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Doctor not liable for physician assistant’s misconduct, court rules
If a physician has supervised a physician’s assistant properly, the state medical board shouldn’t discipline the supervising physician for the PA’s improper conduct, the Vermont Supreme Court has ruled. The ruling upheld a 2012 decision by the Vermont Board of Medical Practice, which found that the physician wasn’t answerable for a PA who prescribed opiates improperly. The state argued that Jon Porter, MD, should be held accountable for the PA’s actions because physicians are vicariously liable for those that they supervise. “With the court’s decision, physicians may be less likely to supervise PAs to a certain degree,” said Vermont Assistant Attorney General Kurt A. Kuehl. An attorney for Dr. Porter and an executive for the Vermont Medical Society each said the court got the ruling right. If it had ruled the other way, it likely would have made it difficult to find physicians willing to supervise PAs, they said. “Physicians’ licenses would have been at [Read more]
E-prescribing soars among doctors with EHRs
Government incentives and better education on the benefits of e-prescribing are being credited for a dramatic increase in the number of physicians who use electronic health record systems to e-prescribe. The Office of the National Coordinator for Health Information Technology in the Dept. of Health and Human Services published a report in November that looked at e-prescribing trends in the U.S. As of June, 48% of physicians are e-prescribing with an EHR. That is up from 7% in December 2008. Physicians sending prescriptions electronically can do so using stand-alone systems or EHRs with an e-prescribing component. Although e-prescribing adoption rates among states vary, each state has seen growth since 2008. In 23 states, more than half of physicians e-prescribe through an EHR. The highest growth rates are in New Hampshire, which saw an increase of 70 percentage points from 2008, and North Dakota, which had an increase of 65 percentage points. “What we are really seeing is [Read more]
Preventable birth injuries cut after proven interventions are bundled
Harm to mothers and their infants is significantly reduced when physicians, nurses and others follow protocols in the perinatal setting, a new study shows. Between January 2008 and December 2010, 14 hospitals participating in the Premier Perinatal Safety Initiative, a collaborative of facilities from 12 states, reduced by 25% birth hypoxia and asphyxia that can cause infant brain damage. Neonatal birth trauma — from minor bruising to nerve or brain damage — was reduced 22%, according to results from the initiative published in December. Mothers saw a 15% decrease in complications associated with anesthesia during labor and delivery, including events such as cardiac arrest and other complications. They also saw postpartum hemorrhaging, the most common cause of perinatal maternal death in the developed world, drop by 5.4%. To achieve those numbers, the initiative used “care bundles,” groups of evidence-based interventions that are more effective when used together rather [Read more]
Seniors say doctors don’t provide enough mental health care
Three in four adults 65 and older say they would tell their primary care physicians about feelings of anxiety or depression. But doctors don’t always provide appropriate care to older patients with those conditions, says a survey of more than 1,300 seniors issued Dec. 13 by the John A. Hartford Foundation. Appropriate, evidence-based care for anxiety and depression includes educating patients about their condition, engaging them in medical care and following up to ensure they’re responding properly to treatment, said Christopher Langston, PhD. He is program director at the foundation, which works to improve the well-being of seniors. “Depression is one of the most common and burdensome issues in older individuals,” Langston said. It’s unfortunate “that so many older people are still receiving mental health care that does not measure up.” Forty-six percent of older adults who received mental health treatment said their primary care physician didn’t follow up aft [Read more]
Some EHRs in danger of missing data connections
Many physicians could discover that just because they implement an electronic health record system that is certified to meet meaningful use doesn’t mean it is capable of connecting with all the entities with which doctors want to exchange data. Experts are advising doctors who are adopting EHRs to think about what data exchange they plan to do and ensure that the system is capable of doing it. And that goes beyond checking for meaningful use certification. “Notwithstanding the improved information flow that an electronic health record makes possible within a hospital or medical practice, even certified EHRs often have limited capacity to share important care-related data with other EHRs, in effect creating electronic information silos,” said Kenneth W. Kizer, MD, MPH, director of the University of California, Davis Health System’s Institute for Population Health Improvement, in a statement. The IPHI developed the “HIE Ready Buyers’ Guide,” which addresses these l [Read more]
26 organizations team up to fight antibiotic resistance
Antibiotic resistance has been a growing health concern for decades. But 26 organizations are joining together to highlight the increasing urgency of the problem and protect the effectiveness of antibiotics for future generations. The Centers for Disease Control and Prevention, American Academy of Pediatrics, Robert Wood Johnson Foundation and Center for Disease Dynamics, Economics & Policy are among the 26 organizations that announced the effort on Nov. 13. By signing a joint statement, the groups agreed to better coordinate efforts to fight antibiotic resistance, support related research, improve surveillance and raise awareness. “Antibiotic resistance has become one of the world’s most pressing health problems,” said Brian C. Quinn, PhD, senior program officer and team director of the Robert Wood Johnson Foundation’s Pioneer Portfolio, which is aimed at driving social change to improve health. “Antibiotics continue to be overused at alarming rates across the country. [Read more]
OIG reports Medicare nursing home upcoding
Skilled nursing facilities in many instances may be billing for higher-paying therapies that aren’t always necessary, according to a report from the Dept. of Health and Human Services Office of Inspector General. OIG determined that these facilities improperly billed a quarter of all claims in 2009, resulting in $1.5 billion in inappropriate payments out of the nearly $27 billion paid to them that year. Medicare typically pays higher rates for therapies than it does for non-therapy services. OIG determined that most of the facilities’ incorrect claims were due to up-coding, or billing for therapies in higher payment categories that weren’t necessarily warranted. Another small percentage of these claims failed to meet Medicare coverage requirements, the report stated. In many cases, facilities didn’t report the correct amount of therapy a patient either received or needed, or they misreported information on whether patients were receiving special care or on the amount of h [Read more]
Reminders linked to sizable increase in cancer screening rates
Interventions aimed at guiding patients and helping them better understand colorectal cancer screening can significantly boost screening rates, says a study published online Nov. 1 in Cancer Epidemiology Biomarkers and Prevention. Researchers examined two types of interventions, including mailed materials and phone calls, and found that patients who received those services were about three times as likely to undergo screening than those who had neither. Colorectal cancer is the third-leading cause of cancer-related deaths in the U.S. There will be an estimated 103,170 new cases of the disease and 51,690 related deaths in 2012, according to the American Cancer Society. For the study, 945 patients ages 50 to 79 participated in the randomized, controlled trial. Of those, 312 received a tailored navigation intervention in which they were asked whether they would prefer undergoing a colonoscopy or taking a stool blood test. Based on their preference, those patients were mailed eith [Read more]
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