AAFP News Now: AFP Edition
Policy and Health Issues in the News
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Am Fam Physician. 2010 Mar 15;81(6):697-698.
Journal Retracts Study Linking Measles, Mumps, and Rubella Vaccine to Autism
The Lancet fully retracted a 1998 study that linked autism to the measles, mumps, and rubella vaccine after an independent panel concluded that the study was flawed and the conduct of its lead author, Andrew Wakefield, MD, was “dishonest, irresponsible, and misleading.” The United Kingdom's General Medical Council (GMC) announced in 2004 that it was launching an investigation into the allegations of misconduct against Wakefield and two of his former colleagues. A hearing, which began in July 2007, concluded January 28, 2010. A report from the GMC determined that Wakefield had committed numerous ethical violations. In April 2010, the GMC will deliberate whether sanctions should be imposed on the U.K. medical registrations of Wakefield and two of his former colleagues. Although 10 of Wakefield's coauthors later renounced the study—and numerous studies that followed found no links between autism and vaccines—many parents in the United States and abroad avoided vaccinating their children based on the Wakefield study. The United States and other countries have had outbreaks of measles and mumps in recent years. For more information, visit http://www.aafp.org/news-now/clinical-care-research/20100210lancet-retracts.html and The Lancet Web site at http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2960175-7/fulltext.
Merck's PedvaxHIB Vaccine Available for First Time Since Its December 2007 Recall
Merck & Co. Inc. announced that its monovalent Haemophilus influenzae type b (Hib) conjugate vaccine PedvaxHIB is back on the market after an absence of more than two years. In December 2007, Merck recalled about 1 million doses of PedvaxHIB and its combination Hib/hepatitis B vaccine Comvax, and suspended production of the two vaccines, after routine testing of equipment used to manufacture the vaccines identified the presence of the pathogen Bacillus cereus. The Centers for Disease Control and Prevention's (CDC's) 2008 Immunization Survey found that coverage with three or more doses of Hib vaccine decreased nearly 2 percent (to 90.9 percent) from 2007 because of the vaccine shortage, which contributed to outbreaks of invasive Hib disease in Minnesota and Pennsylvania. The Comvax vaccine remains unavailable. For more information, visit http://www.aafp.org/news-now/clinical-care-research/20100212pedvax-returns.html.
Michelle Obama Launches Campaign to Help Overcome Childhood Obesity
During a February 9, 2010, White House event, First Lady Michelle Obama unveiled her Let's Move campaign to combat childhood obesity. The campaign is designed to support parents, provide healthier foods in schools, help kids be more physically active, and make healthy food affordable and available. Obama noted that physicians are seeing more obesity-related health problems (e.g., high blood pressure, high cholesterol, type 2 diabetes mellitus) in young persons than ever before. American Academy of Family Physicians (AAFP) President Lori Heim, MD, Vass, N.C., said that the AAFP, which is a partner in the Let's Move campaign, will be undertaking a number of new activities to help family physicians work with families to prevent and treat obesity and overweight, including initiating educational efforts and providing Web-based resources. For more information, visit http://www.aafp.org/news-now/health-of-the-public/20100211lets-move.html and the Let's Move Web site at http://www.letsmove.gov.
California to Implement Physician Access Regulations for Managed Care Plans
California physicians are preparing for the effects of new regulations from the California Department of Managed Health Care (DMHC) that will require physicians in managed care organizations to meet a series of timelines for providing care and services to patients seeking treatment. The timely access regulations will take effect January 17, 2011, making California the first state in the country to set time limits for physicians to see patients, and possibly providing an example for other states to follow when trying to improve access to care. Under the guidelines, primary care physicians in managed care plans will have to see patients in their networks who ask for an appointment within 10 days. Subspecialists will have 15 days to see in-network patients. The regulations also require all physicians in the plans to return phone calls from managed care patients within 30 minutes and to see those who are seeking urgent care that does not require prior authorization within 48 hours. Managed care plan companies will be responsible for surveying physicians and for using that data to develop and submit plans to the DMHC to address problems. According to Tom Riley, director of government relations for the California Academy of Family Physicians, about 11,000 family physicians practice in the state, and roughly 80 percent of them take some form of managed care payment. Although Riley noted that many primary care physician practices are meeting and even beating the time limits spelled out in the regulations, he said there are physicians who will have to shorten the time they spend with patients to accommodate the new requirements. Riley hopes, however, that the timeline standards in the legislation will induce health plans to create adequate networks of primary care physicians—something that can be accomplished only by paying primary care physicians fairly. For more information, visit http://www.aafp.org/news-now/government-medicine/20100128calif-timely.html.
Salami Linked to Outbreak of More Than 200 Cases of Salmonellosis in 42 States
Family physicians and their patients should be aware that an outbreak of foodborne illness caused by Salmonella serotype Montevideo, linked to certain salami products from Rhode Island–based Daniele Inc., is responsible for more than 200 reported cases in 42 states and the District of Columbia. According to a news release from the U.S. Department of Agriculture (USDA), as of January 23, 2010, Daniele Inc. had recalled more than 1.2 million pounds of ready-to-eat varieties of Italian sausage products. The USDA posted a list of products associated with that recall, as well as a second list of additional products recalled on January 31, 2010, that consumers can check to see if they have any of the products in their homes. A third notice was issued on February 4, 2010, citing yet more products recalled by the manufacturer. The CDC recommends that physicians report suspected cases of foodborne illness to their local public health officials. For more information, visit http://www.aafp.org/news-now/health-of-the-public/20100208salmonella-montevideo.html and the CDC Web site at http://www.cdc.gov/salmonella/montevideo.
Study Shows Disparity in Health IT Reality; Regional Extension Centers to Help with IT
A study released by the Center for Studying Health System Change and published online December 22, 2009, in the Journal of General Internal Medicine reveals a gap between what the federal government hopes health information technology (IT) can achieve in terms of patient care coordination and how well the technology actually assists physicians in practice. The study's authors said that small- and medium-sized physician practices generally agree that their electronic health records (EHRs) are useful in terms of making data available and coordinating patient care within their own practices, but most physicians interviewed said their EHRs are less helpful for exchanging information between practices and other health care settings because of a lack of interoperability between systems. The study's authors concluded that a highly functioning EHR should be able to ensure continuity of care; document and store patient information; use information to manage and coordinate care; initiate and track referrals and consultations; enable health care sharing across practices and clinical settings; and provide the exchange of information necessary for transitional and emergency patient care. The federal government plans to establish a nationwide network of regional extension centers to help primary care physicians benefit from government programs that aim to promote the adoption and “meaningful use” of health IT. The centers primarily will help practices that are likely to face numerous challenges in meeting meaningful use requirements, and also will help practices with workflow and redesign issues by, for example, providing guidance on project management and implementation. The regional extension centers are part of a broader program enacted through the American Recovery and Reinvestment Act of 2009. Many of the components of the legislation are designed to help health care professionals and hospitals become meaningful users of certified EHRs. For more information, visit http://www.aafp.org/news-now/practice-management/20100216hsc-ehr-study.html and http://www.aafp.org/news-now/practice-management/20100215seidman-ehrs.html.
AAFP Offers New Resources to Help Family Physicians Prepare for ICD-10 Transition
The AAFP is offering new resources to help prepare family physicians for the transition to the clinical modification of the International Classification of Diseases, 10th revision (ICD-10), which becomes effective on October 1, 2013. The ICD-10 contains nearly five times the number of codes as the current ICD-9 code set, or about 69,000 diagnosis codes versus 14,000 codes. The new resources on the AAFP's Web site are intended to help its members with the changeover and also to coach family physicians on how to correctly use the ICD-10 codes. As part of that training effort, the AAFP has signed an agreement with the American Health Information Management Association (AHIMA) to serve as a collaborating organization to the second annual AHIMA ICD-10 Summit, April 12 to 13, 2010, in Washington, DC. AAFP members are eligible for a discount on conference registration by using coupon code MX4376 when registering. For more information, visit http://www.aafp.org/news-now/practice-management/20100210icd-10-help.html and http://www.aafp.org/online/en/home/practicemgt/codingresources/icd10cm.html.
— AFP and AAFP NEWS NOW staff
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