EHR Fatigue

Electronic health records (EHR) are supposed to improve quality. While EHRs certainly are highly useful for information sharing, they may have adverse consequences. One issue may be that EHRs may induce fatigue in physicians and sap their needed energy/concentration away from their primary task: caring for patients. To test whether EHRs increase physician fatigue and…

Accountable Pharmacy Organizations?

Pharmacists are typically paid for dispensing drugs. They receive a fee to cover the price for acquiring a given drug and a dispensing fee. In general, however, pharmacists are not paid based on patient outcomes. Will that change? Troy Trygstad (2020) argues that value-based reimbursement for pharmacists through accountable pharmacy organizations (APOs) may be the…

Nurse practitioner employment is growing

Nurse practitioner employment has nearly doubled between 2010 and 2017 according to Auerbach et al. (2020). If nurse practitioners can provide similar quality for some services at lower cost, nurse practitioners could save money. If nurse practitioners can help better leverage physician time for more complex services, and increase access to care, they may be…

For-profit chains are gobbling up local hospitals. What trend in the broader US economy explains this behavior?

One trend in recent years is how many hospitals are being purchased by large regional or national hospital chains. An April 2019 slide deck from the NIHCM Foundation shows this trend graphically. A paper by Hsieh and Rossi-Hansberg (2019) provide some aggregate data as well as a case study from the Boston area. Four decades…