Report: Ways to Make ED Information Systems Safer

From Health Data Management.

(It’s Annals, not Annuals, BTW)

A published paper in the Annuals (sic) of Emergency Medicine examines four clinical scenarios that that could result in use of an emergency department information system contributing to medical errors, with recommendations to make EDIS use more safe.

Woman Tries to Kill Husband, Drives him to Emergency Room

Click through for the cool mug shot. From Arkansas Matters:

According to LCSO, the man told deputies that his wife, 58-year-old Kelley Kelley told him, “I killed the dog and I just killed you, you should go to the hospital.” She then drove him to the emergency room.

Kelley reportedly told hospital staff members that she gave her husband an overdose of prescription medication and killed their Boston Terrier, which she left in the bathtub.

Smartphone App Facilitates Use of Air Medical Service

From Northwest MedStar.

From JEMS:

The app interface allows for texting between air crews and responders in the field. Since many tablets and smartphones have cameras, the app also lets users send photos of EKG tests, injuries and other circumstances.

Eveline Bisson, director of Northwest MedStar, said in a news release that the app’s key value is reducing the need for emergency responders to focus on landing zone location and lets them spend more time on patient care.

The app also allows first responders to download detailed guides to setting up a landing zone and how to prepare a patient for transport.

Sens. Franken and Klobuchar support legislation to help reduce hospital readmissions through telehealth technology

From the Minnesota Hospital Association:

Senators Franken and Klobuchar are original co-sponsors of S.596, the Fostering Independence through Technology Act. This legislation was introduced by Sen. Thune (R-SD) on March 18 and is supported by the American Hospital Association, among other national advocacy groups.
 
The bill would establish pilot projects under Medicare aimed at increasing the use of remote monitoring technology for home health patients that can improve care and outcomes and help reduce unnecessary hospital readmissions or patient transfers from home to higher acuity settings. This technology provides patients the ability to stay in their homes longer without jeopardizing their health while reducing overall health care costs and improving outcomes.

The Acute-Care Continuum: The Future of Hospital-Based Care

From Becker’s (hat tip: Ed Gaines):

Emergency physicians, hospitalists, anesthesiologists, radiologists, intensivisits and skilled-nursing providers all interact regularly as they care for patients receiving services across the acute-care continuum. Without formal pathways for handoffs, communication and patient care coordination, outcomes can suffer. For example, a studypresented at the 2013 American Thoracic Society International Conference found delayed transfer to the intensive care unit increases mortality rates in hospitalized patients. Of the patients transferred to the ICU within 6 hours of the critical Cardiac Arrest Risk Triage score, 27 percent died during admission. Researchers determined that for every hour the ICU transfer is delayed, the risk of mortality increases by 7 percent.

Coordination along the acute-care continuum simply requires physicians and providers in various hospital-based specialties work together to drive best practices and ensure communication. While this sounds simple, hospital politics can sometimes get in the way.

A Letter from the President of Iowa ACEP to Governor Branstand

Dear Governor Branstad,

I appreciated showing you the Emergency Department at the University of Iowa prior to your latest election and appreciate this opportunity to comment on the Healthy Iowa Plan 1115 WAIVER APPLICATION and the Iowa Medicaid expansion issue.

The Iowa chapter of the American College of Emergency Physicians strongly supports increased access to care for all Iowans. We appreciate that the state is expanding its Medicaid program to provide more access for our population.

However, we are very concerned that the Healthy Iowa plan includes a provision for co-pays for Emergency Department visits if the visit is later determined to be non-urgent. Determining the legitimacy of an emergency department visit from the final diagnosis documented is not appropriate and contradicts the Prudent Layperson Law (Effective 8/15/97, R.S. 22:657 (D) (2)). We also feel such a copay, applied only after the diagnosis is made, puts patient safety at risk and will weaken the already fragile safety net emergency departments across the state provide. Studies show that most emergency department visits are true emergencies.*

*http://www.rand.org/pubs/external_publications/EP20040204.html

*http://www.cdc.gov/nchs/data/databriefs/db38.pdf

*http://www.ncbi.nlm.nih.gov/m/pubmed/23512061/

To provide an example: think about the situation of the patient who hurts their ankle. If the patient trips, their ankle is swollen, tender and they are concerned that they have an ankle fracture. X-rays however reveal that the ankle is not broken. The final diagnosis is ankle sprain which is considered a non emergent diagnosis. Yet if the same patient had the x-rays and it was positive for fracture, the diagnosis is ankle fracture, very much an emergent diagnosis. There is no way for a layperson (or a physician!) to know ahead of time if the x-rays were to be positive or negative and further care drastically different. Imagine a similar complaint of chest pain. Is it indigestion or a heart attack? An Iowan will die instead of seeking care if such a provision is not corrected.

Thank you for the opportunity to work together to improve healthcare for Iowans. Please feel free to contact me anytime, as we would be happy to provide council as you work to address these important healthcare issues for Iowans.

Sincerely,

Michael P Miller, MD FACEP

President

Iowa American College of Emergency Physicians

Squirrel Takes Flight In New Jersey Hospital Emergency Room

From WUSA9:

A flying squirrel invaded a Rahway, N.J., emergency room, where  firefighters were needed to corral the animal.

The squirrel kept launching itself from an 8-foot-high wall-mounted lamp into a glass wall. The squirrel had become trapped in a trauma room at Robert Wood Johnson University Hospital in Rahway on Tuesday night.