Friday
Mar162018

National Healthcare Measures: A lot of Improvement Overshadowed By Obesity and Diabetes

National Healthcare Measures: A lot of Improvement Overshadowed By Obesity and Diabetes
 

By Clive Riddle, March 16, 2017

On this Ides of March the CDC
National Center for Health Statistics released Selected Estimates Based on Data From the January-September 2017 National Health Interview Survey with great data covering measures fifteen different selected topics. We selected a key statistic from ten of the topics to share below.

What’s striking is that despite our marked improvement in most topics during the past two decades, the percentage of persons reporting they had excellent health didn’t improve (although half a percentage point better than ten years ago, it is two percentage points lower than twenty years ago.)

The culprits in the case must be due in a large part to the fact we living large(er). Two topics below in which increasing percentages aren’t a good thing are obesity and diabetes, but increase we did. We can make policy and administrative changes that impact the percentage of people with insurance, access  care, receive vaccinations, promote exercise and promote smoking cessation. Obesity and Diabetes seem  tougher to tackle.

·         Percentage of persons without health insurance coverage: 2017  9.0% | 2007 14.5% | 1997 15.4%

·         Percentage of Persons With a Usual Place to go for Medical Care (Age adjusted):  2017  88.1% | 2007 86.5% | 1997 86.3%

·         Percentage of persons of all ages who failed to obtain needed medical care due to cost at some time during the past 12 months (Age Adjusted): 2017 4.4% | 2007 5.8% | 1997 4.5%

·         Percentage of adults aged 65+ who received an influenza vaccination during the past 12 months (Age Adjusted):  2017 70.6% | 2007 66.8% | 1997 63.1%

·         Percentage of adults aged 65 and over who had ever received a pneumococcal vaccination (Age Adjusted):  2017 69.9% | 2007 57.8% | 1997 42.6%

·         Prevalence of obesity among adults aged 20 and over (Age Adjusted):  2017 31.4% | 2007 26.6% | 1997 19.5%

·         Percentage of adults aged 18 and over who met 2008 federal physical activity guidelines for aerobic activity through leisure-time aerobic activity (Age Adjusted):  2017 54.8% | 2007 42.0% | 1997 43.3%

·         Prevalence of current cigarette smoking among adults aged 18 and over (Age Adjusted):  2017 14.3% | 2007 19.7% | 1997 24.6%

·         Percentage of persons of all ages who had excellent or very good health:  2017 66.5% | 2007 66.0% | 1997 68.5%

·         Prevalence of diagnosed diabetes among adults aged 18 and over: (Age Adjusted):  2017 8.4% | 2007 7.5% | 1997 5.3%

 
Friday
Mar162018

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition
 

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

The Other Opioid Crisis: Hospital Shortages Lead To Patient Pain, Medical Errors

Even as opioids flood American communities and fuel widespread addiction, hospitals are facing a dangerous shortage of the powerful painkillers needed by patients in acute pain, according to doctors, pharmacists and a coalition of health groups.

Kaiser Health News

Friday, March 16, 2018

GOP support for Obamacare stabilization grows, but abortion policy still unresolved

Congressional Republicans are growing more receptive to funding an Obamacare stabilization effort in the omnibus spending bill but remain divided over abortion restrictions.

Politico

Thursday, March 15, 2018

BCBS joins with Lyft, CVS and Walgreens in new pop health effort

The Blue Cross Blue Shield Association (BCBSA), the parent company for 36 Blues companies spread across the country, has launched the Blue Cross Blue Shield Institute to address social determinants of health (SDOH) and the influence on health and outcomes.

HealthCare Dive

Thursday, March 15, 2018

SEC charges Theranos CEO with 'massive fraud'

Elizabeth Holmes, founder and CEO of the embattled blood-testing startup company Theranos, has been charged with “massive fraud,” the Securities and Exchange Commission announced Wednesday.

The Hill

Wednesday, March 14, 2018

More than 60% of healthcare orgs saw cyberattack in past year

Cybersecurity concerns continue to hound healthcare organizations, with 62% of executives reporting a cyberattack in the past year and more than half of those losing patient data, a new Ponemon Institute survey shows.

HealthCare Dive

Tuesday, March 13, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

 
Friday
Mar092018

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition
 

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

A Health Plan ‘Down Payment’ Is One Way States Try Retooling Individual Mandate

As President Donald Trump and congressional Republicans tirelessly try to dismantle the Affordable Care Act, a number of states are scrambling to enact laws that safeguard its central provisions.

Kaiser Health News

Friday, March 9, 2018

US to Idaho: ‘State-based’ health plans don’t pass muster

Idaho’s move to let companies offer health insurance plans that don’t meet Affordable Care Act standards is illegal, U.S. officials said Thursday.

AP News

Friday, March 9, 2018

Cigna Bets on Getting Bigger as Rising Costs Vex Health Business

Under pressure to tame ever-increasing health-care costs, the companies that help millions of Americans manage their medical care are wagering that they can be stronger and simpler by joining forces.

Bloomberg

Thursday, March 8, 2018

Amazon Offers Discount Prime Membership to Medicaid Recipients

Amazon.com Inc said on Wednesday it was expanding its discounted Prime membership offer to Medicaid members, the U.S. government's health insurance program for the poor.

The New York Times

Wednesday, March 7, 2018

UnitedHealthcare to share drug rebates with 7M members; the Trump administration approves, says HHS' Alex Azar

UnitedHealthcare will offer drug rebates directly to some of its members, a move that comes as payers and pharmaceutical companies fight over who's to blame for rising drug prices. Beginning in 2019, UnitedHealthcare will expand its pharmacy discounts to about 7 million enrollees who are in fully insured commercial group plans, the insurer announced.

Fierce Healthcare

Tuesday, March 6, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.
 
Friday
Mar092018

Perhaps Accenture’s Surveyed Consumers So Willing To Share Healthcare Data Should Read Accenture’s CyberSecurity Survey Report

Perhaps Accenture’s Surveyed Consumers So Willing To Share Healthcare Data Should Read Accenture’s CyberSecurity Survey Report
 

By Clive Riddle, March 9, 2018

 

Accenture has just released a 12-page report with findings from their 2018 Consumer Survey on Digital Health in which they conclude that “Growing consumer demand for digital-based health services is ushering in a new model for care in which patients and machines are joining doctors as part of the healthcare delivery team, and that  “consumers are becoming more accepting of machines — ranging from artificial intelligence (AI), to virtual clinicians and home-based diagnostics — having a significantly greater role in their overall medical care. “

 

Here’s some survey response highlights shared in the report:

·         19% have already used AI-powered healthcare services, with 66% of these consumers likely to use AI-enabled clinical services

·         Consumer use of mobile and tablet health apps has increased from 16% in 2014 to 48% currently.

·         44% have accessed their electronic health records in patient portals over the past year, with 67% of these consumers seeking information on lab and blood-test results; 55% viewing physician notes regarding medical visits, and 41% looking up their prescription history

·         The use of wearable devices by consumers has increased from 9% in 2014 to 33%t currently.

·         75% view wearables  as beneficial to understanding their health condition; while 73% cite them helping engage with their health, and 73% also cite monitoring the health of a loved one

·         90% are willing to share personal data with their doctor, and 88% are willing to share personal data with a nurse or other healthcare professional.

·         72% are willing today to share with their insurance carrier personal data collected from their wearable devices has increased over the past year, compared to from 63% in 2016.

·         47% are willing so share such data and with online communities or other app users today, compared with 38% in 2016.

·         38% are willing to share data with their employer  and 41% with a government agency

 

Interestingly while consumers seem to trust sharing their data most with their doctor and clinical professionals much more than their health plan, another Accenture survey recently released on healthcare cybersecurity found that while overall 18% of healthcare organization employees were willing to sell confidential data to unauthorized parties for as little as between $500 and $1,000; there was considerable disparity between plans and provider offices: 21% from provider organizations would sell confidential data compared to 12% from payer organizations.

 
Friday
Mar022018

Five Questions for Patrick Horine, CEO DNV GL Healthcare: Post-Webinar Interview

By Claire Thayer, March 2, 2018

This week, Patrick Horine, CEO DNV GL Healthcare, participated in a Healthcare Web Summit webinar panel discussion on Leveraging Hospital Accreditation for Continuous Quality Improvement webinar. If you missed this informative webinar presentation, watch the On-Demand version here. After the webinar, we interviewed Patrick on five key takeaways from the webinar:

1. What is ISO 9001 and how is this closely related to strategic goals for hospitals?

Patrick Horine: Goals are just goals unless there are objectives in place to be measured and met to achieve them.   The ISO 9001 quality management system (QMS) is the means for managing the objective to determine the needs of and desires for customers.    The ISO 9001 QMS is customer focused and to ultimately enhance patient satisfaction.    Engaged employees means more patient satisfaction.   Enhance patient satisfaction increase HCAHPS scores.   Increased HCAHPS scores are what provide the financial and reputational incentives for hospitals.    Given the current challenges with reimbursement and the competitive climate it is imperative for hospitals to ensure the patient experience and satisfaction is best as it can be.  Quality objectives are at every level of the organization.  They may apply broadly across the organization or more narrowly.   The goal may be the result but there are a lot of contributors to ensure the goal is attained.    Quality objectives are specified and aligned with the goals to enable the measuring and monitor of progress to evaluate progress.

2. What are some of the benefits and challenges associated with implementing ISO 9001?

Patrick Horine: In short, I would note the following:

  • Improving consistency
  • Added accountability
  • Increasing efficiency
  • Engagement of Staff

What drove us to consider integrating this within the accreditation process was because the hospitals we were working with could make improvements or address compliance but they had a more difficult time sustaining what they put in place.    ISO 9001 requires such things as internal auditing and management review are two of the most impactful aspects for the ISO 9001 requirements.  

Through these internal audits and then reflecting the success of the actions taken with the management reviews will lead to more consistent practices through the organization.   It is not uncommon see multiple versions of similar policies all throughout the hospital.  Are they really different?   Likely not, so reducing these to one practice will improve consistency.    I often ask groups “How many of you think you follow your policies and procedures exactly as they are written?”   Rarely, if ever, would you see anyone state they did.   So, if we don’t then why do we have them?   If we need to have them, as we really do, then they should be written, communicate, implemented and measured to ensure they are being consistently followed.   Without fail, doing so will lead to better results in some manner.

Simplification and consistent processes lead to more efficient operations of the hospital.   Hospitals or any organization for that matter that considers the quality management to be an integral part of their business operations will commonly achieve more efficiency than those that do not.

Gaining this understanding of the processes and getting to the efficiency is not possible without the involvement of those closest to them.    As an organization, if we strive to improve every day, it is imperative that the staff are engaged so they can be directly involved to improve their work to be more satisfied with what they do and their contribution to the success of the organization.   

Happy wife = Happy life, the same holds true with Happy employees = Happier patients.    Those who are more involved with improving of the processes they work with are happier and more engaged employees. Engaged employees are more productive when they are identifying improvements to be made and how to go about making them.  

Challenges

  • Culture not conducive to change
  • Making it more complicated than it needs to be
  • Too many details

Can an organization implement ISO 9001 overnight?  No.   This is something that will leadership commitment, engagement of staff, willingness to be self-critical, ability to break with traditional thinking.    More easily described, the culture of the organization must be such that you are open to change, making improvements and have patience to know the quality management system will mature over time.   

What seems to be more universal thinking among us healthcare people, if it is not difficult then we will find a way to make it so somehow.    In my opinion, I think the ISO 9001 standard has evolved with each revision to be more and more befitting to healthcare than other industry sectors.    Process thinking, sequence and interactions, risk-based, competence of staff, customer expectations and satisfaction.   It fits.   We have much of what ISO requires already in place but still some work to be done.   This does not require wholesale changes so we don’t have to make it more difficult.   What is working and what is not working is a critical step because we must understand where improvements or change need to be made.  

Like I mentioned, policies and procedures are rarely followed exactly as they are written, but some are written as works of literature with elaborate detail.   Simplify, a 30-page policy is more effective when adapted to a 2-page work instruction.   More likely that one would read it, better opportunity for it to be consistently applied.    That is not to say that some we rid ourselves of all policies and procedures but rather don’t add complexity to what we already have and ask what we need to really keep.   

3. How does ISO 9001 hold hospitals accountable for meeting CMS requirements?

Patrick Horine: ISO 9001 itself does not address the CMS Conditions of Participation (CoPs).    All hospitals are accountable for compliance if they want to bill and be reimbursed under Medicare & Medicaid.   All CMS approved accreditation organizations must develop standards that meet or exceed the CMS CoPs.  Some choose to have more extraneous requirements, others apply the minimum.   DNV GL Healthcare wanted to have a standard that would meet the CoPs but we have integrated the ISO 9001 to the accreditation process and made this a requirement for hospitals under our program.  Compliance to the CMS requirements should be the by-product of a good quality management system and this is where ISO 9001 can be most effective. 

The ISO 9001 helps organizations have a more robust quality management system in place where compliance should be more of a by-product then the end goal.   Our thinking was that hospitals are often not complying with the minimum requirements to be met and these are what are fundamental to the organization to have provide safe and effective care.    To be more consistent meeting the fundamental requirements is the first challenge.   Going beyond, rather than more prescriptive requirements, the CoPs can be the parameters and the organization can me innovative to put practices in place.  We can still hold the hospital accountable meeting the CoP and then see how they demonstrate the effectiveness and outcomes of what they have in place.  

4. While the accreditation process for hospitals is part of Medicare / CMS program requirements, are there any plans to accredit hospital labs, physician clinics, or long term care organizations?

Patrick Horine: We currently have CMS deeming authority for acute care and critical access hospitals.   Next, we will complete the process for securing deeming authority for Psychiatric Hospitals and then Ambulatory Surgery Centers.   Most likely will not purse approval under CLIA for laboratories, but always possible.   There is desire to be more certification programs with physician/medical clinics and other providers.   Presently these would be self-governed as there is no deeming authority for such medical offices nor long term care.   I believe additional quality measures and oversight would make an impact in these environments.

5. How is DNV GL different from the Joint Commission and are there other accrediting organizations?

Patrick Horine: The more evident differences would be:

  • Annual surveys vs. once every 3 years
  • Less prescriptive standard more closely aligned to the CoPs – but inclusive of some additional requirements as well as maintaining compliance with ISO 9001
  • Demeanor of our surveyors
  • No types of accreditation; preliminary denial, conditional accreditation, double secret probation

It is better to describe those differences as told to us by those we have accredited, so I will use some of their quotes;

 “With DNV GL the surveys have been more meaningful and more consistent”

  • “It is nice get away from an inspection oriented approach but still be thorough”
  • “DNV GL is not easy but is easier to get along with”
  • “We have appreciated more of a collaborative process rather disciplinary one”
  • “We want to learn from the surveyors and how we can do better”
  • “The annual surveys help keep us focused on compliance and we do less getting ready for surveys”

“Doing things for the right reason not because of … have to”

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