In This Issue:
  • The Impact of Social Media on Children, Adolescents, and Families
  • Medical errors now the third leading cause of death
  • Patient portals helping increase revenue, decrease costs
  • CEO Note: Reduce Your IT Cost
  • Tier3MD is Calling all Bloggers
  • Tier3MD Upcoming Events:
  • Exhibitor: Florida Annual 2016 Conference being held June 22-24 at Hyatt Regency Grand Cypress in Orlando.
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April 2011, VOLUME 127 / ISSUE 4
From the American Academy of Pediatrics
Clinical Report
The Impact of Social Media on Children, Adolescents, and Families
Gwenn Schurgin O'Keeffe, Kathleen Clarke-Pearson, Council on Communications and Media
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Using social media Web sites is among the most common activity of today's children and adolescents. Any Web site that allows social interaction is considered a social media site, including social networking sites such as Facebook, MySpace, and Twitter; gaming sites and virtual worlds such as Club Penguin, Second Life, and the Sims; video sites such as YouTube; and blogs. Such sites offer today's youth a portal for entertainment and communication and have grown exponentially in recent years. For this reason, it is important that parents become aware of the nature of social media sites, given that not all of them are healthy environments for children and adolescents. Pediatricians are in a unique position to help families understand these sites and to encourage healthy use and urge parents to monitor for potential problems with cyberbullying, “Facebook depression,” sexting, and exposure to inappropriate content.

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Medical errors now the third leading cause of death, new study finds

While human error can never be eliminated, better measurement of errors can mitigate the frequency, visibility and consequences of such errors, finds the BMJ study.

By Bill Siwicki
Healthcare IT News
While accurate data on deaths associated with medical errors is lacking, it is estimated that between 210,000 and 400,000 people in the U.S. die every year because of medical errors, making medical errors the third biggest cause of death in the country after heart disease and cancer, a new study found. While human error can never be completely eliminated, better measurement of medical errors can mitigate the frequency, visibility and consequences of such errors, the study said.

To remedy the problem of human error, hospitals should properly investigate patient deaths for potential contribution of error, and should include additional information on death certificates, according to “Medical error—The third leading cause of death in the U.S.,” a report from research firm The BMJ.

Martin Makary and Michael Daniel at Johns Hopkins University School of Medicine in Baltimore noted that U.S. death certificates have no place for acknowledging medical error, and the academics call for better reporting to
help understand the scale of the medical errors problem and how to tackle it, the BMJ report said.
Currently, death certification depends on assigning an International Classification of Disease (ICD) code to the cause of death; thus, causes of death not associated with an ICD code, such as human and system factors, are not captured.

As a result, accurate data on deaths associated with medical errors is lacking.

Using studies from 1999 onward, and extrapolating to the total number of U.S. hospital admissions in 2013, Makary and Daniel calculated a mean rate of death from medical errors of 251,454 a year, the study said. They acknowledge that human error is inevitable, but say “although we cannot eliminate human error, we can better measure the problem to design safer systems mitigating its frequency, visibility and consequences,” according to the study.

The Johns Hopkins experts believe strategies to reduce death from medical care should include three steps: Making errors more visible when they occur so their effects can be intercepted; having remedies at hand to rescue patients; and making errors less frequent by following principles that take human limitations into account, the study reported.

For instance, instead of simply requiring cause of death, they suggest that death certificates could contain an extra field asking whether a preventable complication stemming from the patient’s medical care contributed to the death.
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Patient portals helping increase revenue, decrease costs
'As healthcare delivery moves toward value-based reimbursement, patient care and consumer engagement are becoming increasingly intertwined.'
By Sherree Geyer
Healthcare IT News

Michael Middleton, MD, credits online patient portals with helping him grow his Orlando, Florida-based pediatric practice more than three-fold in two-and-a-half years – while keeping staff cost increases at 20 percent.

"The primary way it's benefited us financially is by not forcing us to hire more admins as our practice has grown," he said. "The efficiency comes with instantly directing the right message to the right person. The other part is accountability; things are written down not verbalized."

Indeed, patient portals can offer financial benefits that improve collections, reduce staff workload and help drive engaged patients with better health outcomes.

Lesley Kadlec, director of health information management practice excellence at American Health Information Management Association, says portals "automate and streamline many processes that previously required staff time, such as setting up appointments, requesting prescription refills, asking and answering questions and providing account and billing information.

"Beyond administrative tasks, portals can distribute educational resources and targeted information to the appropriate audience," she said.

Middleton, who uses online portals to triage non-emergent patient questions, says "previously, we'd schedule an appointment, be in a room together. They'd verbalize, I'd type and then get to the therapeutic part of the visit." Now, on the other hand, "we start the appointment at the mid-point. It's much more efficient, not to mention details are relayed more thoroughly," he says.

According to a report from athenahealth, which develops patient portals of its own, such triaging enabled one practice to contain physician email responses to about 20 percent of patient inquiries.

Use of secure email allowed physicians respond to patients at their convenience and view "inquiries in the context of the full patient record, which they may not have at hand when patients call," according to the report. "All of these can improve provider productivity, which, in turn, can improve practice finances."

Portals also let patients receive electronic statements and pay their bills online. Summit Medical Group, a 500-physician group in Berkeley Heights, New Jersey, receives 30 percent of its patient payments via online portals, according to the report.

Middleton, for his part, says about 7 percent of payments come through the portal. He hopes that will increase as the convenience makes it "easier for families to sign up and utilize" the online tool.

"Initially, one of the obstacles we had was patients weren't linked by families," he said. "If a patient had four kids, they'd have four portal accounts. Sign-up and sign-on has become much easier. There's a great mobile app for our patients."

Josh Gray, vice president, athenaResearch, says online access translates into financial rewards: "When clients increase portal adoption by 20 percent or more, they see improvements in patient pay yields of four to eight percent.

"They get paid more and faster," he said. "If you can get a patient on a portal, they're 13 percent more likely to return. The value of the patient who returns is eight to 20 percent higher."

The athenahealth report echoes this point, noting that patients, who return to a practice at least once generate more than $800 in ambulatory practice collections over three years, versus $147 for those who don't.

Kadlec describes consumer engagement "a high priority" for healthcare today, and one "likely to increase as health information technologies, like portals, continue to evolve." She adds that, "as healthcare delivery moves toward value-based reimbursement, patient care and consumer engagement are becoming increasingly intertwined."

Patients "expect to have insight into their care and demand value for their healthcare dollar, particularly in an environment where healthcare costs are rising and reimbursement is decreasing," she said. "Patient portals are becoming a technological catalyst that allow patients to interact and communicate with their healthcare providers in a 24/7 environment."
Reduce Your IT Cost
Have you thought about ways to reduce your IT cost? I often talk about how the IT Department gets a bad reputation because they are not revenue generators, and are mostly seen as an expense. There may be some truth to that, but the efficiency of the IT department is just as good as generating revenue. There are numerous ways to reduce your IT cost. In addition, there are many ways to benefit from being smart about your IT support. What kind of price would you put on efficiency? What kind of price would you put on downtime?

What You Can Do?

To reduce your IT cost is not as difficult as you think. The first thing to do is to analyze your In-house IT support. Are you using them properly? Do you have every level of support you need, or are you outsourcing in addition to your in-house staff?

If you are outsourcing, you may already see some cost savings. You may be able to save even more by utilizing the outsourced group as more of an IT partner, than a break fix group of people who only come in when something is broken. Take a look at how you are using your outsourced IT department and see if you can better use them to reduce your IT cost.

A great way to reduce your IT cost, whether you have in-house support, or outsourced support is to purchase new equipment. That’s right! I am telling you to spend money to save money. How many resources are you using on your current equipment patching things together, blue screening which causes downtime, or network inefficiencies. How much is that costing you? A good network with good equipment could help you reduce your IT cost significantly. Having good IT, saves you time, downtime, and money. Think about it!

Sheryl J. Cherico,
CEO/COO, Co-Founder

Sheryl is the CEO of Tier3MD and one of the leading Healthcare IT Consultants in the country.

Tier3MD is asking for Guest Bloggers
Tier3MD asks for topics that focus on healthcare IT or practice workflow. Please submit your articles, along with a picture and short bio. If your blog is published then Tier3MD will give you a $25.00 gift card.

Tier3MD Upcoming Events:
Exhibitor: Florida Annual 2016 Conference being held June 22-24 at Hyatt Regency Grand Cypress in Orlando.
Michael H. Brown
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