By now, it’s probably safe to say that some, if not all, of you have experienced some level of “big data fatigue.” The phrase has become ubiquitous, no matter the industry, although it seems none more so than in healthcare. Indeed, almost every healthcare news source to which I subscribe these days seems to have weekly articles, essays, white papers and blogs about big data. But there’s a common thread often missing from these reports. While they all report on the inevitability of big data’s influence on the healthcare sphere, as well as the manner in which electronic health/medical records (EHR/EMR) will continue to impact the future of care delivery, there is little discussion of the role of evidence as it relates to big data.
There’s no disputing that the current state of healthcare is in flux. Regardless of public opinion and political leanings about the topic, the manner in which clinicians and health systems deliver care is changing, and more disruption to long-accepted paradigms is on the horizon. Though the move away from fee-for-service medicine has been in existence for some time, the adoption of an evidence-based approach in the provider market has been uneven at best. Perhaps now more than ever, a refocusing is required on just what evidence-based medicine (EBM) is, and why the application of the scientific method to healthcare delivery is essential to achieving the crucial Triple Aim.
Last week, the Journal of the American Medical Association (JAMA) released a report about research performed at the University Of Pittsburgh School Of Medicine and the VA Pittsburgh Healthcare System. The findings revealed that sepsis, a potentially fatal condition triggered by an infection in the bloodstream, has a greater readmission rate (12.2%) than all four of the medical conditions currently tracked by the Centers for Medicare & Medicaid Services (CMS). Those conditions are:
As part of the Patient Protection and Affordable Care Act (ACA), the Hospital-Acquired Condition Reduction Program (HACRP) was established to incentivize hospitals to reduce the number of HAC’s per year (Source:www.cms.gov). HAC’s differ slightly from hospital-acquired infections (HAI’s) although both designations fall under the regulations set forth by the HACRP.
- HAI’s: infections patients may contract while under treatment in a healthcare facility (urinary tract infections, sepsis, etc).
- HAC’s: any other situation or condition that may occur (including medication errors, pressure sores, falls).
This week, the Centers for Medicare & Medicaid Services (CMS) issued a proposed Decision Memorandum regarding coverage for leadless pacemakers. If approved, it will provide conditional coverage for leadless pacemakers only if they are used in an approved clinical study as determined by the Coverage with Evidence Development (CED) program.