It’s a critical time for healthcare leaders as they face new challenges from the COVID-19 pandemic and continued declining reimbursements. In a recent Modern Healthcare article, ECRI’s Executive VP and COO, Tony Montagnolo, was featured alongside other industry leaders on the topic of COVID-19 and the market pressures thought to be reshaping procurement. Here’s what he shared with Modern Healthcare on his vision and strategies for reaching value-based care goals and wisely preparing your health care system for the future.
A Continuing Inside Look into the Partnership Workgroup on Optimizing Health IT for Safe Integration of Behavioral Health and Primary Care
"Integration" of behavioral health and primary care is a promising approach to enhancing care, enabling patient safety and improving quality. Technology-enabled tools, including electronic health records (EHRs), clinical decision support, and standards-based interoperability, can enable integration to achieve these goals.
Tightly woven into ECRI’s DNA is the imperative to speak truth to power, based on facts and evidence. The facts are that for centuries in the United States, racism has caused historic and acute trauma and untold pain, suffering, and justified anger.
The senseless death of George Floyd in Minneapolis this past May has reignited a worldwide movement against racism, inequality, and inequity. This movement speaks volumes, as people from many nations raise their voices in unison and move to take action against racism.
Topics: Diversity and Inclusion
When technology entered healthcare, so too did alerts. Alerts acted as attention grabbers, reminders, notices of changes in a patient's condition, and warnings about malfunctions or improper functioning. As technology grew more prevalent with the advent of automated dispensing cabinets, computerized provider order entry (CPOE), digital point-of-care monitors and devices, and electronic health records (EHRs), the number of alerts grew exponentially. Clinicians were exposed not only to their own patients' alerts, but to all of the alerts or alarms sounding within a particular unit. The number of per-patient alerts can be astounding. One facility determined that in its critical care unit, "between 150 to 400 physiologic monitoring alarms" sounded per patient, per day.1 This cacophony is compounded by alerts triggered by electronic records.
An Inside Look into the Current Partnership Workgroup
COVID-19 anxiety is increasingly part of our everyday lives. The resulting disruptions in daily routines can create or worsen anxiety and raise other mental and behavioral health concerns. In the best of times, behavioral health conditions are often underdiagnosed and undertreated. According to Jetelina et al., every year "26% of the United States population experiences an emotional, mental, or behavioral health problem."1 In addition to the current events triggering these conditions, behavioral health issues can also be associated with chronic medical conditions such as diabetes,2 cardiovascular disease, and substance use disorder (SUD).3
Infection prevention is of vital concern right now, and reducing disease transmission between healthcare workers (HCWs) and patients is critical for patient safety.
One source of danger to patient safety is infection from healthcare workers who wear artificial nails or nail polish.
Appropriate policies are required to help mitigate infection risk in hospitals and other healthcare settings. HAIs are a concern not only in hospitals; infections can be acquired in any healthcare setting (e.g. physicians’ offices, clinics, dialysis facilities, nursing homes, and rehabilitation centers) when patients encounter bacteria, fungi, or viruses while receiving treatment for unrelated conditions.
The seeds of an adverse drug interaction can be planted at any point in the care process, by any of the individuals involved. For instance, take a look at these common scenarios:
- A clinician, overwhelmed by meaningless alerts, overrides a warning and misses crucial information about a patient's drug allergy.
- A physician office's electronic health record (EHR) system enters the correct drug allergy information, but the pharmacist is unaware of the information.
- A young adult patient is allergic to an antibiotic, but doesn't know exactly what happened when he took the antibiotic as a child and he doesn't mention it when being treated for pneumonia.
The chances that any one of these situations may occur is increasing.
Decisions made and actions taken in the first minutes and hours after an incident occurs in an aging services organization set the stage for everything else that follows. For instance, consider this hypothetical scenario:
A resident falls out of a lift, breaking a hip, but it is unclear what caused the fall. The lift is briefly checked by the staff involved, and they see nothing wrong, so the lift is not removed from service while the incident is investigated further. The next day, another resident falls from the same lift in a similar manner.
Ethylene oxide (EtO) sterilization has been in the news a lot lately, and healthcare has much at stake. According to officials at the U.S. Food and Drug Administration (FDA), approximately 56% of all critical medical devices are sterilized using industrial EtO sterilization. Currently, there are no validated industrial alternatives, so additional closures of EtO processing facilities would have the potential to impair the U.S. healthcare system.
While some state legislators are considering bans on industrial EtO sterilization facilities, healthcare leaders, manufacturers, and FDA have been reviewing options to ensure the availability of sterile medical devices and supplies necessary for patient care.
In the United States, there are 30 times more outpatient visits as hospital discharges. As a result of the high volumes and complexities inherent to ambulatory settings, one in twenty patients can expect to experience a diagnostic error in their lifetime. According to the Agency for Healthcare Research and Quality, 55 percent of patients said that diagnostic errors were a chief concern to them.
Earlier this fall, ECRI Institute Patient Safety Organization took an in-depth look at patient safety events in ambulatory care, specifically physician practices and healthcare clinics. Nearly half of the 4,355 analyzed events were related to diagnostic testing. Errors that occur during diagnostic testing can have potentially devastating consequences for patients. The majority of these events occurred after tests had taken place, often due to a gap in communication.