Retaining Good Employees; Nonadherence Talks

July 22, 2013

Noteworthy items from Physicians Practice

62 - Percentage of U.S. physicians who receive their clinical results, such as lab tests, directly into their EHR system.

Source: Accenture's survey of 2,700 physicians in eight countries, conducted in late 2012

Foreign Docs

"IMGs play an integral part in American medicine, often joining physicians in practices serving patients in rural and low-income urban areas."

AMA President Jeremy Lazarus, in a statement on the reauthorization of the J-1 visa waiver program.

New Post

"So far, she has shown a willingness to work with members of both parties, which is a welcome development, particularly under this administration."

Republican Senator Orrin G. Hatch of Utah, on CMS Administrator Marilyn Tavenner's confirmation, as reported by The New York Times

Retaining Good Physicians

The latest Physician Retention Survey from Cejka Search and the American Medical Group Association reports that physician turnover has reached an all-time high, exceeding pre-recession levels. After spending months or years finding the right physician candidate for your practice, how can you make sure all that work doesn't go to waste? Keeping employees happy begins the moment they arrive at your practice. Your first call to action: Commit to weekly scheduled calls to discuss news or answer questions, suggests staffing expert Melissa Byington, in a piece for Practice Notes, Physicians Practice's blog. For more tips, see http://bit.ly/keep_newhires.

When to Bill

To capture the most revenue, you need to provide the best possible service and experience for patients so they keep coming back to your practice. But when should you bill them for their visit - so they stay happy? The answer depends on the type of patient you want to attract, writes practice management expert Audrey "Christie" McLaughlin, in a piece for Practice Notes, Physicians Practice's blog. For example, if your practice caters to busy soccer moms, offering electronic pre-payments might make sense. If your practice serves Medicare patients, asking for payment after the visit might make more sense. For more tips, see http://bit.ly/tailor-collections.

Nonadherence Talks

Do you talk to your patients who don't refill prescriptions about why they aren't adhering to their treatment plan? If so, they're more likely to have a positive clinical outcome, says a study based on 774 patients, which was published in the Annals of Internal Medicine. According to the study on "contextual factors," or circumstances behind patients' nonadherence, the outcome was positive in 71 percent of cases where docs addressed the reasons for nonadherence, Modern Physician reported. Alternately, only 46 percent of cases where red flags (such as repeated missed appointments or failure to refill a prescription) were present saw positive outcomes.

Removing HIPAA Obstacles

In an effort to curb gun violence, HHS in April issued a notice for advanced rulemaking to remove unnecessary legal barriers under HIPAA Privacy Rule that may prevent states from reporting mental health information to the National Instant Criminal Background Check System (NICS). The system is used to prevent felons with serious mental illnesses from buying guns. According to a 2012 Government Accountability Office report, 17 states had submitted fewer than 10 records of individuals prohibited for mental health reasons. The rule addresses one of 23 executive orders that President Obama issued on January 16 related to gun control following the tragedy in Newtown, Conn., Health Data Management noted.

Online Visits Save Costs

While virtual visits are relatively new, they're showing promise, says a report published in Health Affairs that tracked the savings of an online clinic. The Minnesota online-based clinic, called virtuwell, which launched in late 2012, has reported an average savings of $88 per episode of care compared with traditional in-person episodes. "The possibility of extrapolating such savings to larger volumes of cases is compelling," said authors. The news comes on the heels of a report by the London School of Economics - based on a study of 965 patients with heart failure, chronic obstructive pulmonary disease, and diabetes - that failed to show significant cost savings when patients monitored their symptoms via telehealth equipment at home.

Marijuana Use and Prescription Misuse

A recent study by Quest Diagnostics suggests that medical marijuana users are no more likely to misuse prescription drugs such as oxycodone than other patient populations. However, recreational marijuana users are more likely to misuse those drugs. The study, "Prescription Medication Misuse in America," based on an analysis of 227,402 de-identified urine lab-test results of patients on commonly abused prescription medications, shows that 37 percent of medical marijuana users (those taking prescribed cannabinoids as pharmaceutical preparations) misused other non-prescribed drugs, while nearly half of patients who used marijuana recreationally misused prescription medications. Study author Leland McClure, director of pain management and mass spectrometry operations for Quest, told Physicians Practice the report is evidence that doctors should screen for recreational marijuana use before prescribing medications.

Small-name EHRs Satisfy

Are solo physicians and small practice docs happier with small-name EHRs? Possibly so, if you believe the recent EHR satisfaction scores published by AmericanEHR and the ONC. EHR vendors with the fewest ambulatory providers attesting for meaningful use had higher satisfaction scores than larger corporations, EHR Intelligence reported. Rated on a scale of 1 to 5, relatively low-use products such as ChartMaker, Praxis EMR, and ABELMed scored 3.82 and above, while larger vendor Cerner scored 2.94 and Allscripts scored between 2.9 and 3.2, according to EHR Intelligence.

ADHD Med or Study Aid?

When college kids on Twitter think of Adderall, it's not just for treating ADHD. A new study by Brigham Young University researchers published in the Journal of Medical Internet Research found 213,633 tweets from 132,099 unique user accounts mentioning "Adderall." It also found that tweets peaked during college and university final exam periods, and 12.9 percent of tweets mentioned an alternative motive for taking the drug in the same tweet. "If people are having a conversation about this online, it creates a social norm that encourages the behavior," lead study author Carl Hanson, an associate professor at BYU, told Deseret News.

Patient Loyalty

After the Affordable Care Act takes hold, how loyal will your patients be? That's the question researchers for HealthPocket, a website that ranks and compares health plans, sought to answer when they asked 713 consumers if they would be willing to change physicians if it meant saving money on insurance premiums. The survey also asked how much money they would need to save annually to make that switch. Here's what results reveal, as noted by American Medical News:

• 34 percent of consumers said that keeping down out-of-pocket insurance costs was more important than retaining their doctor;

• 42 percent of consumers would not change their doctor for any amount of money;

• And 19 percent of consumers would swap their doctor to save $500 to $1,000 per year.