More critical-access hospital closings likely

From Modern Healthcare (hat tip: Dr. Menadue):

Amid ongoing federal scrutiny of the extra funding paid small hospitals to serve remote areas, the number of critical-access hospitals in the U.S. continued to fall over the past year, according to Modern Healthcare magazine’s annual review of CMS data published in this week’s By the Numbers list.

States such as Georgia, which suffered the most closings last year, are girding for more shutdowns among its rural facilities.

Critical-access hospitals, which have 25 beds or fewer, saw 14 closings in 10 states last year. Hospitals in three states switched designation from prospective payment systems to critical-access, bringing the total loss to 11. Overall, there are 1,321 critical-access hospitals in the country in 2014, down from 1,332 in 2013.

University of Illinois at Urbana-Champaign Propose New Engineering-Based Medical School

From the Chicago Tribune:

University of Illinois at Urbana-Champaign officials are lobbying to establish a new and independent college of medicine, an idea that has rankled counterparts at its sister campus in Chicago who currently oversee the university system’s medical education.

The proposal calls for a specialized, engineering-based medical college, making it unique nationwide, U. of I. Chancellor Phyllis Wise said in an interview. It would draw on the university’s strengths, including engineering and technology, to graduate physician-scientists who could work in clinical practice but also be positioned to develop new medical equipment and innovations.

AAN: The risks of powerful narcotic painkillers outweigh their benefits for treating chronic headaches, low back pain and fibromyalgia

From Philly/HealthDay:

The risks of powerful narcotic painkillers outweigh their benefits for treating chronic headaches, low back pain and fibromyalgia, a new statement from the American Academy of Neurology says.

Narcotic, or opioid, painkillers include medications such as morphine, codeine, oxycodone (Oxycontin), methadone, fentanyl, hydrocodone or a combination of the drugs with acetaminophen.

The drugs can cause serious side effects, overdose, addiction and death. Research shows that 50 percent of patients who took opioids for at least three months are still on them five years later, according to the academy.

Studies find that while opioids may provide short-term pain relief, there is no proof that they maintain pain relief or improve patients’ ability to function over long periods of time without a serious risk of overdose, dependence or addiction, the statement says.

Code Black movie has plenty of villians and frustrated heroes in the ER

From MedCity News:

Code Black, the independent film screened Monday by the attendees of MedCity ENGAGE in Washington D.C., managed to tell a true, exciting and emotional story about what it’s like to work in the emergency room of a county hospital. In ER language, Code Black means “holy sh*t” – there are patients everywhere.

Three ER doctors who attended the showing at the first night of ENGAGE said that it was an accurate picture of what it was like to work in an emergency department.

ER May Reveal Basic Problems in Hospitals

From the Huffington Post:

Signs of excessive defensive medicine were rampant, most obviously in the form of repeated tests and exams. I don’t have a solution to medical professional’s fear of being sued, but I am confident that the problem is exaggerated for purposes that don’t benefit front-line providers.

Like many large institutions, ERs have acquired an odd sort of lethargy. Despite the life-and-death environment, a shocking number of ER staff were simply standing around, texting, gossiping, and repeatedly getting in the way of those with something to do. Technology might play a role here, too, using data mining to better anticipate supply and demand and schedule employees accordingly. Time is, indeed, money, and the amount wasted in an era of spiraling costs is appalling.

One wonders what kinds of consultants are used. Smart problem solvers from outside of the health care field could bring fresh eyes and ideas to these obvious problems. But lawyers, insurance companies and doctors — as well as bean counters — have to be in the act too, with divergent motives and interests.

Missouri Shares Data , Decreases Medicaid Hospital Use & ED Visits

From GovTech:

The state of Missouri is saving money and improving health care by sharing data. Through a multi-agency effort built over the past 10 years, the state’s Information Technology Services Division (ITSD) has, in recent months, added new functionality — functionality that has reduced hospital use by 20 percent and emergency room visits by 12 percent among enrollees in the state’s Medicaid program, known as Health Homes.

Google Glass medical app maker Pristine raises $5.5 million

From MobiHealthNews:

Pristine’s flagship product, called EyeSight, streams near-real time audio and video from Glass to authorized iOS devices, Android devices, Macs, and PCs so that, among other uses, wound care nurses can transmit point-of-view video to a physician; emergency responders can send relevant video and information to hospital staff who are preparing to treat the patient; and surgeons can send a livestream of a surgery from their point of view to residents, fellows, and surgeons at other medical centers.

Inpatient utilization and ED use stagnates, falls for nonprofit hospitals.

From Becker’s:

In the first and second quarters of 2014, inpatient utilization was either unchanged or down for 68 percent of nonprofit hospitals, according to a Kaufman Hall survey of nonprofit hospital executives

The survey also found 72 percent of responding hospitals saw an increase in outpatient utilization during the same period. Emergency department use was flat or down for 60 percent of respondents.

Accountability slow to reach rural hospitals

From the Chicago Tribune:

“It’s very unfortunate that critical-access hospitals continue to be exempt from all the new policies aimed at improving quality and safety at hospitals in America,” said Leah Binder, CEO of The Leapfrog Group, a nonprofit that evaluates hospital performance for consumers and employers. “If you live in a rural community and you are dependent on a critical-access hospital, the federal government has abandoned you.”

Some rural health care leaders say they are rankled at being marginalized and concerned that they could be left behind as reforms spread.

“I do not want to see my hospital on the sidelines,” said Don Annis, chief executive of Crawford, which serves people near the Indiana border about four hours south of Chicago. “I want us to be prepared for this.”

Instead, Crawford is part of the Illinois Critical Access Hospital Network, which is developing its own ACO. “That’s a much better environment to be in,” he said.

Five babies in Texas test positive for TB after possible mass exposure

From Reuters:

Five babies have tested positive for tuberculosis infection in El Paso after being at a hospital where hundreds of newborns may have been exposed to TB by a diseased worker at the facility, health officials said on Saturday.