Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions.

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When the Literary Digest conducted a poll to predict the winner of the 1936 presidential election, the results were clear: Alfred Landon would overwhelmingly defeat Franklin Delano Roosevelt. The Literary Digest was confident about its results: after all, they had surveyed 10 million people and received 2.4 million responses. But they could not have been more wrong. Why? Those 10 million people were drawn from a pool of Literary Digest subscribers, automobile owners, and telephone owners. In 1936, automobiles, phones, and subscriptions to the Literary Digest were available only to the rich. These selection factors skewed the results toward Landon, the choice of the wealthy.

The systemic failure of their sampling technique is cited in most introductory statistics textbooks, since it shows so clearly how bad sampling can lead to wrong conclusions. Roosevelt won in the most lopsided victory in American history.

5/29/2013 5:44:47 PM | 2 comments

Our bi-weekly news updates are designed to keep you up to date with current developments relating to the Acute Care Continuum. Feel free to share your perspective on these stories or link to articles that you have found relevant to today’s healthcare environment.

Today we focus on budget estimates and healthcare spending, including new figures from the Congressional Budget Office, the ongoing battle over a Medicaid pay increase, and disturbing findings on the actual cost of emergency medical care.

5/22/2013 4:44:07 PM | 0 comments

Childress placed both hands on his temple and proceeded to roll his fingers through his graying hair.  Looking up again at his agent, he said, “Tell me how companies are going to be affected?”

Agent Ajemian rolled his eyes, and replied, “How are they not going to be affected?  Costs go up.  Reporting goes up.  Confusion ramps up big time!”  The agent sat up, leaned forward so that his right elbow was on his thigh and his left hand scratched his cheek so you could hear the stubble on his face. 

“The hardest part will be interpreting the rules.  Every quarter, companies that do not provide insurance will need to tally up their employees and determine what penalties they owe to the IRS or to Health and Human Services [HHS] in lieu of providing coverage.”

5/21/2013 9:16:51 PM | 0 comments

The room was mostly dark, with just an overhead light and a recliner that showed more stuffing than fabric. A slightly wet khaki trench coat was draped over the back of the chair. Drops from a roof leak beat a very slow rhythm in one corner. A half rusted folding chair lay on the concrete floor. The operative, wearing his own standard issue unbuttoned trench coat, lit a cigarette and leaned against the only brick wall in the room. A few feet away, Childress stood with a rolled newspaper under one arm and the other hand unconsciously gripping the closed doorknob. “Alright,” he said forcefully, “Tell me what you know, what you don’t know, and what you think.”

Agent Ajemian lifted his hand and took the cigarette from his mouth, exhaled a cave of smoke, watched it rise for a second, and then flicked the stub across the room. It landed perfectly into the accumulating puddle. He shook his head slightly, and in a voice of resignation he responded, “I’ll tell you what I know… but it’ll be costly. I’ll tell you what I don’t know, but I’m not sure I’m going to tell you what I think!“

5/17/2013 6:23:08 PM | 1 comments

If you have practiced healthcare pretty much anywhere in the United States during the last five years, you have probably been involved in at least one Electronic Health Record (EHR) conversion or implementation. In some cases, you may have converted from a user friendly template to a less user friendly EMR. In other cases, your hospital may have converted from one EHR brand to another. Regardless of the specifics of your transition, it is likely that some degree of frustration happened at the point when you adjusted to the first EHR. And it is also likely that after months of frustration you contacted one of those Scribe companies.

EHRs are still in their relative infancy and continuously improving. Penalties for not automating will be implemented in 2015, so they are here to stay. Learning from implementation issues is critical to improving implementation and effective use of EMRs.

5/16/2013 4:53:19 PM | 0 comments
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