• News New Blog Banner

  • Blum Resigns From CMS

    Jonathan Blum, principal deputy administrator for the US Center for Medicare and Medicaid Services (CMS), has resigned his position effective May 16, according to an alert from Modern Healthcare (access via free signup).

    Blum was the Obama administration's first appointee to CMS, and he led the development of regulations for accountable care organizations (ACOs) as well as "developing many … value-based payment strategies," according to an e-mail from CMS Administrator Mary Tavenner announcing Blum's resignation. Most recently, Blum oversaw the release of extensive Medicare payment data for 880,000 health care providers.

    At the time of this writing, details behind Blum's resignation were not available. In her e-mail Tavenner cited "new opportunities" as the reason for his departure.

    Tablets: The Future of Care Coordination in Home Health?

    It may not be a 1-size-fits-all solution, but least 1 fairly large home health care agency thinks it may have hit upon the technology that can best coordinate care, reduce costs, and minimize privacy concerns: the 7-inch mobile tablet.

    A recently published case study (.pdf) from the College of Healthcare Information Management Executives (CHiME) tells the story of Sutter Health at Home, a division of Northern California-based Sutter Health. With a program that employs about 1,300 caregivers who make home visits to nearly 100,000 patients across 23 counties, Sutter was on the lookout for technologies that could improve coordination of care and reduce costs.

    After experimenting with individual laptops (too big, too hard to learn, glitchy) and smartphones (too small, limited computing and document-handling capabilities, spotty connections), Sutter switched to 7-inch Android-based devices. The devices themselves are the same tablets commonly available to consumers, but these are equipped with electronic health records (EHR) software specially made for Sutter Health at Home. Caregivers are also supplied with a bluetooth-enabled keyboard and a stylus.

    According to the case study, the use of tablets dramatically reduced turnaround for patient documentation from 72 to 24 hours. "In the past, if 1 of the clinicians went to see the patient on Monday and the physical therapist would go on Tuesday, the therapist would not have the information about the Monday visit available," said the program's project manager. "This is better from a productivity perspective and better for the patient." Sutter Health at Home also estimates that it has reduced costs in a number of areas, including supply ordering, which is now done directly through the tablet rather than by calling a medical supply vendor.

    The home health agency is also pleased with improvements to privacy safeguards. Built-in cameras allow clinicians to send photos quickly and securely—an improvement over past practice of taking pictures with a separate digital camera (that could be lost) and uploading the photos later (a time-consuming process). Another significant benefit: greater IT control over security and the ability to remotely wipe a device clean if it is lost or stolen.

    The case study reports that the switch to tablets is not without challenges. Sutter Health at Home invests heavily in training, requiring 18 hours of education on the tablet for any new user. And while the fact that Sutter is using easily available devices makes purchasing easier, it also means that the devices are subject to the same kind of forced obsolescence that can frustrate individual consumers. The platform has also required the agency's IT department to relinquish control of when patches and updates are installed—for tablets a process typically managed by the communications carriers.

    APTA offers a variety of resources on home health and physical therapy, including a free video on the role of home health physical therapy in the continuum of care, and a webpage devoted to payment, coding, and billing for home health patients in the Medicare system. The association also offers resources on electronic health records at its EHR webpage.  

    Interprofessionalism: Jargon vs Practice

    Peruse articles on the future of health care, and you're likely to read plenty of references to "interprofessionalism" and how it will become central to effective delivery.

    But have we agreed on what the word means? And if we can manage to agree on a definition, do we know how to apply it to real-world situations?

    Panelists at this year's Rothstein Roundtable at the APTA NEXT Conference and Exposition will investigate some of the current thinking around interprofessionalism and its implementation in physical therapy in a session titled "Interprofessionalism: Is It Campfire Kumbaya, or the Means to the Triple Aim (Better Health, Better Care, Lower Cost)?" The conversation will focus on successful interprofessional models and how they might be generalized into physical therapist practice, and will address how interprofessionalism can be infused in education.

    The session will be held from 3:00pm – 4:30 pm Friday, June 13 as part of NEXT activities in Charlotte, North Carolina. Moderator is Anthony Delitto, PT, PhD, FAPTA, with panelists Aaron Friedman, MD, Mary Knab, PT, DPT, PhD, and Holly Wise, PT.

    NEXT evolved from the meeting formerly known as the Annual Conference and Exhibition. Though the focus and tone of NEXT will be on what's ahead for the profession, the event will also feature many of the popular elements of past annual conferences including the McMillan and Maley lectures and the Oxford Debate. As with past annual conferences, NEXT will occur immediately after APTA's House of Delegates. Registration and housing information can be found on the NEXT webpage along with a schedule of presentations and preconference sessions.