Objective. To estimate the impact of deductibles on the initiation and continuation of psychotherapy for depression.
Data Source/Study Setting. Data from health care encounters and claims from Group Health Cooperative, a large integrated health care system in Washington State, was merged with information from a centralized behavioral health triage call center to conduct study analyses.
Study Design. A retrospective observational design using a hierarchical logistic regression model was used to estimate initiation and continuation probabilities for use of psychotherapy, adjusting for key sociodemographic/economic factors and prior use of behavioral health services relevant to individual decisions to seek mental health care.
Data Collection/Extraction Methods. Analyses were based on merged datasets on patient enrollment, insurance benefits, use of mental health and general medical services and information collected by a triage specialist at a centralized behavioral health call center.
Principal Findings. Among individuals with unmet deductibles between $100 and $500, we found a statistically significant lower likelihood of making an initial visit, but there was no statistically significant effect on making an initial or subsequent visit among individuals that had met their deductible.
Conclusions. Unmet deductibles appear to influence the likelihood of initiating psychotherapy for treating depression.
Tuesday, July 31, 2012
Monday, July 30, 2012
Healthcare Data Breaches Still Rising
By Deborah Hirsch
HealthTechZone Contributor
Originally published July 19, 2012
Here are some excepts:
The healthcare industry has the highest percentage of data breaches of any sector, according to a report by Symantec. Healthcare also had the highest number of reported breaches, at 43 percent, Patricia Resende reports.
And the costs continue to rise, with each breach costing organizations $5.5 million, and each compromised record, $194, the Symantec study reports. And even though the costs have dropped slightly from several years ago, according to a Ponemon study, healthcare is the one area where they have not. Physicians’ offices and small clinics say they have lost more than 54,000 patient records due to breaches since 2009.
And they’ve occurred all over the country, from Utah, where the files of almost 300,000 Medicaid patients were breached in March, to Boston, where the laptop of a Boston Children’s Hospital employee at a South American conference containing more than 2000 patient records was stolen.
The entire story is here.
HealthTechZone Contributor
Originally published July 19, 2012
Here are some excepts:
The healthcare industry has the highest percentage of data breaches of any sector, according to a report by Symantec. Healthcare also had the highest number of reported breaches, at 43 percent, Patricia Resende reports.
And the costs continue to rise, with each breach costing organizations $5.5 million, and each compromised record, $194, the Symantec study reports. And even though the costs have dropped slightly from several years ago, according to a Ponemon study, healthcare is the one area where they have not. Physicians’ offices and small clinics say they have lost more than 54,000 patient records due to breaches since 2009.
And they’ve occurred all over the country, from Utah, where the files of almost 300,000 Medicaid patients were breached in March, to Boston, where the laptop of a Boston Children’s Hospital employee at a South American conference containing more than 2000 patient records was stolen.
The entire story is here.
Beth Israel Deaconess reveals health data breach
By Kyle Murphy, PhD
EHR Intelligence
Originally published July 20, 2012
EHR Intelligence
Originally published July 20, 2012
The personal health information of close to 4,000 patients at Beth Israel Deaconess Medical Center (BIDMC) has been compromised after a physician’s personal laptop was stolen on May 22, says the Boston Globe. BIDMC officials could not be reached for comment.
Thanks to Ken Pope for this information.
Sunday, July 29, 2012
Hospitals Reaping Financial Benefits of Telehealth
By Karen Minich Pourshadi
Health Leaders Media
Originally published July 19, 2012
Here are some excerpts:
The passing of the years has softened resistance by patients to using this approach. Patients are now willing to forego an in-person visit with the doctor in order to get the care they need swiftly, without having to travel, and in some instances at a lower cost. Moreover, the reimbursement environment is changing. Whereas at one time payers rejected the notion of reimbursing e-health, now more are willing to pay for it. Plus, legislators nationwide are creating state laws requiring payers to reimburse for these services, though in many instances payers are doing so irrespective of mandate.
"Telemedicine can lower healthcare costs by reducing avoidable hospital visits and providing regular access to care in remote parts of the state, and it's more convenient for patients," says Georgia Partnership for TeleHealth CEO Paula Guy. The nonprofit telehealth provider works with more than 350 partners and 175 specialists and other healthcare providers and has handled some 40,000 patient encounters as of 2011.
(cut)
GPT has also placed telehealth into nursing homes. In 2011, using telehealth resulted in 160 ED visits being avoided, saving approximately $480,000 in ED cost, Guy says, "In the past, these older patients may have just called for an ambulance when they had a problem. But now patients can be seen by a doctor without an expensive ambulance trip to the ED. Plus they can use it for routine access to care, and by getting that they're less likely to end up in the hospital as frequently," Guy says.
Telehealth visits saved 310 miles and nearly six hours of traveling on average, according to a study by Children's Healthcare of Atlanta, a three-hospital system for children and teens. CHA reviewed 609 appointments over a nine-month period and noted that approximately 86% of patients would have missed school and more than 80% of parents would have missed a full day of work to go to the city for an in-office visit, according to data published in the Atlanta Journal-Constitution. Additionally, Guy explains that out of the 40,009 telehealth visits GPT tracked, a random sample showed an average savings of patient travel time of 124 miles per encounter and nearly $762,027 in fuel alone.
The entire article is here.
Health Leaders Media
Originally published July 19, 2012
Here are some excerpts:
The passing of the years has softened resistance by patients to using this approach. Patients are now willing to forego an in-person visit with the doctor in order to get the care they need swiftly, without having to travel, and in some instances at a lower cost. Moreover, the reimbursement environment is changing. Whereas at one time payers rejected the notion of reimbursing e-health, now more are willing to pay for it. Plus, legislators nationwide are creating state laws requiring payers to reimburse for these services, though in many instances payers are doing so irrespective of mandate.
"Telemedicine can lower healthcare costs by reducing avoidable hospital visits and providing regular access to care in remote parts of the state, and it's more convenient for patients," says Georgia Partnership for TeleHealth CEO Paula Guy. The nonprofit telehealth provider works with more than 350 partners and 175 specialists and other healthcare providers and has handled some 40,000 patient encounters as of 2011.
(cut)
GPT has also placed telehealth into nursing homes. In 2011, using telehealth resulted in 160 ED visits being avoided, saving approximately $480,000 in ED cost, Guy says, "In the past, these older patients may have just called for an ambulance when they had a problem. But now patients can be seen by a doctor without an expensive ambulance trip to the ED. Plus they can use it for routine access to care, and by getting that they're less likely to end up in the hospital as frequently," Guy says.
Telehealth visits saved 310 miles and nearly six hours of traveling on average, according to a study by Children's Healthcare of Atlanta, a three-hospital system for children and teens. CHA reviewed 609 appointments over a nine-month period and noted that approximately 86% of patients would have missed school and more than 80% of parents would have missed a full day of work to go to the city for an in-office visit, according to data published in the Atlanta Journal-Constitution. Additionally, Guy explains that out of the 40,009 telehealth visits GPT tracked, a random sample showed an average savings of patient travel time of 124 miles per encounter and nearly $762,027 in fuel alone.
The entire article is here.
Saturday, July 28, 2012
EHR Adoption By Doctors Reaches 55 Percent
Kaiser Health News
Originally published July 19, 2012
Physician adoption of the electronic health record (EHR) may be at — or even past — the proverbial tipping point, or so suggests a government study released yesterday that is a litany of progress. In 2011, 55% of physicians reported having adopted an EHR, and of those, 85% said they were either somewhat or very satisfied with the technology, according to the report from the US Centers for Disease Control and Prevention (CDC). Roughly 3 in 4 physicians using EHRs said the software enhanced overall patient care. And 71% of digital physicians would buy their EHR program again.
More can be found here.
Originally published July 19, 2012
Physician adoption of the electronic health record (EHR) may be at — or even past — the proverbial tipping point, or so suggests a government study released yesterday that is a litany of progress. In 2011, 55% of physicians reported having adopted an EHR, and of those, 85% said they were either somewhat or very satisfied with the technology, according to the report from the US Centers for Disease Control and Prevention (CDC). Roughly 3 in 4 physicians using EHRs said the software enhanced overall patient care. And 71% of digital physicians would buy their EHR program again.
More can be found here.
Friday, July 27, 2012
Actress urges action against human trafficking
By Andres Gonzalez
The Associated Press
Originally published July 17, 2012
Actress and activist Jada Pinkett Smith urged Congress on Tuesday to step up the fight against human trafficking in the U.S. and abroad.
The entire story is here.
The Associated Press
Originally published July 17, 2012
 |
| Jada Pinkett Smith |
The actress testified during a Senate Foreign Relations Committee hearing that she plans to launch a campaign to raise awareness and spur action against human trafficking and slavery. She said the "old monster" of slavery "is still with us," almost 150 years after President Abraham Lincoln issued the Emancipation Proclamation that freed slaves in the U.S.
"Fighting slavery doesn't cost a lot of money. The costs of allowing it to exist in our nation and abroad are much higher," the actress said. "It robs us of the thing we value most, our freedom."
The entire story is here.
Human trafficking: Modern day slavery
Women's Psych-E Newsletter
March 2012
On February 1, 2012, the APA Women’s Programs Office, the Graduate and Postgraduate Education and Training Office and the Neighborhood Opportunities for Volunteer Activities (NOVA) Committee hosted a brown bag lunch for APA staff in recognition of January as National Slavery and Human Trafficking Prevention Month featuring Tina Frundt, Founder and Executive Director of Courtney’s House.
Frundt, also a survivor of domestic sex trafficking, discussed the importance of providing programs and services for domestic victims. “Trafficking of American children is often not heard about. The focus is often on foreign trafficking, she says. Due to a lack of funding for programs for trafficking victims, minors are all too often arrested, charged with child prostitution and placed in juvenile detention centers which are unsafe.” She is currently working to get legislation that will prevent children from being arrested and charged with child prostitution and to will allow them to receive services. Dr. Marsha Liss, PhD, member of the newly formed APA Task Force on Trafficking of Women and Girls, also in attendance, emphasized the importance of services and supports that prevent survivors from being sent into situations where they're at risk.
The entire article can be found here.
March 2012
On February 1, 2012, the APA Women’s Programs Office, the Graduate and Postgraduate Education and Training Office and the Neighborhood Opportunities for Volunteer Activities (NOVA) Committee hosted a brown bag lunch for APA staff in recognition of January as National Slavery and Human Trafficking Prevention Month featuring Tina Frundt, Founder and Executive Director of Courtney’s House.
Frundt, also a survivor of domestic sex trafficking, discussed the importance of providing programs and services for domestic victims. “Trafficking of American children is often not heard about. The focus is often on foreign trafficking, she says. Due to a lack of funding for programs for trafficking victims, minors are all too often arrested, charged with child prostitution and placed in juvenile detention centers which are unsafe.” She is currently working to get legislation that will prevent children from being arrested and charged with child prostitution and to will allow them to receive services. Dr. Marsha Liss, PhD, member of the newly formed APA Task Force on Trafficking of Women and Girls, also in attendance, emphasized the importance of services and supports that prevent survivors from being sent into situations where they're at risk.
The entire article can be found here.
Thursday, July 26, 2012
Five Doctors Settle SEC Insider Trading Charges
Reuters Health Information
Originally published July 10, 2012
Five doctors have agreed to pay $1.9 million to settle U.S. Securities and Exchange Commission civil charges that they conducted insider trading in shares of a medical professional liability insurer that was preparing to be sold.
The SEC said Apparao Mukkamala routinely tipped the other doctors in 2010 about confidential details of the sale process for American Physicians Capital Inc ("APCapital"), where he had been chairman at the time.
It said the other doctors bought nearly $2.2 million of the East Lansing, Michigan-based company's stock between April 30 and July 7, 2010, based on the tips, and that Mukkamala himself bought shares through a charitable organization where he was president.
The entire story is here.
Originally published July 10, 2012
Five doctors have agreed to pay $1.9 million to settle U.S. Securities and Exchange Commission civil charges that they conducted insider trading in shares of a medical professional liability insurer that was preparing to be sold.
The SEC said Apparao Mukkamala routinely tipped the other doctors in 2010 about confidential details of the sale process for American Physicians Capital Inc ("APCapital"), where he had been chairman at the time.
It said the other doctors bought nearly $2.2 million of the East Lansing, Michigan-based company's stock between April 30 and July 7, 2010, based on the tips, and that Mukkamala himself bought shares through a charitable organization where he was president.
The entire story is here.
Wednesday, July 25, 2012
The Ethics of Influencing the Political Process
Stephen A. Ragusea, PsyD, ABPP
Chair, Florida State Psychological Association Ethics Advisory Committee
Ethics Corner
Summer 2012
In the last edition of the Florida Psychologist, I wrote an article about how psychologists often hesitate to encourage their patients to influence the political process. Psychologists frequently fear to unfairly utilize powerful relationships, somehow pushing patients into action they would not normally take.
However, psychologists also too often personally and professionally avoid being involved with the political process. To some, this avoidance is incomprehensible and frustrating. Based on my experience, psychologists usually stay out of the political process for the most common of reasons, they just feel too busy in their daily lives to take the time to participate in the fray. And, some psychologists seem to feel as if they would be sullied somehow by wrestling in the mud of the political arena. Of course, some folks are just plain lazy and engage is what some writers have called, “social loafing.” My ethics chair colleague in Pennsylvania, Dr. John Gavazzi, once wrote, “Social loafing is the tendency for people to expend less effort on a given task when working in groups than when working alone. It is easier to loaf when individual contributions are not evaluated and when the individual can rationalize that someone else will ‘pull the weight.’”
In any case, because of social loafing and a variety of other reasons, psychologists seem to avoid involvement in the political process more often that do some other professionals. For example, based on data from a variety of sources nurses are much more involved in political and legislative matters than are we. Nurses and physicians also contribute substantially more money to lobbying efforts than do psychologists. These tendencies of ours endure despite the fact that we are acting against our own best interests. We need to do much better or, very soon I fear, we risk professional oblivion.
From my perspective in the catbird’s seat, I also think there are more lofty reasons for psychologists to be actively involved in the democratic process. I believe psychologists have an ethical responsibility to be involved with influencing the political and legal process of our society. It is what we owe in service to our culture and our patients.
The APA Ethical Standards actually address this topic in the preamble. Specifically, the preamble declares the following. (Italics are added by this writer for emphasis.)
“Psychologists are committed to increasing scientific and professional knowledge of behavior and people’s understanding of themselves and others and to the use of such knowledge to improve the condition of individuals, organizations, and society…. They strive to help the public in developing informed judgments and choices concerning human behavior. In doing so, they perform many roles, such as researcher, educator, diagnostician, therapist, supervisor, consultant, administrator, social interventionist….”
Therefore, beyond our own self-interest, based on our ethical standards, we are not only free to participate in the political process through political giving and social activism, but we actually have an affirmative ethical responsibility to do so. Again, quoting John Gavazzi’s article, “Although no law, statute, or ethical code mandates ‘Thou shall participate in the political process,’ psychologists are responsible to promote our patients’ welfare. Enhancing patient welfare can occur at the community and systems level, not just within the confines of our offices. The goals of political advocacy are noble and worthy.”
Amen, brother John. Is anybody out there listening? Is anybody out there acting?
References
American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. American Psychologist,Vol. 57, 1060-1073.
Gavazzi, J. D. (2006). Legislative Efforts and Positive Ethics: Say what? The Pennsylvania Psychologist, February Quarterly, 2, 6.
If you have specific suggestions for topics to be covered in The Ethics Corner, please e-mail me with your suggestions. My e-mail address is ragusea@aol.com.
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