Top 10 actions to take for medical emergency preparedness

Once a virus such as the swine flu becomes widespread in the United States, medical practices should consider implementing their emergency response plan. Here's what you should do to keep yourself, your practice and your patients safe during such an event.

1. Create a monitoring system.
   As the group's administrator, you must assign responsibility for monitoring the flu outbreak and updating appropriate staff on a regular basis. Establish a planning committee comprising physicians, nurses and key administrative staff.
   
   For monitoring outbreaks such as the swine flu, the Centers for Disease Control and Prevention (CDC) provides a weekly flu report online and are tracking recently diagnosed swine flu cases in the United States.


2. Set protocols for flu patients.
   Begin with phone triage when patients call: Provide a checklist for your receptionist to follow if a patient may have flu. Consider separate waiting areas, appointment times, exam rooms and even a dedicated flu staff. To segregate potential flu patients from at-risk patients you may need to limit medically unnecessary visits.


3. Investigate resources for treating flu patients.
   Know the agencies to turn to in your community and state for assistance. The United States Department of Health and Human Services (HHS) and the CDC list helpful resources by state, such as pandemic planning information, health and wildlife contact information and federal assistance available to your medical practice.


4. Establish a reporting system to appropriate health authorities.
   Maintain a current, easily accessible list of agencies to which you should report suspected or confirmed flu cases. The CDC provides this information for clinicians.


5. Educate and train staff about flu and its control measures.
   Educating employees can help reduce their risk of infection and maintain the work force. The CDC has training resources such as posters, handouts and podcasts in different languages for you to share with staff. Education should include infection control procedures to mitigate the spread of influenza. Emphasize that all employees should have an individual or family pandemic plan to minimize risk of exposure.


6. Establish respiratory hygiene/cough etiquette for patients and staff.
   To reduce the risk of disease transmission, plan for an ample supply of tissues, appropriate disposal receptacles, regular removal of waste tissue and regular disinfection of virus-exposed surfaces. The CDC has plenty of resources for proper respiratory hygiene, and recommends coughing into a tissue or your sleeve, not your hand, and being diligent about hand washing. Symptomatic patients may have to wear masks, so be sure to have an extra supply on hand.


7. Compile information on obtaining antiviral drugs and vaccines and inventory other medical supplies.
   Your medical practice may need antiviral drugs and vaccines, if available, for staff as well as patients. Inventory important medical supplies such as gloves, masks, and gowns that need rotation to ensure readiness and minimize loss from theft, expiration or spoilage. Consider whether supplies have special storage requirements and whether you have adequate storage space. Identify alternate suppliers if normal vendors can’t meet your practice's needs.


8. Establish a sick-leave policy for staff with influenza.
   This policy should address what to do when employees become sick at work, when they should return to work, when they are symptomatic but well enough to work and when they must tend to ill family members. Severe pandemics may call for counseling services.


9. Anticipate staff absence.
   Figure the minimum number and mix of employees necessary to operate your practice. If absences take your group below that minimum, you'll have to decide whether to close the office or call on alternative, pre-arranged personnel. Be sure to communicate how employees will be paid if the office closes.


10. Evaluate information technology resources.
    Evaluate the IT strengths and weaknesses of your organization. What would cause the practice to lose the use of its computers? Can the practice function without computers? Can nonclinical employees work from home? Can your staff and physicians have remote access to the practice's information systems?
    
    You could minimize staff exposure to the flu while maintaining productivity by developing remote access or virtual private network connections for essential nonclinical employees. Transcription, insurance filing, account posting, appointment scheduling, various accounts receivable activities, report functions, purchasing and payroll can all be performed remotely. This level of staff functionality will most likely require additional software and greater server capacity. Employees must have home computers of sufficient quality, speed and capacity, in addition to a broadband Internet connection. Such a system calls for occasional testing to eliminate potential problems with work-from-home logistics.

This article is from The Medical Group Management Association (MGMA) website

AMA: One-stop site: E-prescribing help for physicians

The AMA has created an extensive online resource.
Editorial. April 20, 2009.


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By the close of 2008, only about 13% of physicians were prescribing electronically. The prescription pad and pen still rule in most offices.

But doctors are getting a nudge to automate their prescribing process. Physicians who prescribe electronically for their Medicare patients will be eligible for incentive payments. This year's bonus will be equal to 2% of all Medicare Part B pay for the year.

Before the monetary incentives there was friendly persuasion. A 2006 Institute of Medicine report called on all prescribers to have an electronic prescribing system in place by 2010, saying such systems would help reduce medication errors. In November 2008, the Centers for Medicare & Medicaid Services released a guide for doctors who plan to seek Medicare e-prescribing incentives that started this year.

Will all this be enough to get doctors to embrace e-prescribing? Hard to tell given the expense and uncertainties about choosing the right system.

The American Medical Association has help for physicians at a timely, in-depth resource that provides them with the tools and information they need to make decisions about implementing electronic prescribing in their practices.

On April 1, the AMA launched its e-prescribing learning center, a one-stop shop for what doctors need to know to navigate the proper course when considering and adopting e-prescribing (www.ama-assn.org/go/eprescribing).

The Web site spells out how e-prescribing works, what it can do for a doctor's practice, how to get an office ready to implement it and how to choose an e-prescribing system. Many features of the online center are available only to AMA members, but some starter educational tools and information can be accessed for free by all visitors to the site.

Downloadable in-depth components include a description of Medicare's electronic prescribing incentive program, a survey to help doctors assess their readiness to implement an e-prescribing system, and templates to guide staffing and planning for the project.

The center includes the latest information on federal and state programs that offer e-prescribing incentives.

A section on system costs explores the expense and potential benefits to a practice over time, and examines up-front and ongoing costs and financing options. Another site highlight, according to the AMA, is that it offers complete and unbiased data on vendor prices and features.

Another feature allows doctors to calculate an e-prescribing system's impact on their practices. Physicians can find out whether they're eligible for the Medicare incentive and figure out their annual incentive payments. The calculator addresses questions such as how many prescription renewal requests a practice receives by phone or fax in an average week.

With this new resource, doctors who want to pursue e-prescribing have detailed information at their fingertips to lead them to an informed decision on one of the most daunting and costly decisions facing practices today.

The print version of this content appeared in the April 27, 2009 issue of American Medical News.

The electronic version of this article is located on the AMA News Website.

HHS declares public health emergency over swine flu outbreak

The Department of Health and Human Services yesterday declared a nationwide public health emergency in response to an outbreak of a novel swine flu virus in California, Texas, Kansas, New York and Ohio. Forty cases have been confirmed, with one patient hospitalized to date.

The declaration enables the Centers for Disease Control and Prevention to release stockpiled antiviral medications to the affected states, and gives HHS the authority to ease certain federal regulations, such as critical access hospital bed limits and Health Insurance Portability and Accountability Act privacy rules, to allow hospitals to deliver timely care to infected patients. CDC's Division of the Strategic National Stockpile is releasing one-quarter of its antiviral drugs, personal protective equipment and respiratory protection devices to help states respond to the outbreak. Laboratory testing has found the swine influenza A (H1N1) virus sensitive to the prescription antiviral drugs oseltamivir and zanamivir.

For more information, visit the CDC Web site. Speaking today at the AHA's annual meeting in Washington, former U.S. Surgeon General David Satcher, M.D., suggested hospital leaders review their pandemic plans and monitor the CDC Web site for the latest developments. Satcher will receive the Health Research & Educational Trust's 2009 TRUST Award at a July 23 reception during the AHA/Health Forum Leadership Summit in San Francisco.

--Article from http://www.hwhn.com

HPI EMR Survey

As many of you know the U.S. Federal Stimulus Package includes incentives for “meaningful” adoption of an electronic medical record (EMR). Medicare’s incentives begin in 2011. The maximum amount of the Medicare incentive is $44,000 per physician spread over 5 years. A maximum payment of $18,000/physican available for year 2011. Any physician not “meaningfully” utilizing an EMR by 2015, will face a penalty of 1% reduction in Medicare payments.

In an effort to determine how HPI can best assist our members with qualifying EMR’s we request all practices complete a brief survey. It can be completed through the following link click here.

We need to move quickly as the demand for EMR’s and other related health information technology is expected to dramatically increase causing implementation waiting times to lengthen for more popular options. Therefore, we ask that our providers complete the survey by May 4, 2008.

If you have any questions, issues or need assistance please contact Brant Kelch at 423/392-1920.

Support for SB 1297 and SB 1680

Please forward the following letter to the members of the Senate Commerce committee on TUESDAY and have your physicians do the same (or do it for them). Please cut and paste the letter into your e-mail. In the SUBJECT line put: Support for SB 1297 and SB 1680. Make sure to sign the e-mail. These types of contacts do make a difference.

Please click here to read the letter.

Please click here for the Senate Commerce Contact Information.

Mountain Region Family Medicine buying Quebecor property for Redevelopment

Mountain Region Family Medicine, PC will relocate their offices to the recently acquired historical "Kingsport Press Building" most recently occupied by Quebecor Industries. The Building will be transformed to become a unique downtown center for healthcare with modern-day medical ancillary support.

The project and building location will be named and become known as "The Press Building" with preliminary design nearing completion by CainRashWest, Architects. Phase one of the project will include the renovation of 115,000 to 117,000 square feet of space for physician offices and ancillary support, such as diagnostics, radiology and imaging services. Phase two includes the renovation of another 72,000 square feet of space. Mountain Region hopes to complete the first two phases in 14 to 18 months and be open by the fourth quarter of 2010. More than 30 percent of the space is already committed for occupancy, while the remaining area is either under study or available for tenants.

Phase three, which faces Press Street, calls for the renovation of another 100,000 square feet. It could include various multi-use spaces for professional offices and retail on the first two levels, and residential lofts on the third floor, with balconies overlooking Church Circle. Eventually, the group would also like to see a multi-story parking garage constructed at the site.

Occupancy inquiry and project information is available by contacting Mountain Region's administrator Mr. John Paul Linke, TCI Group's Mr. Charlie Dotson, Mrs. Angie Marshall, or the Architect, M. Hiram Rash, AIA at CainRashWest, Architects.

Click Here to view Official Press Release and photos

Click Here to view article in Kingsport Times News.