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Featuring hospital and health care headlines from the media and the Web.

Iowa News

Grinnell hospital using robot to clean patient rooms
An Iowa hospital is using a robot to clean and decontaminate patient rooms. Grinnell Regional Medical Center is one of the first in Iowa to use the robot. It’s designed as a preventive measure to fight hospital-acquired infections and superbugs that are antibiotic resistant. The robots are becoming more sought after due to the recent Ebola scare. The hospital first started using the Bioquell robot in early 2014 in all patient rooms throughout the hospital. (KCCI)

Oskaloosa hospital recognized by Iowa Donor Network with tissue donation
Mahaska Health Partnership was recognized by the Iowa Donor Network for achieving a greater than 60 percent conversion rate for tissue donation over the last two years. “Once a deceased person is deemed eligible for donation, a House Supervisor talks with the family about end-of-life decisions and sets the stage for a discussion regarding donation,” explained Nursing Support Director Joy Patch. “The IDN then calls the family for additional information and finalizes any arrangements. Of those families called, we have had over 60 percent decide to donate their loved one’s tissue to the IDN.” (Oskaloosa News)

National News

10 ways to boost patient satisfaction
Joan Hablutzel, senior industry analyst with the Medical Group Management Association, told attendees at their annual conference Monday that increasing patient satisfaction was challenging, but necessary to the success of a medical practice in an increasingly competitive healthcare marketplace. “Identify low patient satisfaction scores and work as a team to design, implement and maintain solutions,” she said. “But focus on the patients, not the scores.” (Healthcare Finance News)

Gawande: why the health system should stop trying to help everyone live longer
Atul Gawande’s current best-seller, Being Mortal, has touched a nerve regarding our medical system’s very poor handling of aging, life-altering illnesses, hospice, and palliative care. The book raises the question of why the U.S. health system prizes the length of a patient’s life over the quality of that life in a person’s final years. (Washington Post)

Lack of understanding about insurance could lead to poor choices
They know less than they think they know. That’s the finding of a recent study that evaluated people’s confidence about choosing and using health insurance compared with their actual knowledge and skills. As people shop for health coverage this fall, the gap between perception and reality could lead them to choose plans that don’t meet their needs, the researchers suggest. (Kaiser Health News)

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

Iowa doctor discusses Ebola quarantine
Quarantines aren’t used very often, but it’s a practice that all health care professional must learn about. Dr. Allen Zagoren of Drake University and UnityPoint Health discusses Ebola fears and the use of quarantines to control the spread of illness. (WHO-TV)

Getting large employers ready for the Affordable Care Act
Starting January 1, 2015 large employers will be required to provide health insurance to their full-time employees, or pay a penalty. This Wednesday and Thursday the Iowa Insurance Division is hosting a free training conference for employers and stakeholders on the changes coming up in the 2015 Affordable Care Act. (WHO-TV)

New Genesis HealthPlex offers patients a ‘medical home’
Genesis Medical Center is opening its second healthplex, a $15 million, 43,140-square-foot complex in Bettendorf, with a full-service lab, space for 17 family medical providers, an imaging center and Convenient Care for drop-in urgent care. Imaging services to be offered include MRI, CT, ultrasound, bone density testing, digital mammography and general X-ray. During a tour of the building Wednesday, Dr. Kurt Andersen, a partner in the physician practice, described the healthplex as a “medical home.” (Quad Cities Online)

New ER planned at Methodist, Blank Children’s
UnityPoint Health – Des Moines is planning to start construction next week on new emergency departments at Iowa Methodist Medical Center and Blank Children’s Hospital. UnityPoint said the new ERs are part of $54.7 million in renovations at the hospital that also includes critical care and cardiac units. Work on the new critical care unit started in May and in September the cardiac are renovations began. (KCCI)

National News

New health care payment model lowering costs
A first-of-its kind health plan that rewards doctors for keeping patients healthy, rather than just doing expensive procedures, lowered health care spending and improved the quality of patient care for the fourth straight year, according to a new study. The analysis by researchers at Harvard Medical School and published in the New England Journal of Medicine shows spending for patients in Blue Cross Blue Shield of Massachusetts’ Alternative Quality Contract grew 10 percent slower than for patients in traditional plans. (Boston Globe)

Ebola and the need for personal protective equipment
Preventing transmission of pathogens in the health care setting with the use of personal protective equipment (PPE) has been an area of longstanding debate in the infection prevention community. Recently, reports of nosocomial transmission of Ebola virus to two nurses from the same patient in Texas (despite their use of PPE) has generated great concern and presents new challenges. (Journal of the American Medical Association)

Bellevue employees face Ebola at work, and stigma of it everywhere
“Again, the medical personnel fighting this fight, particularly our nurses, deserve our respect,” New York Mayor Bill de Blasio said. “We heard reports in the last few days of nurses being mistreated in our city — when it became clear that they worked at Bellevue — being treated differently. We heard reports of people being unwilling to serve them food or treating their children differently. That is absolutely unacceptable.”

Rural hospitals’ success under ACA marred by delays, Supreme Court ruling
In the aftermath of the Affordable Care Act’s passage, some stakeholders expressed concern that rural hospitals would struggle to meet the law’s requirements and would be forced to shut down or merge with larger health systems. However, nearly four years later, the jury is still out on how rural hospitals have been affected by the law. (California Healthline)

Blue Zones comes back to Albert Lea
This community played a critical role in demonstrating that these concepts can be translated into tangible well-being improvement, and the work from the pilot here was also instrumental in developing a program and tools that have been implemented across the country including in California’s Beach Cities, 15 Iowa communities, Fort Worth, Texas and Hawaii. (Albert Lea Tribune)

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

UIHC: fine-tuning Ebola protocols since September
Infectious disease experts at the University of Iowa Hospitals and Clinics said Tuesday that they’ve been honing procedures, training and retraining staff, and feel “very well prepared” should an Ebola patient require treatment at the facility. Over the summer, the hospital began actively preparing for the possibility that a deadly Ebola virus crippling West Africa could travel to the United States. But once the first U.S. case was diagnosed in Dallas in September, UIHC has fine-tuned its plans, officials said Tuesday. (KCRG)

Iowa health officials say flu activity low so far this season
Surveillance by the Iowa Department of Public Health (IDPH) Iowa Influenza Surveillance Network shows while flu activity in the state is slowly increasing and remains low, there already are two strains of the virus circulating. “This is the perfect time to get your flu vaccination,” said IDPH Medical Director, Dr. Patricia Quinlisk. “Identification of two circulating strains by the State Hygienic Lab means that without a flu vaccination, an individual could become ill with the flu two different times.” (KWWL)

New emergency departments for Des Moines hospitals
UnityPoint Health – Des Moines announced it will begin construction next week on new emergency departments for Iowa Methodist Medical Center and Blank Children’s Hospital. The latest piece of a $54.7 million project that includes renovations to the hospitals’ critical care unit and cardiac care spaces, the new emergency departments will “address the key challenges faced by the current facility,” said Jennifer Perry, regional marketing director of UnityPoint. (Des Moines Business Record)

Iowa boy’s strange illness sparks debate
The plight of one sick boy in Iowa has inspired an outpouring of sympathy and advice from around the globe. My column in the Sunday Register chronicled how 12-year-old Landon Jones of Cedar Falls woke up one day last October having lost all urge to eat and drink. In the past two days, the boy’s story has triggered reaction nationwide as well as from Canada, Brazil, Italy and beyond. (Des Moines Register)

National News

Major medical groups endorse Ebola guidelines
Three of the largest U.S. medical organizations threw their weight behind new federal guidelines that reject mass quarantines for healthcare workers returning from Ebola-ravaged countries. In a joint statement, the American Hospital Association, the American Medical Association and the American Nurses Association said the guidance strikes the right balance between protecting public health and ensuring healthcare workers are not “unduly” burdened. (The Hill)

How the poorest, sickest state got left behind by Obamacare
The state’s low standard of living means many people earn less than the federal poverty limit but too much for Medicaid; under the health law, they can’t buy insurance on the exchange, leaving 138,000 Mississippians who fall into what has come to be known as the Medicaid gap. (Politico)

On Superstorm Sandy anniversary, Red Cross under scrutiny
In the months after the disaster, the Red Cross touted its success in delivering food, clothes and shelter to tens of thousands of people left homeless by the storm. Gail McGovern, the Red Cross president and CEO, told NBC News two weeks after the storm: “I think that we are near flawless so far in this operation.” The truth, however, is different. The venerable charity’s track record in dealing with the megastorm is now being challenged by an unusual cadre of critics — its own employees and records. (National Public Radio)

Medicare agency is focus of insider trading investigations
Employees of the federal agency that oversees Medicare and the federal health exchange website are the focus of three Securities and Exchange Commission investigations to determine whether they leaked news about pending health policy decisions that would up in the hands of Wall Street traders. The investigation is also focusing on at least three policy and research firms that may have acted as middlemen for the inside information. (Fox News)

Dental board case before SCOTUS has far-reaching implications
The outcome of a case before the Supreme Court has the potential to extend far beyond teeth whitening and mall kiosks to state regulatory boards governing the actions of physicians, says a health care antitrust lawyer observing the case. (HealthLeaders Media)

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

Terry Branstad won’t order Ebola quarantine in Iowa
Gov. Terry Branstad said Monday he won’t order a mandatory quarantine for people arriving in Iowa who have had contact with Ebola-infected patients in West Africa. Unlike New York, New Jersey and Illinois — where the governors have ordered quarantines for travelers considered high-risk — Iowa has no airports with direct flights from West Africa, Branstad noted. He said he doesn’t believe a mandatory quarantine is necessary here. (Des Moines Register)

Pella Regional staff prepared for potential Ebola Patient
Pella Regional Health Center has been preparing for the potential spread of the Ebola Virus. Quality, Safety, and Risk Management Advisor Shawna Forst says they are using similar practices to the recent outbreak of H1N1, and that they have been working with Marion County Public Health and the CDC to determine the best practices in treating patients and keep hospital staff safe. (KNIA/KRLS)

Value in leveraging EHR use across the care continuum
Much of the focus on adopting EHR technology is on primary care, but with the expansion of the care continuum to include an array of clinical and healthcare professionals EHR use must be able to be leveraged in dramatically different care environments. With the extension of UnityPoint Health beyond inpatient and ambulatory care settings, the Iowan health system has looked to its EHR technology as a means of addressing patient needs at any and all points along the continuum of care. One area of concern was the coordination of its home health providers whose roles in the era of the Affordable Care Act are growing. (EHR Intelligence)

National News

CDC says people at high risk for Ebola should stay home
New guidelines from the Obama administration would restrict the movement of people at high risk of Ebola but would not require mandatory quarantines. The guidelines, issued by the Centers for Disease Control and Prevention on Monday, individualize recommendations for travelers based on a person’s level of risk. (USA Today)

Paying thousands before health insurance even kicks in
Got health insurance at work? You may still have to shell out thousands of dollars before it kicks in. That’s because more employers are offering consumer-directed health plans, which usually come with high deductibles. In 2015, 81 percent of large employers will offer at least one of these plans, up from 63 percent five years earlier. (CNN)

The team approach to longer living
In researching spots around the world where people live long and live well, National Geographic fellow Dan Buettner found that very-long-term health has little to do with dieting or trips to the gym. Rather than running marathons, the world’s most long-lived people “moved naturally,” living in environments that “nudged” them into physical activity. They had daily rituals that reversed the effects of stress. They could articulate their sense of purpose. (Spokane Spokesman-Review)

Some doctors wary of taking insurance exchange patients
Now that many people finally have health insurance through the Affordable Care Act exchanges, some are running into a new problem: They can’t find a doctor who will take them as patients. Because these exchange plans often have lower reimbursement rates, some doctors are limiting how many new patients they take with these policies, physician groups and other experts say. (USA Today)

Study: Emails between patients, physicians tripled over 10 years
Email communications between physicians and patients at Beth Israel Deaconess Medical Center in Boston nearly tripled over a 10-year period, according to a study published in Health Affairs, Health Data Management reports. For the study, researchers examined email communications at Beth Israel. In 2000, the hospital created a Web portal through which patients could view parts of their medical records and communicate via email with their physicians. (iHealthBeat)

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Health Care ReformThe Affordable Care Act has now been in place and functioning for a year and many are wondering, is the law fulfilling its core goals?  The New York Times recently provided an expanded analysis of the law and generally concluded the law is succeeding, though more time is needed to know for certain.  Here is a summary of the Times’ findings:

Fewer Uninsured

The main goal of the Affordable Care Act was to reduce the number of Americans without health insurance.  Since the law was enacted, the percentage of uninsured Americans has decreased by about 25 percent within one year, or approximately eight to 11 million people.  Much of this is because of state Medicaid expansion, with at least as many people enrolled in Medicaid as have signed up for private insurances.  Although the Affordable Care Act will never bring universal health insurance coverage, it hopes to continue closing the gap and over the next four years it is projected to expand coverage to millions more Americans.

Affordable Coverage

For millions of Americans, the Affordable Care Act has provided access to comprehensive coverage at an affordable price.  Of the 7.3 million people who signed up for private insurance through online exchanges, 85 percent qualified for government subsidies to reduce the cost of premiums.  Although the law has made insurance affordable for some, it has also created high deductibles and out-of-pocket expenses for others, and has caused premiums to raise for some who already had insurance or were not eligible for subsidies.  Additionally, while trying to keep costs down, insurers may be too restrictive about allowing consumers to use doctors outside of the company’s network.  With wide variations in pricing between states, it is difficult to know who will find plans unaffordable, but evidence suggests middle-income people who don’t qualify for subsidies will struggle the most with health insurance costs.  A 4 percent median premium increase is expected for 2015, so consumers will need to shop around for the lowest prices.

Improved Health

Currently, there is not enough data on the entire population to determine whether the law is improving the nation’s overall health.  Some early data does suggest that the law is having a positive impact on young people.  Because the law permits young Americans to remain on their parent’s insurance plans until reaching the age of 26, the share of 19-to-25-year-olds without health insurance declined to 21 percent in the first quarter of the year, a reduction of about four million people.  Outside the young adult group, there were very little changes in a variety of health measures, such as the number of flu shots received or whether people had a regular place to go for medical care.  However, preventative screenings, especially for colon cancer, have increased 8 percent since 2010.  More time is needed to determine if the law will positively impact the nation’s health in the long run.

Financial Stability for Providers and Insurers

Both Wall Street analysts and health care experts say the Affordable Care Act has helped the health care industry financially.  The insurance industry has seen the greatest benefits thus far, because of new customers and growth in demand for private insurance. The number of insurers participating in the online health exchanges is also expected to increase in 2015, an indicator of the profitability of the marketplace and the business the law has created.  The law also brought new paying patients to hospitals and new prescription users to the pharmaceutical industry.  Although hospitals are being hurt by a provision of the law that cuts their Medicare payments by $260 billion over 10 years, they are estimated to save $5-7 billion in uncompensated care costs this year because more people have insurance, according to the Department of Health and Human Services.  Iowa hospitals have seen a significant decrease in charity care over the last year.

Expanded Medicaid

The expansion of Medicaid, the government health care program for low-income citizens, is a crucial part of the Affordable Care Act. Medicaid expansion is optional for all states and 27 states and the District of Columbia (as well as Iowa) have expanded.  These states, including Iowa, have seen a significant reduction in uninsured people, while states without expanded Medicaid are seeing a coverage gap in health insurance for people who earn too much to receive Medicaid, but too little to receive federal subsidies to reduce premiums.  Pressure from hospitals that can get federal funds from Medicaid expansion has caused some states to consider expansion.  Federal officials say 8.7 million people have been added to Medicaid rolls since last October; however, with so many new people in the expanded program, there are growing concerns with the shortage of doctors.

Controlling Health Care Spending

While the Affordable Care Act was intended to slow down health care spending, the amount of money being spent on health care had begun slowing even before the law was put in place.  There has been a significant slowdown in the growth of health spending, due to the recession, higher-deductible policies that discourage people from seeking health care, a decline in the development of new and costly prescription drugs and the reduction of unneeded care.  In the short term, the law could actually increase health care spending because of the expansion of health insurance to millions of Americans.  The real test of the Affordable Care Act will be whether or not the declined spending continues, even with the amount of new insured people in the system.

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