CMS Releases Interpretive Guidelines Update for Hospital CoPs – October 17, 2008

Kathy Matzka, CPMSM, CPCS was kind enough to forward a link this week that I’ve been searching for with limited success.  In October, the Centers for Medicare and Medicaid Services (CMS) issued an update to their interpretive guidelines for the Hospital Conditions of Participation.  One would think that release would be well advertised and easy to find; not so.  

Since all hospitals in the United States that rely on government reimbursement are expected to live by these standards, it’s good to know what they are.  Thanks Kathy!

 2008 Interpretive Guidelines as they pertain to patient grievance requirements

Is Your Doctor Thinking of Quitting?

 “Our physicians are suffering from regulatory fatigue.”  So said an administrator at my hospital recently, and he’s right.  Healthcare regulations seem to be multiplying like bunnies, but unlike cute little bunnies, the penalties and fines attached to many of these regulations make them seem more like baby alligators.

In a sad commentary, CNN reports that one half of the nation’s primary care physicians would leave medicine within the next three years if they could find an alternative career.  

The survey was released this week by the Physicians’ Foundation. Of the 12,000 respondents, 49 percent said they’d consider leaving medicine. Many said they are overwhelmed with their practices, not because they have too many patients, but because there’s too much red tape generated from insurance companies and government agencies.

I work in an administrative healthcare field, and confess to being the (second hand) source of some of that red tape. Some of it I wield with absolutely no apology.  Do you need to be reminded to perform a 10 second “time-out” before making that first surgical incision?  Did you forget that you need to apply for hospital privileges before you treat patients in the hospital?  My colleagues and I will be right there, red tape and scissors in hand.  Work with us and the red tape can be snipped into short little pieces; work against us and it will just continue to unwind and snarl. 
That having been said, I have an inordinate amount of respect and sympathy for physicians, especially primary care docs.  In general they work very long hours, spend a great deal of time on-call, and don’t receive the respect they deserve from patients and patients’ families.  They also work in an environment that is often emotionally draining. I may not be able to do much to change that, but I can at least make sure that I personally treat the physicians with whom I work with the respect they’re due.  
We need them. I don’t want them to quit.

Cleveland Clinic and Microsoft HealthVault Partner for Home Health Monitoring

Earlier this year I wrote about the take-away message from the Estes Park Institute Conference I attended in Orlando.

The delivery of healthcare is beginning to decentralize.  Care that now requires a trip to the doctor’s office, (sometimes considerable) time in the waiting room, and a wait of hours (or days) for test results, will increasingly be available remotely or in the local (think Walmart clinic) community. 

The Cleveland Clinic, often a leader in healthcare technology innovation, announced this week that it is partnering with Microsoft HealthVault to pilot a home-based chronic condition management program.  Patients involved in the pilot will be able to  monitor high blood pressure, diabetes and heart failure at home. These patients will use high-tech devices, home computers and the Internet to keep Clinic doctors posted on their conditions. 

Doctors could rely on the information to adjust medications or order aggressive medical care without seeing patients for office visits. Early medical interventions could lead to healthier patient.

The Clinic and Microsoft are providing patients with digital blood pressure and heart rate monitors, as well as blood sugar meters, said Peter Neupert, vice president of Microsoft’s Health Solutions Group.

The monitors and meters can be plugged into computers, which upload information into HealthVault – the online service that enables users to collect, organize and share their health information.

The Clinic hopes to involve between 400 and 500 patients in the 90-day pilot project, which began Nov. 5th.

November 2-8, 2008 – National Medical Staff Services Awareness Week

The first week in November has been designated National Medical Staff Services Awareness Week.  The 1992 White House proclamation that established this annual observance opens with the words:   “The professionals who direct or manage medical staff services, from hospital communications to the accreditation of physicians and nurses, play an important role in our Nation’s health care system.” 
When Emily Berry, Associate Editor for HcPro’s Briefings on Credentialing contacted me recently to ask for a quote for an article she was working on for the November issue, I saw it as an opportunity to highlight the excellent work performed by Medical Staff Service Professionals around the country.    
“Having worked in both medical staff services and healthcare risk management, I remain exceedingly impressed with the depth of knowledge and commitment I see in the vast majority of MSPs. Most medical staff service professionals spend considerable time learning and applying both Joint Commission standards and CMS Conditions of Participation, and it is time well spent. They function as invaluable resources to organization and medical staff leadership and play a vital role in patient safety.”  
“In many organizations, they are the best, and sometimes only, resource for assuring that credentialing and privileging policies are developed in accordance with accreditation standards and carefully followed. Because of their diligent, thorough efforts, patients and providers are safer, and the workload of the department of risk management is diminished.”
So this week in particular, take a moment to recognize the work of NAMSS and the medical staff service professionals in your organization.  Happy Medical Staff Services Awareness Week.