Hospital: 15 fired for looking at octuplet mom’s file

From CNN.com:

Fifteen employees were fired for improperly accessing medical records of Nadya Suleman, the mother of octuplets, a Kaiser Permanente spokesman said Monday.

“We always provide training on the importance of patient privacy and confidentiality,” said Jim Anderson, the hospital spokesman.

“We knew from the time she (Nadya Suleman) was admitted to the hospital in December, this case would attract attention.

“Numerous training sessions were held to remind people of the need to keep the information confidential.”

Eight other employees of the Bellflower, California hospital were disciplined for accessing Suleman’s files, Anderson said.

Mich. system agrees to $13.6 million settlement

From Modern Healthcare:

St. John Health System will pay $13.6 million to settle a class-action lawsuit alleging that the seven-hospital Ascension Health subsidiary conspired with several of its Detroit-area competitors to depress nurse wages. The settlement, which is subject to court approval, is the second stemming from lawsuits backed by the Service Employees International Union targeting hospitals and systems in Albany, N.Y.; Chicago; Detroit; Memphis, Tenn.; and San Antonio.

“St. John Health believes it acted appropriately and lawfully, and strongly denies the allegations in the lawsuit, including the allegation that nurse wages have been adversely affected, but agreed to settle to avoid further expense, inconvenience, and the distraction of protracted litigation,” St. John said in a written statement.

The lawsuits, filed in 2006, alleged that the hospitals and systems violated federal antitrust law by sharing wage data in a scheme to prevent competition for nurses from driving up what hospitals would have to pay to recruit and retain them. With St. John settling, there are seven remaining defendants in the Detroit lawsuit. Earlier in March, two-hospital Northeast Health, Troy, N.Y., agreed to pay $1.25 million under a proposed settlement while, like St. John, vigorously denying the alleged conduct.

Can Second Life help teach doctors to treat patients?

From CNN.com:

At Imperial College London, medical students navigate a full-service hospital where they see patients, order X-rays, consult with colleagues and make diagnoses.

It’s an interactive, hands-on learning experience — and none of it is real.

These prospective doctors are treating virtual patients in Second Life, the Internet world where users interact through online alter egos called avatars. The third-year med students are taking part in a pilot program for game-based learning, which educators believe can be a stimulating change from lectures and textbooks.

Doctor’s Day

From Quint ‘s (Quint Studer) Blog:

More than the application of science and technology, medicine is a special calling, and those who have chosen this vocation in order to serve their fellowman understand the tremendous responsibility it entails.” With these words spoken 28 years ago, President George H. W. Bush proclaimed March 30th as the annual date to celebrate National Doctor’s Day. Today, hospitals and patients across the nation will thank their doctors for answering the call to practice medicine. One of the best ways to say “thank you” today is to commit year-round to providing a great place for physicians to practice medicine.

Fundamentally, physicians want four things from the place where they choose to practice medicine:

•    Quality – Physicians want to know their patients are receiving quality care and very good service even when they’re not around.

•    Efficiency – Physicians want a friction-free place to practice medicine where delays, waste and frustration are minimized

•    Input – Ask physicians where they feel the organization should focus to make things run better; fix what can be fixed; and then follow-up to let them know what has been addressed.

•    Appreciation – Physicians value a “thank you” and acknowledgment when things are going well.

Characteristics of Physicians Choosing EM

From InterScience:

ABSTRACT

Objectives: This study sought to account for trends in medical student specialty choice by examining the importance of lifestyle factors. Emergency medicine (EM) is among several medical specialties classified as having a “controllable lifestyle.” The primary objective of this study was to determine if medical students choosing careers in EM have a different profile of influences, values, and expectations from students choosing other specialties or specialty groups. Of secondary interest was how much lifestyle influenced students choosing EM compared to students choosing controllable lifestyle (CL) specialties.

Results: A total of 13,440 students completed the two supplemental surveys of the GQ. Of these students, 9,529 identified a specialty choice that fell within one of the four comparison groups and were included in the analysis. Compared to other specialty groups, students choosing EM reported lifestyle and length of residency as strong influences, while attributing less influence to mentors and options for fellowship training.

Conclusions: Students choosing a career in EM have distinctly different priorities and influences than students entering PC and SS. The profile of students who choose EM is very similar to those choosing traditional CL specialties. A more thorough understanding of the values and priorities that shape medical student career selection may allow educators to provide better career counseling.

EDPMA Conference

Here’s a link (PDF File) to the Emergency Department Practice Management  Association (EDPMA) Solutions Summit Conference brochure

Doctors Push for Clean Slate on Medicare Reimbursement Rates

From the Wall Street Journal Health Blog:

Every year or so, we hear that some big Medicare pay cuts for doctors are on the way. Almost every time, Congress swoops in at the last minute to block the cuts. Leaders of the AMA and other big doctor groups have been in Congress lately asking for a change to the underlying system that keeps creating these near misses.

“Nighthawks, dayhawks and the demise of the American radiologist”

From Kevin MD:

More hospitals are resorting to so-called “dayhawk” radiology services to read their x-rays.

It’s modeled after the “nighthawk” model, where radiologists (via Shadowfax), in some cases as far away as India, remotely read films in the middle of the night.

Now, the phenomenon is happening during business hours as well, which according to radiologist Giles W. L. Boland, means that “some radiologists can no longer assume long-term job security because their core value proposition can now be outsourced.”

This trend was entirely foreseeable. Cash-strapped hospitals are finding it cheaper to outsource x-ray readings, and furthermore, it seems that both nighthawks and dayhawks provide better service and more timely interpretations. This adds up to a declining need for an in-house radiology staff.

Are Paramedics Necessary?

From JEMS:

A committee charged with finding ways for Columbus to save money has recommended that the city return to a basic emergency medical system.

The last time the Columbus Division of Fire provided only basic-level care was in 1968.

Since then, Columbus has provided advanced life support to anyone who calls 911 for medical attention, whether a patient needs it or not.

Basic care mostly involves stabilizing injuries before a patient is transported. Paramedics trained in advanced support can administer lifesaving drugs and treat heart attacks on the way to a hospital.

The economic advisory committee, appointed by Mayor Michael B. Coleman and City Council President Michael C. Mentel, suggested comparing costs and benefits of the current system with basic life support.

The group cited a 2005 study published in the Journal of Prehospital and Disaster Medicine that found that patients fared about the same. The study examined 22 previous studies, 18 of them more than a decade old.

“The (2005) study would lead you to the conclusion that whether you have advanced life support or basic life support, you really don’t have much difference in the outcome,” said Robert F. Howarth, a lawyer who led the committee.

“If there’s no positive result or effect … and basic life support is cheaper, then in fact the Fire Division could reallocate those assets and use them elsewhere.”

Health Affairs Issue Briefing: Stimulating Health Information Technology

From Health Affairs:

There is widespread agreement that greater investment in information technology (IT) is critical to reforming U.S. health care. The use of such technologies as electronic health record systems, personal health records, e-prescribing, and computerized physician order entry holds the potential for vastly improving care at a reasonable cost. The recently enacted economic stimulus legislation included just over $19 billion for health information technology, so major public and private investments in the sector now lie ahead.

At this crucial moment, Health Affairs devoted its March-April 2009 issue to health IT—its transformative promise, but also the challenges to its adoption and the substantial dangers it could pose if that adoption is not done right. The issue was released at a briefing on Tuesday, March 10, at the JW Marriott in Washington, D.C. At the briefing, speakers discussed the public policy issues surrounding health IT, particularly those raised by the health IT provisions in the stimulus package. Speakers also discussed pioneering health IT initiatives, the privacy concerns raised by health IT, and industry health IT innovations.

The briefing and the new Health Affairs issue were supported by grants from the Markle Foundation, the California HealthCare Foundation, and the federal Agency for Healthcare Research and Quality.