Healthcare Reflections Blogs
 

Healthcare Reflections Blogs


A longer road to EMR adoption? CDC and CHIME surveys hint

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1 in 2 office-based physicians in the U.S. use any sort of electronic medical record (EMR) or electronic health record (EHR). However, only 10% of doctors have a fully functional EMR or EHR system. This means that the great majority of doctors currently using electronic records are not yet meeting meaningful use criteria as defined by the U.S. Department of Health and Human Services (DHHS).

Physicians reported the computerized functions of their electronic records systems as part of the annual Centers for Disease Control‘s (CDC) National Ambulatory Medical Care Survey (NAMCS). The chart illustrates the good news: that every year since 2003, U.S. physicians are increasingly adopting EMRs/EHRs. However, the green line on the bottom shows that a small minority report using these systems as fully as they are capable of doing.

Both basic and “fully functional” systems include: patient history and demographics, patient problem lists, physician clinical notes, list of patient medications, prescription orders, lab results, and viewing imaging results. Fully functional systems also incorporate medical history and follow-up notes, drug interaction/contraindication warnings, e-prescribing, computer orders for lab tests, out-of-range values highlighted, computerized radiology ordering, and guideline-based interventions or screening tests.

The survey polled 10,301 U.S. office-based physicians in April-July 2010 via mail, with follow up phone calls to nonrespondents. The response rate was 2 in 3 physicians.

Health Populi’s Hot Points:  There is dwindling confidence among hospital Chief Information Officers on their ability to qualify for economic stimulus funding for EHR implementation, according to a survey conducted by the College of Healthcare Information Management Executives (CHIME). CHIME’s 1,400 members are CIOs and other senior health IT leaders.

The top barriers to achieving meaningful use are computerized order entry, cited as the #1 obstacle to MU by 29% of CIOs, and capturing/submitting quality measures, noted as the prime barrier by 22% of CIOs, shown in the pie chart based on CHIME’s survey data.

These findings demonstrate a more sobering perspective on health CIOs and meaningful use since CHIME’s August 2010 survey, which found “cautious optimism” according to the organization. At that point, 28% of respondents expected to quality for stimulus funding in the first half of 2011; in the December 2010 survey, only 15% of CIOs said they expect to qualify for stimulus early.

The reasons for concerns have changed in the past 3 months: there are fewer concerns about certification in the most recent survey, which probably relates to more vendors’ systems receiving certification by approved bodies. However, CPOE and quality reporting have risen to the top, with these two challenges embodying 50% of the CIOs reporting concerns about reaching MU.

CPOE involves clinicians entering orders into EMRs/EHRs, which means doctors are changing their regular workflows. CHIME points out that history has shown once a doctor begins to use CPOE, she demonstrates its value and influences other physicians.

Adopting EMRs/EHRs may be job 1 for health providers’ HIT and administrative departments. However, with pressing business concerns such as Medicare payment cuts and continued Medicaid financial stresses, the road to achieving meaningful use could be longer and more winding than health CIOs believed earlier this year.

Read More: http://healthpopuli.com/2010/12/14/a-longer-road-to-emr-adoption-cdc-and-chime-surveys-hint/

 

The Robot Will See You Now

Healthcare Blogs - Healthcare Reflections Blogs

The headline by the AP was "Robots' use in emergency room being studied" but my local paper only gave this abbreviated tale of engineers playing around at Vanderbilt. My internet search didn't show any more info. What sad piece of reporting. I am sure the AP reporter did a bigger story but it was chopped up to this small nugget of nothing. Suffice it to say here it the big ending in the article:

Officials said robots could shorten the wait time for patients, relieve the strain on overburdened emergency room staff and reduce mistakes.

Robots would treat patients with non-life-threatening conditions.


There just seems to be a ton of jokes for this. I could see robots in the future sitting around the robot lounge exchanging war stories about the patients that are driving them crazy.
Anyway, on a serious note, does anyone see anything ironic about this? Replace the word "robots" with midlevel providers. That was how it was first used. This is not a criticism (though I am sure I will get hammered again) but rather an explanation how the people in charge are always trying to replace us.

Read More: http://feedproxy.google.com/~r/PlaceboJournalBlogMedicalHumorWithAPurpose/~3/URJMxERwhqs/robot-will-see-you-now.html

 

Options to clinically address obesity

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A number of key events are likely to take place during the 2011-2019 forecast period that will serve to determine the size and course of various segments of the market for products in the clinical management of obesity. We have projected their occurrence (or not), and likely impact, following extensive industry participant interviews, our knowledge of the market approval processes in the various countries and regions, advantages and disadvantages of the various products as derived from clinical trial reports, and observations regarding the apparent attitude of the US FDA in 2010 when it comes to reviewing anti-obesity drugs for marketing in the USA.

  • Drugs
    • Satiety
    • Malabsorption
    • Appetite suppression
    • Combination drugs
  • Medical devices
    • Restrictive
    • Artificial fullness
    • Malabsorption
    • Gastric emptying
    • Appetite suppression

From a surgical perspective, which may or may not involve the use of an accompanying device, the options are:

  • Gastric bypass, including a variation known as vertical banded gastroplasty (VBG); the latter is both malabsorptive and restrictive.
  • Roux-en-Y (vertical division)
  • Sleeve gastrectomy independent of biliopancreatic diversion.
  • Biliopancreatic diversion with duodenal switch (both malabsorptive and restrictive)
  • Gastric banding (restrictive)

These may be performed using either open surgery or laparoscopically, but are usually done via laparoscope.


For more information, see Report #S835, “Products, Technologies and Markets Worldwide for the Clinical Management of Obesity, 2011-2019.”

Read More: http://feedproxy.google.com/~r/AdvancedMedicalTechnologies/~3/2U8prMy6WMk/

 

Fibrin and other surgical sealants

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From, “Worldwide Surgical Sealants, Glues, Wound Closure and Anti-Adhesion Markets, 2008-2015″ (actual data through 2010, forecast 2011-2015) Report #S180.

Surgical sealants and fibrin glues are biologically based products designed to aid in the process of clot formation. Clotting is the first naturally occurring process in wound repair, and affects many subsequent biochemical processes in the wound-healing cascade.

During the wounding event, blood from capillaries at the damaged tissue site seeps out and reacts with tissue proteins and air to cause platelets and complement factors to trigger the cleavage of pro-thrombin into thrombin, which then changes fibrinogen into fibrin, the main insoluble component of a blood clot.

It was natural for practitioners, looking for effective hemostasis, to look at fibrin as a source of effective hemostatic activity. In the 19th century, physicians used fibrin powder to stop bleeding. During the period from 1940 to 1960, understanding of blood fractionation and the development of processes for preparing blood fractions meant that a pure form of fibrin could be prepared and manufactured in a stable format.

Fibrin sealants represent the most useful of surgical hemostats. These products can be used to clot blood but are also used to seal around suture lines for organ transplants, mastectomies, and various resection procedures, and to prevent leakage of fluids and gases. A number of companies have developed devices capable of preparing autologous fibrin and platelet formulations that can be used as sealants, and active mixes of growth factors to aid repair. Harvest Technologies, AccessClosure and Vivostat are some of the companies with products designed to address this need.

Because sealants are often available as multicomponent systems that need to be mixed immediately prior to surgical application, several innovative devices have been developed to facilitate application. During product manufacture, the thrombin component and the Factor XIII/fibrinogen components are kept separate until required. Addition of fibrin product to a bleeding surface primed with the other component results in accelerated hemostasis and a sealing effect on the bleeding surface.

Internal applications for fibrin glues in surgical procedures including cardiac, vascular and thoracic surgery account for the majority of sealant usage. General surgery, neurosurgery, plastic, ear, nose and throat, wound management, urology, and orthopedics are the other major uses of the products today. The majority of fibrin glue products and sealant products were first used for internal surgical hemostasis and sealant effects. This is now changing with the realization that appropriate hemostasis and gluing of surgical wounds during closure results in reduced infection rates and better cosmesis. Growth rates in the synthetic and biological adhesives segment of the surgical closure market will be more modest than in the high-strength segment of the market, since these technologies have most potential in niche opportunities, competing with established use of autologous and allogeneic fibrin products from a number of major established players (e.g., Baxter, CSL Behring) and a number of newer device suppliers such as Aeris Therapeutics, as well as future recombinant human fibrin producers such as Actamax Surgical Materials (a DuPont/Royal DSM joint venture).

The success of synthetic and biological sealants will be based on the uniqueness of procedure-based benefits, which enable niche high added-value segments to be created. Although these products offer potential for active delivery and adjunctive repair with sutures, their scope will be more limited than the stronger cyanoacrylate technologies.


For more information, see report #S180.

Read More: http://feedproxy.google.com/~r/AdvancedMedicalTechnologies/~3/7K70w3RRj5Q/

 

December 2010 Medtech Financings

Healthcare Blogs - Healthcare Reflections Blogs

Bookmark this page to check recent changes in individual financings and totals.)

Below is the spreadsheet listing of medtech financings for December 2010.

Source: MedMarket Diligence, LLC

Read More: http://feedproxy.google.com/~r/AdvancedMedicalTechnologies/~3/LX1guim5eGk/

 
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