EHR Algorithms Overwhelm Physician Inboxes and Contribute to Burnout

MedicalResearch.com Interview with:

Ming Tai-Seale, PhD, MPH Professor Department of Family Medicine and Public Health University of California San Diego School of Medicine 

Dr. Tai-Seale

Ming Tai-Seale, PhD, MPH
Professor
Department of Family Medicine and Public Health
University of California San Diego School of Medicine 

MedicalResearch.com: What is the background for this study?

Response: The electronic health record (EHR) potentially creates a 24/7 work environment for physicians. Its impact on physicians’ wellness has become a challenge for most health care delivery organizations. Understanding the relationships between physicians’ well-being and “desktop medicine”1 work in the EHR and work environment is critical if burnout is to be addressed more effectively.

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Open Communication Linked to Lower Hospital Mortality

MedicalResearch.com Interview with:
Veronica Toffolutti PhD

Postdoctoral researcher working with Professor David Stuckler
Department of Sociology
Bocconi University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Openness has been linked with better patient safety and better understanding of patients’ care goals. In addition, more open environments appear to be linked with positively ranked quality of teamwork, which in turns lead to better health care.

Yet if the expected benefits are to be achieved, it is necessary to show that greater openness actually corresponds to improvements in performance or lower mortality rates. To the best of our knowledge our is the first study to show an association between hospital mortality and openness and more precisely one point increase in the standardized openness score leads to a decrease of 6.48% in the hospital mortality rates. With the term openness we refer to an environment in which communication among patients, staff members and managers is open and transparent.  Continue reading

Not All Skilled Nursing Patients Seen Promptly By Physicians After Transfer From Hospital

MedicalResearch.com Interview with:

Kira L. Ryskina  MD MSAssistant Professor Of MedicineDivision of General Internal MedicinePerelman School of Medicine, University of Pennsylvania

Dr. Ryskina

Kira L. Ryskina  MD MS
Assistant Professor Of Medicine
Division of General Internal Medicine
Perelman School of Medicine,
University of Pennsylvania 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Post-acute care in skilled nursing facilities (SNF or sometimes called subacute rehab) is a very common discharge destination after a hospital stay. Patients discharged to these facilities represent more clinically complex and high-need patients than patients discharged home.

We wanted to understand how soon after discharge from the hospital to a skilled nursing facility are patients seen by a physician. We found that first visits by a physician or advanced practitioner (a nurse practitioner or physician assistant) for initial medical assessment occurred within four days of SNF admission in 71.5 percent of the stays. However, there was considerable variation in days to first visit at the regional, facility, and patient levels.

One in five initial physician visits occurred more than 4 days after admission to skilled nursing facilities.  In 10.4 percent of stays there was no physician or advanced practitioner visit. Much of the variability in visit timing had to do with SNF characteristics and geography compared to patient clinical or demographic characteristics. Patients who did not receive a physician visit had nearly double the rates of readmissions or deaths compared to patients who were seen.  Continue reading

Specialty Drugs and Increase Price of Brand Names Raise Health Care Costs

MedicalResearch.com Interview with:

MedicalResearch.com Interview with: Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy

Dr. Hernandez

Inmaculada Hernandez, PharmD, PhD
Assistant Professor of Pharmacy and Therapeutics
University of Pittsburgh School of Pharmacy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The objective of our study was to answer a research question of high policy relevance: to what extent are rising drug costs due to inflation in the prices of existing products versus the market entry of new, more expensive drugs.

We found that rising prices of brand-name drugs are largely driven by manufacturers increasing prices of medications that are already in the market rather than to the entry of new products.

In contrast, increases in costs of specialty and generic drugs were driven by the entry of new drugs.

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