Published in the January 2004 issue of Today’s Hospitalist
Physicians getting more involved in IT projects
Physicians appear to be picking up the pace when it comes to building better health care information systems.
The Foundation for EHealth Initiative, which late last year gathered information from 134 communities on electronic health information projects, found that 24% of all projects were organized by physician groups.
The organization also found that more than 85% of organizations seeking health information technology grants included physicians on their advisory committees, while 80% reported physicians were leading the charge to adopt technology in their communities. About 70% of the projects reported that physicians help test the usability of their systems.
The foundation was planning to award nearly $4 million in seed money for health care information technology initiatives late last year. The group said it would award three to five large projects about $500,000 per community. It was also planning to award four to 16 smaller projects between $50,000 and $70,000.
The organization planned to award other funds to a variety of groups interested in health care information technology.
More information is online.
IOM: Government needs bigger role in health care IT
A report from the Institute of Medicine (IOM) urged the government to take a leading role in not only setting standards for data exchange and collection, but in giving physicians and hospitals incentives to adopt information technology.
The report, “Patient Safety: Achieving a New Standard for Care,” said that health care organizations need to develop standardized formats and data standards that can work in different information technology systems. The report also called on the federal government to invest in that standardized infrastructure and establish a public-private partnership to develop data standards.
The report urged the government to use financial incentives to encourage physicians and hospitals to adopt information technology. It said that the use of such technology should eventually be a requirement for participating in Medicare.
The report urged the government to oversee how information technology can be used to report “near misses” and enhance error prevention efforts. It also called on the government to decide what kind of computerized “decision support” should be given to physicians in ordering tests and designing treatments.
An IOM press release and a link to the full report are online.
Report looks at readmission rates in Pa. hospitals
A study found that 12,000 patients were readmitted to Pennsylvania hospitals in a one-year period because of infections and complications that are preventable.
A report from the Pennsylvania Health Care Cost Containment Council found that these readmissions resulted in 93,000 extra hospital days, or $410 million in additional charges. The report examined care for 28 illnesses ranging from pneumonia to stroke.
The council noted that readmission rates for complications or infection increased slightly in five of the eight categories for which two years of data was available. Hemorrhagic stroke had the highest readmission rate for complications or infection, at 7.7%. Poisoning and toxic effects of drugs had the lowest rate, at 0.9%.
The report examined patient care during a one-year period that ended Sept. 30, 2002. It analyzed 71 common medical treatments provided by 168 general hospitals.
More information about the report is online.
One in four people don’t follow drug regimens
An analysis of a recent poll found that large numbers of patients intentionally delay or fail to fill prescriptions written by their physicians. They cited reasons ranging from costs to concerns about side effects.
The Boston Consulting Group analyzed data from a survey that asked respondents if they had taken a medication less than directed in the previous 12 months. One in four said they had delayed filling a prescription, and one in five said that they had failed to fill a prescription.
One-fifth of respondents said they had stopped taking a prescription medication sooner than prescribed, and one in seven took their medications, but in smaller doses than prescribed.
Of the respondents who said they didn’t take their medications as prescribed, only one in four blamed forgetfulness for their actions. Most said they made a conscious decision to take their prescription medicine other than directed.
About 20% of respondents, for example, said they decided to forgo medications because of worries about side effects, while 17% said their medicines cost too much.
Another 14% said they didn’t think they needed the drug and thought they could judge what medication they needed better than their physician, and 10% said they had trouble filling the prescription.
More information about the report is online.
Medical students say malpractice issues affect career choices
An AMA survey found that roughly half of the nation’s medical students consider medical liability problems when choosing a specialty, while 39% choose states where they intend to practice based on similar considerations.
Almost two-thirds of medical students responding to the survey (74%) said they were very or somewhat familiar with problems related to escalating malpractice premiums.
Surveyed medical students identified several specialties as high risk, including emergency medicine, ob/gyn and general surgery. Respondents also identified 19 states as “crisis states” because of their medical liability problems.
Thirty eight% of medical students said their professors had discussed medical liability concerns with them. Specific topics of conversation included increasing liability premiums, the practice of defensive medicine, and which areas of the country faced the most severe liability problems.
The survey, which was conducted in the middle of last year, gathered responses from almost 4,000 students.
A summary of AMA survey results is online.
What young physicians earn “and owe
Recent data from the Association of American Medical Colleges show that the average debt load of recently graduated U.S. medical students rose more than 5% last year, to a median of $109,457. Here’s a look at other numbers that affect both medical students and residents.
Graduates with debt: 82.1%
Medical student debt
$100,000 and up: 58%
$150,000 and up : 25.4%
$200,000 and up : 7.5%
Source: 2003 AAMC Survey of Housestaff Stipends, Benefits and Funding.