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Physician quality reporting system

Deven A Karvelas, Sean D Rundell, Janna L Friedly, Alfred C Gellhorn, Laura S Gold, Bryan A Comstock, Patrick J Heagerty, Brian W Bresnahan, David R Nerenz, Jeffrey G Jarvik
BACKGROUND: The association between early physical therapy (PT) and subsequent healthcare utilization following a new visit for low back pain is not clear, particularly in the setting of acute low back pain. PURPOSE: To estimate the association between initiating early physical therapy following a new visit for an episode of low back pain and subsequent back-pain-specific health care utilization in older adults. STUDY DESIGN/SETTING: Prospective cohort study...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Sytske Anne Bergstra, Pedro M M C Machado, Rosaline van den Berg, Robert B M Landewé, Tom W J Huizinga
OBJECTIVES: Ten years ago, the METEOR tool was developed to simulate treatment-to-target and create an international research database. The development of the METEOR tool and database, research opportunities and future perspectives are described. METHODS: The METEOR tool is a free, online, internationally available tool in which daily practice visits of all rheumatoid arthritis patients visiting a rheumatologist can be registered. In the tool, disease characteristics, patient- and physician-reported outcomes and prescribed treatment could be entered...
September 2016: Clinical and Experimental Rheumatology
Theodore Pincus
An MDHAQ/RAPID3 (multidimensional health assessment questionnaire/routine assessment of patient index data) was developed from the HAQ over 25 years, based on observations made from completion by every patient (with all diagnoses) at every routine rheumatology visit since 1980. Modification of the HAQ was viewed as similar to improving a laboratory test, with a primary focus on clinical value for diagnosis, prognosis, and/or management, as well as feasibility for minimal effect on clinical workflow. Rigorous attention, was also directed to validity, reliability, other methodologic and technological considerations, but after clinical value and feasibility were established...
September 2016: Clinical and Experimental Rheumatology
Ernesto Schiffrin
Clinical practice guidelines, which are systematically developed statements aimed at helping people make clinical, policy-related and system-related decisions, frequently vary widely in quality. A strategy is needed to differentiate among guidelines and ensure that those of the highest quality are implemented. Hypertension Canada provides annually updated standardized recommendations and clinical practice guidelines to detect, treat and control hypertension. The annual, evidence-based recommendations are developed through intense discussion of the clinical implications via a systematic review of the literature followed by critical appraisals of all the new clinical research, taking into account the assessment criteria in the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument that evaluates the process of practice guideline development and the quality of reporting...
September 2016: Journal of Hypertension
Tamar Sapir, Erica Rusie, Laurence Greene, Jinoos Yazdany, Mark L Robbins, Eric M Ruderman, Jeffrey D Carter, Barry Patel, Kathleen Moreo
INTRODUCTION: In recent years researchers have reported deficits in the quality of care provided to patients with rheumatoid arthritis (RA), including low rates of performance on quality measures. We sought to determine the influence of a quality improvement (QI) continuing education program on rheumatologists' performance on national quality measures for RA, along with other measures aligned with National Quality Strategy priorities. Performance was assessed through baseline and post-education chart audits...
December 2015: Rheumatol Ther
Joshua R Ehrlich, Monica Michelotti, Taylor S Blachley, Kai Zheng, Mick P Couper, Grant M Greenberg, Sharon Kileny, Greta L Branford, David A Hanauer, Jennifer S Weizer
OBJECTIVES: To understand the attitudes and perceptions of ophthalmologists toward an electronic health record (EHR) system, before and after its clinical implementation. METHODS: Ophthalmologists at a single large academic ophthalmology department were surveyed longitudinally before and after implementation of a new EHR system. The survey measured ophthalmologists' attitudes toward implementation of a new EHR. Questions focused on satisfaction, efficiency, and documentation...
October 12, 2016: Applied Clinical Informatics
Martin Dawes, Martin N Aloise, J Sidney Ang, Pieter Cullis, Diana Dawes, Robert Fraser, Gideon Liknaitzky, Andrea Paterson, Paul Stanley, Adriana Suarez-Gonzalez, Hagit Katzov-Eckert
BACKGROUND: Inappropriate prescribing increases patient illness and death owing to adverse drug events. The inclusion of genetic information into primary care medication practices is one solution. Our aim was to assess the ability to obtain and genotype saliva samples and to determine the levels of use of a decision support tool that creates medication options adjusted for patient characteristics, drug-drug interactions and pharmacogenetics. METHODS: We conducted a cohort study in 6 primary care settings (5 family practices and 1 pharmacy), enrolling 191 adults with at least 1 of 10 common diseases...
July 2016: CMAJ Open
Andrea Driscoll, Sharon Meagher, Rhoda Kennedy, Melanie Hay, Jayant Banerji, Donald Campbell, Nicholas Cox, Debra Gascard, David Hare, Karen Page, Voltaire Nadurata, Rhonda Sanders, Harry Patsamanis
BACKGROUND: Hospital admissions for heart failure are predicted to rise substantially over the next decade placing increasing pressure on the health care system. There is an urgent need to redesign systems of care for heart failure to improve evidence-based practice and create seamless transitions through the continuum of care. The aim of the review was to examine systems of care for heart failure that reduce hospital readmissions and/or mortality. METHOD: Electronic databases searched were: Ovid MEDLINE, EMBASE, CINAHL, grey literature, reviewed bibliographies and Cochrane Central Register of Controlled Trials for randomised controlled trials, non-randomised trials and cohort studies from 1(st) January 2008 to 4(th) August 2015...
October 11, 2016: BMC Cardiovascular Disorders
Maria K Peltola, Joel S Lehikoinen, Lauri T Sippola, Kauko Saarilahti, Antti A Mäkitie
INTRODUCTION: The patient's role in toxicity reporting is increasingly acknowledged. There is also a need for developing modern communication methods between the patient and the medical personnel. Furthermore, the increasing number of head and neck cancer (HNC) patients is reflected in the volume of treatment follow-up visits, which remains a challenge for the health care. Electronic patient-reported outcome (ePRO) measures may provide a cost-efficient way to organize follow-up for cancer patients...
2016: Clinical Medicine Insights. Ear, Nose and Throat
A K Lofters, M Slater, M Vahabi
Cancer screening is a core component of family medicine but screening inequalities are well documented in Canada for foreign-born persons. Although people of Muslim faith and culture are the fastest growing immigrant population in Canada, there is little information in the literature about their cancer screening practices. Determining screening gaps could inform practice-based quality improvement initiatives. We conducted a retrospective chart review combining patient-level medical record data with self-reported religious affiliation to examine the relationship between religion and cancer screening in a large multi-site urban family practice...
October 6, 2016: Journal of Immigrant and Minority Health
Roberto W Dal Negro, Massimiliano Mazzolini, Paola Turco, Alessandro Zanasi
BACKGROUND: Cough is one of the most common discomforts affecting general population, which can disrupt subjects' quality of life due to its physical, social, and psychological effects. Aim of the study was to investigate the impact of cough and related beliefs of general population. METHODS: A cross-sectional telephone survey was carried out by means of a specific, validated questionnaire on a representative sample of Italian general population. All the interviews were carried out according to the Computer Assisted Telephone Interview (CATI) methodology by expert, professional interviewers...
2016: Multidisciplinary Respiratory Medicine
David Peiris, Madeleine C Phipps-Taylor, Courtney A Stachowski, Lee-Sien Kao, Stephen M Shortell, Valerie A Lewis, Meredith B Rosenthal, Carrie H Colla
Accountable care organizations (ACOs) have diverse contracting arrangements and have displayed wide variation in their performance. Using data from national surveys of 399 ACOs, we examined differences between the 228 commercial ACOs (those with commercial payer contracts) and the 171 noncommercial ACOs (those with only public contracts, such as with Medicare or Medicaid). Commercial ACOs were significantly larger and more integrated with hospitals, and had lower benchmark expenditures and higher quality scores, compared to noncommercial ACOs...
October 1, 2016: Health Affairs
Anahita Sadeghi, Hamidreza Aghaei Meybodi, Behrouz Navabakhsh, Ahmadreza Soroush, Masoud Mohammad Malekzadeh, Zhamak Khorgami
Quality of clinical education for medical students has always been a concern in academic medicine. This concern has increased in today's time-squeeze while faculty members have to fulfill their complementary roles as a teacher, researcher, and practitioner. One of the strategies for program evaluation is obtaining trainees' feedbacks since they are the main customers of educational programs; however, there are debates about the efficacy of student feedback as a reliable source for reforms. We gathered Likert scores on a 16-item questionnaire from 2,771 medical students participating in all clerkship programs in a multidisciplinary teaching hospital...
August 2016: Acta Medica Iranica
Nasriah Zakaria, Shafiz Affendi Mohd Yusof
BACKGROUND: Hospital Information Systems (HIS) can improve healthcare outcome quality, increase efficiency, and reduce errors. The government of Malaysia implemented HIS across the country to maximize the use of technology to improve healthcare delivery, however, little is known about the benefits and challenges of HIS adoption in each institution. This paper looks at the technology and people issues in adopting such systems. METHODS: The study used a case study approach, using an in-depth interview with multidisciplinary medical team members who were using the system on a daily basis...
September 24, 2016: Journal of Infection and Public Health
Savithri Nageswaran, Shannon L Golden
The objectives of this study were to describe how home healthcare nurses collaborate with other clinicians caring for children with medical complexity, and identify barriers to collaboration within the medical neighborhood. Using qualitative data obtained from 20 semistructured interviews (15 English, 5 Spanish) with primary caregivers of children with medical complexity and 18 home healthcare nurses, researchers inquired about experiences with home healthcare nursing services for these children. During an iterative analysis process, recurrent themes were identified by their prevalence and salience in the data...
October 2016: Home Healthcare Now
Laxmaiah Manchikanti, Alan D Kaye, Joshua A Hirsch
The Centers for Medicare and Medicaid Services (CMS) released the proposed 2017 Medicare physician fee schedule on July 7, 2016, addressing Medicare payments for physicians providing services either in an office or facility setting, which also includes payments for office expenses and quality provisions for physicians. This proposed rule occurs in the context of numerous policy changes, most notably related to the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) and its Merit-Based Incentive Payment System (MIPS)...
September 2016: Pain Physician
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
UNLABELLED: The Merit-based Incentive Payment System (MIPS) was created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to improve the health of all Americans by providing incentives and policies to improve patient health outcomes. MIPS combines 3 existing programs, Meaningful Use (MU), now called Advancing Care Information (ACI), contributing 25% of the composite score; Physician Quality Reporting System (PQRS), changed to Quality, contributing 50% of the composite score; and Value-based Payment (VBP) system to Resource Use or cost, contributing 10% of the composite score...
September 2016: Pain Physician
Debra E Weese-Mayer, Casey M Rand, Amy Zhou, Michael S Carroll, Carl E Hunt
The "bedside-to-bench" CCHS research journey has led to increased phenotypic-genotypic knowledge regarding autonomic nervous system (ANS) regulation, and improved clinical outcomes. CCHS is a neurocristopathy characterized by hypoventilation and ANS dysregulation. Initially described in 1970, timely diagnosis and treatment remained problematic until the first large cohort report (1992), delineating clinical presentation and treatment options. A central role of ANS dysregulation (2001) emerged, precipitating evaluation of genes critical to ANS development, and subsequent 2003 identification of PHOX2B as the disease-defining gene for CCHS...
September 27, 2016: Pediatric Research
Adam Lustig, Michael Ogden, Robert W Brenner, Jerry Penso, Kimberly D Westrich, Robert W Dubois
BACKGROUND: In 2013, it was reported that about 1 of every 3 U.S. adults has hypertension. Of these 70 million individuals, approximately 50% have their blood pressure under control. Achieving hypertension control, especially in at-risk populations, requires a multipronged approach that includes lifestyle modifications and pharmacological treatment. As provider groups, hospital systems, and integrated delivery networks optimize their care processes to promote population health activities in support of the accountable care organization (ACO) model of care, managing hypertension and other chronic diseases will be essential to their success...
October 2016: Journal of Managed Care & Specialty Pharmacy
Karoline Krause, Athanasios Tsianakas, Nicola Wagner, Jörg Fischer, Karsten Weller, Martin Metz, Martin K Church, Marcus Maurer
BACKGROUND: Schnitzler's syndrome is an adult-onset autoinflammatory disease characterized by urticarial exanthema and monoclonal gammopathy accompanied by systemic symptoms such as fever, bone and muscle pain. Up to now, approved treatment options are not available. OBJECTIVE: We here assessed the effects of the anti-IL-1ß monoclonal antibody canakinumab on the clinical signs and symptoms of Schnitzler's syndrome. METHODS: In this phase II, randomized placebo-controlled multi-center study, 20 patients with active disease enrolled in four German study centers...
September 19, 2016: Journal of Allergy and Clinical Immunology
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