The 10 Biggest Hospital Stories of 2013

2013 was a challenging year for healthcare, and one marked with much uncertainty.

Perhaps the most uncertainty in the industry stemmed from the rollout of the Patient Protection and Affordable Care Act's healthcare exchanges. For months leading up to their launch, health systems worried as they struggled to estimate, and therefore plan for, the number of patients who would enroll in plans offered on the exchanges and reimbursement rates under these plans.

When the exchanges did launch, they launched in the midst of a federal government shutdown. And, the federal exchange website, www.Healthcare.gov, experienced weeks of technical difficulties, forcing the Obama administration to delay the start date for imposing penalties on the uninsured by six weeks, at the time this issue went to press. What other issues impacted hospitals and health systems the most during 2013? Following are 10 of the biggest stories covered in the pages of Becker's Hospital Review throughout the year.

Nominations for 2014 Great Hospitals in America List

Becker’s Hospital Review is currently accepting nominations for the 2014 list. Download the nomination form here. Please email completed nomination forms to Heather Punke, Becker's Hospital Review assistant editor, at hpunke@beckershealthcare.com. Nominations must be received by Jan. 17, 2014 to be considered.

CO officials strategize on offering access to healthy food and recreation

More than 100 elected officials, city planners and health officials from across the state participated in the recent LiveWell Colorado HEAL Cities & Towns Campaign summit in Westminster, Colo., to discuss the role of municipalities in improving access to healthy foods, enabling active lifestyles and encouraging workplace wellness.

Seventeen cities and towns across Colorado are currently participating in the HEAL Cities & Towns Campaign of Colorado, a partnership effort of LiveWell Colorado and the Colorado Municipal League. As part of the program, LiveWell Colorado provides free training, support and technical policy assistance to community leaders as they work toward implementing healthy eating and active living policies - known as "HEAL" policies. Read more about Colorado Officials Strategize on Offering Access to Healthy Food and Recreation - BWWFitnessWorld by www.broadwayworld.com

Clinical management apps: Creating partnerships between providers and patients

Clinical Management Apps: Creating Partnerships Between Providers and Patients

Reflecting on health reform: A tale of two IT procurements

Last week, the president of the United States, the most powerful person on earth, the man whose finger rests on the nuclear button, struck a bold blow for . . . procurement reform?

"There are a whole range of things that we're going to need to do once we get [the Affordable Care Act (ACA) rollout] fixed—to talk about federal procurement when it comes to IT and how that's organized," the president said on November 4, speaking to a group of donors and supporters. Read the full article here.

Barriers to Telemedicine Slowly Dropping

Obstacles to reimbursement and state licensure that have hindered widespread adoption of telehealth still abound, but there are signs of improvement, according to industry experts.

A maze of state requirements and reimbursement hurdles are onerous for telehealth providers, industry members said at a recent Alliance for Health Reform Briefing.

But the prospects are improving for telemedicine including less restrictive Medicare reimbursement rules for telehealth services. Click here to read more.

How ideas become innovations: Roundtable with healthcare innovation leaders from UCLA, Ohio State

Innovation is increasingly becoming an important discipline for many of the country's hospitals and health systems. Leaders are dually tasked to build a culture that promotes the sharing of ideas and a willingness to learn, but they must also ensure the creative process is formalized and methodical. Here, four leaders from two of the top academic medical centers in the country share their approach to innovation.

Los Angeles-based UCLA Health System has and continues to deliver a range of innovations, from how employees answer the phone to the integration of military veterans as primary care coordinators. Molly Coye, MD, MPH, is chief innovation officer for the system and oversees the UCLA Institute for Innovation in Health. David Feinberg, MD, MBA, is president of UCLA Health System and CEO of UCLA Hospital System. Both participated in the roundtable. Click here to read more.

Innovations in addiction treatment Providers working with Integrated Primary Care Services

On April 16, 2012, the SAMHSA-HRSA center for integrated health solutions convened a meeting of substance abuse providers that have integrated primary care services. the meeting aimed to gain insights and perspectives from addiction treatment programs, and their primary care partners, experienced in integrating primary care services. this document is structured around the aspects of the organizations’ integrated services, including events that precipitated their integration efforts, common and significant challenges, and lessons learned, with additional information to help other substance abuse providers integrate service delivery with primary care. it also aims to inform other specialty substance abuse treatment providers interested in integrating primary care. Click here to read the full article.

Quality matters in focus: Learning health care systems

Government agencies, health care systems, and private companies are using data drawn from electronic medical records and administrative claims to advance medical knowledge. The tools they're developing are helping to monitor the safety and effectiveness of drugs already on the market, predict an individual's risk of developing different diseases, and identify those patients most likely to benefit from a given intervention. Click here to read the full length article.

Quality matters Q&A: Using machine learning to sort through treatment options

Quality Matters: You've said what Google is to search Watson is to discovery. What do you mean by that and why is it important as Watson delves into medicine?

Gold: If you think about your own experience doing searches on the Internet, you get millions of results that you have to sort through to find the ones that are contextually relevant. Watson is a little more thoughtful. It's looking to understand the context of the question and bring back not an answer, but a set of responses that are aligned to the questions, supported by evidence, and weighted by confidence. The reason that's so important, especially in health care, is that there is often more than one possibility of what's wrong when you describe your symptoms to a doctor. The cause could be viral or bacterial and even if you know it's bacterial, you have to consider a host of other things: which bacteria, what comorbidity issues are present, what medications you're taking, your family history, and what's happening in the general populace at any given time. For instance, if you knew there was an early outbreak of pollen that year because everyone was blogging and tweeting about it, you may draw a different conclusion if your throat is scratchy.

Quality Matters: How is Watson able to make sense of such disparate information? Click here to read more.

Chicago Public Health: Q&A with Bechara Choucair

Last week the Public Health Accreditation Board (PHAB) awarded five-year national accreditation status to five public health departments, bringing the number of health departments now accredited to 19 since the credential was launched two years ago. Hundreds more health departments are currently preparing to apply for accreditation, which includes a peer-reviewed assessment process to ensure it meets or exceeds a set of public health quality standards and measures. Among the newly accredited is the Chicago Department of Public Health.

"This is an important achievement and recognition that highlights the city of Chicago’s ongoing commitment to health and wellness on the part of all of our residents,” said Chicago Mayor Rahm Emanuel in a statement issued by PHAB. Click here to read the full article.

To promote wellness, Public Health Departments are launching apps. Will they work?

The Alabama Department of Public Health is venturing into the mobile universe as the first state with a health app for residents.

“Normally Alabama comes in last when it comes to health indicators, but we were one of the first states to be on Facebook and Twitter and YouTube. This is just another goal for us,” says Jennifer Pratt Sumner, the director of the digital media branch of the department.

The app, which is free to download from Google Play or iTunes, brings all of the social media feeds put out by the various public health divisions into one place. It also provides health news alerts and information about wellness events, such as the annual Alabama Youth Rally. Some recent tips included educational conferences open to the public, and tips on safely consuming shellfish in the state. Click here to read more.

4 Technology strategies required for population health management success

As healthcare moves toward value-based care and ultimately an at-risk payment environment, population health management is emerging as the delivery model required for success. Born before health reform, population health management is fundamental to the new system's "triple aim" — to improve health outcomes, lower costs and enhance the patient's care experience.

Population health management strives to achieve the triple aim "one patient at a time" by ensuring that people receive appropriate and timely preventive and chronic care, assistance navigating the system and resources to help them become more informed and engaged in caring for themselves. Click here to read more.

The value of pediatric symptom-checkers

A common pediatric injury is a tear in the tissue connecting the upper lip to the gum, usually the result of a fall. It's also a minor injury and will heal on its own without stitches.

It can seem anything but minor to parents, however, as the injured site will bleed every time the lip is pulled out to examine it.

"That's why in the symptom-checker, if you go to 'mouth trauma' it's all spelled out for them," says Barton Schmitt, MD, the creator of one of the world's first online symptom-checker platforms currently used on more than 200 hospitals' and physicians' websites. "It tells parents, just stop looking at it, it always heals." Click here to read more.

Nurses use Google Hangouts to collaborate on technology

Google Hangouts are getting more and more interesting. The ability to easily start a live video conference with colleagues all over the world, share screens, and see each other -- all in real time -- is opening many doors for innovation.

Sure, live video conferencing has been around for years, and it's been quite good for some time. But it hasn't been as easily and freely available as Hangouts on the ubiquitous Google infrastructure. Now, anyone with a Google account can start a live video conference. Read more here.

Mobilizing health information technology

We've all heard that electronic health record adoption has tripledsince 2010, which is especially noteworthy considering that the field of health information technology is still in its relative infancy. But while EHRs are top of mind in most health IT discussions, they're only one facet of a rapidly growing and evolving industry.

It's time to start expanding our health IT focus to encompass devices and applications that are much more accessible to patients, who are increasingly using smartphones and tablets to capture their health data. These data paint a more complete picture of their health and have significant potential to positively change our health care delivery system.

This new kind of data is termed "observations of daily living," or "ODLs." They're the bits of information that are defined and recorded by people during the course of their daily lives, based on health information that is personally relevant and meaningful to them.

Read more on how ODLs provide tangible, real-world feedback about how patients are doing here.

Answer to healthcare's million dollar question could snag $2M in rewards

The Knight Foundation is levying its lance alongside a quartet of healthcare's heavy hitters to spur new ideas to harness healthcare data technology for community health.

The Miami-based media conglomerate is launching a health innovation contest with the Robert Wood Johnson Foundation, California HealthCare Foundation, Clinton Foundation and Health Data Consortium. The contest challenges participants to answer the question, "How might we harness data and information for the health of communities?"

The right answer could be worth up to $2 million...read more here.

Getting the most out of gadgets and gizmos

Grantees adapt technology to educate patients, prevent domestic violence, improve physician-patient visits, and even make us happy.

As a teenager, Kyna Fong’s after-school job was quite a challenge. Kyna and her brother Conan where charged with helping their dad work with insurance companies and assist patients in his primary care practice.

Those early encounters gave Fong, a former Robert Wood Johnson Foundation (RWJF)Scholar in Health Policy Research (2008-2010), an intimate look at the needs of patients and providers. “That’s why my brother and I knew there was a need for a new type of electronic medical record [EMR],” she said.

Fong, who now has a PhD in economics, is one of many RWJF grantees who are maximizing the potential of technology to improve health. They are breaking new ground by finding innovative ways to use some of our favorite gadgets to perform research and inspire people to live healthier lives. Read the full article here.

Calhoun County Community Dental Access Initiative

This program began in 2007 to address the oral health needs of poor and largely uninsured residents of Calhoun County, Michigan. In the Community Dental Access Initiative (CDAI), patients volunteer at community non-profits in exchange for dental care. To ensure that the urgent need for care diminishes over time, patients also receive oral health education.

Dentists can join the Dentists’ Partnership Initiative (DPI) at different levels of commitment, ranging from 2-3 visits per month to 8 or more per month. Participating dentists can see their work is valued because the patients have paid for services through their volunteer work. Dentists receive community recognition of their service and, depending on the level of participation, support for purchases to improve their practice or enhance patient care.

Read who the program is a community partnership is made of here.

'My dear Watson' -- from 'Jeopardy' to a doc's office near you

Best known for beating brilliant humans at “Jeopardy,” Watson, the super computer, soon may be coming to a hospital or insurance company near you.

But don’t call him (or her) Dr. Watson. The more appropriate reference may be to Sherlock Holmes’ “my dear Watson,” the indispensable right-hand man — or woman as Lucy Liu now portrays Dr. Joan Watson in the re-imagined TV show, “Elementary.”

IBM’s Watson is actually named to honor the company’s founder, Thomas J. Watson. But as Watson’s creators dream up future roles for their intelligent machine — medical sleuth, patient watchdog and reading buddy to humans may be a handful of them — IBM is now trying to tap the silicon genius’ remarkable ability to digest information in nanoseconds for a variety of health care applications. Read more here.