Overcoming the Barriers to Telehealth Use in Urban Settings

Imagine a mother who is juggling two children under the age of five and a full-time hourly wage job.  When her child contracts pink eye or a worsening cold or a sinus infection or asthma, she is forced to choose between giving up wages to see the primary care physician or going to the emergency department that is unable to turn her away, even if she cannot pay, after work hours.  Many choose the latter option but it is costly and risks additional illness. While retail clinics have closed some of the gap in primary care, telehealth visits have the potential to close even more of the gap.  Unfortunately, these visits are rarely covered by private payers and are rarely covered by public payers like Medicare and Medicaid.  So, unless the mother can afford $40-55, the telehealth visit, while saving time, will not be utilized. Read More

Drones Enter the Lives and Careers of Nurses

Drones are far more than toys. Drones will transform diverse areas of life, including business, defense, education, entertainment, and, of course, health and medicine. Drones will also transform the role and function of nurses and other healthcare professionals. Just consider the possibilities...
As nurses look forward to a future where drones are active participants, they may witness myriad problems-from privacy, security and designated delivery spots to traffic patterns, durability and licensing. However, nurses can become part of the drone revolution if they take action on the following: Read More

Medicare to reimburse for Diabetes Prevention Program, including Omada's digital version

HHS Secretary Sylvia Burwell announced 3/23/2016 that Medicare will cover the Diabetes Prevention Program, including digital versions like Omada Health’s. This marks the first time a preventative model from a CMS Innovation Center has been expanded into the Medicare program.
In a recent study, six months after starting the program, 84 percent of participants, with an average age of 69, remained engaged and lost an average of 7.8 percent of their body weight. Read More

NY providers prepare for coming e-prescribing mandate

Starting Easter Sunday, March 27, electronic prescribing for both controlled and non-controlled substances will be required in New York, making it the first state to require all prescriptions be created electronically. Physicians who fail to comply with the mandate face fines and imprisonment.
Read More

NIST issues draft guides on telework security

New draft guidelines aim to improve security of telework and bring-your-own-device practices. The draft guide outlined:
  • Access control for network communications
  • Access control for applications
  • Remote access client software security
  • Telework client device security
For more:
read the draft guide to telework
read the draft guide to enterprise telework  

Hospitals rethink ERs with patient satisfaction in mind

Many hospitals, recognizing the ED's importance to hospital revenues, have made changes such as allowing patients to schedule appointments or working to attract specific patient sub-populations such as parents. Not only does this draw patients to emergency services, it can also benefit hospitals' patient satisfaction scores, themselves a driver of payments, according to the article.
Patients and their family members respond well to efforts to meet their needs.  To learn more:
- read the article

4 red flags for geriatric ER patients

Monday, March 7, 2016 | By Zack Budryk
Elderly emergency department patients with a few key symptoms are at particular risk for intensive care admission or death in the hospital, according to a new study published in the Annals of Emergency Medicine.
Researchers, led by Gelareh Gabayan, M.D., of the Department of Medicine at the University of California at Los Angeles, analyzed ED visit records for 300 elderly patients discharged from any of 13 hospitals in 2009 and 2010. They found four symptoms made patients more likely to die or be admitted to the intensive care unit or die within a week of the visit:
  • Low blood pressure
  • Elevated heart rate
  • Cognitive impairment
  • Changes in disposition between admission and discharge
"Emergency physicians must exercise extra caution when making the decision to admit or discharge a geriatric patient," Gabayan said in a statement. "These patients tend to be more delicate than their younger counterparts. Even abnormal vital signs, like blood pressure and heart rate, are associated with potentially catastrophic events for patients who are discharged from the ER rather than admitted."
The results, Gabayan added, demonstrate that hospital leaders and patient family members alike should exercise caution when it comes to discharging geriatric patients from emergency settings. In early 2014, four healthcare industry group issued new standardized guidelines for geriatric emergency care to address the risks such patients present, FierceHealthcare previously reported, including falls, delirium, dementia and medication mismanagement. As the population ages, hospitals have increasingly tailored emergency services to geriatric patients, to the point of opening EDs specifically for the elderly.
To learn more:
- here's the study abstract
- read the statement

8 Reasons to Adopt Telehealth

Telehealth has been a big buzz word in the healthcare industry over the past couple years. A recent survey by the American Academy of Family Physicians (AAFP) found that 78% of physicians believe telemedicine improves access to care. Another report found 75% of surveyed patients said they would be interested in doing a telemedicine visit in lieu of an in-person medical visit.

There’s clearly momentum behind telehealth. But what many physicians may wonder is - is telemedicine worth it? How will it directly help my practice? Is it worth the initial time and investment?  Read More »

Other Nursing Informatics & HIT Blogs of Interest

Nursing Informatics & Technology: A Blog for All Levels of Users

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mobihealthnews

iHealthBeat

Health information technology improves care and saves lives

AHRQ Research about: * Telemedicine * School Health * Health Maintenance

Ethics and HIT

Challenges...
http://jamia.bmj.com/site/icons/amiajnl8946.pdf
  • patient safety should trump all other values; corporate concerns about liability and intellectual property ownership may be valid but should not over-ride all other considerations;
  • transparency and a commitment to patient safety should govern vendor contracts;
  • institutions are duty-bound to provide ethics education to purchasers and users, and should commit publicly to standards of corporate conduct; and
  • vendors, system purchasers, and users should encourage and assist in each others’ efforts to adopt best practices.

e-Behaviorial Health


Benefit from new technologies... enable people to have remote access to CBT

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