Report Validates Provider/Patient Interaction with Computers in the Exam

Having a Provider use a computer in the room during a patient visit does add a level of complexity to the actual visit itself. However, according to a new report from the American Medical Association, the actual patient/provider interaction and communication is not affected for the most part.

Fears of negative effects of using an Electronic Health Record while in the room with a patient have not materialized. This report notes. “Technical improvements in EHRs that focus required computer tasks on activities that meaningfully influence patient outcomes, or that streamline data input and reduce the time needed to complete common tasks in clinical work and decrease the potential for distraction, will help minimize the possibility for disruption.”

Based in large part on findings in 14 previously published studies of the introduction of EHRs into the exam room, an AMA committee developed the report hoping to extinguish the fears. The authors’ of the report found that physicians’ interacting with patients influences how complementary or distracting the EHR can be. Providers skilled in collecting data during patient visits, and recording it on paper charts, before there were EHRs; were better able to integrate use of the computer into the visit.

Also discovered in the study is that those providers who displayed discontent with the computer while in the room with the patient, could easily influence patients’ perceptions of using an EHR.  Those patients who understood the importance of recording the data, in their patient record, for quality of care, and less medical mishaps; were more accepting to the use of computers being used during the visit/exam.

You can view the study here:  Click Here

Five communication behaviors learned at Kaiser Permanente with the Interregional Clinical-Patient Communication Leaders that eased integration of a computer into the exam room:

1. Let the patient look on – move the computer screen so the patient can see it, invite the patient to view information, ask the patient to verify information as it is entered

2. Eye contact – greet the patient, maintain eye contact

3. Value the computer as a tool – acknowledge the computer, let the patient know how it improves care

4. Explain what you are doing – inform the patient about actions and decisions, tell the patient what you are doing, such as ordering lab tests

5. Log off and say you are doing so – tell the patient you are logging off to safeguard his or her clinical information

Ventres W, Kooienga S, Marlin R. EHRs in the exam room: tips on patient-centered care. Available at http://www.aafp.org/fpm/2006/0300/p45/ Accessed Feb 12, 2013.

Utilizing these five behaviors helped to establish a positive experience during and after the visit.
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Study on Youth Concussions Recovery Time vs. the Severity of the Symptoms

Sources: Mayo Clinic, Washington Post, Kaiser Permanente, Science Daily, kidshealth.org, and Denver Post

SOURCE: The Journal of Pediatrics, news release, April 2013

More severe concussion symptoms take longer to recover from their head injury than patients with milder symptoms. The study finds that most children recover from sports-related concussions within a few days, but some continue to have symptoms for months after the injury has occurred. The reasons for this have been undetermined. Authors of this study to identify have looked into risk factors that might be associated with longer recovery times.

One Hundred and Eighty Two children, who were analyzed, were seen at a Sports Concussion Clinic within three weeks of their injury. The patients completed the Post-Concussion Symptom Scale (PCSS), which uses a 0-6 scale to assess the severity of Twenty Two symptoms; the higher the number, the more severe the symptoms. The researchers found that the total score on the PCSS was independently associated with the length of time that patients had concussion symptoms. The higher the score, the more likely the youth would have symptoms for longer than 28 days, according to the study published in April’s The Journal of Pediatrics. Identifying risk factors for prolonged recovery from concussion will enable providers to provide the best treatment for patients, said the researchers.

A list of symptoms included on the PCSS questionnaire included:

1. Headache

2. Vomiting

3. Problems with keeping balance

4. Sleeping more or less than usual

5. Sensitivity to light or noise

6. Fatigue

7. Numbness

8. Memory or concentration issues

9. Visual Acuity

Dr. William P. Meehan, III and colleagues from Boston Children’s Hospital and the University of Pittsburgh Medical Center analyzed data.

"Parents, physicians and caregivers of athletes who suffer from a high-degree of symptoms after a sports-related concussion should start preparing for the possibility of a prolonged recovery," study author Dr. William Meehan said in a journal news release. ©The Journal of Pediatrics April 2013

In the previous studies, it was found that younger patients and those with memory loss had longer recovery times after suffering a concussion; results from this study do not suggest that age or amnesia are risk factors for prolonged recovery time. What were determined athletes will suffer prolonged recoveries after concussion; therefore, the analytical tools to deliver results, should be based on initial symptom scores. The researchers made this public out in a news release.

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Also, Check out the methods for which this study was conducted.

Cumulative Effects of Concussions

100 Most Common Medicare Inpatient Stays Now are Publicly Available

Pricing by hospitals across the nation for treating the 100 most common Medicare inpatient stays now is publicly available from the Centers for Medicare and Medicaid Services.


CMS, which is trying to use its claims data to bring transparency to hospital pricing, also has announced a funding opportunity totaling $87 million to help states enhance their rate review programs and extend price transparency.
Data released on May 8, 2013, shows how vast prices can vary across the nation’s hospitals and local healthcare organizations. The average inpatient hospital charges for services that may be provided to treat heart failure range from $21,000 to $46,000 in Denver, and from $9,000 to $51,000 in Jackson, Miss. For example, average inpatient charges for services a hospital may provide in connection with a joint replacement (MS-DRG 470) range from a low of $5,300 at a hospital in Ada, Oklahoma, to a high of $223,000 at a hospital in Monterey Park, California.

Map Provided by CMS Even within the same geographic area, hospital charges for similar services can vary significantly.

Please refer to the following links for more information:

-CMS-released pricing data is available here
-With a fact sheet showing national variations in hospital charges here
-Grant Funding opportunities for states are here