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Category Archives: Research

Rural Women’s Health Study

January 17, 2014 

The Rural Women’s Health Study is a research project, based in Missouri, that aims to collect information from women and their health care providers regarding the strengths and challenges of finding help for domestic violence in a rural area. Women who live in rural parts of the state who receive their primary health care at either a 1) federally qualified health center or 2) rural health clinic are encouraged to contribute to this research, as are health care providers (doctors or nurses) who work at a rural health clinic or federally qualified health center. Participating in this study means sitting down with the researcher to answer a few questions at a location of your choosing, at a time that is convenient for you.

Learn more about how to participate.

EHRs and Patient Care

PubHub has released the following report:

Does Use of EHRs Help Improve Quality?

Summarizes a case study of an Aligning Forces for Quality initiative in the Greater Cleveland area to help local physicians leverage electronic health records to improve patient care for chronic conditions, medication reconciliation, and follow-up care.

MHA Reports On Status Of Electronic Health Records In Missouri Hospitals

Missouri hospitals are making significant investments in health information technology, according to a new special report released by the Missouri Hospital Association. Hospitals’ investment in electronic health records promises new opportunities for quality improvement in Missouri’s health care delivery system and an economic boost through expansion of jobs in the state’s health care and information technology sectors.

“Hospital’s progress on EHR implementation is vitally important to our health care system in Missouri,” said Herb B. Kuhn, MHA president and CEO. “There are federal incentives for hospitals that are contingent on demonstrating meaningful use of the technology in 2011. These funds will not only partially offset part of the cost of adoption for hospitals, but it also will increase economic investment and the addition of technology jobs.”

The report tracks Missouri hospitals’ progress across four main areas of use and 24 basic quality and performance functions. The data indicate that 60 percent of hospitals reported operation of a certified EHR system and the intention to seek federal incentives during the next two years.

Click here for more information.
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Trends in Skilled Nursing Facility and Swing Bed Use in Rural Areas Following the Medicare Modernization Act of 2003

Changes in Medicare reimbursement policy that began with the Balanced Budget Act of 1997 resulted in differential reimbursement for care in swing beds and skilled nursing facilities.  This final report looks at whether the availability of post-acute skilled care stabilized once these changes were implemented and how and where this care is being provided today.

Key findings include:

  • Options for post-acute skilled care are available for many rural residents, but availability and choice are limited for some residents residing in the most rural areas.
  • The swing bed program represents a small proportion of all post-acute skilled care in rural areas but may be important for access for certain populations.
  • Access to hospital-based Skilled Nursing Facilities (SNFs) has declined in rural areas.
  • Swing bed participation and total swing bed days have grown.
  • The proportion of CAHs with swing beds has not changed.  The contribution of swing beds to CAH average daily census has increased modestly and only in the most rural areas.

Clinical Quality Measures: Perceptions and Reality

Many new EHR users currently view clinical quality measures as just another item on the checklist towards demonstrating meaningful use.  However, veteran EHR users, like Northwest Health Services, Inc., see clinical quality measures as an important tool that enables providers to distinguish between perceptions and reality when it comes to patient care and outcomes.
 “On the Road to EHR Success” traveled to St. Joseph to speak with Raman Seth, MD, a Family Practice physician and chief medical information officer for Northwest Health Services, Inc.  Seth said providers at his health center have embraced clinical quality measures, but acknowledged it took time for providers to get to this position. 

When Northwest Health Services generated their first clinical quality measures report seven years ago, the results surprised them.  Providers worked very hard to deliver the best in health care; but, the reports reflected occasional gaps. Although providers may not have been pleased by these reports, they accepted the results and took immediate action to improve their performance.  Today, their outstanding efforts to improve care is easily seen in Northwest Health Services’ decreased hospitalizations, significant reduction in duplicated labs and the increase in patient education.

Northwest Health Services continues its quest to expand and perfect its use of electronic health records. They are currently working with the Missouri Primary Care Association, a Missouri Health Information Technology Assistance Center partner, to achieve meaningful use of its certified EHR.  They are also participating in a regional health information exchange, the Lewis and Clark Information Exchange (LACIE), and are also implementing measures to improve patient satisfaction through increased physician-patient eye contact during office visits. 
Seth encouraged new EHR users to be open to the new and valuable perspective clinical quality measures offer on health care.  He recommended new EHR users quickly master the correct method to collect and record the clinical quality measures data. He said physicians have a tendency to free text on the EHR, meaning the data are placed in the notes sections of the EHR instead of its proper place in a dropdown menu or checkbox.  He warned that although the provider may be able retrieve the information during the next visit, the information is not stored in the database and will not be reflected in a database query.  Learning how to do it right the first time around will make it easier for the provider and improve the accuracy of the data. 
Seth’s full story can be viewed on “On the Road to EHR Success,” a series of video stories on the adoption of electronic health records from the perspective of Missouri health care providers.  These insightful stories inspire providers to embark on their own EHR transformation. To view this story, visit the “On the Road to EHR Success” page on the MO HIT Assistance Center’s Website.
   
For information on the Medicaid and Medicare EHR incentive programs, EHR adoption, or how the MO HIT Assistance Center helps health care providers adopt and achieve meaningful use of certified EHRs, please visit the Missouri Health Information Technology Assistance Center Website, E-mail us, or call us toll-free 1-877-882-9933.

Health Research

PubHub has made the following reports available:

Measuring the Impact of Patient Portals: What the Literature Tells Us
 
Reviews research documenting the implementation of patient portals and their impact on healthcare delivery, including use of features, user demographics, and satisfaction; measures of healthcare quality and operational efficiency; and expected trends.

North Vallejo Patient Access Partnership: Right Care, Right Place Project Evaluation
 
Assesses the impact of a project designed to provide a regular, coordinated source of affordable care, reduce unnecessary emergency department visits, and achieve cost savings through on-site referrals from the ED to a federally qualified health center.

The Social Life of Health Information, 2011
 
Presents survey findings about trends in use of the Internet, including social networking sites, hospital and doctor review sites, and mobile apps to seek, share, or monitor health-related information among adults in general, patients, and caregivers.

New Publication Available for Health Care Providers

A new publication is available from the North Carolina Rural Health Research & Policy Analysis Center. Download “Final Report: Trends in Skilled Nursing Facility and Swing Bed Use in Rural Areas Following the Medicare Modernization Act of 2003 ” here.

This final report looks at whether the availability of post-acute skilled care has stabilized, and how and where it is being provided today, now that the reimbursement policy changes that began with the Balanced Budget Act of 1997 have been fully implemented.

Key findings include:

  • Options for post-acute skilled care are available for many rural residents but availability and choice are limited for some residents residing in the most rural areas.
  • The swing bed program represents a very small proportion of all post-acute skilled care in rural areas, but may be important for access for certain populations.
  • Access to hospital-based SNFs has declined in rural areas.
  • Swing bed participation and total swing bed days have grown.
  • The proportion of CAHs with swing beds has not changed and the contribution of swing beds to CAH average daily census has increased only modestly and only in the most rural areas.