Kathy Method

Patients suffering from depression who participated in online cognitive-behavioral therapy (CBT) sessions were nearly 2.5 times more likely to recover from depression than their standard care counterparts, according to results of a study published in the August 22, 2009, issue of the 

 randomized 297 patients diagnosed with depression (defined as a score of 14 or more on the Beck depression inventory [BDI]), recruited from 55 general practices in three U.K. locations, to either online CBT in addition to usual care or to usual care alone from a primary care physician. Patients receiving usual care alone qualified for online therapy but were placed on a waiting list to begin therapy after follow-up so that they could serve as the control.

The online therapy consisted of up to 10 CBT sessions, each 55 minutes long, completed within 16 weeks of randomization when possible. Participants were assigned to one therapist for the duration of the study. Sessions were conducted via online instant messaging in real time, secured by individual passwords. Each entire session was recorded and available to the participant to review at any time.

The primary outcome was the BDI score at four months, where a score of less than 10 indicated recovery. Primary data were analyzed for 210 participants. Patients were followed for four months and eight months after completion of the sessions.

At four months, 38 percent of the patients who received the online therapy were considered recovered from depression compared with 24 percent in the control group. At the eight-month follow-up, 42 percent and 26 percent of the online-therapy and control patients were recovered, respectively, showing that therapeutic gains at four months were maintained.

Researchers concluded from the results of the study that online delivery of CBT is effective. They speculated that the online delivery method enhanced the effect of CBT by encouraging reflection, because thoughts and feelings were written rather than spoken, and therapist advice was available for review. They also concluded that the number of patients using online CBT sessions should grow because it is available in areas where access to treatment is limited and can be offered discreetly to people whose symptoms are severe.

Articles

Patients suffering from depression who participated in online cognitive-behavioral therapy sessions were nearly 2.5 times more likely to recover from depression than their standard care counterparts.

Internet psychotherapy for depression in primary care shows effectiveness

The Centers for Medicare and Medicaid Services have released 

 outlining the World Health Organization’s International Classification of Diseases, 10th edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS).

ICD-10 has been in development since 1983, and was completed in 1992. A number of countries have already begun using ICD-10. Implementation of ICD-10 coding in U.S. healthcare organizations is mandated for Oct. 1, 2013.

The current system, ICD-9-CM, is 30 years old. According to CMS, it is outdated and obsolete and inconsistent with current medical practice. ICD-10, used by hospitals and physicians for disease classification and billing, represents significant improvements by using more detailed information and capturing advancements in clinical medicine.

ICD-10-CM/PCS consists of two parts. ICD-10-CM is the diagnosis classification system developed by the Centers for Disease Control and Prevention (CDC) for use in all U.S. healthcare settings. ICD-10-PCS is the procedure classification system developed by CMS for use in inpatient hospital settings only.

According to the fact sheet, diagnosis coding under the ICD-10-CM is similar to ICD-9 but will use seven alpha or numeric digits, whereas the ICD-9-CM coding system uses three or four numeric digits.

CMS says that ICD-10-CM/PCS incorporates much greater specificity, which will improve the ability to measure healthcare services, increase sensitivity when refining grouping and reimbursement methodologies, enhance the ability to conduct public health surveillance; and decrease the need to include supporting documentation with claims.

The codes will allow comparison of mortality and morbidity data and will provide better data for measuring care, designing payments systems, processing claims, making clinical decisions, tracking public health, identifying fraud and abuse, and conducting research.

CMS says organizations can plan for ICD-10-CM/PCS implementation by developing a plan that includes identifying stakeholders, formulating strategies and goals, developing education and training on all levels, developing an IT-system-change plan, and planning for documentation changes. Healthcare facilities will also need to plan on how to acquire resources and evaluate the financial effect the change will have on the organization.

ICD-10-CM/PCS will not affect physician, outpatient facility, or hospital outpatient department use of Current Procedural Terminology codes on Medicare fee-for-service claims since CPT will continue to be used.

The Centers for Medicare and Medicaid Services have released a new fact sheet outlining the World Health Organization's International Classification of Diseases, 10th edition.

CMS releases new ICD-10 fact sheet

Details of a $694-million program that will create a national extension service to help office-based physicians set up their health information technology have been announced by officials at the U.S. 

 will provide $643 million in grant money to nonprofit organizations that will run an estimated 70 regional extension centers, each serving a defined geographic area. Another $50 million has been allocated to create a National Health Information Technology Research Center that will serve as a resource for the regional program.

Most of the money, $598 million, will be spent in the initial two years to get the regional centers started. An additional $45 million will be available for years three and four. The goal of the program is to have more than 100,000 physicians putting EHRs to “meaningful use,” enabling nationwide health information exchange.


Each regional extension center is expected to assist at least 1,000 physicians, with the emphasis on primary care doctors in groups of 10 physicians or less. Doctors in public and critical-access hospitals, community health centers, and rural health centers may also be served.

The centers will offer technical assistance, guidance, and information to help physicians select, implement, and use certified EHR systems. The centers will ensure that the systems are in compliance with legal, regulatory, professional, and ethical requirements to protect the privacy and security of patient health information. Basic, generic support services for a wide range of EHR products, more in-depth support for a narrower list of systems, and on-site coaching and troubleshooting will also be available.

The performance of each regional center will be evaluated every two years by HHS. Continued support after the conclusion of each second year of performance will be contingent on a positive evaluation.

The extension program expects all regional centers to be operating at full capacity by the end of December 2010. The government anticipates its subsidies of the centers will phase out as the centers move to self-sustainability and obtain funding from local sources. After four years, the regional centers will be on their own.

Details of a $694-million program that will create a national extension service to help office-based physicians set up their health information technology have been announced by federal officials.

HHS announces HIT Extension Program funding plan

Medical students view electronic-health-record technology as an important component of their medical education and a critical factor when choosing where they will practice medicine, according to results of a survey conducted in July by 

, a healthcare information technology company.

The Future Physicians of America survey is the largest survey of medical students using Epocrates software, more than 90 percent of whom will be practicing physicians in less than two years.

Each year, students are asked to rate their medical school experience, grading factors such as clinical training and quality of education. Students this year said that the greatest improvement occurred in the area of the integration of medicine and technology, up from a grade of “B” in 2008 to an “A–” in 2009.

More than 1,000 medical students gave their opinions on their technical priorities, including EHRs and mobile referencing software.

Eighty-four percent of survey respondents had experience with an EHR during their clinical rotations, and 90 percent said that the use of EHRs will be an important factor when choosing where to practice medicine. Nearly 60 percent of the students surveyed indicated that they use the decision-support software at least twice daily.

Students rely heavily on technology as they prepare to become physicians. The survey found that 45 percent of respondents currently use an iPhone or an iPod Touch, followed by other PDA devices (27 percent). Nearly 60 percent of non-smartphone users plan to purchase one within the next year.

When survey participants were asked, “When you need information to help you solve a clinical question, where is the first place you are most likely to turn?,” 71 percent said that they consult an internet or mobile-drug-and-disease reference, such as Epocrates, rather than ask their attending physicians. Students (nearly 90 percent) said that they trusted the information they received from these references only slightly less than they do medical journals (93 percent).

Students reported using the referencing software most often to confirm proper drug doses, to check for adverse reactions and interactions, and to consult the disease reference guide.

Medical students view electronic-health-record technology as an important component of their medical education and a critical factor when choosing where they will practice medicine, according to results of a recent survey.

Author | Kathy Method

Articles

Internet psychotherapy for depression in primary care shows effectiveness

CMS releases new ICD-10 fact sheet

HHS announces HIT Extension Program funding plan

Survey shows technology, mobility vital to future physicians