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Patients Have Different View of Threats to Safety,
Study Finds President’s
EHR Goal Could Cost Up to $700 Billion, Report Says Practice Strategies Have Little Impact on Diabetes
Care NQF Forms Long-term Care Commission JCAHO Seeks Nominees for Outcomes Measurement
Award HIMSS Conferences to Help Physicians With EHRs Chronic
Disease May Worsen With ‘Cyber-Medicine,’ Study
Finds Patients Have Different View of Threats to Safety,
Study Finds A study
on the patient’s
perspective on errors in medicine suggests that patients are more disturbed
with lack of access to and relationships with their physicians than
technical errors in diagnosis and treatment. Published in the August issue of the Annals of Family Medicine, “Patient
Reports of Preventable Problems and Harms in Primary Health Care,” found
that patients were more likely to report being harmed psychologically
and emotionally than physically, suggesting that the current preoccupation
of the patient safety movement with adverse drug events and surgical
mishaps could overlook patient priorities. There was no apparent pattern
with respect to the sex or specialty of the doctor, duration of physician-patient
relationship, community type, state, form of health insurance, or the
age, sex, or social economic status of the patient. However, African
American patients surveyed indicated a perception of apparent racism. Richard Frankel, PhD, research scientist at the Regenstrief Institute,
Inc. and professor of medicine at the Indiana University School of Medicine,
said the study is unique because it focuses on learning from patients
themselves what counts as an error. “Much of the research on medical errors and patient safety has
come from professionals speaking on behalf of patients,” Frankel
said, “Many of the things patients consider as threats to safety,
such things as racism, and discrimination based on age haven’t
been part of the dialogue in the research community about what increases
or decreases risk.” Among the preventable problems in the process of care identified by
the patients were: The study was funded by the Agency for Healthcare Research and Quality. For more info www.annfammed.com. President’s
EHR Goal Could Cost Up to $700 Billion, Report Says Meeting
President George W. Bush’s goal of electronic health records
by 2014 could cost $500 billion to $700 billion or 20% of the nation’s
$1.7 trillion health care costs, according to a survey of health care
information technology vendors and hospital information officers by Federal
Computer Week . A weekly publication dedicated to government IT buying team-executives,
program managers, IT managers and integrators, Federal Computer Week said
those costs represent a 3-4% investment of total industry revenues into
health information technology ( HIT ). Finance and manufacturing industries
invest 5-7% into IT, the magazine reported in its Oct. 15 edition. The United
Kingdom ’s
National Health Service, after adopting a 10-year plan to provide 50
million patients with EHRs, awarded $11 billion in contracts late last
year for HIT infrastructure. For more info, http://fcw.com/fcw/articles/2004/1011/web-ehr-10-15-04.asp. Practice Strategies Have Little Impact on Diabetes
Care A Harvard Medical School study found that current practice management
strategies and financial arrangements have a limited impact on the quality
of care for patients with diabetes. Led by Nancy L. Keating, MD, researchers reviewed medical records of
652 diabetes patients enrolled in three health plans in Minnesota along
with the 399 physicians in 135 practices who cared for them. Researchers
defined the main outcome measures by a quality score indicating receipt
of care in accordance with six accepted quality indicators. Only 5%
of the variation in quality was attributed to characteristics of physicians’ practices.
Quality scores tended to be higher for patients whose physicians received
quality performance reports or utilization profiles from more than
one source (P = 0.08), routinely enrolled diabetic patients in disease-management
programs (P = 0.06), or received diabetes-specific reports. The study, “The Influence of Physicians’ Practice Management
Strategies and Financial Arrangements on Quality of Care Among Patients
With Diabetes,” is available in the September issue of Medical
Care, the journal of the American Public Health Association. For more info, www.lww-medicalcare.com/pt/re/medcare. NQF Forms Long-term Care Commission The National Quality Forum has convened the National Commission for
Quality Long-term Care, charged with evaluating the current quality of
long-term care, identifying factors that influence the ability to improve
quality of this care, and tracking improvement in the years ahead. Co-chaired
Bob Kerrey, former U.S. senator and Newt Gingrich, former speaker of
the House, the Commission seeks to: In addition to the co-chairs, the commission includes two sitting governors,
representatives of patients and their families, health care providers,
academics, and former local government officials. Initial funding for the commission is provided by the Alliance for
Quality Nursing Home Care, the American Association of Homes and Services
for the Aging, and the American Health Care Association. For more info, www.qualitylongtermcarecommission.org. JCAHO Seeks Nominees for Outcomes Measurement
Award Deadline is Feb. 14, 2005 The Joint Commission on Accreditation of Healthcare Organizations is
now accepting applications for the ninth annual Ernest A. Codman Award,
which recognizes excellence in the use of outcomes measurement by organizations
and individuals to achieve improvements in the quality and safety of
health care. The Ernest
A. Codman Award showcases the effective use of performance measurement
by health care organizations to improve the quality and safety of health
care.In 1910, Codman proposed a system for physicians and hospitals
to track every patient treated to determine whether individual treatments
were effective. Codman’s “end
results” system emphasized the important utility of outcomes measurement
for performance improvement. Awards are given only to meritorious applications and are not necessarily
made in each category. A panel of national experts in quality measurement
and improvement will select the recipients of the 2005 Awards. The 2004
Codman Awards will be presented Dec. 2 at the Joint Commission’s
2004 National Conference on Quality and Safety in Health Care in Chicago
. The deadline for submitting an application for the award is Feb. 14,
2005 . For more info, www.jcaho.org or twilson@jcaho.org. HIMSS Conferences to Help Physicians With EHRs The Healthcare Information and Management Systems Society has organized
two, one-day conferences next month for clinicians who have either already
implemented an electronic health record, or plan to move toward EHR adoption. The Physicians Adopting Computer Technologies ( PACT ) meetings have
been scheduled for Nov. 6 in Jacksonville , FL and Nov. 13 in Portland
, OR . The PACT conferences will feature physicians now using electronic
health records who will discuss the challenges they faced in successfully
implementing electronic health records in their practices. Following the keynote presentations, attendees can attend one of two
educational tracks: one for physicians who are exploring the technology
and another for those who have implemented an EHR and want to maximize
return on investment. Technology demonstrations and exhibits of EHR products
now in the marketplace are designed so that participants can see how
the systems work and ask questions related to their specific EHR implementation
needs. HIMSS plans to hold two additional PACT conferences in the spring.
Health care organizations interested in bringing a PACT conference to
their city should contact Linda Costodio, HIMSS ambulatory care program
manager, at lcostodio@himss.org. For more info, www.himss.org/
PACT . Chronic
Disease May Worsen With ‘Cyber-Medicine,’ Study
Finds People who use their computers to find information about their chronic
disease often wind up in worse condition than if they had listened to
their doctor, according to a University College London ( UCL) review
of studies on internet health. Using interactive computer tools does improve the medical knowledge
of people with diabetes, asthma or other chronic conditions, and does
provide them with positive feelings of social support, according to researchers
reviewing 28 randomized controlled trials involving 4,042 participants.
But there was no evidence that cyber-medicine helps people change their
behavior and startling evidence that it may leave them in worse health. “This whole finding confounds conventional wisdom,” said
lead author Dr. Elizabeth Murray of UCL ’s Department of Primary
Care and Population Sciences. The authors looked at studies that measured
the effectiveness of Interactive Health Communication Applications (IHCAs)
on people’s information gain, feelings of social support, self-efficacy,
behavior change and overall clinical outcomes. IHCAs
had a positive effect on people’s information gain and
feelings of social support; no effect on self-efficacy (the belief that
behavior change is possible) or on actual behavior change; and a strikingly
negative effect on outcomes. Murray said there are two possible reasons for the paradox between
active knowledge-seekers and their seemingly worsening health. One reason
may be that when they learn of small, but important, statistical effects
of a treatment they become less frightened and therefore avoid following
doctor’s order.s A second reason might be because knowledge-seekers become so steeped
in information from the Internet they make treatment choices on their
own, contradicting advice from their doctors. For instance, a diabetic
person might be told by a doctor to lower blood sugar but decide, based
on his own interpretation of data, that the short-term tradeoffs of not
complying are worth the long-term risks. For more info, www.hbns.org.  Home :: Inside AHQA :: For The Media :: Public Policy :: Advancing Quality :: Quality Connections :: SiteMap
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