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Telemedicine has long been recognized for improving access to care as well as access to specialist expertise, particularly in rural facilities.
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Although a recent study at the University of Rochester (NY) seems to indicate that telemedicine could eliminate many pediatric ED visits, a pediatric ED physician with extensive experience with telemedicine believes that its applications are not broad enough to have a significant impact on ED overcrowding.
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There is a significant amount of research that demonstrates ED crowding due to boarding is responsible for poor outcomes, says Tom Scaletta, MD, president of Emergency Excellence, a Chicago-based organization that improves patient care and efficiency in the ED while controlling costs. He also is medical director of a high-volume community hospital in a Chicago suburb.
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If your documentation assurance program focuses on reimbursement alone, you're not going far enough. With pay-for-performance initiatives on the rise and increasing mandates for public reporting of hospital data, it's critical that the medical record accurately reflect the severity of illness and the services provided to your patients.
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Regular audits and continuing education are the keys to a successful documentation assurance program, says Liz Youngblood, RN, MBA, vice president, patient care support services at Baylor Health Care System in Dallas.
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"When I conduct an initial review of the chart, I read it from the beginning, like a story starting with the emergency department notes, through the history and physical and start building a story from a clinical standpoint.
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An emergency physician is managing an acute myocardial infarction, arranging for a patient transfer, sewing up a laceration, and putting in a chest tube, with 20 people still waiting to be seen in the waiting room.
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This is the first in a two-part series about the hidden risks and liabilities of medical helicopters.
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When a medical helicopter goes down, there often is more than one cause. Bad risk assessment, insufficient technology, and pilot error can combine to create a tragedy.
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If you are going to use medical helicopters, Don Maciejewski, JD, an aviation attorney with the Jacksonville, FL, law firm of Zisser Robison, recommends that risk managers be prepared for the worst. Make sure you are adequately insured to cover the payouts from a crash that kills five people on a nonurgent mission, he says.
