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Policy and Health Issues in the News



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Am Fam Physician. 2009 Jun 1;79(11):931-932.

PCPCC Provides Guide for Integrating HIT into the Patient-Centered Medical Home

The Patient Centered Primary Care Collaborative (PCPCC) recently released a resource guide to help physician practices integrate health information technology (HIT) into the patient-centered medical home. “Meaningful Connections, A Resource Guide for Using Health IT to Support the Patient-Centered Medical Home” specifies five core capabilities that are required to support the medical home practice model. These include the ability to store and share personal health information; communicate with other members of a patient's health care team; collect and report patient outcomes and practice performance measures; engage in decision support processes with other physicians about evidence-based treatments; and foster health literacy and personal health management among patients. The PCPCC has also endorsed a new set of guidelines for implementing medical home demonstration projects. The guidelines, which were released by several medical organizations, including the American Academy of Family Physicians (AAFP), contain 16 recommendations for structuring projects that test the medical home model of care. For more information, visit http://www.aafp.org/news-now/professional-issues/20090506pcpcc-hit-guide.html.

Online Screening Tool Helps Physicians Assess Patients' Use of Alcohol and Drugs

The National Institute on Drug Abuse (NIDA), a division of the National Institutes of Health, has created new resources to help physicians and other health care professionals assess patients' use of tobacco, alcohol, and illicit and nonmedical prescription drugs. The outreach initiative, called NIDAMED, includes an online screening tool, a comprehensive resource guide for physicians, a quick reference guide, and a patient-tested postcard. The online screening tool was adapted from the World Health Organization's Alcohol, Smoking, and Substance Involvement Screening Test. The tool guides physicians through a short series of questions, and recommends a level of intervention based on patients' responses. NIDA's goal is to help physicians identify unhealthy behaviors before they evolve into life-threatening conditions. Research shows that screening, brief intervention, and referral for treatment can promote reductions in patients' alcohol and tobacco use. Additionally, there is growing evidence that these methods can achieve reductions in patients' illegal and nonmedical prescription drug use. For more information, visit http://www.aafp.org/news-now/clinical-care-research/20090504nidamed. html or the NIDA Web site at http://www.drugabuse.gov/nidamed/index.php.

Policy Options Paper Recommends Payment Increase for Medicare Primary Care Services

The Senate Finance Committee has issued a policy options paper for health care reform that could benefit primary care physicians who care for Medicare patients. The recommendations include a bonus payment of at least 5 percent for Medicare primary care services during the next five years. The options paper also calls for a 1 percent increase in the overall physician payment rate in 2010 and 2011. To accommodate the payment increase, the committee proposes reducing payments for non-primary care services under Medicare by about 0.5 percent. The options paper also recommends an additional 2 percent bonus payment for physicians who participate in Medicare's Physician Quality Reporting Initiative. Although the options paper does not propose an immediate elimination of Medicare's sustainable growth rate (SGR) formula, it does recommend blocking and ultimately mitigating the effects of the SGR formula. For more information, visit http://www.aafp.org/news-now/government-medicine/20090506optionspaper.html.

Proposed Cooperative Extension Service Focuses on Assisting Local Practices

A cooperative extension service for primary care could help family physicians transform their practices into patient-centered medical homes, according to AAFP member Kevin Grumbach, MD, professor and chair of the Department of Family and Community Medicine at the University of California, San Francisco. Speaking before the Society of Primary Care Policy Fellows in Washington, DC, Grumbach called on the federal government to establish an extension service that would be funded and directed by the U.S. Department of Health and Human Services. One of the main goals of the extension service would be to encourage a proactive model of care that focuses on managing chronic diseases and providing preventive care. Through the extension program, states would form centralized hubs to deploy personnel to work with private health care practices, community-based primary care practices, community health centers, and hospital outpatient departments. Local agents from the extension program would assist practices by helping them implement HIT, build team-based models of care, and create practice-based research networks. For more information, visit http://www.aafp.org/news-now/government-medicine/20090505grumbach-coop.html.

CDC Receives Funding to Make Vaccines Available to Underserved Patients

The Centers for Disease Control and Prevention (CDC) will receive $300 million in funds for vaccines and grants to distribute through its Section 317 program. The funding, which is part of the American Recovery and Reinvestment Act of 2009, will be divided between public and private immunization providers to make recommended vaccines available to underinsured patients who are ineligible for the CDC's Vaccines for Children program. The Section 317 program also provides vaccines to uninsured and underinsured adults, as funding allows. According to the CDC, approximately 42,000 adults and more than 300 children die in the United States each year from vaccine-preventable diseases and their complications. For more information, visit http://www.aafp.org/news-now/health-of-the-public/20090429section-317.html.

Prepackaged EHR System Bundles Products and Services for Small Physician Practices

Physicians in Virginia, Illinois, and Georgia are now able to purchase an electronic health record (EHR) system through Sam's Club, a division of Wal-Mart Stores, Inc. The online-only offer includes a prepackaged assortment of products and services from e-ClinicalWorks and Dell. Designed with small physician practices in mind, the systems start at approximately $24,000 for one physician, and include hardware, software, installation, training, technical support, and maintenance. Steven Waldren, MD, director of the AAFP's Center for HIT, said some physicians will appreciate the pre-packaged concept, which makes the EHR system selection process easier. Waldren encouraged physicians to choose an EHR system based not only on the price, but also because it is the right system for their practice. Sam's Club plans to make the prepackaged bundle available nationwide by the end of 2009. For more information, visit http://www.aafp.org/news-now/practice-management/20090424sams-club-ehr.html.

MedWatch: FDA Issues Warning for Weight Loss, Botulinum Toxin Products

The U.S. Food and Drug Administration (FDA) has issued a warning to consumers to stop using Hydroxycut weight loss products. The FDA has received 23 reports of adverse events in persons using Hydroxycut products, including asymptomatic liver enzyme changes, jaundice, liver damage requiring transplant, and liver failure. In response, the makers of Hydroxycut have recalled more than a dozen of the weight loss products from the market. The FDA is also requiring safety label changes, a boxed warning, and a risk evaluation and mitigation strategy for all botulinum toxin products. The agency received reports that the effects of the products may spread from injection sites to other parts of the body, causing muscle weakness, trouble speaking, loss of bladder control, and vision problems. For more information, visit the FDA Web site at http://www.fda.gov/bbs/topics/NEWS/2009/NEW02006.html or http://www.fda.gov/bbs/topics/NEWS/2009/NEW02005.html.

Report Calls on Physicians to Help Prevent Mental and Emotional Disorders in Youth

A recent report from the National Research Council and the Institute of Medicine calls on physicians to make the prevention of mental, emotional, and behavioral disorders in young persons a priority. According to the report, 14 to 20 percent of persons 25 years or younger experience one or more of these disorders at any one time. Such disorders affect patients' well-being and cost the United States approximately $247 billion annually in quantifiable costs. Primary care physicians can help patients by recommending prevention and intervention programs, support networks, and community services that offer skills training and youth development programs. For more information, visit http://www.aafp.org/news-now/health-of-the-public/20090429nrc-iom-teen-rpt.html.

Fact Sheets Offer Guidelines for Addressing Conflicts of Interest in CME Content

Two fact sheets on continuing professional development are now available from the American Medical Association National Task Force on Continuing Medical Education Provider/Industry Collaboration (NTF). The sheets were created for NTF's “Get the Facts!” campaign, which aims to disseminate information and dispel myths about continuing medical education (CME) issues. The first sheet, “CME: Providing Valid and Independent Evidence for Clinical Decisions,” discusses the high standards of medical information that physicians rely on for clinical decision making. The second sheet, “CME: Addressing Conflict of Interest (COI),” provides a step-by-step guide for CME presenters, planners, and authors to resolve potential conflicts of interest between financial interests and CME content. For more information and to download the NTF fact sheets, visit http://www.aafp.org/news-now/cme-lifelong-learning/200903166ntf-fact-shts.html.

AFP and AAFP NEWS NOW staff


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