Hospital Bed Capacity Tracking and Preparedness

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The Affordable Care Act has brought a number of changes to the American healthcare landscape, the most well-known of which is the health insurance mandate, the result of which will theoretically increase the number of Americans with health insurance coverage. Here at Health Monitoring Systems, we are closely monitoring the effects of the ACA on emergency department utilization, but also of interest to public health is a provision regarding funding for regional systems for emergency care, including real-time tracking of hospital bed availability.
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Predicting Disease with Google & Comets

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Google Flu has been getting a lot of coverage lately, mostly for how it is getting the flu “wrong.” There was a Nature news item in February about Google Flu overestimating the peak of the current flu season. Not to be outdone, Science followed up a month later with an article on the forecast errors of Google Flu from the past two seasons as well as the current one. (original paper here) Also mentioned in the Nature item is the fact that Google Flu missed the initial novel H1N1 epidemic in the spring of 2009.
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Alcohol-Related Illness: St. Patrick's Day Edition

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St. Patrick’s Day marks the veneration of the island’s patron saint. In the dioceses of Ireland, it is both a solemnity and a holy day of obligation, and throughout Ireland it has become a day of parades, family feasts, and celebrations of Irish cultural heritage.
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Asthma and EpiCenter

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Now that we’ve sprung forward, health care professionals are readying themselves for the yearly increase in seasonal asthma visits. While spring allergens related to pollen do lead to increased ED visits for exacerbation of asthma symptoms, the highest spikes in asthma-related ED visits usually occur each year in the fall, beginning in September.
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ICD-9 to ICD-10: An Upgrade

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The year 2014 is bringing a lot of changes for the health care industry, including the ICD-10 compliance date. ICD is the classification used to code and classify diseases. The ICD has been revised periodically to incorporate changes in the medical field. To date, there have been 10 revisions of the ICD. On October 1st, 2014 all of the ICD-9 code sets that were previously used will be replaced by ICD-10 code sets. This transition is required for everyone covered by HIPAA.
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Dr. Andrew Walsh to Present at 2014 CSTE Conference

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It has just been announced that Dr. Andrew Walsh of HMS will be giving a poster presentation on his abstract, Visualizing Spatio-Temporal Patterns of Emergency Department Utilization during a Polar Vortex at the 2014 CSTE Annual Conference in Nashville, TN.
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The HIE: Part 1

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One of the great mysteries of the recent healthcare reform movement is why “HIE” has been used as the acronym for both Health Insurance Exchanges and Health Information Exchanges. As the Affordable Care Act health insurance exchanges continue to garner media coverage, the original HIEs—health information exchanges—continue to struggle.
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Urgent Care and Mini Clinics – the Donut Hole in Syndromic Surveillance

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doughnut-1023028-mIn recent years the range and availability of ambulatory care service providers has continued to grow. These include urgent care centers, mini clinics, and so-called “Doc in a box” providers. While the emergence of these services benefits consumers on many levels, it also creates a potentially serious “donut hole” in regional syndromic surveillance. A proliferation of these facilities can lead to diminished accuracy and efficacy of the population health data that’s made available, which can result in potentially serious negative consequences…for both public health officials and the communities they serve.
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In Development: Hospital Readmissions Tracking Tool

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In light of the recent Medicaid changes regarding hospital readmissions within a 30 large_readmitday time period, HMS is working to create a tool which will allow facilities to track readmissions.

Beginning on October 1, 2012, section 3025 of the Affordable Care Act added section 1886(q) to the Social Security Act establishing the Hospital Readmissions Reduction Program (HRRP). The HRRP has imposed a financial penalty on hospitals with many readmissions during a certain timeframe. The HRRP defines readmission as a patient who is readmitted to the same or another hospital within a 30-day time period. It excludes certain readmissions, such as transfers to another hospital. The goal of this penalty is to encourage improvements to patient care and reduce Medicare costs.
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Population Health and the Polar Vortex

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This winter’s “polar vortex” has led to discussions about everything from the devastating effects sub-zero temperatures can have on homeless populations, to the difficulties it’s caused marathon runners in training, and the dangers extreme cold can pose to pets.

Here at HMS, we saw several state public health departments use EpiCenter to implement a cold weather classifier that would enable them to track the number of injuries related to the extreme cold. This tool allowed for the tracking and analysis of emergency department registrations with chief complaints containing phrases like “out in the cold,” “no heat,” “hypothermia,” “frostbite,” and “exposure.” Observing event-specific data in situations like these allows public health to track the overall health of the population, and also to monitor the effectiveness of public outreach efforts and public health warnings.

New Jersey used EpiCenter to create a cold-related injury classifier with input from HMS, which they utilized in conjunction with their Super Bowl surveillance. Ohio created their own, separate cold-related injury classifier in EpiCenter and then shared the SAS code for that classifier with the International Society for Disease Surveillance (ISDS). Several other regions, including Indiana, New Hampshire, Washington, and Boston, then implemented the same code in their own cold weather surveillance.

During the first round of severely cold temperatures on January 6th, 7th, and 8th, temperatures in Ohio dropped well below zero degrees Fahrenheit. As could be expected, they observed a surge in ED visits due to cold-related injuries, with visit numbers peaking on the 8th. After that initial cold snap, Ohio initiated public health messages warning the population about taking precautions to seek shelter and stay out of the cold. The second cold snap on January 28th and 29th, during which temperatures dropped even lower, yielded dramatically fewer emergency department visits, a trend that Ohio’s public health officials believe can be attributed in part to the warnings they issued following the initial burst of below-freezing temperatures.

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Cold-Related Injury ED visits in Ohio

The availability of this sort of data is opening doors for research on the relationships between public policy measures and emergency department utilization. For example, January’s cold-related injury data could be leveraged in conjunction with information about the capacity of homeless shelters and auxiliary facilities to assess the effects of public policy on the numbers of emergency department visits. Several state public health departments have also created heat-related injury classifiers in preparation for summer; as this sort of data becomes more widely available via tools like EpiCenter, we look forward to seeing the new ways public health discovers to more effectively monitor and improve population health.