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The Anesthesia Insider

Inside information for anesthesiologists and Certified Registered Nurse Anesthetists (CRNAs) on the most current best practices during changing times.

Transitioning to an Anesthesia EMR? Think System Modification First

​Although the majority of hospital-based ABC clients have implemented an electronic medical record, or plan to implement one in the near future, many of our ambulatory surgery center clients have been slower to move from paper to a digital platform. However, the transition is an inevitability for all practices. We review the essentials of a success...
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The Perioperative Surgical Future

“I look upon ourselves as partners in all of this, and that each of us contributes and does what he can do best. We can create ourselves and our future.” – Jonas Salk, 1985 Presented with this opportunity by Dr. Salk, how will each of our anesthesia groups create its own future? How will you as a physician maintain your professional relevance? Will you continue to commit yourself to fading traditional practice patterns and reimbursement models? Or will you take advantage of the paradigm shifts in medicine that are already upon us? Payers are demanding better results, hospital administrators are in need of help, patients are in the middle without access and the specialty of anesthesia needs a tune-up. The perioperative surgical home promises to address it all. Led by the Centers for Medicare and Medicaid Services (CMS), payers are mandating coordinated care and improved quality through pay-for-performance reimbursement models. CMS...
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The Perioperative Surgical Home: Our Partnership with the C-Suite

“CMS’ pay-for-performance reimbursement changes are looming. As members of the Huntington Accountable Care Organization (ACO), anesthesia recognizes the need to improve surgical outcomes. Our collective financial future is tied to solid quality improvements that only increasingly coordinated care can deliver. We will double down on our cooperative effort with our hospital in order to improve medical outcomes, to lower costs and to improve the patient experience.” – Pacific Valley Medical Group, Pasadena, CA. Summary of Recent Events The Centers for Medicare & Medicaid Services (CMS) is pushing quality, the American Society of Anesthesiologists (ASA) is pushing the perioperative surgical home (PSH) and our 30-partner Pacific Valley Medical (anesthesiology) Group (PVMG) in Pasadena, CA is picking up both causes. In our commitment to a PSH clinic staffed and managed by anesthesiologists, we are fully embracing the concept of transitional care & perioperative medicine. This is our contribution to our patients and to...
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Hospitalists and Anesthesiologists and Perioperative Medicine

There are more nearly 50,000 hospitalists practicing in the U.S. today and the specialty continues to grow rapidly.  A recent American Society of Anesthesiologists (ASA) Health Policy Research paper entitled “Prevalence of Hospitalists in U.S. Community Hospitals” found that between 2012 and 2013, 34 out of 50 states showed an increase in the percentage of hospitals using hospitalists and that the percentage of community hospitals using hospitalists increased by almost five percent during that period. Hospitalists in general are trained as internists.  (The American Board of Medical Specialties does not include a “hospital medicine” board nor offer subspecialty certificates.)  Their roles encompass the following, according to the Society of Hospital Medicine's (SHM's) website for residents and medical students, Future of Hospital Medicine: Care of patients who do not have primary care physicians (ED unassigned) Coordination of care: improving hospital throughput, decreasing length of stay and discharge planning Cost-effective, resource utilization Surgical...
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The Perioperative Surgical Home: “Right for Our Group?”

Our Pacific Valley Medical Group (PVMG) in Pasadena, California consists of 29 partners. We’re an independent, single specialty group primarily serving Huntington Memorial Hospital and Shriners Hospital for Children, Los Angeles. We love our practice, our hospitals and our community, and as a group we think we do a great job. As is true for most anesthesia practices, the delivery of our standard, elective anesthetic involves meeting a patient three minutes ahead of time, delivering anesthesia in the OR, landing that person in recovery and moving on to the next; “wash, rinse and repeat.” We delegate pre-operative management and post-discharge care to others. But many of us are now asking “Is this the best we can do? Is this our best effort?” Many think not. Patients, payers, administrators and our partner surgeons are beginning to expect more from our practice in this pending era of ‘pay for performance.’ The healthcare funding...
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