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Quote of the Month
"It is a dangerous thing to reform anyone."
Oscar Wilde
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Consumer Reports goes into the hospital ratings business
By Anne Zieger
Most consumers reach for Consumer Reports when they're thinking about buying a car or a dishwasher. But soon, they'll be able to use CR to rate their local hospital.
The venerable consumer publication has set plans to provide patient satisfaction ratings for more than 3,400 U.S. hospitals, using data from the government's Hospital Consumer Assessments of Healthcare Providers and Systems Survey. The Consumer Reports Health Ratings Center will display its hospital ratings online using the familiar Consumer Reports color-coded interface.
The data, which will be available to subscribers to www.ConsumerReportsHealth.org, integrates intensity of care rankings, linking patient satisfaction and intensity of care. Researchers with the Health Ratings Center have found that hospitals that have above-average patient satisfaction ratings typically provide more conservative, less costly care.
Users will be able to look up their local hospital's Overall Patient Experience Rating, plus ratings for eight performance measures, including doctor communication, nurse communication, discharge information, staff attentiveness, pain control and quietness.
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"Discoveries are often made by not following instructions, by going off the main road, by trying the untried."
- Frank Tyger
"Every abuse ought to be reformed, unless the reform is more dangerous than the abuse itself."
Voltaire
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FL hospital employee sells medical records to personal injury attourney
By Anne Zieger
Just when you thought you'd heard about every possible way to misuse medical information, here's another one for your personal library of true health information crimes.
In this case, according to the FBI, an ultrasound technician at Miami's Jackson Memorial Hospital sold medical records to a second party, who then sold those records to a personal-injury attorney. The lawyer used the records to find clients, and shared any money he earned with the middleman.
The ultrasound tech pleaded guilty to wrongful disclosure of healthcare information and not surprising, was canned by Jackson Memorial. The purported medical records broker in the middle has been arrested, and the lawyer is being investigated. Jackson, of course, has gone on the record stating that it won't put up with such behavior.
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Health Care Vote Illustrates Partisan Divide
By ROBERT PEAR and DAVID M. HERSZENHORN
WASHINGTON - A party-line Senate committee vote on legislation to remake the nation's health care system underscored the absence of political consensus on what would be the biggest changes in social policy in more than 40 years.
The bill, which aims to make health insurance available to all Americans, was approved, 13 to 10, by the Committee on Health, Education, Labor and Pensions. The panel was the first Congressional committee to approve the health legislation.
"If you don't have health insurance, this bill is for you," said Senator Christopher J. Dodd, Democrat of Connecticut, who presided over more than three weeks of grueling committee sessions. "It stops insurance companies from denying coverage based on pre-existing conditions. It guarantees that you'll be able to find an insurance plan that works for you, including a public health insurance option if you want it."
But the partisan split signified potential trouble ahead. Republicans on the panel, who voted unanimously against the measure, described the idea of a new public insurance option as a deal-breaker. They said they still hoped that a consensus bill would emerge from the Senate Finance Committee.
The health and finance committees share jurisdiction over health issues. The finance panel, the next step on the way to passage of any measure, is now the focus of intense scrutiny. It must say how it intends to pay for its proposals and, unlike the health panel, has the power to do so because it can write tax legislation and has authority over Medicare and Medicaid.
Senators said the White House had been sending mixed signals. For months, they said, it emphasized the need for a bipartisan bill. But in the last 10 days, one Democrat said, the message has been: "Hurry up. If you have to go without Republicans, it's not the end of the world."
As a presidential candidate, Mr. Obama boasted of his ability to transcend partisan splits that had stymied action in Washington. At a candidates' forum in Las Vegas in March 2007 - even before he had a detailed health care proposal - Mr. Obama declared that "the most important challenge is to build a political consensus" on covering all Americans.
The Senate committee vote came just a day before three House committees plan to start amending and voting on similar legislation that has little chance of Republican support.
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What's all this about healthcare reform?
I've been working in healthcare for a long time. I've worked in hospitals, medical schools, nursing homes, clinics and other "provider" sites. I think our healthcare "system" or perhaps the lack of a system needs a great deal of improvement. With that said, I have to admit that I am very concerned about what our government will do to healthcare in the U.S.
I do know that the government cannot manage our banks. I do know that our government cannot run our car companies (although our car companies do not appear to know how to run themselves). I do know that the words budget and savings are almost never heard in Washington, D.C. While I understand that most people think their Medicare works well (and I agree) I am very nervous about what I've seen in the fine print of the drafts so far. If a bill gets pushed through without much oversight and "surprises" pop up later, "reform" will rapidly lose creditability with the people it is supposed to help.
Today, millions of Americans do not have health insurance. This is not only unacceptable, it is stupid. Not having health insurance does not necessarily mean you will not receive care. What it often means is that you will not receive preventive care, you will not receive routine care, you will not receive primary physician care, but you will receive very expensive care in a hospital emergency department or intensive care unit. As most of you know, one day of ICU care can pay for a huge amount of preventive care.
We all have heard about health systems in other countries. Some people have waxed poetic about care provided as close as Cuba and Canada and as far as Sweden and Russia. Unfortunately, we never hear the full story about the waits for routine x-rays, lab tests and surgical procedures. Can we learn from these other systems? Of course! Do they have all the answers or the perfect system? No, they do not.
My point here is that we all need to study, to think about what we want in a healthcare system that will care for us all. Then, and soon, we need to tell our elected representatives over and over again, what we expect of them. Healthcare is at the very least the issue of a generation. Let's try hard not to blow it.
One more thing, check out this You Tube video from ABC News. Ignore the headline and give it a listen.
Ken
 KenBast@MgtConsultinginHealthcare.com |
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AMERICANS NOT READY FOR HEALTH REFORM Take a look at the American Enterprise Institute's summary of current public opinion. We are in a very uncertain mood right now. About the economy, efforts to improve it, big change and big institutions. The crisis in health care cost, access and quality, which is necessary for deep policy reform, is not as strong as it was back in 1994. As is so often the case, our political leaders have not yet made the case for their legislative specifics. Except for those that require the government to change, or someone else to pay.
http://www.aei.org/docLib/Political%20Report%20July-August%202009.pdf
From: Senator Dave Durenberger, Founder the National Institute of Health Policy
http://www.nihp.org/ | |
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Guest commentary: Reform must include investment in quality
By Mark Chassin
Posted: July 22, 2009
All we need to do to find sufficient funds to extend health insurance to all Americans is to make healthcare as safe as commercial air travel. Eliminating the preventable complications that today harm millions of patients would easily save the many billions of dollars lawmakers are struggling so hard to locate. And, as a bonus, the health of patients who do not suffer those complications will increase, too. Simple, right? Yes. And, no.
The first part of the argument is not in doubt. Avoidable injuries from medications, preventable infections, surgical complications that should not occur, and problems resulting from poor communication among healthcare providers cost hundreds of billions of dollars each year. Nor is this a complete list of our healthcare quality and safety problems. If you add in the consequences of the inappropriate use of health services (think antibiotics for colds), the possible savings are staggering.
Is truly safe healthcare a science-fiction fantasy, or an achievable goal? Answering this question is where the simplicity ends.
As President Barack Obama and Congress wrangle over how to reform the healthcare system, let's not lose sight of one of the most urgently needed reforms: quality improvement.
Americans do not understand why routine safety processes break down in healthcare facilities. They don't understand why doctors and nurses and technicians in hospitals and nursing homes don't wash their hands every time they should. They don't understand why, when family members are admitted to a hospital, they have to tell their story to the first nurse they meet and the second nurse and the first doctor they meet, and the second doctor and still the medications may be wrong. They don't understand why these routine, common-sense safety processes do not perform with near-100% reliability. People are getting impatient with the slow pace of improvement in patient safety.
The key to transforming our healthcare system into one in which patients can feel confident in the safety of the care they receive is to incorporate proven quality improvement methods already in use in other environments into the delivery of healthcare. Other industries and organizations that deliver goods and services to consumers (think U.S. nuclear power) have developed robust quality improvement strategies that work. Many such organizations manage risks every bit as hazardous as those in healthcare but with much higher levels of safety. Yet the healthcare system has been slow to adopt these proven approaches to successful results.
What exactly is "robust process improvement"? The core principles involve identifying the problem to be solved; defining precisely a successful goal; measuring performance in relation to that goal; assessing the causes of the organization's shortfalls; implementing interventions targeted to the most important causes; and embedding effective interventions into the everyday work of caregivers so that they are sustainable.
Addressing the capacity of organizations to deliver this kind of robust process improvement is the only way that healthcare can keep up with the ever-changing, moving target of quality and safety. Creating and sustaining improvement is difficult and, unfortunately, not all healthcare organizations have the capability to do it today. Until we can build this capacity throughout the system, we should invest in ways to harness the expertise we do have to create scalable and specified solutions that organizations of all sizes and complexity can easily adopt to combat our most serious and thorny patient safety issues. This will give healthcare providers tools essential to delivering cost-effective care, eliminating preventable complications and achieving significant reductions in healthcare-acquired infections, re-hospitalizations and unnecessary tests.
I urge President Obama and Congress to invest in an infrastructure that will allow healthcare to achieve robust process improvement. I applaud the Senate Affordable Health Choices Act for recognizing the need for quality improvement. But I hope that as the healthcare reform debate continues, we will not lose sight of this goal and will aim our sights even higher. Without such a commitment, healthcare reform will not meet consumer expectations.
Can we rise to the challenge of transforming healthcare into a high-reliability industry, with rates of adverse events and routine safety process breakdowns comparable to or better than air travel or any other high-reliability industry? Are we up to it? I believe we must be. That will be true reform.
Mark Chassin is president of the Joint Commission. |
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