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Physician productivity

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https://read.qxmd.com/read/30763040/are-value-based-incentives-driving-behavior-change-to-improve-value
#1
Cheryl L Damberg, Marissa Silverman, Lane Burgette, Mary E Vaiana, M Susan Ridgely
OBJECTIVES: To understand physician organization (PO) responses to financial incentives for quality and total cost of care among POs that were exposed to a statewide multipayer value-based payment (VBP) program, and to identify challenges that POs face in advancing the goals of VBP. STUDY DESIGN: Semistructured qualitative interviews and survey. METHODS: We drew a stratified random sample of 40 multispecialty California POs (25% of the POs that were eligible for incentives)...
February 1, 2019: American Journal of Managed Care
https://read.qxmd.com/read/30758518/fall-risk-increasing-adverse-reactions-is-there-value-in-easily-accessible-drug-information-a-case-control-study
#2
Susanne Schiek, Katja Hildebrandt, Olaf Zube, Thilo Bertsche
PURPOSE: The individual fall risk of a patient is often multifactorial. Polymedication contributes to an additional risk of fall-risk-increasing adverse reactions (FRIARs). Previous studies have not sufficiently investigated the complexity facing prescribers when balancing the therapeutic benefits of individual drugs against their potential fall risk. METHODS: An expert panel identified drugs with FRIARs based on the Summary of Product Characteristics (SmPC). These FRIARs and other parameters (such as the total number of drugs, dosage, dose adjustments, and drug changes) were then analyzed for their impact on falls in a case-control study using logistic regression...
February 13, 2019: European Journal of Clinical Pharmacology
https://read.qxmd.com/read/30753806/-schizophrenia-what-non-psychiatrist-physicians-need-to-know
#3
REVIEW
Tiago Queirós, Filipa Coelho, Ludgero Linhares, Diogo Telles-Correia
Schizophrenia is a disabling and severe mental illness that affects all social classes and racial and ethnic groups, spreading across every part of the world. It's more frequent in males and it usually manifests itself in late adolescence or early adulthood and its early detection by all clinicians is important so that there is a proper referral to specialized psychiatric care. This article intends to update the knowledge regarding the diagnosis, treatment and prognosis of schizophrenia, with an emphasis on the warning signs for a timely referral to psychiatric evaluation...
February 1, 2019: Acta Médica Portuguesa
https://read.qxmd.com/read/30753748/a-commentary-on-impact-of-women-focused-professional-organization-and-academic-retention-and-advancement-perceptions-from-a-qualitative-study
#4
Kinjal N Sethuraman, Michelle D Lall Md, Susan H Watts, Kathleen J Clem
Despite the steady increase in female medical students and female faculty in the US, there has been little change in the distribution of women across the ranks of assistant, associate, and full professor over the past 30 years.1,2,3 Women are substantially less likely than men to be full professors even after accounting for age, experience, specialty, and measures of research and clinical productivity.4,5 From 2009 to 2017, the percentage of female faculty in emergency medicine dropped from 3% to 1.8%, while it stayed relatively stable for men (9% to 8...
February 12, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://read.qxmd.com/read/30753510/adalimumab-effectiveness-up-to-six-years-in-adalimumab-na%C3%A3-ve-patients-with-crohn-s-disease-results-of-the-pyramid-registry
#5
Edward V Loftus, Walter Reinisch, Remo Panaccione, Sofie Berg, Gabriela Alperovich, Mareike Bereswill, Jasmina Kalabic, Joel Petersson, Roopal Thakkar, Anne M Robinson, Geert D'Haens
Background: PYRAMID was an international multicenter, noninterventional, postmarketing registry assessing long-term safety and effectiveness of adalimumab (Humira), as used in routine clinical practice. Methods: Adult patients with moderately to severely active Crohn's disease with or without prior adalimumab experience were enrolled in the registry and followed for up to 6 years. Effectiveness measurements included the Physician's Global Assessment (PGA, a composite of Harvey Bradshaw Index [HBI] and rectal bleeding score), clinical remission (HBI < 5), Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and Work Productivity and Activity Impairment (WPAI) questionnaire...
February 8, 2019: Inflammatory Bowel Diseases
https://read.qxmd.com/read/30747805/demonstrating-advanced-practice-provider-value-implementing-a-new-advanced-practice-provider-billing-algorithm
#6
Paula B Brooks, Megan E Fulton
BACKGROUND: Rapid changes in health care are driving the adjustment of work flow by which providers serve patients in team-based care. Specifically, there is a need to develop more effective and efficient utilization with accurate attribution of advanced practice providers' (APPs) productivity. LOCAL PROBLEM: The Directors of the APP-Best Practice Center conducted assessments of each clinical area at MUSC Health, a large academic medical center. A knowledge gap was identified, not only regarding billing practices of the APPs (nurse practitioners/physician assistants) but also in the utilization of APPs to practice to the fullest extent of their license, education, and experience...
February 2019: Journal of the American Association of Nurse Practitioners
https://read.qxmd.com/read/30744992/measuring-individual-physician-clinical-productivity-in-an-era-of-consolidated-group-practices
#7
Neel M Butala, Michael K Hidrue, Arthur J Swersey, Jagmeet P Singh, Jeffrey B Weilburg, Timothy G Ferris, Katrina A Armstrong, Jason H Wasfy
BACKGROUND: As physician groups consolidate and value-based payment replaces traditional fee-for-service systems, physician practices have greater need to accurately measure individual physician clinical productivity within team-based systems. We compared methodologies to measure individual physician outpatient clinical productivity after adjustment for shared practice resources. METHODS: For cardiologists at our hospital between January 2015 and June 2016, we assessed productivity by examining completed patient visits per clinical session per week...
February 7, 2019: Healthcare
https://read.qxmd.com/read/30741215/electronic-physician-profiles-developing-an-interactive-web-based-report-for-physicians-at-island-health
#8
Lisa M McEwen, Jay C O'Donnell, Laura Lifoawing, David Matias, Brandon Wagar
Evidence based measurement is accepted as an important aspect of quality improvement. Making this data available to physicians to support them in quality improvement and to inform their practice presents a broad range of challenges. Addressing these challenges requires a solution that allows physicians to leverage the data repositories in the Enterprise Data Warehouse to develop and use evidence based clinical measures using an interactive, user-friendly, and secure infrastructure. In this talk, we discuss key aspects of the development of an interactive web-based report for physicians at Island Health, and present the final product...
2019: Studies in Health Technology and Informatics
https://read.qxmd.com/read/30740403/organic-acid-disorders
#9
REVIEW
Jessica Ramsay, Jacob Morton, Marie Norris, Shibani Kanungo
Organic acids (OAs) are intermediary products of several amino acid catabolism or degradation via multiple biochemical pathways for energy production. Vitamins or co-factors are often quintessential elements in such degradation pathways and OA metabolism. OAs that result from enzyme defects in these pathways can be identified in body fluids utilizing gas chromatography-mass spectrometry techniques (GC/MS). OAs are silent contributor to acid base imbalance and can affect nitrogen balance and recycling. Since OA production occurs in distal steps of a specific amino acid catabolism, offending amino acid accumulation is not characteristic...
December 2018: Annals of Translational Medicine
https://read.qxmd.com/read/30740211/stepwise-approach-towards-adoption-of-allergen-immunotherapy-for-allergic-rhinitis-and-asthma-patients-in-daily-practice-in-belgium-a-belsaci-abeforcal-euforea-statement
#10
REVIEW
P W Hellings, B Pugin, G Mariën, C Bachert, C Breynaert, D M Bullens, J L Ceuppens, G Clement, T Cox, D Ebo, P Gevaert, S Halewyck, V Hox, K Ladha, R Jacobs, P Rombaux, R Schrijvers, K Speleman, X Van der Brempt, L Van Gerven, O Vanderveken, B Verhaeghe, K Vierstraete, S Vlaminck, J-B Watelet, J Bousquet, S F Seys
Allergic rhinitis (AR) affects 23-30% of the European population with equal prevalence reported in Belgium. Despite guidelines on the correct use of effective treatment, up to 40% of AR patients remain uncontrolled. Allergen immunotherapy (AIT) has been shown to improve the level of control up to 84% of patients being controlled by AIT. Recently, new guidelines for AIT have been published, supporting the clinical evidence for effectiveness of various subcutaneous and sublingual products for AIT in patients who are allergic to airborne allergens...
2019: Clinical and Translational Allergy
https://read.qxmd.com/read/30738605/translation-to-practice-accelerating-the-cycle-of-innovation-to-impact
#11
REVIEW
Jeff R Anderson, Thomas D Y Chung, Leon Clark, Jennifer A Weis, Andrew J Danielsen, Sundeep Khosla, Gregory J Gores, Andrew D Badley
The Office of Translation to Practice (OTP) is housed in the Center for Clinical and Translational Sciences at Mayo Clinic. Established in 2015, the office was tasked with developing and managing novel tools, mechanisms, and processes to facilitate and accelerate the translation of products, such as drugs, biological agents, and medical devices, into practice. Since its inception, the OTP is credited with creating valuable services through several strategic alliances and active scientific and project management involvement...
February 6, 2019: Mayo Clinic Proceedings
https://read.qxmd.com/read/30736040/collaborating-to-achieve-the-optimal-family-medicine-workforce
#12
Christina Kelly, Anastasia J Coutinho, Constance Goldgar, Wanda Gonsalves, Cal Gutkin, Rick Kellerman, Gerald Fetter, Mike Tuggy, Viviana Martinez-Bianchi, Judith Pauwels, B Tate Hinkle, Natasha Bhuyan, KrisEmily McCrory, Michelle A Roett, John Snellings, Kim Yu, Ashley Bentley
When the Family Medicine for America's Health (FMAHealth) Workforce Education and Development Tactic Team (WEDTT) began its work in December 2014, one of its charges from the FMAHealth Board was to increase family physician production to achieve the diverse primary care workforce the United States needs. The WEDTT created a multilevel interfunctional team to work on this priority initiative that included a focus on student, resident, and early-career physician involvement and leadership development. One major outcome was the adoption of a shared aim, known as 25 x 2030...
February 2019: Family Medicine
https://read.qxmd.com/read/30725027/-the-isenheim-altarpiece-religion-art-and-medicine
#13
Felipe C Cabello
Northern Europe at the beginning of the 16th Century was in turmoil as a result of religious and political dissention, epidemics of plague, syphilis, ergotism, and famine, and the threat of the Ottoman Empire. In Alsace, a fulcrum between Germany, France, Switzerland and the Netherlands, Grünewald painted his celebrated and complex altarpiece at Isenheim in a convent chapel of the Antonine religious order that kept a hospital for the care of patients suffering from ergotism, plague, syphilis and other illnesses...
September 2018: Revista Médica de Chile
https://read.qxmd.com/read/30719594/unmet-needs-in-psoriatic-arthritis-patients-receiving-immunomodulatory-therapy-results-from-a-large-multinational-real-world-study
#14
Rieke Alten, P G Conaghan, V Strand, E Sullivan, S Blackburn, H Tian, K Gandhi, S M Jugl, A Deodhar
OBJECTIVE: There are limited data on therapy selection and switching in psoriatic arthritis (PsA). This 18 country, real-world study assessed use and switching of immunomodulatory therapy (biologic/apremilast), the extent of treatment failure and its association with reduced physical functioning, health-related quality of life (HRQoL), and work productivity and activity impairment (WPAI). METHODS: PsA patients under routine care and their treating physicians provided demographics, current therapy, reasons for switching, duration of first therapy, HRQoL, HAQ-DI, and WPAI...
February 4, 2019: Clinical Rheumatology
https://read.qxmd.com/read/30719461/features-and-results-of-conducted-studies-using-a-lean-management-approach-in-emergency-department-in-hospital-a-systematic-review
#15
REVIEW
Haleh Mousavi Isfahani, Sogand Tourani, Hesam Seyedin
Objective: To perform a systematic review of the properties and results of the studies that their approaches are lean management in emergency departments and the factors which influence on their performance. Method: The necessary information in the first stage was collected by searching these keywords: "Lean principles" "Lean Six Sigma", "Lean Process", "Lean thinking", "Lean Methodology", "Toyota Production System lean processing", "lean techniques", "emergency department", "emergency medicine", "emergency room" and "emergency care " ...
January 2019: Bulletin of Emergency and Trauma
https://read.qxmd.com/read/30717313/negative-behaviors-among-healthcare-professionals-relationship-with-patient-safety-culture
#16
Diana M Layne, Lynne S Nemeth, Martina Mueller, Mary Martin
Behaviors that undermine a culture of safety within hospitals threaten overall wellbeing of healthcare workers as well as patient outcomes. Existing evidence suggests negative behaviors adversely influence patient outcomes, employee satisfaction, retention, productivity, absenteeism, and employee engagement. Our objective was to examine the presence of negative behaviors within a healthcare system and the influence of negative behaviors among healthcare workers on perceptions of patient safety culture. Using a cross-sectional design, the negative behaviors in healthcare survey (NBHC) and selected composites of the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture (HSOPS) were combined within an electronic survey which was administered to physicians, clinical and managerial staff...
February 1, 2019: Healthcare (Basel, Switzerland)
https://read.qxmd.com/read/30717015/french-and-mediterranean-style-diets-contradictions-misconceptions-and-scientific-facts-a-review
#17
REVIEW
Thulile Ndlovu, Francois van Jaarsveld, Oluwafemi J Caleb
The determination of appropriate dietary strategies for the prevention of chronic degenerative diseases, cancer, diabetes, and cardiovascular diseases remains a challenging and highly relevant issue worldwide. Epidemiological dietary interventions have been studied for decades with contrasting impacts on human health. Moreover, research scientists and physicians have long debated diets encouraging alcohol intake, such as the Mediterranean and French-style diets, with regard to their impact on human health. Understanding the effects of these diets may help to improve in the treatment and prevention of diseases...
February 2019: Food Research International
https://read.qxmd.com/read/30713397/evaluation-of-radiation-exposure-on-physicians-during-angioplasty-for-hemodialysis-access-dysfunction
#18
Po-Sen Huang, Zhih-Cherng Chen, Kuo-Ting Tang, Wei-Ting Chang
Background: Percutaneous interventions help patients with various cardiovascular diseases, however radiation exposure is a safety concern for both patients and health care providers. We previously reported that dose area product (DAP) is apparently different in central body and upper-limb areas during percutaneous transluminal angioplasty for arteriovenous shunt dysfunction. In this study, we investigated the precise radiation dose at the patients' back and at the non-targeted organs of the operators...
January 2019: Acta Cardiologica Sinica
https://read.qxmd.com/read/30712722/evolution-of-homeopathy-a-scientometric-analysis-of-global-homeopathy-literature-between-1975-and-2017
#19
Engin Şenel
OBJECTIVE: Scientometrics is the evaluation of scientific literature in a certain field. Although popularity and use of homeopathy have increased in the recent years, scientific literature lacks a bibliometric or scientometric evaluation of homeopathy literature. METHODS: We collected all data of this study from four databases provided by Web of Science. All documents published between 1975 and 2017 were included. The keywords we searched for in detail were "homeopathy", "homeopathic", "homoeopathy" and "homoeopathic"...
February 2019: Complementary Therapies in Clinical Practice
https://read.qxmd.com/read/30709973/novel-drugs-of-abuse
#20
George Sam Wang, Christopher Hoyte
Novel drugs of abuse are synthetic illicit drugs, or analogues of known illicit drugs, that can be more potent. Novel drugs of abuse are often labeled as designer drugs, research chemicals, legal highs, or psychoactive substances. They are often sold as designated legal or nondrug products, such as incense, plant food, or bath salts, with labeling such as "Not for Human Consumption" or "For Use in Research Only." The prevalence of use of novel drugs of abuse is difficult to determine because specific drugs, compounds, and availability of these drugs are constantly evolving...
February 2019: Pediatrics in Review
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