SWAT team kills inmate who took hostage at Illinois hospital

From CNN:

A SWAT team killed a jail inmate who’d taken a woman hostage Saturday inside a suburban Chicago hospital, authorities said.

The inmate, Tywon Salters, 22, of Chicago was fatally shot after negotiations broke down inside Delnor Hospital in Geneva, said Patrick Gengler, spokesman for the Kane County, Illinois, Sheriff’s Department.

The hostage, a nurse, was apparently not injured, he said.

Critical Access Hospital Financial Pro Forma for Shared Savings

From Rural Health Value:

The Rural Health Value team has developed an Excel-based financial modeling tool to help critical access hospitals assess the financial implications of joining a Medicare Shared Savings Plan Accountable Care Organization.

Inmate takes Illinois hospital employee hostage

From CNN:

An inmate being treated at an Illinois hospital grabbed an attending officer’s weapon and took a hospital employee hostage, the Kane County Sheriff’s Department said Saturday afternoon.

Hostage negotiators and the Kane County SWAT team have arrived at Delnor Hospital in the Chicago suburb of Geneva.

The inmate was receiving medical treatment near the emergency room when he grabbed the attending sheriff deputy’s weapon, said Sheriff’s Department spokesman Patrick Gengler. The inmate took a hospital employee hostage in a room near the treatment area, he said.

CMS gives 800,000 docs a pass on MACRA requirement

From Modern Healthcare:

More than 800,000 clinicians will not have to comply with Merit-based Incentive Payment System reporting requirements outlined in MACRA, which may save them millions collectively in compliance costs.

The majority of physician practices were expected to use the Merit-based Incentive Payment System, known as MIPS, to comply with MACRA as opposed to alternative pay models. Under MIPS, payments would be based on a compilation of quality measures and use of electronic health records.

The CMS has now sent letters to 806,879 clinicians saying that they will not be evaluated under MIPS in 2017.

Academic study questioning ER pricing sparks fight

From the Chronicle:

The free-standing emergency room industry has launched a fierce challenge to a recent academic study examining the pricing of emergency care in Texas, not only attacking the validity of the data but allegedly striking at the professional integrity of the authors.

The preliminary findings of the study, posted on a medical journal’s website in March but now removed, showed stark disparities in the prices charged for the same diagnosis depending on which type of clinic or emergency room a patient chooses. That can lead to confusion and ultimately sticker shock, the study found.

Lead author Vivian Ho of Houston said this week that Dr. Paul Kivela, president-elect of the American College of Emergency Physicians, contacted her in April to complain about some numbers in an appendix and implied she could be sued.

Smartphones in the ER can help discharge patients faster

Press Release:

Chest pain patients in the emergency department whose attending emergency physicians received lab results delivered direct to their smartphones spent about 26 minutes less waiting to be discharged than patients whose lab results were delivered to the electronic patient record on the hospital computer system. The results of a randomized, controlled trial of a quality improvement initiative were published online Tuesday in Annals of Emergency Medicine (“Push-Alert Notification of Troponin Results to Physician Smartphones Reduces the Time to Discharge Emergency Department Patients: A randomized Controlled Trial”).

“For patients waiting for lab results, 26 minutes is significant, even if the smartphone process did not shorten overall length of stay significantly,” said study author Aikta Verma, MD, MHSc, of the University of Toronto in Ontario, Canada. “For many patients, waiting for lab results that determine if they stay in the hospital or go home is the hardest part of the ER visit. Physicians who received troponin results on their smartphones made the decision to discharge their patients with chest pain a median of 26 minutes faster than physicians without troponin push-alert notifications.”

Patients who come to the emergency department with chest pain have blood drawn to test for troponin levels, which, if elevated, indicate a heart attack. In this study, the overall median interval from final troponin results to discharge decision was 79.7 minutes. For the control group (no smartphone), it was 94.3 minutes and for the intervention group (smartphone) it was 68.5 minutes. The difference of 25.8 minutes is “statistically significant.” The total emergency department length of stay was 345 minute in the control group and 328 minutes in the intervention group, which researchers did not consider statistically significant.

“Our study demonstrated reduced time to discharge decision for chest pain patients by pushing troponin results to smartphones,” said Dr. Verma. “There are many other results that could also be pushed: other critical lab results, radiology reports, vital signs, etc. For now, we recommend the use of the push-alert notification system to improve flow through the emergency department for chest pain patients.”

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Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information, visit http://www.acep.org.

Bigger, more expensive healthcare practices not necessarily better

From Reuters:

You might not get what you pay for when it comes to healthcare, a new study suggests.

A report in Health Affairs found little association between how much physician practices charged and patients’ perceptions of their quality of care.

“We’re asking consumers to make a lot of decisions about healthcare purchasing without a lot of information. Price is not really a definitive signal of quality,” said lead author Eric T. Roberts, a health-services researcher at Harvard Medical School in Boston.

“Practices with higher prices perform no better in terms of patients’ ratings of their care,” he said in a phone interview.