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March 23, 2016
Traditional providers get into the urgent-care game
When it comes to health issues that need immediate attention but aren’t life-threatening, more Americans are turning to urgent-care centers—and
traditional healthcare providers are getting into the game.
Over the past two years, hospital chains and insurance companies have snapped up urgent-care centers in a spate of mergers and acquisitions.
Health systems, too, are moving into this space, striking joint ventures with independent urgent-care operators, says Tom Charland, chief executive
of consulting firm Merchant Medicine.
Estimates of the number of centers in the U.S. are as high as 10,000. The Urgent Care Association of America says it counts about 7,100 full-service
urgent-care centers, with 22% owned by hospitals and 15% in joint ventures with hospitals. Surveys by the group show that some 87% of urgentcare-center operators acquired or built a new location in 2014, and that 89% said patient visits increased in 2014 from the previous year.
For patients, urgent-care centers connected to a health system offer the dual benefit of convenient care and some assurance that they can be
quickly transferred to an emergency room or referred to a primary-care doctor or specialist. Conversely, hospitals can steer patients in crowded ER
waiting rooms to an affiliated urgent-care center nearby if it isn’t a true emergency.
Most urgent-care centers, which have physicians on staff and operate on a walk-in basis, offer wait times of 30 minutes or less, versus an average
wait of four hours for an emergency-room visit, the urgent-care association says. The average cost of an urgent-care center visit is $150 compared
with $1,354 for an ER visit, and urgent-care centers accept insurance, with copays similar to a primary-care visit. Most important, perhaps, the
centers are usually open evenings and weekends when doctors’ offices are typically closed.
They have X-rays, lab tests and other diagnostic equipment and handle common illnesses and injuries such as sprains, animal bites, mild asthma,
rashes and minor burns, ear or sinus pain and respiratory infections. They can treat minor fractures and allergic reactions and remove foreign
objects from eyes or noses.
For reassurance as to quality, patients can ask whether an urgent-care center is accredited or certified by one of three groups: the Urgent Care
Association of America, the National Urgent Care Center Accreditation program, or the Joint Commission, an independent nonprofit. Though
voluntary, such designations indicate that a center has passed through a quality review. Doctors can also be board-certified by the American Board
of Urgent Care Medicine.
Visit the Wall Street Journal for the story.
AHIMA launches petition for national voluntary patient safety identifier
The American Health Information Management Association announced it has launched a petition to ask the White House to address the need for a
national voluntary patient safety identifier by removing legislative language that has prevented open discussion between the government and others,
including AHIMA, who are seeking a solution to this critical patient safety issue.
The petition, available on petitions.whitehouse.gov, needs 100,000 signatures by April 19 to ensure a response from the Obama administration.
“As a patient, you know there’s only one you. But sometimes a name or some personal information is so similar to someone else’s that doctors’
offices or hospitals can have a hard time identifying records correctly,” said AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE,
FAHIMA. “It’s a dangerous and costly problem that can lead to missed diagnoses, inappropriate treatments or unnecessary tests, as well as making
it difficult for providers to exchange health information.”
AHIMA believes a possible solution is a voluntary patient safety identifier that could allow patients to create a way for medical systems to recognize
them quickly and accurately. An identifier will help ensure all each patient’s health information is kept together and is complete, all the while
remaining under the patient’s control.
The petition aims to encourage federal government leaders to engage experts in the private sector who have experience in accurately identifying
people, as they do in banking and other financial businesses, along with security experts. With 80 percent of doctors and 97 percent of hospitals
currently using an electronic health record, having a way to accurately and safely exchange information can make healthcare more safe and
effective.
The petition specifically asks for the removal of the federal legislative ban that currently prohibits the U.S. Department of Health and Human Services
(HHS) from participating in efforts to find a patient identification solution.
Visit AHIMA for more information.
FDA approves new treatment for inhalation anthrax
The U.S. Food and Drug Administration has approved Anthim (obiltoxaximab) injection to treat inhalational anthrax in combination with appropriate
antibacterial drugs. Anthim is also approved to prevent inhalational anthrax when alternative therapies are not available or not appropriate.
Inhalational anthrax is a rare disease that can occur after exposure to infected animals or contaminated animal products, or as a result of an
intentional release of anthrax spores. It is caused by breathing in the spores of the bacterium Bacillus anthracis. When inhaled, the anthrax bacteria
replicate in the body and produce toxins that can cause massive and irreversible tissue injury and death. Anthrax is a potential bioterrorism threat
because the spores are resistant to destruction and can be spread by release in the air.
Anthim is a monoclonal antibody that neutralizes toxins produced by B. anthracis. Anthim was approved under the FDA’s Animal Rule, which allows
efficacy findings from adequate and well-controlled animal studies to support FDA approval when it is not feasible or ethical to conduct efficacy trials
in humans.
Anthim was developed by Elusys Therapeutics, Inc. of Pine Brook, NJ, in conjunction with the U.S. Department of Health and Human Services’
Biomedical Advanced Research and Development Authority.
Visit the FDA for the announcement.
New study reports on accuracy oxygen sensors at saturations below 85% in children with cyanotic congenital heart disease
Masimo announced that a new study reported on the accuracy of Masimo's Blue sensors as compared to other sensors for cyanotic children with
blood oxygen saturation less than 85 percent. Masimo's Blue sensor was designed specifically for cyanotic infants and children with congenital heart
disease.
The study’s aim was to determine, in children with cyanotic congenital heart disease, which of three different pulse oximeter sensors is the most
accurate at lower blood oxygen saturation levels when compared to the gold standard of arterial blood gas analysis with CO-oximetry. The three
sensors were Masimo SET with LNCS sensor (Masimo Standard), Masimo SET with Blue sensor (Masimo Blue), and Nellcor N-600 with MAX-I
sensor (Nellcor).
The investigators concluded that the Masimo Blue sensor has improved accuracy at saturations 75-85 percent versus the Nellcor and Masimo
Standard sensors. However, the authors noted inaccuracies with all three sensors in this saturation range. The authors suggested there is a
continued need for device manufacturers to calibrate and develop algorithms for pulse oximeters to have improved overall accuracy at saturations
less than 85 percent.
Visit Masimo for the release.
Cholera deaths in Haiti could far exceed official count
Deaths from the cholera epidemic that ravaged Haiti after the 2010 earthquake could be much higher than the 9,200 officially tallied so far because
of underreporting during the initial outbreak, a new study suggests.
The study, by Doctors Without Borders, found that incomplete surveillance and data collection, overwhelmed health clinics, the rapid spread of the
disease and cholera’s ability to kill quickly contributed to what appears to have been a drastic understating of the death toll.
Haiti was still deeply traumatized from the January 2010 quake when it was hit 10 months later by the cholera epidemic. Studies have traced the
outbreak to faulty sanitation practices by a United Nations peacekeeping force.
It was the first time in a century that Haiti, the Western Hemisphere’s poorest country, was infected with cholera, which spreads through water
contaminated by feces. Victims die from severe diarrhea and dehydration.
The Doctors Without Borders study, published in the March edition of Emerging Infectious Diseases, a federal Centers for Disease Control and
Prevention journal, is not the first to suggest that Haiti’s cholera victims have been underreported.
But it provided a basis for calculating some new estimates that if applied nationally could multiply the known death toll by roughly a factor of three, at
least in the first six months of the epidemic, when it was most intense.
In some areas, the number of deaths may have been as much as 10 times as high as that reported to the Haitian government, which derived its
statistics largely from mortality information supplied by clinics and hospitals.
Doctors Without Borders was among the first medical aid groups to assist the government in assessing and treating the epidemic, which spread
nationwide within a month. By April 2011, the government had improved its surveillance system and had reported nearly 4,900 deaths. Although
large, the number implied only a small statistical increase when compared with the normal mortality rate for the country.
The study stops short of projecting what Haiti’s cholera death toll might be today, but said that “if the estimates presented here are correct, then
many deaths in Haiti were never counted in the official statistics during the first wave of the cholera epidemic, despite commendable efforts to
promptly implement a national cholera surveillance system.”
More than five years later, cholera remains entrenched in parts of Haiti, and the infection rate appeared to worsen in 2015. The Associated Press
reported on March 3 from Port-au-Prince, the capital, that cholera had sickened more than 6,000 people so far this year and was killing about 37 a
month.
Visit New York Times for the report.
The Joint Commission launches community-based palliative care certification
The Joint Commission is launching the industry’s first certification for home health and hospices that provide palliative care services in the patient’s
place of residence. Organizations can begin to apply for the voluntary Community-Based Palliative Care (CBPC) certification on May 1, 2016, with
onsite surveys to start on July 1, 2016.
The certification’s framework helps providers design, deliver and validate patient-centered care and services.
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Key CBPC certification requirements include:
A robust interdisciplinary care team
Customized, comprehensive care plans
After-hours care and services
Use of evidence-based clinical practice guidelines
A defined hand-off communications process
CPBC prepublication standards were developed based on the 2013 Clinical Practice Guidelines for Quality Palliative Care (3rd ed.); the National
Hospice and Palliative Care Organization’s Standards of Practice for Pediatric Palliative Care and Hospice (2010); other current palliative care
professional literature; and input from a panel of home care and palliative care experts. The standards underwent a six-week field review to obtain
feedback from Joint Commission customers and other healthcare professionals.
Visit Joint Commission for the certification information.
Theranos competitor HealthTell raises $26M for single-drop-of-blood diagnostics that profile immune response
Single-drop-of-blood diagnostics startups are still able to attract a pretty penny, despite the fallout from fallen unicorn Theranos. Arizona upstart
HealthTell is in the midst of an impressive $35.5 million funding round, according to a regulatory filing. Thus far, it’s raised about $26 million from 25
investors, according to a regulatory filing.
The Arizona State University spinout, launched in 2011, assesses a patient’s immunosignature – that is, its immune response to 30 conditions.
These include cancers, infectious, metabolic and autoimmune diseases – including arthritis, influenza and Alzheimer’s disease. It deploys a highdensity peptide array that’s meant to search the countless antibodies present in any human blood sample. Different permutations and combinations
of antibodies can indicate a patient has a disease.
Prior investors in the company include Vital Venture Capital, Paladin Capital Group, Acadia Woods Partners, Cambridge Global Capital and the Broe
Group. MedCity News is waiting to hear back from HealthTell to learn about how it’ll use this new influx of cash. HealthTell has raised a $14 million
Series A prior to this fundraise.
HealthTell’s been likened to Theranos in the past – because both are testing companies looking to make diagnoses based on a small volume of
blood. However, HealthTell has kept a much lower profile – and has published its findings. It’s a little easier to understand the science upon which
HealthTell is based.
On top of disease diagnostics, HealthTell is shopping out its technology to pharmaceutical partners, with an aim to find applications in drug
development. Immunosignatures, it says, could help with patient profiling so as to improve the clinical trial recruitment process – as well as examine
drug response among trial participants.
Visit MedCity News for the story.
Antibiotic resistance common in kids' UTIs
A substantial portion of E. coli urinary tract infections (UTIs) in children were resistant to commonly used antibiotics, both in first world countries and
less developed parts of the world, according to a meta-analysis.
In an analysis of 58 studies from 26 countries that documented antibiotic resistance in pediatric UTIs, resistance rates to ampicillin, cotrimoxazole,
and trimethoprim in first world countries came in at 53.4%, 30.2% and 23.6% pooled resistance, respectively, reported Ashley Bryce, a PhD
candidate at the University of Bristol in England, and colleagues.
In developing countries, pooled resistance was 79.8%, to ampicillin, 69.6% to cotrimoxazole, and 60.3% to co-amoxiclav, they wrote in The BMJ.
Overall, resistance to all three of those antibiotics was particularly high in Organization for Economic Co-operation and Development (OCED)
countries and resistance to ampicillin and cotrimoxazole was even higher in non-OCED countries (poorer countries), the authors noted.
A dozen studies that specifically examined children ages 0-5 years found even higher rates of antibiotic resistance, especially in the five studies from
non-OCED countries. The pooled resistance to ampicillin jumped to 90.3%, while resistance to cotrimoxazole and co-amoxiclav was over 70% each.
Visit MedPage Today for the study.