CMS Announces Temporarily Expanded Telehealth Coverage, Telehealth Toolkits for Medicare Beneficiaries

AHRQ Stats: Use of Morphine To Treat Pain

Overall in 2015-2016, non-elderly U.S. adults obtained an annual average of 376 milligram morphine equivalents (MMEs), and elderly adults obtained an annual average of 774 MMEs of outpatient prescription opioids to treat chronic and acute pain. (Source: AHRQ, Medical Expenditure Panel Survey Research Findings #45: Average Annual Morphine Milligram Equivalents (MMEs) of Outpatient Prescription Opioids and Share of Total MMEs among Elderly and Non-Elderly Adults in 2015–2016.) 

Today's Headlines:

• CMS Announces Temporarily Expanded Telehealth Coverage, Telehealth Toolkits for Medicare Beneficiaries.
• Panel Creates Framework To Study Diagnostic Errors in Emergency Departments.
• Applications Due April 6 for AHRQ Challenge on Digital Solutions To Support Care Transitions.
• AHRQ Seeks New Ideas for Managing Opioids in Older Adults.
• New Approach Enhances Timely, Reliable Communication of Patient Test Results.
• Highlights From AHRQ’s Patient Safety Network.
• Postponed: April 7 Webinar on Using AHRQ’s Survey on Patient Safety Culture Nursing Home Survey.
• AHRQ in the Professional Literature.

CMS Announces Temporarily Expanded Telehealth Coverage, Telehealth Toolkits for Medicare Beneficiaries

The Centers for Medicare & Medicaid Services (CMS) is temporarily extending telehealth coverage for Medicare beneficiaries during the COVID-19 outbreak. Doctors, nurse practitioners, clinical psychologists, licensed clinical social workers and other providers will receive reimbursement for a broadened range of telehealth resources that allow them to offer healthcare services to beneficiaries at home. To answer clinician telehealth questions and maximize the time they spend with patients, CMS also has made two new toolkits available for download. Access a CMS press release about the expanded coverage as well as telehealth toolkits for general practitioners (PDF, 290 KB) and end-stage renal disease providers (PDF, 440 KB) .

Panel Creates Framework To Study Diagnostic Errors in Emergency Departments

Through an AHRQ-funded grant, a panel of experts proposed that diagnostic errors in emergency departments be defined as “a divergence from evidence-based processes that increases the risk of poor outcomes despite the availability of sufficient information to provide a timely and accurate explanation of the patient's health problem(s).” The 17-member, multidisciplinary panel developed the definition and a diagnostic process framework by reviewing existing literature and participating in a moderated focus group. As stated in the Journal of Patient Safety, the new definition and framework can enhance clinical decision support and development of diagnostic errors measures, and refine diagnostic errors mitigation strategies in emergency departments. Access the abstract.

Applications Due April 6 for AHRQ Challenge on Digital Solutions To Support Care Transitions

Applicants will be accepted until April 6 for an AHRQ challenge competition intended to identify cutting-edge digital solutions for managing transitions in care. Transitions in care are critically important, especially at times when health systems face a surge in demand for services, and communication between providers and patients is vital to getting patients the care they need. The Digital Solutions to Support Care Transitions Challenge has a total prize pool of $175,000. Applicants are asked to develop interoperable health information technology solutions that engage patients and family caregivers during care transitions from inpatient hospital care to home, especially among Americans who may have low health literacy or limited English-language proficiency. 

AHRQ Seeks New Ideas for Managing Opioids in Older Adults

A new Request for Information notice issued by AHRQ is aimed at soliciting new and innovative approaches, specific tool, and strategies for opioid management in older adults. The notice, issued for planning purposes, seeks ideas across the care delivery continuum, from optimizing the use of opioids within an effective pain management strategy to screening for opioid misuse and opioid use disorder, as well as developing approaches to opioid tapering in older adults.  Access more information in the Federal Register notice.

New Approach Enhances Timely, Reliable Communication of Patient Test Results

Healthcare providers can improve patient safety by ensuring that patients receive test results in a fail-safe manner, based on research findings highlighted in The Joint Commission Blog by AHRQ grantee Hardeep Singh, M.D., M.P.H., and safety advocate Sue Sheridan, M.I.M., M.B.A. The research, partially funded by AHRQ, found that up to 62 percent of laboratory results and up to 36 percent of radiology results are not communicated appropriately, potentially resulting in patient harm from delays in further testing and treatment. This communication breakdown is caused by factors such as workflow issues and confusion over who should follow up with patients, the authors said. They suggest that a “closed loop communications” approach—in which every test result is sent, received and acted upon—can reduce diagnostic errors by making sure that clinicians and healthcare organizations get the correct test information to the right individual, including the patient. Access the blog.

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• Who gets the benefit of the doubt? Performance evaluations, medical errors, and the production of gender inequality in emergency medical education.
• A systematic review exploring the content and outcomes of interventions to improve psychological safety, speaking up and voice behaviour.
• 'Immunising' physicians against availability bias in diagnostic reasoning: a randomised controlled experiment.

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Postponed: April 7 Webinar on Using AHRQ’s Survey on Patient Safety Culture Nursing Home Survey

The April 7 webinar, “Improving Safety Culture Using the AHRQ SOPS Nursing Home Survey,” has been postponed. The event was intended to highlight how AHRQ’s Surveys on Patient Safety™ (SOPS®) can help healthcare organizations assess how staff members perceive the ability of various aspects of organizational culture to promote a safe patient environment. A new date for the webinar will be announced at a later date. For questions, contact the SOPS User Network at SafetyCultureSurveys@westat.com or call 1-888-324-9749. 

AHRQ in the Professional Literature

Acute care, prescription opioid use, and overdose following discontinuation of long-term buprenorphine treatment for opioid use disorder. Williams AR, Samples H, Crystal S, et al. Am J Psychiatry 2020 Feb;177(2):117-24. Epub 2019 Dec 2. Access the abstract on PubMed®.

Effect of treating parents colonized with Staphylococcus aureus on transmission to neonates in the intensive care unit: a randomized clinical trial. Milstone AM, Voskertchian A, Koontz DW, et al. JAMA 2019 Dec 30. [Epub ahead of print.] Access the abstract on PubMed®.

Factors associated with family experience in pediatric inpatient care. Feng JY, Toomey SL, Elliott MN, et al. Pediatrics 2020 Mar;145(3): e20191264. Epub 2020 Feb 3. Access the abstract on PubMed®.

Comorbidities, anticoagulants, and geriatric-specific physiology for the field triage of injured older adults. Newgard CD, Lin A, Eckstrom E, et al. J Trauma Acute Care Surg 2019 May;86(5):829-37. Access the abstract on PubMed®.

Home health care after skilled nursing facility discharge following heart failure hospitalization. Weerahandi H, Bao H, Herrin J, et al., J Am Geriatr Soc 2020 Jan;68(1):96-102. Epub 2019 Oct 11. Access the abstract on PubMed®.

Using electronic health record system triggers to target delivery of a patient-centered intervention to improve venous thromboembolism prevention for hospitalized patients: is there a differential effect by race? Owodunni OP, Haut ER, Shaffer DL, et al. PLoS One 2020 Jan 16;15(1):e0227339. Access the abstract on PubMed®.

The role of screening in depression diagnosis and treatment in a representative sample of US primary care visits. Samples H, Stuart EA, Saloner B, et al., J Gen Intern Med 2020 Jan;35(1):12-20. Epub 2019 Aug 6. Access the abstract on PubMed®.

Understanding interpersonal and organizational dynamics among providers responding to crisis. McGovern KM, Wells EE, Landstrom GL, et al. Qual Health Res 2020 Feb;30(3):331-40. Epub 2019 Aug 20. Access the abstract on PubMed®.