‘Telepsychiatry’ speeds up hospital release times

From the Journal (AP):

When emergency room patients are deemed “a danger to themselves or others,” every state requires hospitals to hold them until a psychiatrist conducts an evaluation to decide whether it is safe to let them leave. In rural hospitals, it can take days for a psychiatrist to show up and perform the exam. 

Five years ago, rural hospitals in South Carolina illustrated the problem. On a typical morning, more than 60 people were waiting in the state’s emergency rooms for psychiatric exams so they could be discharged or admitted. 

Today, the scene is different, thanks to a “telepsychiatry” program that allows psychiatrists to examine patients through videoconferencing, reducing the average wait time from four days to less than 10 hours. In 2010, North Carolina began rolling out a similar program, and a dozen other states, including Alabama, Kentucky and Wisconsin, plan to follow suit.

A regulator, Harvard prof. walk into an ER …

From Government Health IT:

More views on ER came recently one summer evening from Niall Brennan, the Centers for Medicare & Medicaid Services’ director of information products and analytics, as he entered Johns Hopkins Medicine’s Suburban Hospital, for what would be the first of two ER visits in 36 hours.

While Brennan did not want to elaborate on his experience and it would not be appropriate to pry, his public comments do suggest that, if not Byzantine per se, the American ER is an area of healthcare with a lot of room for improvement, despite the good intentions of doctors, nurses and administrators, the investments in comprehensive electronic health records, and attempts at quality measurement.

Hospital forced to close ER as water enters building

From KCCI (hat tip: Mr. Oliver):

KWWL-TV reports officials closed Mercy Medical Center’s emergency department because of rain water entering the building through an emergency entrance.

EDPMA Comments on Alternative Payment Methodology for Short Hospital Stays and the Two-Midnight Rule


Today EDPMA filed these comments with CMS regarding its proposed rule on the 2015 Update to the Inpatient Prospective Payment System (IPPS).  The ACOEP agreed to cosign our letter.  CMS admits that the two-midnight rule has met with a great deal of criticism and sought comment on how to develop an alternative payment methodology for short hospital stays.  EDPMA’s letter provides a list of general principles that CMS should follow when developing a payment methodology for short stays.  For instance, “Payment for the stay should be based on the patients’ acuity, the severity of the patient’s illness or condition, and/or the intensity of services and resources required to treat the patient.”   It should “avoid setting arbitrary time-bound standards”  that lead to inconsistent application and a large number of unjustified audits.  EDPMA also encouraged CMS to acknowledge the essential role of the emergency physician in the short stay and develop physician reimbursement incentives that align with inpatient reimbursement policy. 

Researchers devise new method to preserve organs for transplant

From Upstart:

Researchers have devised a new method to preserve organs for more than three days. This breakthrough experiment can lead to many positive changes in the human transplant operations.

Overdose of overdoses

From the News:

Since Jan. 1, county EMS personnel have responded to 61 reports of overdose, Callebs said, though not all of those have been for heroin, and the calls aren’t coded for specific drugs.

Drug-abuse overdose deaths in Athens County averaged 11.9 per year between 2006 and 2013, according to figures from the Athens City-County Health Department.

“It’s something we’ve dealt with for a long time, but the big change I think we’ve seen over time is that heroin is pretty much the big one any more,” Callebs said. “That’s a change we’ve seen in the past two or three years.”

Emergency department workers inherently vulnerable to violence

From the Post-Gazette:

In 2010, the U.S. Bureau of Labor Statistics reported 11,370 assaults on healthcare and social assistance workers nationally, a 13 percent increase over the previous year. The following year, the Pennsylvania Patient Safety Authority reported 384 acts of violence or verbal abuse, most of them threats, from 2006 through 2010.

Ms. Brecher said the nurses association, based in Des Plaines, Ill., once surveyed 13,000 members about whether they had experienced physical or verbal violence such as threats in the previous seven days.

More than half answered “yes.”

Predictive Healthcare Analytics: When a Health Plan Knows How You Shop

From the NY Times:

There may be a link between your Internet use and how often you end up in the emergency room.

At least that’s one of the curious connections to emerge from a health care analysis project at the insurance division of the University of Pittsburgh Medical Center.

U.P.M.C. is a $12 billion nonprofit enterprise that owns hospitals in western Pennsylvania as well as a health insurance plan with about 2.4 million members. It is at the forefront of an emerging field called predictive health analytics, intended to improve patients’ health care outcomes and contain costs. But patients themselves are often unaware of the kinds of intimate details about their households that insurers and hospitals may use to try to sway their treatment decisions.

“How to Get Reliable Medical Information on the Internet”

From Lifehacker:

Getting sick seems a lot more stressful now that we have the internet. You can research your symptoms, but inevitably you’ll fall down a rabbit hole of illnesses that are so unlikely, every search will turn up a life-threatening disease. It is possible to get reliable, useful information, vet it properly, and even get an expert opinion, all online. Here’s how.

Code for America is working on reducing ER calls in Long Beach using big data

From Venture Beat:

So, how to identify those people who are making ER calls repeatedly? The team aggregated ER call data from the fire department and the police department — address, time, and the type of call it was.

To make it actionable, they also poured in business-license data from the city’s Business License Division for determining what the addresses are. If a single-family home made 40 ER calls last year, you probably want to send a nurse there. If a restaurant made 40 ER calls last year, you might want to send an inspector.

The team visualized its data to identify trends for the city’s departments to look at and to assemble the right team to take action.