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Next Generation ACO post-discharge home visit Medicare waiver Print E-mail
Written by   
Thursday, 14 December 2017 08:37

To lower readmission rates, the number of incident to billable visits will jump next year to nine in the first 90 from the current two in the first 30 days.
The new rules eliminate the time intervals between visits. If a patient requires more upfront attention, a post-discharge team can evaluate her or him three times in the first two weeks, and therefore reduce costs by preventing an avoidable readmission. 
Not all nine home visits may be needed and the first in-home assessment is the most critical. The doctor should send an experienced registered nurse, someone who has done either case management or social services and thus knows how to assess the patient physically, functionally and socially.
That professional will find out how much the patient can do on her or his own, whether a caretaker or family is there to assist, and whether certain measures are in place such as power of attorney and notification of next of kin. The nurse will also assess the patient’s condition, which will then dictate the next visits and follow-up office appointment.
Again, much depends on the initial assessment: What types of care would help the patient stay in the home? How much assistance does the individual need? How would the doctor be alerted to send a care team so the patient doesn’t need to call 911?
The answers can help the patient stay healthier and more independent, and could bring down the national 18 percent Medicare readmission rate.

Last Updated on Thursday, 14 December 2017 08:40
JAMA study: Double booking surgeries leads to negative outcomes Print E-mail
Written by FHI News   
Tuesday, 05 December 2017 18:51

Overlapping surgery, also known as double-booking, refers to a controversial practice in which a single attending surgeon supervises 2 or more operations, in different operating rooms, at the same time. Entitled Association of Overlapping Surgery With Increased Risk for Complications Following Hip Surgery, A Population-Based, Matched Cohort Study and published online December 4, 2017 by JAMA Intern Med., the authors found that for "patients undergoing overlapping procedures, there was an approximately 90% increase in the risk for surgical complications at 1 year."

Gastric Cancer Risk Doubled With Long-term PPI Use Print E-mail
Written by Megan Brooks | Medscape   
Wednesday, 01 November 2017 00:00
Use of a proton-pump inhibitor (PPI) after Helicobacter pylori eradication more than doubles the risk for gastric cancer, according to a population-based study from Hong Kong. The "clear dose-response and time-response" trend in PPI use and gastric cancer risk observed suggests the need for "caution when prescribing long-term PPIs to these patients even after successful eradication of H. pylori," write Wai Keung Leung, MBChB, MD, from Queen Mary Hospital, Hong Kong, and colleagues. The study was published online October 31 in Gut.
Case Study: Wrong Site Surgery Print E-mail
Written by Hall B. Whitworth, Jr., MD | Mutual Matters   
Monday, 09 October 2017 00:00

A 49-year-old man underwent a colonoscopy by a colorectal surgeon who identified a large, firm tumor causing partial narrowing, approximately 60-70 cm from the entry site. Pathology of this tumor was suspicious for carcinoma. In addition, a polypectomy was performed at a different location, and the site was tattooed. Pathology of this second site was consistent with tubulovillous adenoma.
Two weeks later, the same surgeon performed a partial colectomy of the tattooed area, believing it to be the marker for the tumor to be removed. On further consideration, after the procedure, the surgeon reviewed the colonoscopy and pathology reports and realized the wrong portion of the colon had been removed.

Last Updated on Tuesday, 10 October 2017 18:38
New STD Cases Hit Record High in U.S. Print E-mail
Written by FHI's Week in Review   
Monday, 02 October 2017 00:00

Sandee LaMotte reports for CNN on September 28, 2017:

In 2016, Americans were infected with more than 2 million new cases of gonorrhea, syphilis and chlamydia, the highest number of these sexually transmitted diseases ever reported, the Centers for Disease Control and Prevention said Tuesday.
"STDs are out of control with enormous health implications for Americans," said David Harvey, Executive Director of the National Coalition of STD Directors. The coalition represents state, local and territorial health departments who focus on preventing STDs. "If not treated, gonorrhea, chlamydia and syphilis can have serious consequences, such as infertility, neurological issues, and an increased risk for HIV," said Harvey.

Read more in the latest issue of Week in Review>>
Last Updated on Monday, 23 October 2017 11:37
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