The American journal of managed care
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The adoption of advanced health information technology (HIT) capabilities, such as predictive analytic functions and patient access to records, remains variable among healthcare systems across the United States. This study is the first to identify characteristics that may drive this variability among health systems. ⋯ Health systems that standardize their EHRs and that own and manage hospitals and medical groups have higher rates of advanced HIT adoption and use. System leaders looking to increase the use of advanced HIT capabilities should consider ways to better standardize their EHRs across organizations.
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To determine the proportion of patient transitions that could be connected through 3 proprietary alternatives to open, community-based health information exchange (HIE): HIE between physicians who are part of the same integrated system, use the same electronic health record (EHR), or use an EHR that participates in an EHR vendor alliance. ⋯ Proprietary approaches to HIE do not eliminate the need for open HIE and may further disadvantage providers in small healthcare organizations using less common EHRs. Ongoing support and innovative value creation within open HIE will likely remain necessary to support HIE by independent physicians. Public efforts to promote interoperability should seek to integrate proprietary models with open HIE.
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Pancreatic cancer remains a disease that is difficult to treat due to a typically late presentation, relatively high resistance to chemotherapy, and lack of effective targeted therapies. The standard of care relies on cytotoxic chemotherapy, primarily FOLFIRINOX and gemcitabine-based regimens. Dose modifications and/or the use of alternative combinations can reduce adverse effects, but these regimens remain highly toxic. ⋯ There is a great need for novel anticancer agents that provide efficacy with minimal toxicity. Currently, inhibitors of immune tolerance and immune checkpoint inhibitors; PARP inhibitors; novel cytotoxic chemotherapies, such as trifluridine/tipiracil; and modifiers of the tumor microenvironment, such as pegylated hyaluronidase, are in clinical trials for the treatment of pancreatic cancer. This activity will review the current treatment landscape and preview emerging therapies for the treatment of advanced pancreatic cancer.
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Migraine is a highly prevalent neurological condition with substantial impact on individuals through associated complications, comorbidities, and increased healthcare costs. The burden on society is likewise substantial via increased healthcare costs and greater indirect costs, such as lost productivity. ⋯ A highly competitive and rapidly evolving market landscape is being shaped by biopharmaceutical manufacturers and managed care payers. With an understanding of the societal impact of migraine and the potential impact of CGRP biologics, healthcare providers and managed care professionals should be prepared to develop policies and procedures to ensure appropriate patient access to new therapies.
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The increasing and widespread availability of personal technology offers patients and clinicians the opportunity to utilize real-time virtual communication to enhance access to health services. Understanding the perceived value of different modes of care may help to shape the future use of technology. ⋯ For established patients, VVVs may provide effective follow-up and enhanced convenience when compared with traditional office visits.