Digital Health

Three times as many patients want text appointment reminders from doctors than receive them now

A survey of more than 5,000 consumers and more than 600 physicians presented by The Council of Accountable Physician Practices (PDF, 440 KB) in partnership with Nielsen uncovered a strong desire by patients to connect with doctors (PDF, 440 KB) through digital technologies, yet both sides in the relationship lag in their capacity to do so. For example, 9 percent of the consumers said they receive text appointment reminders from primary care physicians and another 28 percent said they want to receive them. But, only 8 percent of the surveyed doctors said they offer that basic digital health technology. The poll found similar patterns for online portals, online appointment scheduling, e-mail appointment reminders, communication via online messing platforms and various telemedicine services. The digital experience that consumers have come to expect in their retail lives quickly is becoming one they expect to experience in their health care lives as patients.

58.8% of patients are comfortable receiving routine test results via password-protected websites

Patients' growing acceptance of electronic communication with health care providers was documented by a survey of 409 patients conducted by researchers at Georgetown University Medical Center and published in the Journal of the American Board of Family Medicine (2015, Nov). The researchers asked patients to rank their comfort level with receiving results from three categories of diagnostic tests through seven electronic communication channels with providers. For common tests like cholesterol checks and colonoscopy results, patients were most comfortable with personal e-mail followed by personal voicemail then online portals. They were least comfortable with a fax.

Health Care Reform

HHS: 87,000 fewer patients died from hospital-acquired conditions because of ACA safety provisions

That covers the period from 2010 through 2014, according to the Saving Lives and Saving Money report released by HHS. The reduction in HACs over that four-year period also saved nearly $20 billion in health costs, the agency said, crediting the patient safety provisions of the Affordable Care Act for the positive results. However, a closer look at the numbers from the Agency for Healthcare Quality and Research tells a story of progress that may be in danger of stalling. The HAC rate per 1,000 hospital discharges dropped for three consecutive years --starting at 145 in 2010 to 121 in 2013. But from 2013 to 2014, the rate was unchanged at 121 HACs per 1,000 discharges.

Health insurers paid consumers $470 million in rebates because of ACA medical-loss ratio rules

HHS also credited the ACA with generating nearly half a billion dollars in health insurance company rebates to consumers this year because of the law's medical-loss ratio provisions, according to a recent CMS press release (2015, Nov 19). The provisions require insurers to spend 80 percent to 85 percent of their premium revenues on health care services to enrollees. Insurers that miss their targets are required to rebate the difference to enrollees. According to HHS, $470 million in rebates from 2014 are payable to consumers this year. A total of $2.4 billion in rebates have been paid since 2011, when the medical-loss ratio rules took effect, HHS said. Most payers have adapted to the MLR rules just as they have to other ACA provisions affecting how they do business.

Medical Adherence

68% of Medicare patients took beta blockers 90 days after discharge following a heart attack

A research abstract presented at the American Heart Association's annual Scientific Sessions meeting in November documented wide variations in medication adherence by Medicare patients discharged from 459 hospitals after a heart attack. They divided the hospitals into high, medium and low categories based on the level of adherence by their discharged patients and each group's risk for major adverse cardiac events by patients after discharge. Hospitals in the high adherence group had the lowest risk for major adverse cardiac events, leading the researchers to conclude: “Our results suggest that the development of collaborative initiatives between health care providers and patients to improve post-discharge medication adherence may enhance longitudinal patient outcomes.”

79.7% of patients took their blood pressure meds prescribed by their primary care physicians

That's if the patients had access to their doctor's notes in their electronic medical record, according to researchers at the Geisinger Health System in Danville, Pa., who studied the impact of the OpenNotes initiative on medical adherence. If patients with hypertension didn't have access to their doctor's notes? That adherence rate dropped to 75.3 percent. The study is based on a sample of 2,147 patients being treated by Geisinger primary care physicians for high blood pressure and high cholesterol. Some 35 percent had access to their doctor's notes; 65 percent did not. Access to physicians' notes had no impact on the adherence rates for anti-cholesterol medication.

Population Health

The percentage of U.S. adults considered obese reached 37.7% in 2014, up from 30.5% in 2000

That's according to data released in November by the National Center for Health Statistics (PDF, 704 KB). The Centers for Disease Control and Prevention defines obesity as a person with a body mass index of 30 or above. Obesity has been linked to a host of chronic medical conditions and illnesses, including heart disease, hypertension, stroke, diabetes and cancer. Health care providers that operate population health management programs under risk-based contracts with payers may want to devote additional resources to improving the diet and physical activity level of their patient population.

10 steps to prevent the next infectious disease pandemic

In November, a panel of public health experts published its post mortem on the Ebola outbreak in The Lancet (2015, Nov.28). The group's 10 recommendations to prevent a small-scale disease outbreak from becoming an international public health disaster offer important local population health lessons for health care providers in the U.S. A crucial factor is hiring individual caregivers who are committed to public health safety. Another is having reliable health IT systems to share epidemiological, genomic and clinical data among stakeholders.

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