To Err is Human — Some Tools to Help
Hospitals are changing culture of handling medical errors
Assessing blame for medical errors is difficult, and hospitals are looking to see if their own systems may be partly responsible when providers make mistakes. The National Quality Forum has developed a Care of the Caregiver standard, and the Just Culture model stresses the middle ground between blaming a physician or nurse and holding a system failure accountable. The Wall Street Journal (3/16)
Heart and Stroke Risk Factors
Psoriasis is a risk factor for heart attack, stroke
Psoriasis may raise the risk of heart attack, stroke and other cardiovascular problems, likely through a shared inflammatory response, Danish researchers told a cardiology conference. Study data showed severe psoriasis raised the risk of a heart attack by 24%, and having moderate or severe disease increased the odds of a stroke by 45%. HealthDay News
Moving from Fee for Services
Editor’s note: It is critically important that we move the reimbursement system from fee for services to fee for care. A movement in that direction is bundled services, but it has to be more than that. Payment has to involve information about efficient process, quality, and outcomes. Otherwise in the words of Demming, “If you only focus on the ends, you may get it in ways you never intended.”
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Expert: U.S. is on path toward health care payment reform
More than a dozen health care payment reform efforts are under way around the U.S., according to Karen Davis, president of the Commonwealth Fund. She told a conference that the country is on a path away from fee-for-service and heading toward bundled payments that go beyond pay-for-performance models. Healthcare Finance News (3/12)
Too Many Tests – Impact Your Health
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John Goodman, Ken Thorpe, Uwe Rheinhardt
Editor’s note: a terrific piece by John Goodman with comments by some of the greatest minds in health care policy – debating some of the most salient points.
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Writing in Health Affairs, Ken Thorpe and his colleagues offer a description of the current phase of the problem:
Medicare beneficiaries’ medical needs, and where beneficiaries undergo treatment, have changed dramatically over the past two decades. Twenty years ago, most spending growth was linked to intensive inpatient (hospital) services, chiefly for heart disease. Recently, much of the growth has been attributable to chronic conditions such as diabetes, arthritis, hypertension, and kidney disease. These conditions are chiefly treated not in hospitals but in outpatient settings and by patients at home with prescription drugs.
So how are we dealing with this challenge? Poorly.
Now read more and the various rebuttals…at:
The Value of Retail Clinics
Time, money are factors in decision to use retail clinics
A survey found that people would rather see their primary care provider but if that is not possible they are likely to use a retail-based clinic. People were willing to see a nurse practitioner at a retail clinic if they could save at least $31.42 and would wait a day or more to do so if they could save at least $82.12. Los Angeles Times/Booster Shots blog (3/8)
Good Blood Pressure Control, Exercise and a Healthy Weight
Family history is key in stroke risk, study finds
U.S. researchers found that children of men or women who had a stroke by age 65 had a fourfold increased risk of stroke by that age and double the risk of stroke at any age. The lead researcher said people with a positive family history of stroke should work to modify risk from other factors, such as good blood pressure control, exercise and maintaining a healthy weight. HealthDay News (3/8)
From Fee for Service to Fee for Care
Support grows for move to bundled payments
Many health policy experts say it is time to dump fee-for-service physician reimbursement and move to a bundled payment model that could save money without reducing quality of care. Pilot programs have shown that the model can offer high-quality care, greater patient satisfaction and lower costs. The Washington Post (3/9)
Group appointments are a growing trend
Health care providers say patients like group appointments because they cut down on wait times, give them more face time with physicians and allow them to share experiences with other patients. The Future of Family Medicine Project named group visits one of 10 trends to be taken seriously. The Washington Post (3/9)
What Requires Legal Change and What Doesn’t?
Editor’s note: What requires new laws? What requires regulatory intervention? And what will not yield regardless?
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- Estimated range of healthcare system waste is $600-$850 billion annually
At President Obama’s Healthcare Summit, SEN. Tom Coburn cited Thomson Reuters’ white paper “Where Can $700 Billion In Waste Be Cut Annually From the U.S. Healthcare System?” The report identifies the most significant drivers of wasteful healthcare spending as follows:
1. Administrative System Inefficiencies: $100-$150 billion
2. Provider Inefficiency and Errors: $75-$100 billion
3. Lack of Care Coordination: $25-$50 billion
4. Unwarranted Use: $250-$325 billion
5. Preventable Conditions and Avoidable Care: $25-$50 billion
6. Fraud and Abuse: $125-$175 billion
Source: Thomson Reuters. “Where Can $700 Billion in Waste Be Cut Annually From the U.S. Healthcare System?” October 2009. http://www.factsforhealthcare.com/whitepaper/HealthcareWaste.pdf
Moving to the Team Concept
Wellness coaching is gaining popularity
A growing focus on wellness coaching is helping women achieve their health goals and improve their heart health, as well as shift the focus of medical care to a team approach. Physician groups increasingly are working with dietitians, diabetes educators, wellness coaches and others to help patients with chronic diseases. Detroit Free Press (3/7)
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