Lee A. Resnick, MD, FAAFP In the beginning, interoperability and health information exchange (HIE) were key selling points for physicians considering adoption of and investment in electronic health records (EHRs), but today most are left feeling misled, stranded on a bridge that leads nowhere. The Healthcare Information and Management Systems Society (HIMMS) defines EHR interoperability as “the ability of different information technology systems and software applications to communicate, exchange data, and use the information that …
Read MoreTop Procedures Performed at U.S. Urgent Care Centers in 2014
Data from the 2014 Urgent Care Chart Survey of 1,778,075 blinded visits by patients to more than 800 different urgent care clinics, conducted by the Journal of Urgent Care Medicine, reveal that the top 3 procedures performed at U.S. urgent care centers in 2014 were as follows, in descending order: • Medication administration (vaccine, IV, steroid injection, anesthesia)—59.7 million procedures (39.8% of visits) • Rapid diagnostic tests and cultures—44 million procedures (29.4% of visits) • …
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Soft-Tissue Infection Due to Vibrio parahaemolyticus and Aeromonas hydrophila
Urgent message: Failure to recognize and treat the early development of skin and soft-tissue infection from a stingray envenomation may result in significant tissue necrosis and systemic inflammatory response syndrome. WILLIAM A. WOOLERY, DO, PhD, MS, MBA, FACOFP Stingray injuries to humans are very common but rarely fatal. Approximately 2000 cases are reported annually in the United States.1–3 At my rural hospital on the west coast of Florida, we see an average of 45 such …
Read MoreProtecting Patients and Assets: Pre-employment Background Checks and Drug Screening
ALAN A. AYERS, MBA, MAcc, Experity A number of patients who had been dispensed the narcotic hydrocodone called the urgent care center to complain that their medications “weren’t potent enough,” that they “didn’t work,” or that the pills in the bottle “didn’t match the description on the label.” Although these reports were initially dismissed by the medical director as drug-seeking behavior, the volume and corroboration of complaints soon led to an internal investigation. It turned …
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Investment Trends in Urgent Care: A Mergers and Acquisitions Roundtable
Urgent message: Urgent care is a highly fragmented industry considered ripe for consolidation. A handful of high-profile deals have made 2015 the biggest year for mergers and acquisitions yet, but high valuations, oversaturated markets, changing buyer and seller expectations, and structural changes attributable to the Patient Protection and Affordable Care Act will influence urgent care deal-making in coming years. ALEXANDER NATHANSON, MD Mergers and acquisitions (M&A) in the U.S. urgent care industry have historically consisted …
Read MoreElectrocardiogram Data Points and Evaluation and Management Visit Level; Gait Training
Q. When counting data points for the complexity of medical decision-making (CMDM) portion of the evaluation and management (E/M) visit level, what is the correct way to assign data points for an electrocardiogram? For example, the Current Procedural Terminology (CPT) code is 71020 for a chest radiograph with interpretation and report. The description itself has the interpretation and analysis included in the code already. Is it considered double-dipping if we count the interpretation as 1 …
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Urgent Care Management of Animal Bites and Stings
Urgent message: Because bite and stings can be sustained in a variety of settings from many different animals and can transmit a wide variety of infectious agents, urgent care providers should have specific knowledge about treating wounds from mammals, nonmammals, and marine animals. ALEXANDER NATHANSON, MD Practitioners at urgent care centers often see patients who have sustained animal bites or stings. In addition to causing structural damage to tissues, bites and stings expose patients to …
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Adult with Painful Lesion That Enlarges and Darkens
An 80-year-old man reports waking up with a localized area of erythema on his forehead. He says that he did not worry about it until the lesion slowly became white and then started turning blue over a few hours. He says that the lesion is painful and is getting larger and darker. He reports no headaches, muscle pain, abdominal pain, sweating, or tremors. View the image taken (Figure 1) and consider what your diagnosis would …
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Skin Rash with Pustules on a Newborn
A healthy, full-term baby girl was born to a healthy mother who had adequate prenatal care and no signs of infectious diseases. Three days after birth, the baby developed multiple 1-mm pale-yellow to yellow pustules within a large inflammatory wheal on her cheek. Several hours later, the rash starts to resolve. View the image taken (Figure 1) and consider what your diagnosis would be.
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Concussion Care Adds Value to an Urgent Care Sports, Camp, and School Physical Program
Alan A. Ayers, MBA, MAcc, is Practice Management Editor for JUCM—The Journal of Urgent Care Medicine, a Board Director for the Urgent Care Association of America, and Vice President of Strategic Initiatives with Experity. Urgent message: Many urgent care centers have embraced school, sports, and camp physicals as a way to raise awareness of their services among athletic directors, coaches, trainers, and parents of high school and middle school students. Because of the increasing attention …
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