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The CMG Voice

From Hospital to Nursing Home to Hospital

Posted Friday, June 29, 2018 by Morgan Cartwright

The elderly end up in hospitals due to falls, disease, stroke, and illness. Often, patients are forced to nursing homes sooner than may be ideal for their health. Unfortunately, many of these homes fail to live up to provide the needed care. This includes not heeding or receiving accurate hospital/physician instructions and creating new problems. Many are potentially preventable conditions, including dehydration, infections, and medication errors.

As a result, the elderly patients often arrive to the nursing home from the hospital and are sent back shortly thereafter. Federal records show that one in five Medicare patients sent to a nursing home from the hospital are sent back to the hospital within 30 days. Further, out of the nation’s 15,630 nursing homes, one out of five send 25% or more of their patients back to the hospital. This is largely a result of financial coverage of these patients for both the hospitals and nursing homes, including variable rates according to hospital treatment time, higher nursing home insurance coverage upon return from hospital, and bed-hold insurance.

However, even the fifth of nursing homes with the lowest overall readmission rates were at about 17%. As a result, the government has stepped in to try to address this readmission problem. In 2013, the government began fining hospitals for high readmission rates to discourage premature discharges and encourage referrals to good nursing homes. Starting this October, the government will start giving nursing homes bonuses or penalties on their Medicare rehospitalization rates.

While the government’s readmission policies are just beginning to take form, there seems to be progress. The rate of potentially avoidable readmissions dropped to 10.8% in 2016 from 12.4% in 2011. However, there are some who worry the effect will be that bad nursing homes will stop sending patients to the hospital.

Medicare Eyes Hospital Readmissions from Nursing Homes

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Cyber security attacks on hospitals put Electronic Health Information at risk

Posted Tuesday, June 26, 2018 by Tyler Goldberg-Hoss

Given the nature and depth technology has been incorporated into our lives, it is not hard to imagine how we might be affected if such technology was hacked and malicious entities gained access to it.

Add Electronic Health Information to the list of such concerns. A recent survey of health care institution executives (and some from device manufacturers) counted as many as 1000 patients who have suffered harm due in some part to cyber security attacks.

Preventing attacks can be problematic. Technology becomes antiquated relatively quickly, and it is more and more difficult to support updates or patches to possible vulnerabilities.

Interestingly, the FDA has set forth guidance on cyber security, including regulations for meeting mandatory quality system regulations. 20% of survey respondents said they did not implement these new policies, and another twenty percent said they don’t plan to.

You can read more on this topic here:

New research shows patients harmed by medical device breaches

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Amazon is coming for you(r health care)

Posted Thursday, June 21, 2018 by Tyler Goldberg-Hoss

If you live in Seattle, you’ve probably heard of Amazon. Heck, if you live period, you’ve probably heard of Amazon. Like millions of others, you may also interact on occasion with Amazon’s virtual assistant, Alexa.

Alexa often comes though an Amazon device called an Echo. The Echo sits in your home, and you can tell it to do things, such as set a timer, play a song, turn the volume up or down, and tell you what the weather is like outside.

You may also have heard that Amazon is dipping its rather large toe into the health care industry. Recently it announced a partnership with other corporations to revolutionize health care, including drug manufacturing. Now, it appears that Amazon may use Alexa to help it gain traction in the health care industry.

Now obviously, Alexa isn’t going to be performing surgery anytime soon (though it has been tested in operating rooms to help surgeons go through safety checklists prior to operating), nor is it likely to diagnose you with medical conditions. But it may be useful in managing chronic illnesses such as diabetes, or otherwise helping patients keep compliant on taking medications.

Further, for family members who are elderly, Alexa can be a way for someone to call for help in the event he or she is incapacitated from a fall.

You can read more about this development here:

Why Alexa’s Next Big Move Is Into Health Care

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Researchers hope to use precision medicine to treat depression.

Posted Monday, June 18, 2018 by Tyler Goldberg-Hoss

If you or a close friend or family member suffers from depression, you may understand the difficulty in finding a medication and/or treatment plan that works. Oftentimes, a health care provider may prescribe one medication, only to find out after weeks (or months) that it doesn’t work, or it’s not the right dose.

And people change, making the right medication and/or dose challenging to determine dynamically.

In an effort to find a more effective approach, researchers are attempting to apply the concepts of precision medicine to this mental health disorder.

Precision medicine refers to better tailored treatments for each patient. Researchers have begun by gathering data – brain scans, blood work, patients’ subjective symptoms – and attempting to find subtypes of depression. From there, the goal is to find the best treatment for each subtype.

The same approach has worked in recent years in cancer treatment. It is the hope of these researchers – and everyone affected by depression – that we will find similar success.

You can read more about this here:

Can precision medicine do for depression what it’s done for cancer? It won’t be easy

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Walmart’s answer to better healthcare: find the bad doctors and get rid of them.

Posted Friday, June 15, 2018 by Tyler Goldberg-Hoss

As readers of this blog know, there are many amazing things happening in healthcare in the United States (particularly technological advancements), and there are still real problems.

Recently, large corporations like Amazon and Walmart have entered the fray. Walmart itself has been gathering data from its own healthcare program, attempting to find ways to improve the care provided to its patients, and improve profits from delivering that health care.

What it found was that the behavior of some doctors was a “root cause” of giving wrong care, not enough care, and not offering sufficient value for the cost of the care.

And instead of working with those providers to understand better why those problems are occurring, it appears Walmart is going the other way: “We will build networks that realize some providers just won’t cut it and won’t get any value from the network.”

These doctors have been identified as not practicing evidence-based medicine, and the implication is, at least within the Walmart system, that unless they do, they will be out of the Walmart system.

You can read more about this here:

Walmart’s next healthcare move: Using data to identify bad doctors

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