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https://www.readbyqxmd.com/read/28224938/overview-on-the-challenges-and-benefits-of-using-telehealth-tools-in-a-pediatric-population
#1
REVIEW
Patrick D Brophy
Telehealth in Pediatric Medicine presents many of the same benefits and challenges noted in adult-based medicine. In terms of health care delivery, the promise of improving access and reducing costs using telehealth in Pediatrics, particularly chronic care, is high. The ability to address clinician shortages and provide remote guidance for chronic care pathways from pediatric subspecialists to rural-based referring physicians is a developing model that represents a sustainable and cost-effective strategy to improve pediatric care...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28224937/telehealth-in-the-delivery-of-home-dialysis-care-catching-up-with-technology
#2
REVIEW
Vinay N Krishna, Kamesha Managadi, Michael Smith, Eric Wallace
Geographic and socioeconomic barriers may pose a significant difficulty in delivering home dialysis care to remote underserved populations leading to low utilization rates and poor outcomes. Telehealth may serve as a solution to overcome geographic barriers in delivering home dialysis care. Although technologic advances in telehealth have progressed rapidly making it accessible and inexpensive, it has been underused by nephrologists. Components of a regular face-to-face visit that can be successfully accomplished remotely using telehealth techniques include physician-patient communication, physical examination, laboratory and treatment data monitoring, nursing and nutrition education...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28224441/does-medicaid-insurance-confer-adequate-access-to-adult-orthopaedic-care-in-the-era-of-the-patient-protection-and-affordable-care-act
#3
Joseph T Labrum, Taylor Paziuk, Theresa C Rihn, Alan S Hilibrand, Alexander R Vaccaro, Mitchell G Maltenfort, Jeffrey A Rihn
BACKGROUND: A current appraisal of access to orthopaedic care for the adult patient receiving Medicaid is important, since Medicaid expansion was written into law by the Patient Protection and Affordable Care Act (PPACA). QUESTIONS/PURPOSES: (1) Do orthopaedic practices provide varying access to orthopaedic care for simulated patients with Medicaid insurance versus private insurance in a blinded survey? (2) What are the surveyed state-by-state Medicaid acceptance rates for adult orthopaedic practices in the current era of Medicaid expansion set forth by the PPACA? (3) Do surveyed rates of access to orthopaedic care in the adult patient population vary across practice setting (private vs academic) or vary with different Medicaid physician reimbursement rates? (4) Are there differences in the surveyed Medicaid acceptance rates for adult orthopaedic practices in states that have expanded Medicaid coverage versus states that have foregone expansion? METHODS: Simulated Patient Survey: We performed a telephone survey study of orthopaedic offices in four states with Medicaid expansion...
February 21, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28221304/outcome-measures-in-myasthenia-gravis-incorporation-into-clinical-practice
#4
Srikanth Muppidi
The development of validated assessment tools for evaluating disease status and response to interventions in patients with myasthenia gravis (MG) has been driven by clinical studies of emerging MG therapies. However, only a small proportion of MG-focused neurology practices have adopted these assessment tools for routine clinical use. This article reviews the suitability of 5 assessment instruments for incorporation into clinical practice, which should be driven by their ability to contribute to improved patient outcomes, and to be implemented within practice personnel and resource constraints...
March 2017: Journal of Clinical Neuromuscular Disease
https://www.readbyqxmd.com/read/28218867/-screening-diagnosis-treatment-and-follow-up-of-hepatitis-c-virus-related-liver-disease-national-consensus-guideline-in-hungary-from-15-october-2016
#5
Béla Hunyady, Zsuzsanna Gerlei, Judit Gervain, Gábor Horváth, Gabriella Lengyel, Alajos Pár, Zoltán Péter, László Rókusz, Ferenc Schneider, Ferenc Szalay, István Tornai, Klára Werling, Mihály Makara
Treatment of hepatitis C is based on a national consensus guideline updated six-monthly according to local availability and affordability of approved therapies through a transparent allocation system in Hungary. This updated guideline incorporates some special new aspects, including recommendations for screening, diagnostics, use and allocation of novel direct acting antiviral agents. Indication of therapy in patients with no contraindication is based on demonstration of viral replication with consequent inflammation and/or fibrosis in the liver...
February 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28218628/childhood-obesity-screening-and-treatment-practices-of-pediatric-healthcare-providers
#6
Amanda Staiano, Arwen Marker, Michelle Liu, Ellery Hayden, Daniel Hsia, Stephanie Broyles
This study evaluated physicians' childhood obesity screening and treatment practices. A 26-question survey was delivered to pediatric providers in-person or via mail, e-mail, or fax throughout Louisiana. Fifty-seven providers completed the survey, the majority in primary care clinics. Five providers met at least four of seven clinical guidelines, but no provider met all of the guidelines. Whereas 88% of providers screened for obesity, 7% met guidelines for referring patients with obesity to weight management services...
January 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28217968/payer-type-and-low-value-care-comparing-choosing-wisely-services-across-commercial-and-medicare-populations
#7
Carrie H Colla, Nancy E Morden, Thomas D Sequist, Alexander J Mainor, Zhonghe Li, Meredith B Rosenthal
OBJECTIVE: To compare low-value health service use among commercially insured and Medicare populations and explore the influence of payer type on the provision of low-value care. DATA SOURCES: 2009-2011 national Medicare and commercial insurance administrative data. DESIGN: We created claims-based algorithms to measure seven Choosing Wisely-identified low-value services and examined the correlation between commercial and Medicare overuse overall and at the regional level...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28207807/how-much-is-a-child-worth-providers-and-patients-views-and-responses-concerning-ethical-and-policy-challenges-in-paying-for-art
#8
Robert Klitzman
Infertility treatments remain expensive and in many countries are covered by little, if any, insurance, raising critical questions concerning how patients and providers view and make decisions regarding these challenges. In-depth semi-structured interviews of approximately 1 hour were conducted with 37 IVF providers and 10 patients (17 physicians, 10 other providers and 10 patients), and were systematically analyzed. These data suggest current insurance policies and legislation pose critical ethical and logistical challenges for both patients and providers...
2017: PloS One
https://www.readbyqxmd.com/read/28201849/the-role-of-value-based-care-in-patients-with-cirrhosis
#9
Michael L Volk
Value-based care means delivering high-quality care while keeping costs at a reasonable level. Many physicians have long viewed quality care and the responsible utilization of resources to be an integral part of their professional responsibilities. As the health care system changes, however, physicians are increasingly being asked to objectively demonstrate value. In this review article, the author describes the reimbursement and regulatory shift toward value-based care, and provides specific strategies for meeting this care...
February 2017: Seminars in Liver Disease
https://www.readbyqxmd.com/read/28196448/provider-perspectives-on-advance-care-planning-documentation-in-the-electronic-health-record
#10
Ellis Dillon, Judith Chuang, Atul Gupta, Sharon Tapper, Steve Lai, Peter Yu, Christine Ritchie, Ming Tai-Seale
CONTEXT: Advance care planning (ACP) is valued by patients and clinicians, yet documenting ACP in an accessible manner is problematic. OBJECTIVES: In order to understand how providers incorporate electronic health record (EHR) ACP documentation into clinical practice, we interviewed providers in primary care and specialty departments about ACP practices (n = 13) and analyzed EHR data on 358 primary care providers (PCPs) and 79 specialists at a large multispecialty group practice...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28195003/average-duration-of-treatment-with-antipsychotics-among-concession-card-holders-in-australia
#11
Svein R Kjosavik, Marianne H Gillam, Elisabeth E Roughead
OBJECTIVE: To analyse average treatment duration with antipsychotics reimbursed for concession card holders under the Pharmaceutical Benefits Scheme; the proportion of initial prescribing by general practitioners, psychiatrists and other physician; and the trend in drug choice in Australia. METHOD: Based on a representative 10% sample of patients receiving Pharmaceutical Benefits Scheme prescriptions since 2005, antipsychotics redeemed by concession card holders in the period from 2010 to 2013 were analysed...
February 1, 2017: Australian and New Zealand Journal of Psychiatry
https://www.readbyqxmd.com/read/28193376/radiology-research-in-quality-and-safety-current-trends-and-future-needs
#12
REVIEW
Matthew E Zygmont, Jason N Itri, Andrew B Rosenkrantz, Phuong-Anh T Duong, Lori Mankowski Gettle, Mishal Mendiratta-Lala, Elena P Scali, Ronald S Winokur, Linda Probyn, Justin W Kung, Eric Bakow, Nadja Kadom
Promoting quality and safety research is now essential for radiology as reimbursement is increasingly tied to measures of quality, patient safety, efficiency, and appropriateness of imaging. This article provides an overview of key features necessary to promote successful quality improvement efforts in radiology. Emphasis is given to current trends and future opportunities for directing research. Establishing and maintaining a culture of safety is paramount to organizations wishing to improve patient care. The correct culture must be in place to support quality initiatives and create accountability for patient care...
March 2017: Academic Radiology
https://www.readbyqxmd.com/read/28192148/something-new-in-the-air-paying-for-community-based-environmental-approaches-to-asthma-prevention-and-control-work-group-report-of-the-practice-diagnostics-and-therapeutics-committee-of-the-american-academy-of-allergy-asthma-immunology
#13
Megan M Tschudy, Joshua Sharfstein, Elizabeth Matsui, Charles S Barnes, Stacey Chacker, Rosa Codina, John R Cohn, Megan Sandel, H James Wedner
Despite the recommendation in national asthma guidelines to target indoor environmental exposures, most insurers generally have not covered the outreach, education, environmental assessments, or durable goods integral to home environmental interventions. Emerging payment approaches, however, offer new potential for coverage of home-based environmental intervention costs. These opportunities are becoming available as public and private insurers shift reimbursement to reward better health outcomes and their key characteristic is a focus on the value rather than the volume of services...
February 10, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28181058/analysis-of-reimbursement-of-genetic-counseling-services-at-a-single-institution-in-a-state-requiring-licensure
#14
Jennifer R Leonhard, Paul J Munson, Jason D Flanagan, Kristen L De Berg, Paul A Thompson, Lori W Dean, Quinn P Stein
Reimbursement for genetic counseling services was examined at a single institution. Patient encounters utilizing the 96040 CPT® code from 7/31/2009 through 7/31/2013 were reviewed. Exclusion criteria included billing records of patients seen by a physician the same day, self-pay, Medicaid, and Medicare patients. Of the 8,630 encounters with a genetic counselor, 582 encounters were eligible for review. Descriptive statistics (i.e., percentage of encounters receiving some level of reimbursement, average reimbursement rate, number of third party payors providing any level of reimbursement, and number of ICD-9 codes receiving any level of reimbursement) depicted reimbursement of the 96040 CPT® code for the encounters analyzed...
February 8, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28169959/the-impact-of-preoperative-depression-on-hospital-consumer-assessment-of-healthcare-providers-and-systems-hcahps-survey-results-in-a-lumbar-fusion-population
#15
Jay M Levin, Robert D Winkelman, Gabriel A Smith, Joseph Tanenbaum, Edward C Benzel, Thomas E Mroz, Michael P Steinmetz
STUDY DESIGN: A retrospective cohort study at a single institution. OBJECTIVE: To determine the effect of preoperative depression on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores in a lumbar fusion population. SUMMARY OF BACKGROUND DATA: HCAHPS surveys are used to assess the quality of the patient experience, and directly influences reimbursement for hospital systems and spine surgeons nationwide. Untreated depression has been linked to worse functional outcomes in spine surgery...
February 6, 2017: Spine
https://www.readbyqxmd.com/read/28168332/a-rapid-systematic-review-of-outcomes-studies-in-genetic-counseling
#16
REVIEW
Lisa Madlensky, Angela M Trepanier, Deborah Cragun, Barbara Lerner, Kristen M Shannon, Heather Zierhut
As healthcare reimbursement is increasingly tied to value-of-service, it is critical for the genetic counselor (GC) profession to demonstrate the value added by GCs through outcomes research. We conducted a rapid systematic literature review to identify outcomes of genetic counseling. Web of Science (including PubMed) and CINAHL databases were systematically searched to identify articles meeting the following criteria: 1) measures were assessed before and after genetic counseling (pre-post design) or comparisons were made between a GC group vs...
February 6, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28159476/treatment-induced-neuropathy-of-diabetes-long-term-implications-in-type-1-diabetes
#17
Christopher H Gibbons
AIMS/HYPOTHESIS: Aggressive glucose control can result in treatment induced neuropathy of diabetes (TIND) if glycemic control is achieved too quickly. The aim of the present study is to describe the 8-year follow-up data on a cohort of individuals with type 1 diabetes who developed TIND. METHODS: Twenty-six individuals with type 1 diabetes and TIND were followed longitudinally for 8years with regular quantitative measurement of pain, neurological examinations and evaluation of microvascular complications...
January 21, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28157382/electronic-health-record-ehr-organizational-change-explaining-resistance-through-profession-organizational-experience-and-ehr-communication-quality
#18
Ashley K Barrett
The American Recovery and Reinvestment Act passed by the U.S. government in 2009 mandates that all healthcare organizations adopt a certified electronic health record (EHR) system by 2015. Failure to comply will result in Medicare reimbursement penalties, which steadily increase with each year of delinquency. There are several repercussions of this seemingly top-down, rule-bound organizational change-one of which is employee resistance. Given the penalties for violating EHR meaningful use standards are ongoing, resistance to this mandate presents a serious issue for healthcare organizations...
February 3, 2017: Health Communication
https://www.readbyqxmd.com/read/28153856/death-of-outrage-over-talking-about-dying
#19
Nrupen A Bhavsar, Sara Constand, Matthew Harker, Donald H Taylor
OBJECTIVES: We examined public reaction to the proposed Center for Medicare and Medicaid Services rule reimbursing physicians for advanced care planning (ACP) discussions with patients. METHODS: Public comments made on regulations.gov were reviewed for relevance to ACP policy and their perceived position on ACP (ie, positive, negative and neutral). Descriptive statistics were used to quantify the results. RESULTS: A total of 2225 comments were submitted to regulations...
February 2, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28153189/components-of-a-successful-peritoneal-dialysis-program
#20
REVIEW
Xueqing Yu, Rajnish Mehrotra, Xiao Yang
Although varying widely among different countries and geographic regions, the development of peritoneal dialysis invariably requires a well-established program. Key ingredients for the successful delivery of this therapy include adequate chronic kidney disease education, governmental or nongovernmental reimbursement, qualified physicians and nurses trained in the principles and practice of peritoneal dialysis, clinical management that incorporates an excellent and well-trained peritoneal dialysis team, a feasible and well-designed program for catheter insertion, a sound patient training and follow-up scheme, and continuous quality improvement...
January 2017: Seminars in Nephrology
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