Archive for September, 2012

Electronic Health Records Help Docs in Emergency Care Prep

21 Sep

As hospitals increasingly adopt electronic health record systems, a new study has found that inpatient physicians who receive patients from the emergency department have begun to do “chart biopsies” of electronic records in preparation. It’s helped doctors be better prepared beforehand.

The study, published in the Journal of the American Medical Informatics Association, defines a chart biopsy as “the activity of examining a patient’s health record to orient oneself to the patient and the care that the patient has received in order to inform subsequent conversations about or care of the patient.”

The researchers spent two years at the University of Michigan Health System (UMHS), studying general internal medicine physicians and surgeons who received patients from the emergency department.

During the study, doctors had access to electronic health records for inpatient and outpatient documentation, and those used in the emergency department. When doctors and nurses in the emergency department entered data into their EHR, the inpatient doctors had immediate access to the information. Eventually, doctors began to review the emergency care charts before speaking with the physician who admitted the patient from that department.

The study defined three primary roles for the chart biopsies: provide an overview of the patient, prepare for patient handoff and subsequent care, and avoiding potential biases.

“Chart biopsies appear to impact important clinical and organizational processes,” wrote researchers. “Among these are the nature and quality of handoff interactions and the quality of care.” The study authors concluded that a “chart biopsy has the potential to enrich collaboration and to enable the hospital to act safely, efficiently, and effectively.”


Anesthesiologists Campaign Against Nurse Pain Payments

06 Sep

Last month, The American Society of Anesthesiologists (ASA) launched a nationwide campaign opposing the Centers for Medicare and Medicaid Services’ (CMS) proposal to pay nurse anesthetists for chronic pain service. The crux of the opposition is that nurse anesthetists are not equipped with the necessary formal education or training in chronic pain management.

“Even in the hands of specially trained physicians, chronic pain procedures are inherently dangerous due to the anatomy and delicate structure of the spine and nerves upon which chronic pain interventions are performed,” said ASA President Jerry A. Cohen, M.D. “Current restrictions on nurse anesthetists providing these services are appropriate and necessary in the interest of patient safety.”

In addition to the health risks, the ASA says there is also the risk of extensive and costly medical interventions. They argue the point that anesthesiologists and other doctors are better equipped to provide pain management care and minimize these risks due to their education and training, and are able to prescribe appropriate medication therapies in the process. 

Chronic pain services will often include opioids, where specialized physician training is required to minimize errors and prevent potentially lethal side effects.

“Using scarce Medicare dollars to pay nurse anesthetists to perform complicated pain service procedures unnecessarily puts patients at risk,” says Cohen. “Patients who require anesthesia or relief from pain deserve the safest and highest quality of care.”