Hospitals and physicians have been driving fairly hard on electronic health record (EHR) adoption over the past year or two, partly in response to the financial incentives for Meaningful Use of EHRs under the American Recovery and Reinvestment Act. Those incentives kick in next year and physicians who qualify in 2011 and 2012 will be in a position to collect the entire incentive payment. However, those who don’t quality until 2013 or 2014 will get less. For physicians starting in 2011 or 2012 means the potential to collect $44,000 compared with only $24,000 for those who don’t qualify until 2014. The hospital rules are a little more complicated; still the earlier they qualify the better they do.

Two new reports show that physicians and hospitals are struggling to reach Meaningful Use. That’s not necessarily a bad thing, because it means the Meaningful Use bar was set high enough so that we taxpayers are likely to see some significant improvements for our investment. But I am concerned that some providers will start to give up on EHR adoption once it looks like the incentives are out of reach. On the other hand, the drafters of the legislation thought about this, too, and implemented a penalty phase that kicks in after 2015.

Human nature being what it is, I expect we’ll see a slowdown in EHR adoption in 2012 and 2013 as the incentives appear out of reach, followed by a pickup as we get closer to 2015 and penalties loom. The picture for hospitals may look a little different as they will likely continue trying to make incremental progress. Still I think the big push will come for the laggards once they start getting slapped.

According to the first report (Survey: Top 5 reasons providers not ready for meaningful use) only about 10 percent of EHR buyers are on track for Meaningful Use adoption. Their top 5 reasons for lagging sound about right to me:

1. A lack of substantive support from their EHR vendor (93 percent);
2. Delayed implementation due to the cost of additional support from EHR vendor/consultants (89 percent);
3. A hurried selection of an EHR vendor has resulted in negative consequences (82 percent);
4. Lack available and/or trained staff to properly implement an EHR (77 percent); and
5. They are unprepared and underfunded to rectify difficult system interfaces (69 percent).

In the other report (‘Meaningful use’ readiness drops among hospital CIOs) hospitals indicated the going gets tougher the closer they get to the meaningful use qualification deadline.

“One potential reason for the drop in confidence may be due to the fact that CIOs are getting a clear view of the horizon, as many of their questions are being answered by federal agencies,” Chuck Christian, director of information systems and CIO at Good Samaritan Hospital in Vincennes, Ind., says in a CHIME press release. “Many of the clarifications are adding to the complexity of the task at hand.”

Share

Read More: http://feedproxy.google.com/~r/HealthBusinessBlog/~3/p2movH1ZihA/

Please consider making an end of the year gift to the Hearts & Noses Hospital Clown Troupe, using the online donation form. I’m chairman of the board and can promise that the money we raise very efficiently supports the efforts of our dedicated volunteers.

Professionally trained, volunteer clowns from the Hearts & Noses Hospital Clown Troupe have made personal, bedside visits to more than 35,000 children since our troupe’s founding in 1997. Hospitalized children often experience stress, fear, and anxiety which can become a barrier to healing. Hearts & Noses clowns are specially trained to provide relief for ill children and respite for their families. While visits are certainly entertaining, the Troupe’s clowns strive to do more. Our clowns seek to uncover the hidden spirit of joy and the creative energy that lives in the heart and soul of children− a spirit that is often dampened by the sterile and sometimes frightening clinical environment. Our clowns’ central goal is to engage, empower and give choices to hospitalized children.

After a life-changing trip to Russia with famous clown and physician Patch Adams, troupe founder Jeannie Lindheim began offering a series of seminars on hospital clowning. Lindheim, an actor, began training clowns to visit ill and disabled children at Boston area hospi-tals. She formed Jeannie Lindheim’s Hospital Clown Troupe and worked diligently to build a strong, professionally-trained group of volunteers. More than a decade later, our clowns are still all volunteers and we have helped build clown troupes throughout the world. Most recently, our troupe has trained and mentored a fledgling troupe at Baystate Medical Center in Springfield, MA as well as a small group of hospital clowns in Sao Paolo, Brazil.

Hearts & Noses Hospital Clown Troupe is the Boston area’s only professionally-trained, vol-unteer clown troupe addressing the special needs of hospitalized children. We meet young-sters when they are most powerless and most vulnerable — dealing with medical issues (acute or chronic) that force them into a hospital or institutional health care setting. Using theater arts, music, and improvisational play, our clowns engage children in interactions that lighten their spirits and take them away, for a period of time, from the hard job of get- ting well. In the process, our clowns open up the child’s will to recover, turning even the most withdrawn patient into one who is more optimistic and more receptive to the treat- ment prescribed by the medical team.
Hearts & Noses Hospital Clown Troupe partners with three Boston-area hospitals: Boston Medical Center, Spaulding Rehabilitation, and Franciscan Hospital for Children. Boston Medical Center is a private, not-for-profit, academic medical center.  Emphasizing community-based care, Boston Medical Center, with its mission to provide consistently accessible health services to all, is the largest safety net hospital in New England. We currently visit children on the Pediatrics Floor, in the Pediatric Intensive Care Unit, and in the Emergency Department.

The children we visit at Spaulding Rehabilitation Hospital are often recovering from cancer treatment, surgery, amputation, or accidents. These children are often facing weeks of painful, physical recovery work and we offer them a break from that stressful pace and the opportunity to play and have some fun. This focus on play allows children to simply be children, no matter their physical disease or disability.

Our young friends at Franciscan Hospital for Children are often medically fragile and many are on long-term care plans. Some of these children live at the hospital for months or even years; some are never able to go home. We often become part of their inner circle of friends and caregivers because we visit so regularly. We are sometimes asked to be present for a procedure such a bandage change. We distract and refocus the child on play so that the nursing staff can take care of the medical need. Franciscan is our longest- term partnership and we are a key complement to their team.
Hearts & Noses hospital clowns train for two years and work closely with artistic specialists, child development specialists as well as our Medical Director, Michael Agus, MD, Director, Medicine Intensive Care at Children’s Hospital Boston. Last year we focused our ongoing training sessions on child development topics and brought in experts to teach us how to better communicate with children who have special needs, particularly those who are on the Autism Spectrum. We are seeing more children with Autism-related disorders at all of the hospitals but especially at the long-term rehabilitation hospital. We hope to expand those trainings to other serious disabilities and special conditions. We work hard to understand the hospital environment and to be an asset. We want to encourage fun without getting in the way. We also want to be able to quickly assess a child’s needs and abilities so that we can launch right into the appropriate level of play for that child. We are hoping to incorporate new skills into our repertoire to better engage the children we visit.
Each hospital has a dedicated team of clowns. These teams work with each hospital to understand its particular patient population, the special needs of the children, and how they can be most helpful to hospital staff. We strive to train to meet the needs of the population served at each hospital. The clown team structure enables a constructive partnership with hospitals that establishes roles and continuity, creates space for reflection, and encourages creativity. Building relationships with staff is the best way for us to understand the impact we make on the children and make sure that we are a truly helpful addition on the hospital unit.

Perhaps the best way to tell you about what we do and why you should partner with Hearts & Noses Hospital Clown Troupe is to share a story of an actual clown visit. As told by one of our clowns,

We have seen a little boy, Benjamin, for years. He is 10 years old. He can’t move his hands, and is either in bed or in a reclining wheelchair. He beams every time he sees our clowns. His one foot and toes act as his hand. He makes magic tricks work by tap- ping our tricks with his foot.

Today we visit him. I play a silent clown. My partner, Poppy says, “Bloopers has lost her voice.” We look in my pockets, behind the nurse’s counter…everywhere for my voice. Benjamin says, “I will say the magic word.” He does and my voice returns. He takes cards we give him with his toes. Benjamin never wants us to leave when we visit and always says, “One more magic trick?”
We visit all the children on the floors and then talk about our visits in the lobby when we are finished seeing all of the children. I am about to leave the hospital. I look through my clown bag and realize I have left my magic box up on the floor where Benjamin lives. So I take the elevator to his floor.

Benjamin is eating lunch and beams when he sees me. I pretend I have lost my voice again. He laughs and laughs. He says the magic word; my voice returns. I see my magic box on the counter. I smile at him and wave a huge wave. As I dash down the hall leaving, he yells, “I love you!”

You can read more stories like this on our website at www.heartsandnoses.org where the contributions of our funders are gratefully acknowledged.

Hearts & Noses clowns bring joy to hospitalized children.  For more than a dozen years, our clowns have performed magic.  Even if for just a few moments, they have changed “pediatric patients” back into laughing, smiling kids.

Please give generously to support the work of Hearts & Noses Hospital Clown Troupe.  Your donation will bring joy to ill children at our partner hospitals: Boston Medical Center, Franciscan Hospital for Children and Spaulding Rehabilitation Hospital and to children at Victory Programs Portis Family Home.  It will also help to train new clowns so that we may reach as many children as possible.

Share

Read More: http://feedproxy.google.com/~r/HealthBusinessBlog/~3/8OvlnVRyQqk/