A new report from the federal Agency for Healthcare Research and Quality (AHRQ) assembles the results of 12 grant studies that, combined, show that effective use of health care IT can play a significant role in improving outcomes, increasing patient engagement, and lowering costs—particularly for patients moving to or from ambulatory care settings.
The report, titled "Findings and Lessons From the Improving Management of Individuals With Complex Healthcare Needs Through Health IT Grant Initiative" (.pdf) tracks the work of a dozen projects awarded AHRQ grants in 2007. The grant initiative is 1 in a 5-part series and a component of AHRQ's Ambulatory Safety and Quality Program, which AHRQ states was designed "to improve the safety and quality of ambulatory health care in the United States."
In the document, AHRQ discusses how grant research informs 5 major content areas: novel approaches to providing high-quality care, integration of patient information across transitions, shared decision making and patient-clinician communication, strategies for IT adoption, and the impact of health IT on outcomes. Almost all projects "demonstrated the potential of EHRs [electronic health records] and PHRs [personal health records] to effectively move evidence-based information to the point of care, including the transfer of structured information between clinical data systems," according to the report.
The projects themselves included the implementation of information exchange systems for ambulatory care providers treating patients in rural areas recently discharged from the hospital, the creation of computer-assisted telephone call systems to monitor patient self-care after discharge, and various care coordination projects aimed at using IT to better manage care of patients with multiple comorbidities. AHRQ characterized the results of the projects as "timely and relevant to better serve patients with complex health care needs."
APTA offers several resources on IT and EHRs, including a webpage devoted to the use of EHRs. The association describes the EHR as a system that "puts a complete medical record at providers' fingertips" and a resource that "can be used to help inform the clinician of trends in care delivery or various aspects of care" through access to evidence-based practice data.
The most recent meeting of the Medicare Payment Advisory Commission (MedPAC) touched on the need for reform of postacute care (PAC) payment systems, the role of accountable care organizations (ACO), and the advisability of taking a measured approach to advocating for the repeal of the sustainable growth rate (SGR) to avoid stalling current momentum in Congress.
APTA staff attended the 2-day meeting, which also included discussions on quality measures for self-care and mobility, and uniform pricing for similar services in PAC settings. The commission addressed both short- and long-term initiatives, and targeted topics for future meetings to address issues such as current approaches to improving primary care, rebalancing payment under the physician fee schedule, reforming payment for graduate medical education, and evaluation of the medical home model.
A significant portion of the meeting focused on the SGR and the status of congressional discussions around ending the flawed policy. The commission noted the progress being made, with Chairman Glenn Hackbarth recommending that MedPAC reiterate its previously shared positions and avoid adding recommendations that would slow progress. APTA is engaged in a grassroots effort to end both the SGR and the therapy cap and offers a Legislative Action Center for its members, as well as a Patient Action Center for consumer supporters. Details on the therapy cap and APTA’s grassroots campaign to end it are available at APTA's Advocacy webpage.
File under "hardly startling": Quick access to a physical therapist (PT) and availability of cutting-edge rehabilitation equipment are 2 of the biggest reasons why professional athletes seem to mend so much more quickly than their amateur counterparts, says a recent article in the Washington Post.
The story, which appears in the November 13 issue of the Post, looks at the attention given to pro athletes' injuries within seconds of an incident, compared with amateurs who take a wait-and-see approach or who have trouble locating an appropriate provider quickly. Reporter Laura Hambleton writes that "for many pros, it is the hours of intensive daily attention from highly experienced physical therapists, along with specialized rehabilitation equipment and exercises, that make their rehab and yours quite different."
Hambleton's story quotes APTA members Jason Craig, PT, DPhil, MCSP, and Kala Flagg, PT, 2 Washington, DC-area PTs who have worked with elite-level athletes. Craig described how waiting for treatment can make an injury worse, while Flagg pointed out that in addition to the availability of services and level of personal investment in home therapeutic equipment, professional athletes are constantly training their bodies to prevent injury in the first place.
The issue of the Post that featured the pro athlete story also contained a report on muscle imbalance that includes quotes from Robert Gillanders, PT, DPT, OCS, who describes the tendency of people to do "exercises they like, rather than exercises they need." This kind of lopsided exercise can lead to muscle imbalances that can cause ongoing pain and discomfort.
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