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https://www.readbyqxmd.com/read/28324321/structured-data-entry-in-the-electronic-medical-record-perspectives-of-pediatric-specialty-physicians-and-surgeons
#1
Ruth A Bush, Cynthia Kuelbs, Julie Ryu, Wen Jiang, George Chiang
The Epic electronic health record (EHR) platform supports structured data entry systems (SDES), which allow developers, with input from users, to create highly customized patient-record templates in order to maximize data completeness and to standardize structure. There are many potential advantages of using discrete data fields in the EHR to capture data for secondary analysis and epidemiological research, but direct data acquisition from clinicians remains one of the largest obstacles to leveraging the EHR for secondary use...
May 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28319619/cost-of-diagnosing-psoriasis-and-rosacea-for-dermatologists-versus-primary-care-physicians
#2
Dane Hill, Steven R Feldman
Growing incentives to control health care costs may cause accountable care organizations (ACOs) to reconsider how skin disease is best managed. Limited data have suggested that disease management by a primary care physician (PCP) may be less costly than seeing a specialist, though it is not clear if the same is true for the management of skin disease. This study assessed the cost of seeing a dermatologist versus a PCP for diagnosis of psoriasis and rosacea.
February 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28306149/medicare-access-and-chip-reauthorization-act-what-do-geriatrics-healthcare-professionals-need-to-know-about-the-quality-payment-program
#3
Kathleen T Unroe, Peter A Hollmann, Alanna C Goldstein, Michael L Malone
Commencing in 2017, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 will change how Medicare pays health professionals. By enacting MACRA, Congress brought an end to the (un)sustainable growth rate formula while also setting forth a vision for how to transform the U.S. healthcare system so that clinicians deliver higher-quality care with smarter spending by the Centers for Medicare and Medicaid Services (CMS). In October 2016, CMS released the first of what stakeholders anticipate will be a number of (annual) rules related to implementation of MACRA...
March 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28301695/justifying-clinical-nudges
#4
Moti Gorin, Steven Joffe, Neal Dickert, Scott Halpern
The shift away from paternalistic decision-making and toward patient-centered, shared decision-making has stemmed from the recognition that in order to practice medicine ethically, health care professionals must take seriously the values and preferences of their patients. At the same time, there is growing recognition that minor and seemingly irrelevant features of how choices are presented can substantially influence the decisions people make. Behavioral economists have identified striking ways in which trivial differences in the presentation of options can powerfully and predictably affect people's choices...
March 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28299031/continuity-of-care-evaluation-the-view-of-patients-and-professionals-about-urban-family-physician-program
#5
Vahid Kohpeima Jahromi, Mohammad Hossein Mehrolhassani, Reza Dehnavieh, Hosein Saberi Anari
BACKGROUND: A responsibility of the family physician (FP) and one of the four aspects of the delivery of primary care services is continuity of care (COC). This study aimed to determine the COC of health care in urban health centers. METHODS: Between September 2015 and March 2016, we conducted a cross-sectional study using Primary Care Evaluation Tool questionnaires with multistage stratified cluster sample of FPs (n = 141) and patients (n = 710) in two provinces in Iran, Fars and Mazandaran...
2017: International Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28282336/practitioner-application-results-knowledge-and-attitudes-regarding-an-incentive-compensation-plan-in-a-hospital-based-academic-employed-physician-multispecialty-group
#6
Margaret B Row
No abstract text is available yet for this article.
March 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28282335/results-knowledge-and-attitudes-regarding-an-incentive-compensation-plan-in-a-hospital-based-academic-employed-physician-multispecialty-group
#7
Robert W Dolan, Richard Nesto, Stacey Ellender, Christopher Luccessi
Hospitals and healthcare systems are introducing incentive metrics into compensation plans that align with value-based payment methodologies. These incentive measures should be considered a practical application of the transition from volume to value and will likely replace traditional productivity-based compensation in the future. During the transition, there will be provider resistance and implementation challenges. This article examines a large multispecialty group's experience with a newly implemented incentive compensation plan including the structure of the plan, formulas for calculation of the payments, the mix of quality and productivity metrics, and metric threshold achievement...
March 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28279924/physicians-responses-to-financial-and-social-incentives-a-medically-framed-real-effort-experiment
#8
Mylène Lagarde, Duane Blaauw
Because compensation policies have critical implications for the provision of health care, and evidence of their effects is limited and difficult to study in the real world, laboratory experiments may be a valuable methodology to study the behavioural responses of health care providers. With this experiment undertaken in 2013, we add to this new literature by designing a new medically framed real effort task to test the effects of different remuneration schemes in a multi-tasking context. We assess the impact of different incentives on the quantity (productivity) and quality of outputs of 132 participants...
March 2, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28274548/-barriers-and-facilitators-to-implementing-shared-decision-making-in-oncology-patient-perceptions
#9
M Ortega-Moreno, N Padilla-Garrido, L Huelva-López, F Aguado-Correa, J Bayo-Calero, E Bayo-Lozano
OBJECTIVE: To determine, from the point of view of the oncological patient, who made the decision about their treatment, as well as the major barriers and facilitators that enabled Shared Decision Making to be implemented. MATERIAL AND METHODS: A cross-sectional, descriptive, sand association study using a self-report questionnaire to selected cancer patients, with casual sampling in different oncology clinics and random time periods. A total of 108 patients provided analysable data...
March 5, 2017: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/28271423/a-quasi-experiment-to-assess-the-impact-of-a-scalable-community-based-weight-loss-program-combining-reach-effectiveness-and-cost
#10
Paul A Estabrooks, Kathryn E Wilson, Todd J McGuire, Samantha M Harden, NithyaPriya Ramalingam, Lia Schoepke, Fabio A Almeida, Amy L Bayer
BACKGROUND: Primary care addresses obesity through physician oversight of intensive lifestyle interventions or referral to external programs with demonstrated efficacy. However, limited information exists on community program reach, effectiveness, and costs across different groups of participants. OBJECTIVE: To evaluate a scalable, community weight loss program using reach, effectiveness, and cost metrics. DESIGN: Longitudinal pre-post quasi-experiment without control...
March 7, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28264948/early-impact-of-carefirst-s-patient-centered-medical-home-with-strong-financial-incentives
#11
Christopher C Afendulis, Laura A Hatfield, Bruce E Landon, Jonathan Gruber, Mary Beth Landrum, Robert E Mechanic, Darren E Zinner, Michael E Chernew
In 2011 CareFirst BlueCross BlueShield, a large mid-Atlantic health insurance plan, implemented a payment and delivery system reform program. The model, called the Total Care and Cost Improvement Program, includes enhanced payments for primary care, significant financial incentives for primary care physicians to control spending, and care coordination tools to support progress toward the goal of higher-quality and lower-cost patient care. We conducted a mixed-methods evaluation of the initiative's first three years...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28251600/surgery-and-trauma-care-providers-perception-of-the-impact-of-dual-practice-employment-on-quality-of-care-provided-in-an-andean-country
#12
L N LaGrone, L N Isquith-Dicker, E Huaman Egoavil, J J Herrera-Matta, A K Fuhs, D Ortega Checa, F Revoredo, M J A Rodriguez Castro, C N Mock
BACKGROUND: Dual-practice, simultaneous employment by healthcare workers in the public and private sectors is pervasive worldwide. Although an estimated 30 per cent of the global burden of disease is surgical, the implications of dual practice on surgical care are not well understood. METHODS: Anonymous in-depth individual interviews on trauma quality improvement practices were conducted with healthcare providers who participate in the care of the injured at ten large hospitals in Peru's capital city, Lima...
March 2, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28245662/sustained-participation-in-a-pay-for-value-program-impact-on-high-need-patients
#13
Dori A Cross, Genna R Cohen, Christy Harris Lemak, Julia Adler-Milstein
OBJECTIVE: To assess whether multi-year engagement by primary care practices in a pay-for-value program was associated with improved care for high-need patients. STUDY DESIGN: Longitudinal cohort study of 17,443 patients with 2 or more conditions who were assigned to primary care providers (PCPs) within 1582 practices that did and did not continuously participate in Blue Cross Blue Shield of Michigan's pay-for-value program (the Physician Group Incentive Program [PGIP]) between 2010 and 2013...
February 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28226336/educational-outreach-to-opioid-prescribers-the-case-for-academic-detailing
#14
Margot Trotter Davis, Brian Bateman, Jerry Avorn
Nonmedical use of opioid medications constitutes a serious health threat as the rates of addiction, overdoses, and deaths have risen in recent years. Increasingly, inappropriate and excessively liberal prescribing of opioids by physicians is understood to be a central part of the crisis. Public health officials, hospital systems, and legislators are developing programs and regulations to address the problem in sustained and systematic ways that both insures effective treatment of pain and appropriate limits on the availability of opioids...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28226301/the-influence-of-welfare-systems-on-pay-for-performance-programs-for-general-practitioners-a-critical-review
#15
REVIEW
Mehdi Ammi, Grant Fortier
While pay-for-performance (P4P) programs are increasingly common tools used to foster quality and efficiency in primary care, the evidence concerning their effectiveness is at best mixed. In this article, we explore the influence of welfare systems on four P4P-related dimensions: the level of healthcare funders' commitment to P4Ps (by funding and length of program operation), program design (specifically target-based vs. participation-based program), physicians' acceptance of the program and program effects...
February 16, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28221895/use-of-evidence-based-prostate-cancer-imaging-in-a-nongovernmental-integrated-health-care-system
#16
Ramzi G Salloum, Maureen O'Keeffe-Rosetti, Debra P Ritzwoller, Mark C Hornbrook, Jennifer Elston Lafata, Matthew E Nielsen
PURPOSE: The overuse of imaging, particularly for staging of low-risk prostate cancer, is well documented and widespread. The existing literature, which focuses on the elderly in fee-for-service settings, points to financial incentives as a driver of overuse and may not identify factors relevant to policy solutions within integrated health care systems, where physicians are salaried. METHODS: Imaging rates were analyzed among men with incident prostate cancer diagnosed between 2004 and 2011 within the Colorado and Northwest regions of Kaiser Permanente...
February 21, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28212657/pharmacists-views-and-reported-practices-in-relation-to-a-new-generic-drug-substitution-policy-in-lebanon-a-mixed-methods-study
#17
Fadi El-Jardali, Racha Fadlallah, Rami Z Morsi, Nour Hemadi, Mounir Al-Gibbawi, Magda Haj, Suzan Khalil, Youssef Saklawi, Diana Jamal, Elie A Akl
BACKGROUND: Governments in both developed and developing countries have adopted generic drug substitution policies to decrease pharmaceutical expenditures and improve access to medicine. In August 2015, the Ministry of Public Health (MOPH) in Lebanon introduced generic drug substitution and a unified medical prescription form as policy instruments to promote generic drug use. The objective of this exploratory study was to examine the attitudes of community pharmacists and the reported practices in relation to the implementation of the new generic drug substitution policy...
February 17, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28196461/national-rates-and-patterns-of-depression-screening-in-primary-care-results-from-2012-and-2013
#18
Ayse Akincigil, Elizabeth B Matthews
OBJECTIVES: Despite high prevalence rates of depression in primary care, depressive symptoms are often undetected by physicians. Screening for depression is now recommended as a part of routine primary care; however, recent estimates of rates and patterns of depression screening are lacking in the literature. This study examined national rates and patterns of depression screening among visits to office-based primary care physicians. METHODS: A secondary analysis of data from the 2012 and 2013 National Ambulatory Medical Care Survey was conducted...
February 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28196448/provider-perspectives-on-advance-care-planning-documentation-in-the-electronic-health-record
#19
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/28167594/incidences-and-costs-of-illness-for-diarrhea-and-acute-respiratory-infections-for-children-5-years-of-age-in-rural-bangladesh
#20
Amal K Halder, Stephen P Luby, Shamima Akhter, Probir K Ghosh, Richard B Johnston, Leanne Unicomb
Understanding illness costs associated with diarrhea and acute respiratory infections (ARI) could guide prevention and treatment strategies. This study aimed to determine incidence of childhood diarrhea and ARI and costs of homecare, hospitalization, and outpatient treatment by practitioner type in rural Bangladesh. From each of 100 randomly selected population clusters we sampled 17 households with at least one child < 5 years of age. Childhood diarrhea incidence was 3,451 and ARI incidence was 5,849/1,000 child-years...
February 6, 2017: American Journal of Tropical Medicine and Hygiene
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