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Digital Health Could Seal Fate of Small Hospitals

Posted on August 30, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I am not a healthcare investment expert by any means, but two recent pieces of news make me wonder if the digital health movement will inadvertently result in the hurried demise of already struggling small and rural hospitals.

According to a recent CB Insights report covered by MedCity News, 362 digital health deals last year accounted for an all-time high of $1.5 billion. Of those deals, 55 were exits – smaller digital health companies bought up by larger players. CB Insights notes the majority of these acquired companies were those that provided products that make administrative health processes more efficient, such as EMRs and revenue cycle management systems. This is an assumption, but I’m inclined to think these EMR companies priced their products below their more corporate competitors. These companies may well have supplied their systems to the budget-conscious small and rural hospital market.

As most everyone knows, small and rural hospitals are facing an uphill battle these days when it comes to keeping their doors open. A recent Georgia Health News item noted that three rural hospitals in the state have closed in 2013, with some predicting an additional 20 facilities will close within the next two years. The article cites constant cash shortages, claims disputes with payers, lower projected payments to hospitals from Georgia’s new state employee benefit contract, and reduced indigent care funding as contributing factors to the poor financial health many small Georgia hospitals find themselves in.

While these may be specific to Georgia, they are almost surely indicative of similar problems seen by similar institutions in the U.S. At least 849 facilities across the country will soon face the common problem of increased scrutiny by Medicare as a result of the current “bloated and unwieldy” state of the critical access hospital program, which was designed to financially stabilize small hospitals by providing them with higher Medicare reimbursement rates.

It looks to me as if the digital health exits noted above are perhaps indicative of a broader industry trend. Small and rural hospitals are already under enormous pressure to care for underserved populations in a fiscally responsible way. As the healthcare vendor market consolidates and looks to digital health as the next best venture, will we see more affordable EMRs folded into those that are less so? Where will small healthcare facilities turn for their healthcare IT?

Where do you think these two trends will converge in the next year or two? Please share your comments below.

Meaningful Use Rule Clarification by John Halamka

Posted on July 28, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In MedCity News, John Halamka makes an effort to summarize as simply as possible the Quality Measures:

I’ve been asked to summarize the Quality Measures as simply as possible

a. The Core Measures for All Eligible Professionals, Medicare and Medicaid are in the Final Rule Table 7, page 287. The Measures are

  • Hypertension: Blood Pressure Measurement
  • Tobacco Use Assessment and Tobacco Cessation Intervention
  • Adult Weight Screening and Follow-up

b. If the denominator for one or more of the Core Measures is zero, EPs will be required to report results for up to three Alternate Core Measures. The Alternate Core Measures for Eligible Professionals are in the Final Rule Table 7, page 287. The Measures are

  • Weight Assessment and Counseling for Children and Adolescents
  • Preventive Care and Screening: Influenza Immunization for Patients ? 50 Years Old
  • Childhood Immunization Status

c. The Clinical Quality Measures for Submission by Medicare or Medicaid EPs for the 2011 and 2012 Payment Year (EPs must choose 3) are in the Final Rule Table 6, page 272 . Here’s a summary of the 44 quality measures that CMS posted last week.

d. The Clinical Quality Measures for Submission by Eligible Hospitals and Critical Access Hospitals for Payment Year 2011-2012 are in the Final Rule Table 10, page 303. The Measures are

  • Emergency Department Throughput ’ admitted patients Median time from ED arrival to ED departure for admitted patients
  • Emergency Department Throughput ’ admitted patients Admission decision time to ED departure time for admitted patients
  • Ischemic stroke ’ Discharge on anti-thrombotics
  • Ischemic stroke ’ Anticoagulation for A-fib/flutter
  • Ischemic stroke ’ Thrombolytic therapy for patients arriving within 2 hours of symptom onset
  • Ischemic or hemorrhagic stroke ’ Antithrombotic therapy by day 2
  • Ischemic stroke ’ Discharge on statins
  • Ischemic or hemorrhagic stroke ’ Stroke education
  • Ischemic or hemorrhagic stroke ’ Rehabilitation assessment
  • VTE prophylaxis within 24 hours of arrival
  • Intensive Care Unit VTE prophylaxis
  • Anticoagulation overlap therapy
  • Platelet monitoring on unfractionated heparin
  • VTE discharge instructions
  • Incidence of potentially preventable VTE

Everything clear now?