US hospitals are not leveraging Facebook to engage patients, improve brand recognition, build communities or just about anything else, a new study finds.

Verasoni Worldwide and Simon Associates conducted the study, which did praise children’s hospitals as pioneers in the use of the popular social networking site.

The study quantified the extent to which hospitals engaged in typical Facebook activities like posting on their walls, using the event function and discussion boards, offering engagement opportunities like games and photo sharing, and providing links to hospital-sponsored blogs and Twitter accounts.

It focused on 120 hospitals of various sizes and types (including academic medical centers, community hospitals and safety net hospitals) in every state. The study took place between December 15, 2010 and January 12, 2011.

Key results from the study include:
Although all hospitals had a presence on Facebook, only 8 (6%) had at least 10,000 fans. More than 50% of the hospitals had less than 1,000 fans. Two of the leaders were Children’s Hospital of Boston (465,073 fans) and Seattle’s Children’s Hospital (15,510 fans).

Only 48 hospitals (40%) posted daily on their walls. Unsurprisingly, these hospitals had more encounters with patients (both current and prospective) and providers. Ninety-six others posted between once per month and twice per week. Once again, children’s hospitals led the way in terms of post frequency.

Just over half (63) the hospitals used Facebook’s event calendar to promote hospital events.

Seventy-six hospitals (63%) had no unsolicited feedback or questions on their pages.

Only 5 hospitals had games, apps, contests or incentives, and a majority of hospitals, 66 (58%), did not allow members to share photos on their Facebook page. Several children’s hospitals allowed parents to post photos of their ‘well’ children, with notes of thanks to hospital staff.

More than 100 hospitals (86%) did not integrate blogs into their Facebook page, and only 10 integrated their Twitter feeds into Facebook.

“While the numbers clearly indicate that patients are on Facebook, it is the job of hospitals to find them, and engage them in a meaningful way. And just because a hospital is on Facebook doesn’t mean that they are building a meaningful Facebook experience for both the hospital and the patient,” Abe Kasbo, a study co-author said in an interview. (more…)

Everyone knew the US’ Rube Goldberg healthcare system was plagued by high costs for billing- and insurance- related activities, but few would have believed it was this bad.

A recently concluded 3-year study of the matter has revealed that administrative (non-physician) costs associated with these 2 activities add up to $51,221 per FTE physician per year.

That’s not including the astonishing $34,052 per year per FTE physician to account for the physician’s own time spent on billing and insurance.

Summing the 2 brings the annual spend on these activities to $85,273 per FTE physician, or 10% of the total operating revenue for an average practice.

Approximately 0.67 FTE non-clinical personnel per FTE physician is allocated to billing and insurance, according to the study.

To reach their conclusions, Julie Sakowski and colleagues at the Sutter Health Institute interviewed business office personnel, observed office work flows, conducted budget and expense reviews and implemented a survey to assess clinician time spent on billing and insurance.

The study was funded by the Commonwealth Fund and the Robert Wood Johnson Foundation.

In a separate study just released by the Medical Group Management Association, investigators found that physicians spend about 43 minutes per workday interacting with insurance plans.

MGMA estimated that system-wide, overall staff time spent on insurance matters alone equaled $21-$31 billion per year, or $68,000 per physician per year, a number that can be reconciled with results from the above-mentioned Commonwealth Fund study.

“Minimizing billing and insurance-related activities is not the only goal of (health system) reform, (but) standardizing health plan features and processing requirements presents a tremendous opportunity for improving efficiency in a multi-payer health care system,” Sakowski told HealthCareITnews.

A computer hacker claims to have stolen 8 million records worth of patients’ personal and prescription drug information from a Virginia government Web site.

The hacker replaced the site with a ransom note demanding $10 million in exchange for safe return of the files.

The Web site belongs to the Virginia Prescription Monitoring Program, which tracks prescription drug abuse.

It contains 35 million prescriptions and personal information from enrollees including names, addresses and social security numbers.

The demand placed on the supposedly secure site was as follows:

“Attention Virginia! I have your [expletive]! In *my* possession, right now, are 8,257,378 patient records and a total of 35,548,087 prescriptions. Also, I made an encrypted backup and deleted the original. Unfortunately for Virginia, their backups seem to have gone missing, too. Uhoh For $10 million, I will gladly send along the password.”

The hacker thoughtfully provided his email address, which is “hackingforprofit@yahoo.com.”

“This was an intentional criminal act against the commonwealth by somebody who was trying to harm others,” Governor Timothy Kaine told the Washington Post.

The Virginia Department of Health Professions is responsible for the hacked site. Its director, Sandra Whitley Ryals has called in the FBI. Apparently the Department has back-ups of the violated database.

“This is a lesson for all health systems,” Deborah Peel, the founder of Patient Privacy Rights told HealthcareITnews. ”Providence hospital system spent $8-9 million fending off lawsuits for a breach; you have to prove you can be trusted.”

The hacker threatened to sell the data by last Thursday if they were not paid off. The deadline has passed and there is no sign they followed through.

State officials have raised questions as to whether the hacker can view the records, as he or she has claimed.

Cleveland Clinic and MinuteClinic have struck a deal in which the 2 organizations will integrate their EMR systems to facilitate communication regarding all aspects of care.

It’s for the benefit of the people, they say.

MinuteClinic, a subsidiary of CVS Caremark, has 500 clinics in 25 states making it the nation’s largest provider of retail healthcare. Cleveland Clinic is Cleveland Clinic.

As part of the collaboration, certified providers at affiliated MinuteClinic outlets will be able to access the Cleveland Clinic’s home grown MyChart EMR if necessary while treating a walk-in.

This means the MinuteClinic provider can access the client’s past medical history, health maintenance record, prescriptions and treatments, among other things…assuming patient consent of course.

And conversely, participating MinuteClinics will upload visit information into MyChart.

That’s closed-loop clinico-electronic integration across the spectrum of care, baby!

Or as Cleveland Clinic’s David Bronson explained to HealthCareITNews, “consumers want access, affordability and coordinated care at all levels. This collaboration…addresses those needs while providing quality medical care for acute minor illnesses.”

By the end of this year, 9 MinuteClinics will be wired into the program.

These facilities will be staffed by a nurse practitioner employed by MinuteClinic with clinical back-up courtesy of a Cleveland Clinic-appointed medical director.

“We are pleased to be working with one of the leading medical institutions in the United States,” Chip Phillips, MinuteClinic’s president understated.

“We look forward to collaborating with Cleveland Clinic on a range of patient education and preventive services.”

Timed to precede the free-for-all that will surely follow the Big O’s decision to jump start EMR utilization in health care, the JCHAO has issued a safety alert regarding their implementation.

The so-called Sentinel Event Alert warns that health IT implementation projects must begin by scrutinizing existing care processes and “be mindful of the safety risks and preventable adverse events that (they) can create or perpetuate.”

“Technology-related adverse events…may involve errors of either commission or omission. They typically stem from human-machine interfaces or organization/system design (flaws),” according to JCAHO.

The commission pointed to the US Pharmacopeia database which reports that 25% of the nation’s 176,000 medication errors in 2006 involved computer technology as either the cause or a contributing factor.

Of these, mislabeled barcodes on medications, and unclear or confusing computer screen displays were the most common problems.

New health IT can also create inefficiencies or decrease documentation speed if not carefully planned and integrated into existing workflow processes, according to the Alert.

“You have to understand what the worker is going through – whether that worker is a nurse, a doctor, (or) a pharmacist,” Ronald Paulus commented to HealthcareITNews.

“The interplay between technology and humans often gets short shrift,” added the chief technology officer at Geisinger Health System who co-authored the Alert.

Physicians that use electronic medical records are less likely to pay out malpractice settlements, according to a study in the Archives of Internal Medicine

Anunta Virapongse and colleagues at Harvard Medical School surveyed a random sample of 1884 Massachusetts physicians to assess EMR utilization and obtained information about paid malpractice claims from the state’s Board of Registration in Medicine Web site.

The scientists found that 6.1% of physicians using an EMR had paid a malpractice claim, whereas 10.8% of those not using an EMR had done so. This difference was significant, but analyses including variables like gender, race, age and practice size diminished the difference. The resulting trend was not significant.

A subgroup analysis revealed that only 5.7% of frequent EMR users had paid malpractice claims, whereas 12.1% of infrequent users had done so. As above, the small sample sizes prevented the trend from achieving significance. The results therefore need to be validated before serving as a basis for policy formulation.

EMRs can reduce malpractice risk by improving follow-up of test results, reducing prescription errors and improving adherence to best practices. The exquisite documentation of care facilitated by EMRs can also help the defense in a malpractice case.
 
If these trends are confirmed, malpractice insurers could conceivably lower premiums for groups that adopt EMRs, an additional incentive to invest in the expensive systems.

GE Healthcare has been in a funk for awhile and John Dineen, its new chief executive has been looking to make a splash.

What better way than announce a 5-year, $200 million initiative to develop a national electronic health record system in conjunction with Mayo Clinic, Intermountain Healthcare, Montefiore and UCSF?

Company press releases tell us the system will help providers share medical records, improve the efficiency and quality of care and cut costs. Later iterations will facilitate evidence-based decision making and more informed patient decisions.

Good luck on that John, and we’ll check back in 5 years.

Meanwhile, 60% of GE Healthcare’s $17 billion annual revenue comes from diagnostic imaging which has been plagued by factory-production glitches and diminishing insurance payments, according to the Wall Street Journal.

As well, some customers complain GE’s machines are too complex and require too much training.

The imaging thing drove a 7% drop in GE Healthcare’s operating profit since January, 2007 and forced the unit to riff a few hundred employees last summer.

So why risk diverting attention from an ailing core business on a project that won’t contribute to the bottom line until the Big O is old enough to qualify for social security?

GE CEO Jeffrey Immelt figures ya’ gotta’ start somewhere and the field is too lucrative to pass up. “At the end of the day,” Immelt said in a press release, “Governments are going to spend money on things that drive productivity. Strategically, it’s a great place (to be) long term.”

The Cleveland Clinic is test driving HealthVault, Microsoft’s Web-based personal health record.

Officials representing the prestigious health care provider indicated that the pilot began November 3. It’s the first one to track multiple diseases using multiple home-based medical devices.

The pilot will enroll 400 patient volunteers that have various combinations of diabetes, hypertension and heart failure. The multitasking volunteers will utilize HealthVault-enabled heart rate and blood pressure monitors, glucometers, weight scales and maybe even their kitchen sinks to monitor daily fluctuations in their health status (no word yet on which kitchen sinks are HealthVault-enabled, by the way).

Using their computers, volunteers will upload all that data into their HealthVault record and share it in secure fashion with their physicians at the Clinic.

The Cleveland Clinic already offers patients a home-grown personal health record known as MyChart. It claims that 150,000 patients use MyChart. Comparisons of the two systems are not available, nor were statements regarding the marginal value of HealthVault in MyChart users, the two systems’ interoperability, pilot costs etc.

It also remained unclear how the pilot would be evaluated and by whom. Financial terms and strategic objectives of the Microsoft-Cleveland Clinic hook-up were not disclosed.

“These kinds of innovative solutions have the potential to help physicians and patients save time, improve accuracy of health information and communicate more effectively,” said Christopher Hebert, MD, of the Clinic’s Nephrology and Hypertension Department.

“We expect to demonstrate that innovative, cost-effective technology solutions can empower patients to partner more effectively with their physicians and better manage their chronic conditions from where they live and play – in the home,” said Peter Neupert, corporate vice president of Microsoft’s Health Solutions Group.

Last week, the Centers for Medicare and Medicaid Services announced an incentive plan for physicians and other prescription writers that should accelerate the adoption of e-prescribing, a technique believed to reduce medication errors and costs.

Providers will receive a 2% bonus on total Medicare charges during 2009 for using qualified e-prescribing systems. The incentive would be on top of the 2% bump received by physicians who provide data using the Physician Quality Reporting Initiative (PQRI), and the 1.1% fee schedule increase mandated by the Medicare Improvements for Patients and Providers Act of 2008.

To capture the bonus, providers must use e-prescribing systems that:
-Communicate electronically with the patient’s pharmacy,
-Remind physicians about cheaper alternatives (if available),
-Provide Medicare formulary information, and
-Alert prescribers about allergies, improper dosing and drug interactions.

“E-prescribing can greatly reduce the number of medication errors that jeopardize the health and safety of Medicare patients and waste precious healthcare dollars treating conditions that never should have happened,” said CMS Acting Administrator Kerry Weems.

The literature appears to back-up Mr. Weems’ claim. Scientists recently reviewed published studies regarding the effectiveness of computerized physician order entry systems. They found that 23 of the 25 studies of the matter concluded that the systems reduce medication errors or adverse events. In these studies, the relative risk of a medication error was reduced by an amount ranging between 13% and 99%.

US medical practices are not prepared for disasters such as hurricanes or bioterrorist attacks according to the results of a survey carried out by the Medical Group Management Association.

The MGMA Center for Research surveyed members enrolled in itsLegislative and Executive Advocacy Response Network during July, 2008 and published the findings at last week’s Annual Conference in San Diego.

84% of survey respondents said their practices had not participated in disaster planning exercises with government agencies during the last year, while 71% indicated they hadn’t participated in drills with nearby hospitals, and 62% said they hadn’t engaged in intramural exercises involving their own practice.

Nearly a third of respondents reported that their practice did not have a disaster plan in place.

Remarkably, 87% of the group believed there was a “moderate or strong” likelihood that a disaster will occur in their community during the next 5 years.

The US Department of Health and Human Services has set aside $1.1 billion to help hospitals, public health departments and other health care organizations develop and practice disaster plans, but according to MGMA almost none of this money has been allocated to medical practices.