Nurses union targets EHRs, other tech in campaign


National Nurses United has launched a media campaign criticizing the effects of what it called “digitalized care.”  The multipronged campaign specifically criticizes electronic health records and bedside computers, saying they “too often fail,” and lead to diagnoses and treatments based on “generic population trends” instead of individualized assessments.  The campaign also references a December report from HHS’ Office of Inspector General, which said EHRs allow hospitals and physicians to cover up fraud or medical malpractice.

The campaign includes radio ads, YouTube videos and social media.  NNU also created  a website to encourage patients to ask for more investment in nurses.  The site features six radio ads as well as links to NNU blog posts and other materials on the issue of technology in healthcare.


“Transformative” deal to take AmSurg into Physician Services

From the Nashville Post:

AmSurg plans to pay more than $2.3 billion for a Florida-based company that provides anesthesia and other specialty services to more than 300 facilities in 25 states. The cash-and-stock deal for Sheridan Healthcare will double the company’s annual revenue to $2.2 billion and its adjusted EBITDA to $380 million.

Sheridan, which is owned by private-equity firm Hellman & Friedman, gets about two-thirds of its revenues from anesthesiology services, where it is the largest player in the country. In addition, the 52-year-old company also markets children’s services, hospital-based radiology and emergency medicine services. Since 2010, Sheridan has grown revenues from $684 million to about $1.1 billion over the past 12 months, thanks both to almost 20 acquisitions (worth about $480 million) and almost 30 new contract wins.


Rural hospitals: On the critical list?

From FoxNews:

The U.S. Department of Agriculture estimates more than 46 million Americans live in rural areas, working on farms or in small factories that provide resources for the rest of the country.

Often in these less populated areas, there is only one medical facility for the entire community.

Much of the funding for rural hospitals, about 60 percent, comes from Medicare. The rest comes from Medicaid or from general health insurance.

Budgets are so tight for these smaller hospitals, where patients are often older and sicker than the general population, that any changes to these programs — even slight changes — can have drastic effects on their budgets.

That’s why recent cuts by the Obama administration for Medicare reimbursement funding are a grave concern to rural healthcare administrators. In addition, there’s an October deadline for upgrading to electronic medical records. If the deadline isn’t met, hospitals risk penalties.

The combination of Medicare cuts and the added expense of transferring to electronic records is part of the reason there has been an epidemic of rural hospital closures. Eighteen have shut their doors since the beginning of 2013, more than closed in the entire decade before then.

When rural hospitals close, residents are left with no easy alternative for medical care. Often a drive to a doctor for a checkup can take more than an hour. In an emergency situation, the distance can be a matter of life or death.

Read more here.

ER docs see increases in Psychiatric Patients

From The Houston Chronicle:

Nearly 85 percent of emergency room doctors polled in 10 states, including Texas, reported psychiatric patients were being held for extended periods in their emergency departments, a new survey shows.

More than half of the doctors who responded to the American College of Emergency Physicians said the amount of time and effort their emergency departments spend transferring psychiatric patients who need hospital admission has increased since Jan. 1, when more Americans became covered under the Affordable Care Act.

Almost half of emergency room doctors said they have noticed an increase in all emergency visits since Jan. 1.

“People having a mental health crisis seek care in emergency departments because other parts of the health care system have failed them,” Dr. Alex Rosenau, president of the college, an association that represents emergency room doctors, said in a written statement. “Because of the critical shortage of mental health resources, some of these vulnerable patients wait for days in emergency departments.”

More than 80 percent of Texas doctors polled said psychiatric patients were being held in their emergency rooms. More than half of Texas doctors surveyed said more time was being spent trying to transfer psychiatric patients for hospital admissions.

Headphones fueling increase in serious accidents

From the Baltimore Sun:

Trains have rumbled through the heart of Hampstead for nearly all of the Carroll County town’s 125-year history. Horn blasts from passing trains are a part of everyday life in the community.

So are headphones, earbuds and all manner of modern digital devices that are increasingly distracting pedestrians — often with tragic consequences — in small towns and big cities alike.

“It’s akin to wearing sunglasses in the dark,” said Dr. Richard Lichenstein, director of pediatric emergency medicine research at the University of Maryland Medical Center.

In nationwide research published two years ago, Lichenstein documented a threefold increase in the number of serious injuries to pedestrians wearing headphones between 2004 and 2011. The overwhelming majority of victims were men under age 30. And more than half of the accidents involved trains, many of which had “sounded some type of warning horn prior to the crash,” according to Lichenstein’s research.

Injuries are likely to continue to climb as more pedestrians walk while using mobile devices for texting, surfing the Internet, playing games, talking, and listening to music, experts say.

Jack Nasar, an Ohio State University professor, published research last summer showing that more than 1,500 pedestrians were treated in emergency rooms in 2010 for injuries related to using a cellphone while walking, a doubling of such injuries from 2005.

“If the current trends continue, I wouldn’t be surprised if the number of injuries to pedestrians caused by cellphones doubles again between 2010 and 2015,” Nasar said in a statement accompanying his research.

Guns to Gauze: Limiting Casualties at Mass Shootings


In 1996, the United States military introduced the concept of Tactical Combat Casualty Care (TCCC). This prehospital care protocol was based on Captain Frank Butler and Lieutenant Colonel John Hagmann’s study of combat-related deaths. The paradigm shifting research found that 90 percent of combat deaths occurred before a casualty reached a medical facility. Limitations identified in advanced trauma life support for combat medics led the military to develop a new set of principles for high-threat trauma care. The TCCC guidelines influenced a shift to address preventable causes of combat death by optimizing care rendered in the field prior to arrival at a fixed medical facility. In essence, every soldier had to have trauma care capabilities.

Over the years, TCCC guidelines have shown to be extraordinarily effective in combat environments. The success of TCCC led to the development of a civilian counterpart of the protocol known as Tactical Emergency Casualty Care (TECC). TECC provides a tactically and medically sound framework to deliver direct threat care, indirect threat care, and evacuation of casualties in a manner that optimizes the preservation of life. These protocols include the incorporation of the fire and EMS communities in operations that are ongoing and high-risk. The principal mandate of TECC is prioritizing medical intervention at these critical times in the same manner as TCCC protocols treat combat wounds at the point of injury. Recent events such as the mass shootings in Aurora, Colorado, and Newtown, Connecticut, and the bombing at the Boston Marathon have demonstrated the need for skilled prehospital trauma care.

The American College of Surgeons, in the Hartford Consensus, compelled first responders to adopt integrated response procedures to achieve rapid hemorrhage control, rapid extraction to safety, and transport to definitive care to limit deaths from mass-casualty shooting events. The council of medical experts insisted that hemorrhage control be a core law enforcement capability. The report emphasized this point by stating: “Maximizing survival requires an updated and integrated system that can achieve multiple objectives simultaneously.” To realize the objectives of the Hartford Consensus, first responders must share tactical and emergency medical skills across disciplinary lines. Considerable knowledge on casualty care can be transferred from the EMS community to law enforcement. Conversely, substantial knowledge on reacting to an ambush, using contact and cover principles, and incendiary explosive device identification can be transferred from law enforcement to EMS. First responders collectively applying these unconventional skills through tabletop exercises, drills, and full-scale exercises will ensure they are working in harmony when called on to save lives in an actual crisis.

Read more here.

Hospitals Rise to Meet Meaningful Use Challenges


Hospitals trying to meaningfully use their electronic health records are caught between a rock and a hard place in 2014. Achieving the Meaningful Use requirements has become harder now that many hospitals must meet the more stringent requirements of Stage 2 of the program.

While almost 95 percent of hospitals have registered for the Meaningful Use program and more than 91 percent have received an incentive payment in years past, only four of the 30 eligible hospitals that have attested for the 2014 reporting year have attested to Stage 2 of the program as of March, a dismal figure.

At the same time, the stakes have become higher: Hospitals need to successfully attest or else suffer lower Medicare reimbursement, as the “payment adjustments” for not meeting Meaningful Use goals kick in starting in 2015.

To that end, what tools and practices are helping hospitals to make the grade and meet Meaningful Use? FierceEMR spoke with experts from Oakland, California-based Kaiser Permanente and the Cleveland Clinic to get a sense for how they’re approaching the task. Read on to learn about four ways these and other hospitals can get ahead of the curve.

Will This Obamacare “Emergency” Lead to Big Profits For One Sector?

From the Motley Fool:

The emergency room boom
According to a survey conducted by the American College of Emergency Physicians, or ACEP, nearly half of all emergency room doctors have reported an increase in ER visits since the beginning of the year with 86% expecting a rise in visits within the next three years.

What’s the primary reason for this surge? As FierceHealthcare pointed out this week, it’s a combination of two major factors.

First, more people are carrying health insurance and taking advantage of that coverage in the form of more hospital visits. Unfortunately, with millions of newly insured persons covered by Medicaid, and a number of physicians simply not accepting Medicaid as a form of payment since the reimbursement rate is sometimes viewed as too low, these individuals in need of medical care are simply turning to emergency departments more often.

Secondly, our population is getting older and living longer. Since older adults are considerably more likely to have chronic conditions in need of treatment, emergency rooms are a common stop for the elderly.

What this means for hospitals
For hospital operators like HCA Holdings(NYSE: HCA  ) , Tenet Healthcare (NYSE:THC  ) , and Community Health Systems(NYSE: CYH  ) this surge in emergency department visits could be a gigantic moneymaker, if the patient breakdown works in their favor.

Huntsville Hospital ED Adapts Blurred Lines

Last year, Huntsville Hospital Emergency Room workers brought the music with their own “Gangnam Style” video. They’ve upped that this year with their salute to “Blurred Lines.”

The video, which features dancing doctors, strutting staff and even a goat, was all done in good fun and part of fundraising efforts for the hospital’s Lifesaver Club. The club, made up of Huntsville Hospital employees, hosts the popular video contest.

Alprazolam (Xanax) misuse still sending tens of thousands to emergency rooms

From USA Today:

Misuse of the popular sedative alprazolam, known by the trade name Xanax, sent more than 123,000 people to the emergency room in 2011, slightly fewer than the year before but more than double the number who went to the emergency room in 2005, a new report shows.

The report was issued Thursday by the Substance Abuse and Mental Health Services Administration.

More than 1.2 million people sought emergency care in 2011 for abusing prescription drugs, the SAMHSA’s Drug Abuse Warning Network reported.