verification of adherence to a specified protocol and an assessment of scanner performance under that protocol, which are currently accomplished manually. This work introduces automated phantom identification and image QA measure extraction towards a fully-automated CT phantom QA system to perform these functions and facilitate the use of Quantitative Imaging methods in clinical trials. METHODS: This study used a retrospective cohort of CT phantom scans from existing clinical trial protocols - totaling 84 phantoms, across 3 phantom types using various scanners and protocols...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047356/mo-fg-campus-tep2-04-optimizing-for-a-specified-target-coverage-probability
#18
A Fredriksson
PURPOSE: The purpose of this work is to develop a method for inverse planning of radiation therapy margins. When using this method the user specifies a desired target coverage probability and the system optimizes to meet the demand without any explicit specification of margins to handle setup uncertainty. METHODS: The method determines which voxels to include in an optimization function promoting target coverage in order to achieve a specified target coverage probability...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046994/su-f-t-607-study-of-dose-falloff-slope-in-rapidarc-planning-of-lung-sbrt
#19
D Desai, G Narayanasamy, S Senthamizhchelvan, H Elasmar, R Zwicker, E Johnson
PURPOSE: SBRT of lung tumor results in steep dose fall-off outside the PTV to limit the normal tissue dose. RTOG report 0915 recommended metrics for plan quality measure, CI, D2cm, R50% and HDloc were evaluated. This study was aimed at ascertaining moderate to low dose spillage using 5 mm ring structures outside the PTV. METHODS: In this retrospective study, 41 clinical RapidArc lung SBRT plans (Eclipse TPS ver 8.9) previously treated at our institution in a TrueBeam STx linac were analyzed...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045797/quality-of-care-for-work-associated-carpal-tunnel-syndrome
#20
Teryl Nuckols, Craig Conlon, Michael Robbins, Michael Dworsky, Julie Lai, Carol P Roth, Barbara Levitan, Seth Seabury, Rachana Seelam, Steven M Asch
OBJECTIVE: To evaluate the quality of care provided to individuals with workers' compensation claims related to Carpal tunnel syndrome (CTS) and identify patient characteristics associated with receiving better care. METHODS: We recruited subjects with new claims for CTS from 30 occupational clinics affiliated with Kaiser Permanente Northern California. We applied 45 process-oriented quality measures to 477 subjects' medical records, and performed multivariate logistic regression to identify patient characteristics associated with quality...
January 2017: Journal of Occupational and Environmental Medicine
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