News Article | May 23, 2017
MILAN--(BUSINESS WIRE)--Today, the biopharmaceutical company Dompé has announced that the Committee for Human Medicinal Products (CHMP) of EMA (European Medicines Agency) has released a positive opinion, recommending the marketing authorization for Oxervate® (cenegermin eye drops), for the treatment of adult patients with moderate or severe neurotrophic keratitis. This is a rare and disabling eye condition that can lead to the loss of vision. As of today, no satisfactory treatment is available for this disease. Due to the risks related to this pathology and to the lack of viable therapeutic options, CHMP completed its review through an accelerated assessment. It began in November 2016 and ended with a positive opinion last week. The origin of neurotrophic keratitis is related to a trigeminal nerve impairment (one of the nerves responsible for the eye anatomy and function), which can lead to the loss of corneal sensitivity. In its most serious forms, it can cause ulcers, melting and corneal perforation, affecting the visual ability of patients2. If confirmed by EMA’s Committee for Orphan Medicinal Products (COMP) and approved by the European Commission, Oxervate® would be the first biotechnology orphan drug in the world authorized for this indication. Cenegermin, the name of the active agent, is the recombinant version of the human nerve growth factor (NGF) discovered by Nobel Laureate Rita Levi Montalcini. This protein is naturally produced by the human body and is implicated in the development, maintenance and survival of nerve cells3. Administered in the form of eye drops to patients with neurotrophic keratitis, Oxervate® helps restore the normal healing processes of the eye and repair the corneal damage. Oxervate® is produced through the recombinant DNA technology, with the introduction of a gene (DNA) into bacteria to allow these latter to produce the human nerve growth factor. CHMP conclusions are based on data from two phase II clinical trials involving 204 patients with moderate and severe neurotrophic keratitis. Both studies have shown that after eight weeks, a higher number of Oxervate® treated patients reached a complete corneal healing vs patients on placebo. The most common adverse reactions observed with Oxervate® include eye pain, eye inflammation, increased lacrimation (secretion of tears), eyelid pain and foreign body sensation in the eye. "We welcome the CHMP opinion with great satisfaction. To us, making Oxervate® available to patients who live with this rare disease is a major achievement. It would be the first biotech treatment obtained thanks to our research efforts", said Eugenio Aringhieri, Dompé’s Chief Executive Officer. "This decision paves the way to the significant prospect of a therapy for those suffering from this disease. In the future, our goal is to keep investigating its potential in other pathologies, to allow more and more patients to benefit from this innovative therapeutic approach". "Having been the first to turn the discovery of the Nerve Growth Factor into a potential therapy is a further confirmation of the value of ‘Made in Italy’ research", explained Sergio Dompé, Chairman of Dompé. "At this time my thoughts and gratitude go to the team of researchers who passionately developed Oxervate®, and especially to Professor Rita Levi Montalcini for her great intuition, from which this research project stems, namely the neuronal growth factor for which she received the Nobel Prize." Until the European Commission’s final decision, Oxervate® remains an investigational therapy. Its marketing authorization has not been granted yet in any country. Dompé is one of the leading biopharmaceutical companies in Italy. It focuses on the development of innovative therapeutic solutions for diseases with a high social impact for which therapeutic options are lacking. Based in Italy, Dompé has its headquarters in Milan. Its research efforts focus on unmet therapeutic needs such as diabetes, organ transplantation, ophthalmology and oncology. The industrial pole of L’ Aquila (Abruzzo) is home to a world class biotechnology plant developing drugs for Primary Care for the markets of about 40 countries worldwide. Dompé has its offices also in Albania, France, Germany, Great Britain, Spain and United States (New York). For more information: www.dompe.com and www.dompetrials.com This press release makes reference to certain information that may not coincide with expected future results. Dompé firmly believes in the soundness and reasonableness of the concepts expressed. However, some of the information is subject to a certain degree of indetermination in relation to its research and development activities and the necessary verifications to be performed by regulatory bodies. Therefore, as of today, Dompé cannot guarantee that the expected results will be consistent with the information provided above. 1 M. Sacchetti, and A. Lambiase, Diagnosis and management of neurotrophic keratitis. Clin Ophthalmol 8 (2014) 571-9. 2 Idem 3 R. Levi Montalcini, The nerve growth factor 35 years later, Science 1987
News Article | May 23, 2017
MILANO--(BUSINESS WIRE)--L’azienda biofarmaceutica Dompé annuncia oggi che il Comitato per i farmaci ad uso umano (Committee for Human Medicinal Products - CHMP) dell’EMA (European Medicines Agency) ha dato opinione positiva raccomandando l’autorizzazione all’immissione in commercio per Oxervate® (cenegermin gocce oculari), per il trattamento di pazienti adulti con cheratite neurotrofica moderata o grave, una patologia oculare rara e debilitante che può portare alla perdita di visione e per cui non esistono, ad oggi, trattamenti soddisfacenti. Proprio per i rischi legati alla patologia e per la mancanza di valide alternative terapeutiche, la valutazione del CHMP è avvenuta con una procedura accelerata, partita a Novembre del 2016 e conclusasi positivamente la settimana scorsa. “Accogliamo con grande soddisfazione l’opinione del CHMP, che rappresenta un importante passo per rendere disponibile Oxervate® per i pazienti che convivono con questa patologia rara, divenendo il primo trattamento biotech ottenuto grazie all’impegno della nostra Ricerca”, afferma Eugenio Aringhieri, Chief Executive Officer Dompé farmaceutici. “Questa decisione apre una significativa prospettiva di cura per chi soffre di questa patologia. In futuro, il nostro obiettivo è proseguire nella ricerca per investigarne il potenziale in altre patologie, e consentire a sempre più pazienti di beneficiare di questo approccio terapeutico innovativo”. “Essere riusciti a portare per primi il Nerve Growth Factor dalla scoperta ad una potenziale terapia è un’ulteriore conferma del valore della Ricerca Made in Italy”, spiega Sergio Dompé, Presidente Dompé Farmaceutici. “Il mio pensiero e la mia gratitudine vanno in questo momento al team di ricercatori che hanno lavorato con passione allo sviluppo di Oxervate®, ma soprattutto alla Prof.ssa Rita Levi Montalcini, per la geniale intuizione da cui nasce questo progetto di ricerca, quel fattore di crescita neuronale che le valse il Premio Nobel.” Fino alla decisione definitiva della Commissione Europea, Oxervate® rimarrà una terapia sperimentale non ancora autorizzata all’immissione in commercio in nessuna parte del mondo. Dompé è una delle principali aziende biofarmaceutiche in Italia, focalizzata sullo sviluppo di soluzioni terapeutiche innovative per patologie ad alto impatto sociale, spesso orfane di cura. Con sede in Italia, Dompé ha il proprio quartier generale a Milano e concentra il proprio impegno in Ricerca in aree con bisogni terapeutici ancora insoddisfatti quali il diabete, il trapianto d’organo, l’oftalmologia, e l’oncologia. Il polo industriale dell’Aquila (Abruzzo) ospita un impianto biotecnologico d’eccellenza nel mondo e sviluppa farmaci per la Primary Care destinati ai mercati di circa 40 paesi nel mondo. Dompé è inoltre presente con propri uffici in Albania, Francia, Germania, Gran Bretagna, Spagna e negli Stati Uniti (New York). 1 M. Sacchetti, and A. Lambiase, Diagnosis and management of neurotrophic keratitis. Clin Ophthalmol 8 (2014) 571-9. 2 idem 3 R. Levi Montalcini, The nerve growth factor 35 years later, Science 1987
News Article | May 9, 2017
PAINWeekEnd (PWE) on June 3 at the Hyatt Regency Westlake, 880 S. Westlake Blvd., will be an educational and exciting full-day program providing busy clinicians and allied healthcare practitioners with 6.0 hours of relevant, practical instruction in the management of chronic pain. California has a 1-time requirement of 12 CME credits in pain management and treatment of terminally ill and dying patients, which must be finished before the second license renewal date or within 4 years, whichever occurs first. By attending PAINWeekEnd Los Angeles, participants can enhance their skills in medication risk evaluation and mitigation, pain assessment and diagnosis, and delivery of individualized multimodal treatment. An attendee of a recent PAINWeekEnd conference said, “Dr. Tennant gave excellent insights on history and physical exam to making a correct diagnosis and treatment. Enjoyed his presentation immensely,” about the Chronic Pain Patients Who Fail Standard Treatment: Identification and Strategies course, which will be presented by Dr. Forest Tennant in Los Angeles. Other courses include (and are subject to change) The Role of the Advanced Practice Provider in the Acute Care Setting; Minimizing Pills and Maximizing Skills: Achieving Successful Opioid Cessation in Chronic Pain; Arachnoiditis: Diagnosis and Treatment; Complex Cases in Pain Management; and Interdisciplinary Management of Pelvic Pain: Bridging the Gap Between Primary Care and Specialty Referral. Commercially supported activities—addressing a range of product, disease state, and medical information topics—will also be presented. Online registration fee for this PAINWeekEnd Conference: $129. PAINWeekEnd registrants may register for the PAINWeek National Conference, September 5-9, in Las Vegas, for $200 off the current online published price. PAINWeekEnd is provided by Global Education Group. About Global Education Group: Global Education Group focuses on producing partnership-based CME for healthcare practitioners. The Global team works with a select group of medical education companies, associations, academic institutions and healthcare facilities to develop and accredit live healthcare conferences and workshops as well as online activities. With each partnership or joint providership, Global brings accreditation expertise, project management excellence and grant funding intelligence. Based in Littleton, Colo., Global has accreditation with commendation from the ACCME. Global also holds accreditations to offer continuing education for nurses, nurse practitioners, pharmacists, dietitians, dentists and psychologists. Global is a division of Ultimate Medical Academy.
News Article | May 10, 2017
Continuing Education Company(CEC), a leader in Primary Care Live Continuing Medical Education (CME), is celebrating 25 years of presenting quality education to Primary Care clinicians. In honor of their 25th anniversary, CEC will be offering a free 20 credit online CME course to all attendees of their 2017 live conferences. The complimentary course will be available through CEC's online portal, CME365, and will enable CEC conference attendees to earn a total of up to 40 credits. This offer is valid only for participants who attend all the days of the live conference they select. Access to the online CME course is sent to registrants after they have attended and successfully completed the live conference. The online CME course is not transferable and is not valid if they cancel their registration or are a no show at the live conference. Webcast participants are not eligible for this offer. Walter Ejnes, President of CEC says "Continuing Education Company's free 20 credit online CME course offering is our way of saying thank you to the thousands of medical professionals who have supported us for the past 25 years." CME365 offers live streaming webcasts of CEC's conferences as well as online courses in Primary Care, Urgent Care and Pulmonology. All the online courses are fully accredited and feature the same high quality education as the live Continuing Medical Education conferences that Continuing Education Company offers throughout the year. Continuing Education Company, Inc. (CEC) is an independent, non-profit, 501 (c)(3) continuing medical education organization. They have been developing and presenting continuing medical education programs for over 25 years. Their mission is to develop and provide educational opportunities to improve the skills and knowledge of medical and healthcare professionals. They accomplish this mission by offering American Academy of Family Physicians (AAFP), AMA PRA Category 1 Credits™ and ABIM MOC accredited live CME conferences and online courses. The mission of Continuing Education Company, Inc. (CEC) is to improve public health by developing and providing educational opportunities to advance the skills and knowledge of physicians and other healthcare professionals. This mission is accomplished by assisting healthcare professionals in assessing their educational needs and providing them with evidence-based education which meet those needs. For more information please visit the company website, http://www.cmemeeting.org. __title__ online link]
News Article | May 10, 2017
The National Patient Safety Foundation (NPSF), newly merged with the Institute for Healthcare Improvement, has announced the recipients of the 2017 Stand Up for Patient Safety Management Awards. NYC Health + Hospitals/Bellevue is being recognized for a program to improve the management of insulin-dependent diabetes in patients at its Adult Primary Care Center. Christiana Care Health System is being honored for a care coordination and management program called Carelink CareNow that has yielded impressive results in reducing readmissions. The awards are presented each year in recognition of the successful implementation of outstanding patient safety initiatives by organizational members of the Stand Up for Patient Safety program. Created in 2002 by NPSF, the Stand Up program is now part of the Institute for Healthcare Improvement’s safety work, following the May 1 merger of the two organizations. The 2017 awards will be conferred during the 19th Annual NPSF Patient Safety Congress, May 17-19, in Orlando, FL. Many patients with insulin-dependent diabetes in the Bellevue Adult Primary Care Center struggled to take time away from work and other responsibilities to visit the clinic to have their insulin dose adjusted. The innovative solution developed by the Bellevue Primary Care Diabetes Team features an evidence-based text messaging program called Mobile Insulin Titration Intervention (MITI, pronounced “mighty”). Patients in the program receive a text message each morning requesting their morning fasting blood sugar level. Patients text back their results and the values are monitored daily by nurses, who call patients once weekly to advise them on an insulin dose titration using a validated dosing algorithm. “This project was designed to both align with and inform the American Diabetes Association’s ongoing policies to promote individualized, patient-centered approaches to diabetes management that reduce health disparities,” said Andrew B. Wallach, MD, FACP, Clinical Director, Ambulatory Care, NYC Health + Hospitals/Bellevue. “We hope to expand the scope of this approach to disease management to other chronic diseases, such as hypertension and asthma.” “MITI overcomes logistical barriers for patients needing to find their correct basal insulin dose by bringing the care to them on their cell phones. Having properly controlled blood sugar means patients have fewer complications from diabetes, allowing them to lead a healthier life,” said Natalie Levy, MD, Director of NYC Health + Hospitals/Bellevue’s Primary Care Diabetes Program and the MITI Program. “Our whole team is honored that the NPSF saw the value of our work and granted us this award.” Christiana Care’s care coordination and management program also uses innovation and technology, along with a dedicated care coordination team, to improve safety and outcomes. This program integrates and analyzes clinical and claims data to help in clinical decision making, coordinate office visits when needed, enhance communication during transitions, and provide educational support to providers caring for patients with chronic illness. “Our success with our care coordination and management program stems from a culture at Christiana Care in which the patient and their family is placed at the center of all we do,” said Sharon Anderson, RN, BSN, MS, FACHE, Christiana Care’s Chief Population Health Officer and Senior Vice President of Quality and Patient Safety. “Through this program, we address the gaps between sicknesses and health crises and we ensure that patients’ social and behavioral health needs – with their great impact on health – are being met, in addition to their medical need.” The Stand Up for Patient Safety Management Award recognizes the successful implementation of an outstanding patient safety initiative led, or created, by mid-level management. Eligible initiatives are those that have demonstrated evidence of patient safety improvement, with involvement of staff at all levels of the organization. “The outstanding work of these organizations is evidence that our Stand Up members are leading the way in innovations to improve patient safety, patient engagement, and health outcomes,” said Tejal K. Gandhi, MD, MPH, CPPS, former President and CEO, NPSF, and now Chief Clinical and Safety Officer at the Institute for Healthcare Improvement, following the recent merger of the two organizations. “We are very pleased to recognize their work at our annual meeting and help inspire others.” About Us The Institute for Healthcare Improvement (IHI) and the National Patient Safety Foundation (NPSF) began working together as one organization in May 2017. The newly formed entity is committed to using its combined knowledge and resources to focus and energize the patient safety agenda in order to build systems of safety across the continuum of care. To learn more about our trainings, resources, and practical applications, visit ihi.org/PatientSafety. About the NPSF Stand Up for Patient Safety Program The Stand Up for Patient Safety program caters to hospitals, health systems, physician offices, ambulatory facilities, and other entities focused on improving the safety of health care. Membership provides the support and education necessary to embed patient safety principles into organizational practice and align with national patient safety goals and critical regulatory requirements. Through participation, Stand Up members around the world gain access to field-tested tools and resources, expertly designed educational programs, and an invaluable support network. Visit the website to learn more.
News Article | May 11, 2017
Kansas City, MO, May 11, 2017 (GLOBE NEWSWIRE) -- As growing health disparities continue to threaten rural America, an increasing number of rural hospitals are transforming their health delivery system through Alternative Payment Models. Caravan Health, the market leader in Accountable Care Organizations (ACOs), announced today that by 2018, 17.5% of all U.S. rural hospitals will be participants in an ACO supported by Caravan Health. The high ACO participation rate is no surprise to Caravan Health’s CEO & Founder, Lynn Barr, as she has been a long-standing advocate that value-based payments are the most effective opportunity for rural communities to improve patient care while lowering costs. “Rural providers face a different set of challenges than their urban counterparts,” said Ms. Barr. “These organizations thrive in ACOs because of the focus on coordinated care. We teach them how to implement new wellness and quality services that minimize high-cost patient care.” Caravan Health’s proven ACO model has already helped hundreds of rural providers transition to value-based care. Most recently, Caravan Health found that their highest performing ACO reduced inpatient utilization by 17.7%. Using the Centers for Medicare and Medicaid Services’ savings projection method, this ACO is expected to save Medicare almost $11 million. Ms. Barr will examine this ACO’s strategies during a presentation with The Commonwealth Fund, “Banding Together for Population Health – A New Business Model for Rural Hospitals.” Moderated by The Commonwealth Fund’s Melinda Abrams, Vice President for Delivery System Reform, a panel of hospital CEOs will join Ms. Barr, as they uncover how value-based payment approaches are strengthening rural hospital systems. “The Commonwealth Fund seeks to find and spread care delivery models that can better serve all patients – but particularly those who have complex conditions or who are vulnerable due to their social circumstances,” said Ms. Abrams. “We are excited to hear from panelists how they’re working to strengthen services and improve population health in rural communities.” The webinar will take place on Monday, May 22, 2017 at 10:00 a.m. PST/12:00 p.m. CST/1:00 p.m. EDT. To join, interested participants must register at the link provided here. For more information about Caravan Health, visit www.caravanhealth.com or email firstname.lastname@example.org. About Caravan Health Caravan Health supports more than 17,000 independent primary care providers making the transformation to value-based payments with affordable, simple solutions that achieve outstanding results through Practice Transformation Networks (PTNs), Accountable Care Organizations (ACOs) and now Comprehensive Primary Care Plus (CPC+). For more information, go to www.caravanhealth.com. About The Commonwealth Fund The mission of The Commonwealth Fund is to promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults. A photo accompanying this announcement is available at http://www.globenewswire.com/NewsRoom/AttachmentNg/10ba3346-8fda-47d2-9541-baa30d718373
News Article | May 12, 2017
On the evening of Friday, April 28th, 56 entrepreneurs and visionaries were honored with the prestigious “USF Fast 56” award recognizing their impressive growth and spreading Bull pride across the globe as well as Tampa Bay. Florida Wellness Medical Group is proud to announce that it has received this distinction four years in a row. “Super proud of our team to hold this honor for four consecutive years,” Dr. Edward Leonard C.E.O., class of 2002 says. “We are humbled by the love and feedback we receive from our patients every day. Tampa Bay wants an alternative to sick-based healthcare. We facilitate that.” “It’s an amazing feeling,” General Manager Michael Eby, USF class of 2006, says, “to be recognized for the hard work we put in every day. To be recognized by my alma mater means that much more. We are honored to receive this award for our fourth year in a row and returning to the Tampa campus to receive it is always heartwarming.” The “USF Fast 56” is an exclusive group of the fastest growing Bull-owned or Bull-led businesses throughout the world. To even be considered for the award, companies must meet rigorous goals. This achievement not only celebrates the success of these innovators and job creators, but also and perhaps more importantly provides a forum to pass on lessons learned to the next generations for Bull entrepreneurs. Florida Wellness Medical Group is a multidisciplinary practice comprised of experienced, compassionate providers dedicated to an integrative approach that helps Floridians attain long-term health. With five locations throughout Tampa Bay – in Carrollwood, Downtown Tampa, South Tampa, Trinity, and Zephyrhills – we offer full-spectrum Primary Care services as well as Chiropractic, Medical Acupuncture, Massage & Physical Therapies to manage chronic illnesses or to help the body heal itself after auto accidents or sports injuries. Florida Wellness Medical Group serviced approximately 27,000 patients in 2016. Florida Wellness CEO & President Dr. Edward Leonard holds a Bachelor of Science in Biology from his alma mater and is passionately dedicated to the health and wellness of the Tampa community. A practicing Chiropractic Physician, certified in Medical Acupuncture with a degree from Palmer College of Chiropractic and training from Harvard Medical School, Dr. Leonard is well-trained in the diagnosis and conservative management of neurological and musculoskeletal conditions. For more information or to schedule an appointment with one of our primary care providers or chiropractors, please visit www.floridawell.com or call 813-229-2225.
News Article | May 8, 2017
Evaluating the degree to which primary care across Canada comports with the goals of the Patient Medical Home model, researchers find considerable room for improvement. Researchers from the Manitoba Centre for Health Policy applied 10 measurable indicators of the PMH model across all 10 Canadian provinces and found an average national PMH composite score of 5.36 (range 4.75-6.23) out of 10 based on survey data from 772 primary care practices and 7,172 patients. Ontario was the only province to score significantly higher than Canada as a whole, whereas Quebec, Newfoundland/Labrador, and New Brunswick/Prince Edward Island scored below the national average. The researchers found little variation, however, among provinces in achieving the 10 PMH goals. The researchers point out that although the PMH is a pan-Canadian model, implementation is dependent on provincial and regional or local policies, and during the past 15 years, new primary care funding models have been introduced without consistency in timing, key model components or implementation strategies across provinces. The authors call for future research into the effects of reform on practice characteristics and processes, and assessment of health services utilization and quality measures for clinical conditions. The information gleaned from these activities, they posit, may motivate further uptake of the PMH model's attributes in all provinces. Alignment of Canadian Primary Care With the Patient Medical Home Model: A QUALICO-PC Study Video visits are being adopted in a variety of health care settings, including primary care, because they offer increased care accessibility, decreased transportation barriers and patient empowerment. In a qualitative study of 19 adult patients interviewed following video visits with their primary care clinician, researchers found patients accept and even prefer video visits to in-person office visits. Participants reported feeling comfortable talking with their clinicians over a video call, and they identified convenience and decreased costs as the primary benefits of video visits. Some patients expressed a preference for receiving future serious news via a video visit citing reasons of comfort, social support and privacy. Primary concerns with video visits concerned privacy, including potential for work colleagues to overhear conversations, and questioning the ability of the clinician to perform an adequate physical examination. The authors conclude these findings add insight into the benefits of video visits in primary care, highlighting improved convenience, efficiency, privacy and comfort for patients. The findings also raise new considerations unique to telehealth that warrant discussion with patients before use, such as whether patients would consider using headphones or finding a private room to maintain privacy during video visits outside of the home. Chronic dizziness is highly prevalent in primary care, with nearly 7 million consultations per year in the United States. Researchers find a publicly-available, self-directed Internet-based vestibular rehabilitation program effectively reduces dizziness and dizziness-based disability in older primary care patients without requiring clinical support. The randomized controlled trial involving 296 patients aged 50 years and older with dizziness exacerbated by head movements found that compared with the usual care group, patients in the Internet-based rehabilitation group had less dizziness on the Vertigo Symptom Scale-Short Form at three months (difference 2.75 points) and at six months (difference 2.26 points). Dizziness-related disability was also lower in that group at three months (difference 6.15 points) and six months (5.58 points). Given the increasing Internet use being seen in older adults, the authors conclude Internet-based interventions may provide a promising means of greatly increasing the provision of evidence-based self-management strategies for adults in primary care. This article is featured in this issue's Annals Journal Club, which provides a template for groups to discuss and critically assess articles. It will also launch Annals' Twitter journal club. Those interested can participate in the conversation on Wednesday, May 31 from 12-1 p.m. EST (4 p.m. GMT), hashtag #AJC. This moderated Twitter chat will pose questions at regular intervals. Internet-Based Vestibular Rehabilitation for Older Adults With Chronic Dizziness: A Randomized Controlled Trial in Primary Care Researchers examine the potential of health information technology to systematically guide patients through decision making processes for three cancer screening choices and find that although automated decision aids have the potential to make office visits more efficient and effective, cultural, workflow and technical changes are needed before widespread implementation. Specifically, this observational cohort study evaluated how clinicians and patients at 12 primary care practices used an automated decision module that promoted the 2012 prostate, 2009 breast and 2008 colon cancer screening recommendations made by the U.S. Preventive Services Task Force, and how that module impacted care. They found practices had a large decision burden - with one in five patients facing a cancer screening decision over the one-year study period. Yet, of the 11,458 patients who faced a screening decision for colorectal cancer (6,329 patients), breast cancer (3,733 patients) or prostate cancer (1,396 patients), only 21 percent started and 8 percent completed the decision module. User data showed patients reviewed a range of topics while in the module and 47 percent of the module completers elected to forward a summary to their clinician. After their next office visit, both patients and clinicians reported that module completion helped with decisions: 41 percent said it made their appointment more productive, 48 percent said it helped engage them in the decision, 48 percent said it broadened their knowledge and 38 percent said it improved communication. The authors conclude that while the model is appealing, a clear challenge is getting patients to use such a system. If future research confirms the benefits of this approach - yielding more informed patients, better decisions and wiser use of encounter time - the return on investment could offset the implementation costs and improve care. A content analysis of Medicare's new Merit-Based Incentive Payment System, set to be fully implemented this year, reveals gaps related to the measurement of access, patient experience, and interpersonal care raising concerns that MIPS may fail to measure the broader aspects of health care quality and even risk worsening existing health disparities. Researchers found a total of 143 of the 270 MIPS measures applied to primary care, and most were related to aspects of clinical experience; most of the domains that reflected quality of primary care were not represented. Notably, their analysis showed five of 12 domains had no applicable measures, and only 10 percent of the measures fell into another five domains of primary care. They conclude that for MIPS and similar pay-for-performance programs to have a positive effect on health outcomes for marginalized populations, there is a need for policy makers to apply a theoretical framework to the measures in order to ensure the broad domains of quality, equality in particular, are encapsulated. By applying a theoretical framework, they assert, it is possible to identify gaps and subsequently develop measures that incentivize addressing health disparities. In neglecting to do so, they warn, pay-for-performance measures may fail in their objective to deliver better quality health outcomes to all members of society regardless of wealth, color, or personal circumstances. Impact of Gaps in Merit-Based Incentive Payment System Measures on Marginalized Populations The University of Auckland, New Zealand Primary care patients who have harmed themselves are at a greatly increased risk of dying prematurely by natural and unnatural causes, especially within a year of a self-harm episode. Using electronic health records data from 385 primary care practices in England linked to national mortality records, researchers investigated the risk of dying prematurely from any cause after a recorded episode of self-harm in a cohort of 30,017 patients aged 15 to 64 years. They estimated the relative risks of natural and unnatural mortality using a comparison cohort of 600,258 individuals matched for age, sex and general practice. They found an elevated risk of dying prematurely from any cause among the self-harm cohort, especially in the first year of follow-up (adjusted hazard ratio, 3.6). In particular, suicide risk was especially high in the first year (adjusted hazard ratio, 54.4). Although it declined sharply after one year, it remained much higher than in the comparison cohort. Large elevations of risk throughout the 10-year follow-up period were also observed for accidental, alcohol-related and drug-poisoning deaths. After 10 years of follow-up, cumulative incidence values were 7 percent for all-cause mortality and 1 percent for suicide. The authors point out that patients with a history of self-harm visit clinicians at a relatively high frequency, which presents a clear opportunity for preventive action. They call for national guidelines that provide more specific recommendations and training on how primary care teams can more effectively intervene, manage, and monitor risk in these patients. They conclude that patients with myriad comorbidities, including self-harming behavior, mental disorder, addictions, and physical illnesses, will require a concerted, multi-pronged, multidisciplinary collaborative care approach to effectively manage their complex health needs. Premature Death Among Primary Care Patients With a History of Self-Harm China's commitment to develop a strong primary care system through the establishment of community health centers has succeeded in creating more than 8,600 centers, however researchers seeking to evaluate the current quality of these facilities, find they are underused in part because of public mistrust of the physicians and because few centers are equipped to provide comprehensive primary care for a wide range of common physical and mental conditions. A nationally representative survey of the structure and organization of the Chinese primary care system involving 158 community health centers and 3,580 primary care practitioners found less than one-half (46 percent) of the physicians employed by CHCs were registered as PCPs and few nurses had training specifically for primary care. Moreover, although virtually all clinics were equipped with basic primary care equipment such as stethoscopes (98 percent) and sphygmomanometers (97 percent), only 43 percent had opthalmoscopes and 64 percent had facilities for gynecologic examination. Most CHCs had inpatient beds for their patients; however, only 38 percent had microbiology support and only 53 percent offered Pap screening. Clinical care was selectively skewed toward certain diseases. Although virtually all CHCs provided management of common ailments, chronic diseases, hypertension, diabetes, traditional Chinese medicine, maternal and infant health care, and vaccinations, large proportions did not provide management for other common conditions such as dyslipidemia (38 percent), mental illness (66 percent), sexually transmitted infections (66 percent), and chronic obstructive pulmonary disease (70 percent). Use of services by patients was poor at each CHC: despite serving 50,000 people, the centers had an average of only 41,000 patient contacts a year, and each physician saw a median of only 12.5 patients per day. Based on these findings, the authors conclude that Chinese policymakers need to reconceptualize health care training and policy in order to alter the public perception of primary care in the country. There is a need, they write, to develop tools to evaluate primary care activities more clearly, integrate community-oriented thinking into primary care, and teach an integrated comprehensive approach (such as multidisciplinary teams), rather than selected care with a purely biomedical approach. Bridging the Gaps Between Patients and Primary Care in China: A Nationwide Representative Survey By William C. W. Wong, MD and Sunfang Jiang, MD, et al With major depressive disorder projected to become the single leading cause of global disease burden in high-income countries by 2030, interest in depression prevention has grown in recent decades. Primary care is an ideal setting in which to undertake disease prevention strategies for depression, yet little is known about the effectiveness of psychological and educational interventions to prevent depression in primary care. Researchers in Spain conducted a systematic review of 14 randomized controlled trials involving 7,365 patients to examine the effect of interventions to prevent depression in nondepressed primary care patients and found a modest though statistically significant preventive effect. Specifically, they found a pooled standardized mean difference of -0.163. Based on these findings, the authors conclude the incidence of new episodes of depression could be reduced on average by 26 percent if primary care managers and physicians were to implement programs and interventions to prevent depression. They call for further randomized controlled trials to determine which programs and interventions are most efficient in primary care. Effectiveness of Psychological and Educational Interventions to Prevent Depression in Primary Care: A Systematic Review and Meta-Analysis Hepatitis C virus is a growing public health problem, causing 15,000 deaths annually in the United States. New oral treatment regimens that have few side effects and are effective across genotypes have opened up the possibility of treatment in the primary care setting, but models for doing so in the era of oral therapies are lacking. Researchers in Boston describe a successful HCV treatment program embedded in an urban, safety-net hospital. The program utilizes a novel multidisciplinary approach with primary care physicians, a pharmacist, pharmacy technician, and public health social workers working together to facilitate patient engagement and provide treatment. Funding support for the multidisciplinary staffing model was also novel, emanating from revenue from the 340b drug discount program, which allows providers to generate revenue when patients fill prescriptions at pharmacies in safety-net settings, as insurance reimbursements for medications exceed the cost at which safety-net providers purchase medications. The authors report that over the course of one year, the program received 302 referrals, approximately 23 percent of whom have received treatment. In dueling point/counterpoint articles, researchers debate the value of quality reporting. Internist David R. Scrase, MD, contends that quality reporting can lead to better outcomes for patients but only if stakeholders follow a six-step model he outlines in his editorial. In contrast, family physician David L. Hahn, MD, MS, argues that quality measurement has made him a worse doctor. He calls for improved measures that provide actionable information, align with good clinical practices, promote patient-centered care and shared decision making, encourage reflection and continuous quality improvement, undergo regular evaluation and allow for changes in response to provider input, and do not arbitrarily and spuriously reward or punish clinicians. Point: How Quality Reporting Made Me a Better Doctor The University of New Mexico Medical School, Albuquerque University of Wisconsin School of Medicine and Public Health, Madison In contrast to the high-tech interventions elucidated in the May/June issue, an essay by Edgoose and Edgoose reexamines the human interactions at the core of medicine: the face-to-face encounter. Using the framework provided by the French philosopher and Holocaust survivor Emmanuel Levinas (1906-1995), the authors explore the unique responsibility and potential for hope found only in face-to-face encounters. They write that although these encounters are at the heart of the patient-clinician relationship, their singular significance is often lost amid the demands of today's high-tech, metric-driven health care systems. They conclude that revisiting this most fundamental attribute of medicine is likely clinicians' greatest chance to reclaim who they are and why they do what they do. By Jennifer Y. C. Edgoose, MD, MPH, and Julian M. Edgoose, PhD University of Wisconsin School of Medicine and Public Health, Madison With the May/June issue, Annals of Family Medicine introduces a new feature on Innovations in Health Care - brief one-page articles that describe novel innovations from the front lines of primary care. Each article describes how the innovation works, who implemented it and where it was carried out - information readers need to make decisions about how to transport or reinvent the innovation in their own setting. Articles close with takeaway lessons. Readers can find additional detail in online appendixes and hyperlinks. This issue's innovations include: - Providing "Just-in-Time" Preventive Care Advice - an intervention providing individualized preventive care information to patients when they are waiting to see their health professional so they can act upon it then and there. - Overcoming Obesity One Patient at a Time - an office-based weight loss program that inspires patients to achieve long-term weight loss by making small, incremental diet and lifestyle changes. - Using QR Codes to Connect Patients to Health Information - an initiative to generate and display around the clinic Quick Response codes for online information about common health issues to entertain and educate patients. - Engaging Complex Patients with Drop-In Group Medical Appointments - a program that offers patients with complex social, behavioral health and medical needs drop-in group medical appointments that include a physician, nurse care manager, behavioral health counsel, peer support, a consulting occupational therapist, and a clinical pharmacist. - Blood Pressure Screening in the Dental Office - an initiative that makes blood pressure screening a part of the intake process for oral health patients in member health centers because many patients see a dentist more frequently than a physician. - A Change Model for GPs Serving Deprived Areas - an initiative funded by the Scottish government in response to the "GP crisis" brought about by increasing demands on general practice and difficulties recruiting and retaining GPs particularly in rural areas and areas of socioeconomic deprivation. - Radical Redesign: The Power of Team-Based Care - a team-based care prototype that allows employees to work at the top of their skill sets and meet patients' needs more efficiently and with higher quality and lower cost. Annals of Family Medicine is a peer-reviewed, indexed research journal that provides a cross-disciplinary forum for new, evidence-based information affecting the primary care disciplines. Launched in May 2003, Annals is sponsored by seven family medical organizations, including the American Academy of Family Physicians, the American Board of Family Medicine, the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, the North American Primary Care Research Group, and the College of Family Physicians of Canada. Annals is published six times each year and contains original research from the clinical, biomedical, social and health services areas, as well as contributions on methodology and theory, selected reviews, essays and editorials. Complete editorial content and interactive discussion groups for each published article can be accessed free of charge on the journal's website, http://www.
News Article | May 9, 2017
iPatientCare, Inc., a pioneer in ambulatory EHR and Revenue cycle enhancement solutions, announced a special session under its MACRA eLearning webinar series where a guest speaker from CMS will share information on Medicare Access and Chip Reauthorization Act (MACRA). The session is scheduled on Thursday, May 25, 2017 at 1:00 PM EST. iPatientCare's MACRA eLearning session mainly focuses on disseminating knowledge about various aspects of MACRA and educating the healthcare professionals on how to utilize the innovative tools and resources to participating in the Quality Payment Program in the most efficient manner. This session of MACRA eLearning series will focus on Advanced APMs. Advanced APMs is alternate pathway to MIPs and rewards high performing providers for participating in risk-bearing arrangements with CMS and other payers. Qualifying Participants would receive 5% lump sum incentive. In this session, we will also cover Comprehensive Primary Care Plus (CPC+) which is one of the Advanced APMs for 2017. Benjamin Chin is a graduate from Rutgers University and is currently a policy analyst specializing in health care policy working for the Center for Medicare and Medicaid Innovation. Prior to joining CMS, Ben worked at the Thailand Institute of Justice in Bangkok, Thailand as a Henry Luce Scholar where he conducted research on alternatives to incarceration for drug involved offenders throughout the ASEAN region. Ben has also worked for Abt Associates and the Substance Abuse and Mental Health Services Administration prior to working for CMS. “It has been our endeavor to keep our users updated on the latest developments in HealthCare IT. The overwhelming response of MACRA eLearning series has encouraged us to invite expert from CMS to impart more specific session on Advanced APMs,” said Arnaz Bharucha, Senior Technology Officer, iPatientCare. She further added, “We are excited to serve the healthcare professionals and provide them with the much needed assistance through a group of talented individuals, who collectively bring broader and deeper healthcare industry experience and a diverse set of skills and knowledge." iPatientCare, Inc. is a privately held medical informatics company based at Woodbridge, New Jersey. The company’s unified product suite includes ONC Certified Electronic Health/Medical Record and integrated Practice Management/Billing System, Patient Portal/PHR, Health Information Exchange (HIE), and Mobile Point-of-Care Solutions for both Ambulatory and Acute/Sub-acute market segments. iPatientCare has been recognized as a preferred MU partner by numerous Regional Extension Centers (REC), hospitals/health systems, and professional academies. iPatientCare is also known for its Revenue Cycle Enhancement services that provides domestically outsourced, technology-enabled and process-driven solutions for patient access, denials management, HIM/billing and coding, and Lean Six Sigma dashboard-based analytics. iPatientCare has been helping healthcare providers dramatically reduce A/R days and improve collections rates, reduce billing costs, eliminate the burden of repeatable, high volume work on their internal teams, and plug gaps in staffing and internal bandwidth.