Health Care Systems, Health Care Workers / 10.06.2024

The US healthcare staffing market is massive, although you wouldn't think it with the constant barrage of news reports telling us that we've got no staff and staffing shortages are increasing. Still, perhaps they're spending all the money attempting to boost staffing levels. And it isn't about the money - it's that people aren't as motivated to work in healthcare anymore. Below, we'll explore why the spending is so big.

The Rise in Demand for Healthcare Professionals

US Healthcare Staffing MarketThe booming healthcare staffing market is driven by an increasing demand for medical practitioners. The US is grappling with a shortage of healthcare workers, including doctors, nurses, and allied health professionals - over 340,000 combined professionals are needed, including doctors and nurses. The issue is, that as more baby boomers retire, they often become more reliant on medical services, putting pressure on an already understaffed industry. But the issue also is that the demand for healthcare staff isn't being met. The US and the UK both use overseas staff to fill the numbers. The people training to be nurses in the US are becoming travel nurses, aesthetic practitioners, and basically avoiding the main healthcare system. Well, not all of them, but a big chunk are. The US has no choice but to rely on outsourced agencies like physician staffing companies. (more…)
Health Care Systems / 03.06.2024

revenue-technologyEffective RCM is particularly important in today’s changing healthcare environment, where reimbursement is a critical issue for hospital finances. Development in RCM staffing is vital in addressing the needs that modern health organizations face. This blog post will outline the following most recent trends and methods associated with RCM staffing and why these approaches can be used to improve the performances of healthcare institutions.

The Crucial Role of Revenue Cycle Management Staffing

All revenue cycle management staffing can be seen as important in the operation of healthcare facilities. RCM stands for the functions that are responsible for the management of patients’ administrative and clinical billing and the patients’ revenue collection. It is possible to note that this area must be manned efficiently to prevent mistakes, delays, and losses to the revenue of the healthcare facilities. (more…)
Addiction, Author Interviews, Health Care Systems / 25.05.2024

MedicalResearch.com Interview with: Srivastava Kodavatiganti, MBS Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, PA MedicalResearch.com: What is the background for this study? Response: Prescription and illicit opioid misuse and overdoses have continued to escalate in the U.S. with annual overdoses exceeding 110,000[1]. There was a substantial rise from 2013 to 2022 in the number of opioid-related overdoses due to synthetic opioids [2]. Even nonfatal opioid-involved overdoses increased 4% quarterly between January 2018 and March 2022 as observed by encounters by emergency medical services [3]. Although the eastern U.S. has been particularly impacted by fatal overdoses, annual increases have increased as of last year in the western states including in Nevada (+27.9%), Washington (+36.9%), Oregon (+38.6%), and Alaska (+45.9%).  In contrast, other states have seen more modest changes (New Mexico = +1.3%) including decreases (South Dakota = -2.4%, Nebraska = -19.5%) [1]. These findings underscore the importance for understanding patterns in usage of prevention and treatment strategies. Naloxone is an opioid antagonist which can reverse the effects of an opioid overdose. This crucial lifesaving tool is administered as an injection or as a nasal spray. This study characterized the patterns of naloxone prescriptions in Medicaid patients from 2018 – 2021 and Medicare patients for 2019. State level differences were also quantified as the fold difference in prescribing between the highest and lowest states when correcting for the number of enrollees in each state. (more…)
Health Care Systems, Mental Health Research / 21.05.2024

In the fast-paced world of healthcare, where clinical skills and knowledge are paramount, the power of empathy in leadership can sometimes be overlooked. However, leading with empathy in the healthcare sector is not just a nice-to-have quality; it's a pivotal trait that can shape patient outcomes, staff satisfaction, and the overall healthcare environment. This article delves into why empathy is crucial in healthcare leadership, supported by real-world insights and strategies to foster a culture of empathy.

The Impact of Technological Advancements

As technology continues to evolve within the healthcare sector, creating new opportunities for enhancing patient care, it's crucial that empathy doesn't get lost in the shuffle. Innovative tools and systems should be seen as avenues to deepen our understanding and connection with patients, rather than as barriers to the human touch. Embracing technology with empathetic intention can lead to an even greater level of personalized care. One specific area where empathy can play a transformative role is in addressing HR challenges in behavioral health. Understanding the unique nature of these challenges, and the emotional toll they can take on staff, is crucial for leaders who strive to create a supportive work environment. This deeper understanding can drive the implementation of effective solutions, fostering a workplace where empathy and professionalism thrive together. (more…)
Author Interviews, Cost of Health Care, Gastrointestinal Disease, Health Care Systems / 20.05.2024

MedicalResearch.com Interview with: Laura Targownik, MD Lead author and Clinician-Investigator Mount Sinai Hospital in Toronto Departmental Division Director, Gastroenterology and Hepatology University of Toronto MedicalResearch.com: What is the background for this study? Was there a difference in the types of patients or need for surgery seen by the female/male physicians? Response: The background for this study is that there is an emerging body of literature that having a female physician leads to better patient outcomes in many health care settings, especially amongst patients undergoing surgery or being admitted to hospital.  However, this has not previously been evaluated in gastroenterology.  Female and male gastroenterologists may have different styles of practice on average, and this potentially could lead to differences in how patients engage with the health care system following an initial assessment. (more…)
Author Interviews, Health Care Systems / 27.04.2024

MedicalResearch.com Interview with: Gaurav Khanna Ph.D. Assistant Professor | School of Global Policy and Strategy University of California, San Diego www.econgaurav.com   MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a shortage of doctors in certain parts of the US. For instance, although about 20% of the United States population live in rural areas, only 11% of physicians practice in these locations. The research shows that relaxed visa requirements enable more foreign-trained doctors to practice in remote and low-income areas, without reducing the employment of U.S.-trained doctors. One such program that facilitates keeping foreign-born physicians in the US is the Conrad 30 Program. Most participants in the Conrad 30 Waiver Program work in Health Professional Shortage Areas (or HPSAs), areas lacking an adequate number of primary care physicians, dentists, or mental health care providers. (more…)
Author Interviews, Health Care Systems, Kidney Disease, NEJM, NIH, UT Southwestern / 04.04.2024

MedicalResearch.com Interview with: Miguel A. Vazquez, MD Professor of Internal Medicine University of Texas Southwestern Medical Center MedicalResearch.com: What is the background for this study? Response: The main reason to conduct our trial was to improve the care of patients with coexistent chronic kidney disease CKD),  type 2 diabetes and hypertension.   Patients with this triad are at high risk for multiple complications, end stage kidney disease and premature death.   There are effective interventions for these conditions.  Unfortunately, detection and awareness of CKD is low and many patients do not receive interventions that could be beneficial In our study in patients with the coexistent triad of chronic kidney disease, type 2 diabetes, and hypertension the use of an electronic algorithm to identify patients from the electronic health record and practice facilitators embedded in four large health systems to assist primary practitioners deliver evidence-based care did not lower hospitalizations when compared to usual care. (more…)
Author Interviews, BMJ, Emergency Care, Health Care Systems, Johns Hopkins / 19.07.2023

MedicalResearch.com Interview with: David E. Newman-Toker, MD PhD (he/him) Professor of Neurology, Ophthalmology, & Otolaryngology David Robinson Professor of Vestibular Neurology Director, Division of Neuro-Visual & Vestibular Disorders Director, Armstrong Institute Center for Diagnostic Excellence Johns Hopkins Medicine MedicalResearch.com: What is the background for this study? Response: Diagnostic errors are believed to be a major public health issue, but valid, quantitative estimates of harm are lacking. In 2015, the National Academy of Medicine stated in their report Improving Diagnosis in Healthcare that improving diagnosis was a “moral, professional, and public health imperative” yet also noted that “the available research [is] not adequate to extrapolate a specific estimate or range of the incidence of diagnostic errors in clinical practice today.” We sought a scientifically robust answer to the question of how many patients in the US suffer serious harms as a result of medical misdiagnosis. (more…)
Author Interviews, General Medicine, Health Care Systems, Heart Disease, JAMA / 26.06.2023

MedicalResearch.com Interview with: Dan P. Ly, MD, PhD, MPP Physician and an Assistant Professor Division of General Internal Medicine and Health Services Research David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? Response: Cognitive biases, or ways of thinking that may deviate from rationality, are thought to influence physician decision-making, but there has been little large-scale evidence of their existence clinically. There is some large-scale evidence of the availability heuristic, under which the likelihood of an event is affected by how easily it comes to mind, but there’s little large scale evidence of other cognitive biases affecting physicians.  (more…)
Author Interviews, Health Care Systems, JAMA, Technology, UCSD / 01.05.2023

MedicalResearch.com Interview with: Zechariah Zhu, B.S. Affiliate Scientist with the Qualcomm Institute at UC San Diego and study co-author First author: John W. Ayers, PhD, MA MedicalResearch.com: What is the background for this study? Response: In today’s day and age (especially after the COVID-19 pandemic), an increasing number of people are turning to virtual options for healthcare. Most notably, there was a 1.6-fold increase in electronic patient messages, which significantly increased the burden on physicians, with a record-high proportion of physicians (62%) reporting burnout symptoms. On the other hand, we also see the rise of AI technologies like ChatGPT—an AI chatbot assistant that has taken the world by storm recently with its ability to provide lengthy response essays to many questions it is asked. Our objective for this study, then, was to evaluate the ability of ChatGPT to provide quality and empathetic responses to patient questions. (more…)
Author Interviews, COVID -19 Coronavirus, Electronic Records, Health Care Systems, Race/Ethnic Diversity / 07.03.2023

MedicalResearch.com Interview with: Dhruv Khullar, M.D., M.P.P. Director of Policy Dissemination Physicians Foundation Center for Physician Practice and Leadership Assistant Professor of Health Policy and Economics Weill Cornell Medicine, NYC   MedicalResearch.com: What is the background for this study? Response: From prior research, we know that there are racial/ethnic differences in the acute impact of COVID-19, including higher rates of hospitalization and death among Black and Hispanic individuals compared to white individuals. Less is known about whether there are differences in the rates or types of long COVID by race and ethnicity. (more…)
Author Interviews, Health Care Systems, Sleep Disorders / 16.02.2023

MedicalResearch.com Interview with: Michael RSchutz, Ph.D. Professor of Music Cognition/Percussion at McMaster University Founding director of the MAPLE Lab and Core member of the McMaster Institute for Music and the Mind. Prof. Schutz is also a professional musician and directs McMaster’s percussion ensemble.   MedicalResearch.com: What is the background for this study? Response: Hospitals around the world are filled with devices generating aconstant stream of tones conveying information to medical staff.overburdened healthcare professionals, and contributes to burnout inmedical staff.  The Emergency Care Research Institute (ECRI) regularlyincludes problems with auditory alarms in their list of "Top 10 HealthTechnology Hazards" and they  are so problematic an FDA surveyimplicated them in hundreds of patient deaths.While there is currently a lot of interest in how to improve alarmmanagement protocols, this study is different in that it looks atimproving the quality of the alarm sounds themselves.  For historicalreasons many default to simplistic "beeps" which are generallyannoying.  While annoying is useful for critical alarms requiringimmediate action, the vast majority of these messages are merelyintended to update medical staff of changes (i.e. blood pressure isrising) or indicate other situations that do not require immediateaction. Unfortunately, many machines use the same simplistic andannoying "beeps" regardless of whether the messages are urgent ornon-urgent.  This constant flood of annoying beeps negatively affectsboth patients (extending recovery time due to interrupted rest) andstaff (who can develop "alarm fatigue" from the constant cacophony). (more…)
Author Interviews, Health Care Systems, JAMA / 13.02.2023

MedicalResearch.com Interview with: David A. Hyman, JD, MD The Scott K. Ginsburg Professor of Health Law & Policy Georgetown University Law Center Washington, DC MedicalResearch.com: What is the background for this study? Response: Many doctors believe medical malpractice claiming is effectively random — meaning good doctors are equally likely as bad doctors to end up being the target of a malpractice claim.  Past research has studied whether physicians with 2 paid claims are likely to have another claim than doctors with 1 paid claim. We study whether physicians with 1 paid claim are more likely to have another paid claim, compared to physicians with zero paid claims.  We also compare the pattern of observed claims with what we would expect to find if claiming were truly random (by running a simulation). (more…)
Author Interviews, Health Care Systems, JAMA, Sleep Disorders, Yale / 18.01.2023

MedicalResearch.com Interview with: César Caraballo-Cordovez, MD Postdoctoral Associate Yale/YNHH Center for Outcomes Research and Evaluation (CORE) New Haven, CT 06511 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our group has been interested in how patients’ experience during hospitalization impacts their recovery and their health for a while. In 2013, Dr. Harlan Krumholz (senior author of the current study) identified that patients who were recently hospitalized experienced a period of generalized risk for myriad adverse health events, a condition that he named ‘post-hospital syndrome’. One of the possible explanations for this observation is that the stress from being hospitalized negatively impacts patients’ health during their stay in the hospital and after being discharged. The stress in a hospital may come from different sources–including sleep deprivation. Sleep is fundamental for recovery, and there are many challenges for patients to have adequate sleep while being hospitalized. Among the many sources of sleep interruption are early morning blood draws. Blood draws are often performed in the early morning in order to have recent lab tests results available during morning medical rounds. However, this common practice may disrupt patients’ recovery by interrupting their sleep. We were interested in determining to what extent blood draws contribute to early morning sleep disruptions and whether there has been recent progress in reducing them. We used data from Yale New Haven Hospital from 2016 to 2019 and found that nearly 4 in 10 of total daily blood draws were collected between 4:00am and 7:00am–a proportion that was persistently high over the 3 years we studied. Importantly, we found that this occurred across patients with different sociodemographic characteristics, including older individuals who are at highest risk of adverse health events from sleep deprivation. (more…)
Author Interviews, Health Care Systems, JAMA / 12.07.2022

MedicalResearch.com Interview with: Dr. Joanna JiangJoanna Jiang, PhD Agency for Healthcare Research and Quality Rockville, Maryland MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Over the last decade we have seen two trends occurring to rural hospitals – closures and mergers. A hospital in financial distress could likely face closure. But if the hospital affiliates with a multihospital system, it may have access to resources from the system that help shelter the hospital from closure. That is exactly what we found in this study. System affiliation was associated with a lower risk of closure for financially distressed hospitals. However, among hospitals that were financially stable, system affiliation was associated with a higher risk of closure. This is somewhat puzzling and needs further study to better understand the reason for closure. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Education, Health Care Systems, Sleep Disorders / 20.05.2022

MedicalResearch.com Interview with: Dr Matthew D Weaver M.P.H., Ph.D. Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women's Hospital Boston, Massachusetts MedicalResearch.com:  What is the background for this study?  Response: The name “resident” stems from the historical practice of resident-physicians residing in hospitals as part of their training. Even after that practice abated, it was common for resident physicians to work 36 consecutive hours followed by 12 or fewer hours of rest. In 1989, the state of New York restricted resident physicians to work no more than 24 consecutive hours and no more than 80 hours per week as part of collective intervention to improve patient safety. The Accreditation Council for Graduate Medical Education (ACGME) then followed in 2003 by limiting work hours to an average of 80 per week over a month and no more than 30 consecutive hours of work. Evidence accumulated demonstrating an association between shifts lasting ≥24 hours and adverse resident and patient safety. As a result, the Institute of Medicine convened a review and report on the issue, ultimately concluding that no resident should work more than 16 consecutive hours without sleep. This recommendation, combined with evidence following the 2003 rules, led the ACGME to issue new rules in 2011 that limited first-year resident physicians to work no more than 16 consecutive hours. Our study compares resident-reported patient safety outcomes before and after this 2011 policy change. (more…)
Author Interviews, Health Care Systems / 14.04.2022

MedicalResearch.com Interview with: James H. Baraldi University of Pittsburgh MedicalResearch.com:  What is the background for this study?  Response: Researchers investigating pharmaceuticals and medical devices in randomized controlled trials (RCTs) often receive payments from the manufacturers of these investigational products. In many cases these payments are not dedicated to the express purpose of research, but rather consist of consulting fees and compensation for travel and lodging and food and beverage. As part of the 2010 Affordable Care Act, the US government passed the Physician Payment Sunshine Act to increase transparency of this type of funding. The law required manufacturers reimbursed by Medicare, Medicaid, or the Children’s Health Insurance Program to disclose to the Centers for Medicare and Medicaid Services information regarding investigator payments. This information became freely and publicly available on the Open Payments website with the earliest data from 2013. Not only have the pharmaceutical and medical device manufacturers disclosed the investigators’ payment information, but the investigators themselves have had to do so in accordance with the requirements of the journals in which they publish their findings or in accordance with the requirements of the International Committee of Medical Journal Editors (ICMJE). (more…)
Author Interviews, Duke, Electronic Records, Health Care Systems, JAMA / 20.04.2021

MedicalResearch.com Interview with: Eugenia McPeek Hinz MD MS FAMIA Associate CMIO - DHTS Duke University Health System MedicalResearch.com: What is the background for this study? Response: Clinician burnout rates have hovered around 50% for much of the past decade.  Burnout is a significant concern in healthcare for its effects on care givers and associated downstream adverse implications on patient care for quality and safety. The ubiquitous presence of Electronic Health Records (EHR) along with the increased clerical components and after hours use has been a significant concern for contributing to provider burnout.  (more…)
Author Interviews, Health Care Systems, JAMA / 22.01.2021

MedicalResearch.com Interview with: Sara Machado PhD Fellow at the Department of Health Policy London School of Economics and Political Science MedicalResearch.com: What is the background for this study? Response: Physician distribution is a determinant of health care access, so knowing how physician density patterns evolve over time is important if we are trying to address disparities in access to care. Moreover, the last 10 years have brought about changes in health care coverage, across the US. Recent evidence points to an uneven physician distribution between urban and rural communities. We examined recent trends in physician density by physician category across rural and urban US counties.  MedicalResearch.com: What are the main findings? Response: We have two main findings.
  • First, density of primary care physicians steadily decreased in more than half of rural counties (994 out of 1,976).
  • Second, medical specialist density, which would care for cardiovascular and pulmonary disease, for example, has been largely stagnant in rural counties, at the lowest density levels (less than 10 physicians per 100,000), and increasing in metropolitan counties.
(more…)
Author Interviews, COVID -19 Coronavirus, Health Care Systems, JAMA, Technology / 27.10.2020

MedicalResearch.com Interview with: Shira H. Fischer, MD, PhD RAND Corporation Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: Before the COVID-19 outbreak, telehealth was talked about a lot, but it wasn’t widely available and wasn’t used that often. We wanted to know who was using telehealth, what the barriers to use were, and whether people would be willing to do so if it were available to them. We conducted a survey of over 2,500 Americans across the country and asked them about these topics.  (more…)
Author Interviews, COVID -19 Coronavirus, Health Care Systems / 27.10.2020

MedicalResearch.com Interview with: Steve Olin Chief Product Officer Rally Health, Inc., part of the Optum business of UnitedHealth Grou MedicalResearch.com: Can you please elaborate on Rally Health’s mission? Mr. Olin: Our founding mission 10 years ago and still to this day is to put health in the hands of the individual. As a digital health company, we live this mission through our focus in three key areas: 1) Providing digital-first access to care by giving individuals easy-to-use digital tools and support to navigate their health care and take full advantage of their health benefits; 2) Engaging people in their daily health by creating experiences that people enjoy and that inspire them to perform healthy actions, and by giving them access to resources that help them achieve their health goals; 3) Saving people time and money by providing digital tools that help them understand health care costs and guide them to lower-cost, high-quality care options. (more…)
Author Interviews, Health Care Systems, JAMA / 09.09.2020

MedicalResearch.com Interview with: Kenton J. Johnston, PhD Associate Professor Dept of Health Management & Policy Dept of Health & Clinical Outcomes Research Saint Louis University MedicalResearch.com: What is the background for this study? Response: Consolidation of physician practices into larger health systems comprised of hospitals and other group practices has been occurring rapidly in the U.S. market over the past 10 years. During this same period, Medicare has been gradually increasing the use of “pay for performance,” or “value-based payment” programs. 2019 was the first year that nearly all physicians in the U.S. were paid under Medicare’s new mandatory Merit-Based Incentive Payment System (MIPS). We conducted a study to see whether physicians who were affiliated with health systems performed better under the MIPS than those not affiliated with health systems. (more…)
Author Interviews, Health Care Systems, JAMA / 22.07.2020

MedicalResearch.com Interview with: Reshma Jagsi, M.D., D.Phil. Newman Family Professor and Deputy Chair Department of Radiation Oncology Director of the Center for Bioethics and Social Sciences in Medicine University of Michigan  MedicalResearch.com: What is the background for this study? Response: Hospitals and health care institutions often rely on philanthropy for support to be able to pursue their missions to serve the public health. Little is known about public perspectives, which are needed to inform ethical guidelines. (more…)
Author Interviews, Health Care Systems, Heart Disease, JAMA, Medicare / 24.02.2020

MedicalResearch.com Interview with: Rishi KWadhera, MD Beth Israel Deaconess Medical Center Harvard Medical Faculty Physicians MedicalResearch.com: What is the background for this study? Response: In recent years, the Centers for Medicare and Medicaid Services has implemented nationally mandated value-based programs to incentivize hospitals to deliver higher quality care. The Hospital Readmissions Reduction Program (HRRP), for example, has financially penalized hospitals over $2.5 billion to date for high 30-day readmission rates. In addition, the Value-Based Purchasing Program (VBP) rewards or penalizes hospitals based on their performance on multiple domains of care.  Both programs have focused on cardiovascular care. The evidence to date, however, suggests that these programs have not improved health outcomes, and there is growing concern that they may disproportionately penalize hospitals that care for sick and poor patients, rather than for poor quality care. (more…)