Acute Care

Is the integration of urgent, emergent, inpatient and
care of patients with
acute medical conditions.


Reform Realtime Video: Problems Facing Hospitals and Providers

The Affordable Care Act has imposed a number of new rules and regulations on hospitals and healthcare providers. In this video, hear from providers across the country talk about the problems they're currently facing. Share your concerns in the comments section below.

Reform Realtime: On the Ground at Hospitals Across the Country

By Joshua Tamayo-Sarver, MD, PhD, FACEP

CEP America is excited to announce the launch of Reform Realtime here on Perspectives. The initiative aims to examine the impact of health exchanges on acute care through:

  • Up-to-the-minute data sharing
  • Expert analysis
  • On-the-ground reports from hospitals and physician leaders
  • And much more

  • The goal of Reform Realtime is to provide you with an in-depth view of trends and changes affecting our industry.

    So how can we do this? That's where our data comes in.

    It's Not too Early to Gear Up for ED CAHPS

    By Tiffany Hackett, MD, MBA, FACEP

    No one plans to spend Saturday afternoon in the ED. This reality hit home when our laughter from lunch with old friends was pierced by the sound of glass shattering. We heard a scream and realized my daughter had just run through a sliding plate-glass door. During this experience, I had a rare opportunity to observe my profession from the patient/family side of things.

    What struck me most is the tightrope that ED providers must walk while providing high-quality, patient-centered care. As a parent, I valued the time the doctors and nurses spent with my child and me. On the other hand, I understood the pressures they were under to move us as quickly as possible through the diagnostic and treatment process. They worked hard to provide a healthy dose of empathy without sacrificing efficiency.

    ED physicians' ability to manage these opposing forces will become even more crucial over the next year or so as Centers for Medicare & Medicaid Services (CMS) rolls out its latest patient satisfaction survey — okay, patient opinion survey — the Emergency Department Consumer Assessment of Healthcare Providers and Systems (ED-CAHPS).

    Want Meaningful Use? Make Technology Meaningful for Doctors.

    By Jason Ruben, MD

    Last fall, as hospitals and healthcare providers scrambled to meet impending EMR "meaningful use" deadlines, regulators were sending some decidedly mixed messages.

    On Nov. 18, 2013, a representative from the Office of the National Coordinator for Healthcare Technology addressed a gathering of the American Medical Informatics Association. She insisted that meaningful use would proceed on schedule.

    "Wish there could be a delay of Stage 2 meaningful use? Don't hold your breath," wrote a reporter from Healthcare IT News, who was covering the story.

    Then, less than one month later on Dec. 6, the Centers for Medicare & Medicaid Services (CMS) announced that it would indeed extend Stage 2 for an additional year and delay the arrival of Stage 3 until 2017.

    Human factors played a pivotal role in CMS' decision. By delaying the program a year, they hoped to create:

    "Ample time for developers to create and distribute certified EHR technology before Stage 3 begins, and incorporate lessons learned about usability and customization."

    News Updates — Reform Victories and Setbacks

    Our biweekly news updates are designed to keep you up to date with current developments relating to the Acute Care Continuum. Feel free to share your perspective on these stories or link to articles that you have found relevant to today's healthcare environment.

    7 Million People Sign Up for Commercial Health Plans

    As the March 31 deadline passed, the White House announced that 7.1 million people successfully signed up for commercial health plans through federal and state exchange programs. Beyond individuals who now have commercial insurance, HHS reported, "roughly 3 million more individuals enrolled in Medicaid or the Children's Health Insurance Program between October and February." The figures are in line with a new report from the Urban Institute, which says that 5.4 million Americans who previously lacked health insurance have gotten coverage since October.

    Slow Death by EMR or: How I Learned to Stop Clicking and Love Google Glass

    By Carl Spitzer, MD

    628x471.jpgHere's a dirty little secret that I'll share with you: the clinical usability of current-generation electronic medical record (EMR) systems is nothing short of atrocious.

    If the Geneva Convention's proscription against torture extended to healthcare information technology (HIT), most vendors would be out of business and behind bars.

    But you probably already knew that: a November 2013 article in the American Journal of Emergency Medicine (AJEM) found that community emergency physicians spend 44 percent of their time interacting with EMRs and click up to 4,000 times in a 10-hour shift.

    A follow-up in Emergency Physicians Monthly extrapolated the AJEM data and pegged the cost of those clicks at $168,000 per year in lost physician productivity for a typical emergency department (ED).

    Little wonder then that a recent report commissioned by the American Medical Association and authored by the RAND Corporation found that "…for many physicians, the current state of [EMR] technology appeared to significantly worsen professional satisfaction in multiple ways."

    Don't Be a Dodo: Three Crucial Steps to Evolving Your Healthcare Organization (Part 1 of 3)

    By David Birdsall, MD

    Recently, my daughter wrote a school report on Charles Darwin.  The title of the report was "Evolve or Die," which I thought was a bit harsh and certainly too fatalistic for a middle schooler. My parental concerns not withstanding, as I thought about our current healthcare environment, I realized we are in an "Evolve or Die" situation in this country.

    Take for example reimbursement. No longer will we be paid simply for what we do but how we do it and how happy our patients are with our service. It is clear that if folks don't make a change (like focusing on delivering higher quality and more patient-centered care), they will go the way of the dodo.

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