Device identifiers, telemedicine, update on Beacons

The clinical practice developments this month include a final rule establishing a unique device identification (UDI) system for medical devices, the first neonatal telemedicine program, a report on patient-centered medical homes and updates on Beacon communities.

The UDI system includes a unique identifier assigned by manufacturers to track devices' lot or batch number, expiration date and manufacturing date; and a public, searchable database administered by FDA —called the Global Unique Device Identification Database —that will serve as a reference catalogue for all devices that have an identifier.

A neonatal telemedicine program unveiled at the Children’s Medical Center Dallas will provide physicians at other hospital neonatal intensive care units with 24-hour access to board-certified UT Southwestern neonatologists on the Children’s medical staff.

Patient-centered medical homes reported higher operating costs per patient but also higher total medical revenue per patient than other practices, according to a report from the Medical Group Management Association (MGMA).

Increased operating costs per patient in PCMHs are partly due to a greater number of providers and staff required to optimize the care-delivery model, according to the organization. PCMHs reported a median of 29 total full-time-equivalent (FTE) support staff per 10,000 patients, compared with 18.5 total support staff FTEs per 10,000 patients for those not in PCMHs. In addition, PCMHs reported more FTE providers per 10,000 patients.  

In a webinar hosted by HIMSS, three Beacon communities shared their experiences over the past three years of the grant-funded projects. The San Diego Beacon Community works with a very dynamic population, said Executive Director Dan Chavez, due to tourism, military, education and border issues. Chavez said he learned from his experience the importance of defining your project and what you’re trying to achieve in your implementations of technology. “Target your population very clearly. Start with a limited user base and only focus on key functionality.” He said the rollout plan also is critical. “Start out with small wins. First achieve adoption, then utilization. Focus on high-volume, high-value transactions. You cannot underestimate vendor dependencies as we get closer to interoperability. Never take your eye off the ball of interoperability. This methodology has worked very well for us.”

The Crescent City Beacon in New Orleans focused on its network of safety net providers who were early EHR adopters but were still experiencing gaps in care coordination, said Chatrian Kanger. “We learned early on that having high quality data was really at the foundation for supporting both of these activities. If practices didn’t trust the data in the EMRs, they certainly weren’t going to trust the data flowing into the HIE.”

"The Beacon project has been tremendously positive for our community," said Patrick Gordon of the Colorado Beacon Community. “We knew we needed advanced tools for our risk strategy, population health management and quality improvement. Those manifest themselves in patient registries, predictive modeling tools and patient activation tools.” To deploy all of that in a flexible, cost-effective way, they created a web services layer to allow multiple participants to receive the app support they most value. “One size fits all cannot accommodate that model,” he added. Development of a web services communication architecture that can support that type of app deployment model was critical to tying back to clinical operations, he said. “If our resources can’t be integrated in real clinical workflow they’re not going to be used.”

Are any of these developments impacting your organization? Please share your experience.

Beth Walsh

Clinical Innovation + Technology editor