February 2009

Cost, Lack of Protocols Could Delay Health IT Adoption

Anita Huslin, The Washington Post

A provision in the economic-stimulus bill that allots about $20 billion for health IT could advance efforts to implement the widespread use of electronic medical records and bolster technology companies, but challenges remain. High implementation costs for providers and the lack of universal standards for data collection and sharing could delay progress.

http://www.washingtonpost.com/wp-dyn/content/article/2009/02/15/AR2009021501284.html

Electronic Medical Records Might Benefit IT Firms

Dallas Morning News

There has been a lot of talk about how this huge infusion of federal cash will benefit healthcare providers and patients, but there is another side of the healthcare business that stands to gain: the vendor. This story from the Dallas Morning News examines benefits and the challenges vendors will face as they attempt to get the multitude of hospitals and doctors' offices and pharmacies and state agencies and private insurers to coordinate with each other and adopt systems that can share that data.

http://www.dallasnews.com/sharedcontent/dws/bus/stories/DN-medicalrecords_15bus.ART0.State.Edition1.4c3f33a.html

Medical Center Cuts ER Wait Times in Half

Heather Duncan, macon.com

Emergency room waits at The Medical Center of Central Georgia have been slashed almost in half since the hospital spent six months overhauling its ER treatment system last year, doctors and hospital officials say. The result is the hospital has not had to refuse emergency patient transfers from other hospitals since October, patient satisfaction ratings have improved and the hospital has increased its revenue because it is able to see more patients. The hospital hired the Wisconsin-based Compirion consulting firm to help hospital workers create a strategy for improving patient flow through the emergency room. The consultants worked with doctors and other staff members from June through this past December, and they will continue to evaluate emergency room data weekly for two years.

http://www.macon.com/198/story/613908.html

At Wal-Mart, a Health-Care Turnaround

Ceci Connolly, The Washington Post

Washington policymakers contemplating a fundamental overhaul of the nation's troubled health-care system may want to study the saga of Wal-Mart. Once vilified for its stingy health benefits, the world's largest company has become an unlikely leader in the effort to provide affordable care without bankrupting employers, their workers or taxpayers in the process. From its headquarters in Bentonville, Ark., the retailer is doing in the real world what many in Washington are only beginning to talk about. At a time when other firms are scaling back or eliminating health coverage, Wal-Mart has made a serious dent in the problem of the uninsured.

http://www.washingtonpost.com/wp-dyn/content/article/2009/02/12/AR2009021204096.html?hpid=moreheadlines

Bay Pines Expands Emergency Services

Bob McClure, Seminole Beacon

A trip to the emergency room at Bay Pines VA Healthcare should be a lot more efficient and beneficial to veterans. The hospital opened the second and final phase of renovations to its emergency department in January. This phase doubles the size of the facility to 15,000 square feet and expands the number of beds from 10 to 20. An electronic bed board at a nurse's station allows the hospital's "bed czar" to calculate more accurately the number of beds that will be required for admitted patients. "The most exciting thing about this is our ability to offer state-of-the-art treatment to our patients," said Diehl. "I would say we have caught and surpassed most emergency rooms in the region and country."

http://www.tbnweekly.com/content_articles/012709_smb-01.txt

Freenomics and Healthcare IT

Robert Rowley, The Health Care Blog

Electronic medical record (EMR) adoption has remained frustratingly low, despite numerous studies showing improvement in health care delivery resulting from EMR use, measured in many different ways (quality, consistency, cost, etc). The Obama administration has proposed widespread, even universal, EMR implementation over the next five years, though how to accomplish it remains to be seen. The Medicare reimbursement "bump" given to physicians this year to use electronic prescribing is a step in this direction, trying to create incentives. The biggest barrier to EMR adoption has been cost.

http://www.thehealthcareblog.com/the_health_care_blog/2009/02/freenomics-and-healthcare-it.html

The $1 Trillion Lean Health Care Opportunity

Evolving Excellence blog

Pretty stunning figure, eh? Also pretty easy to achieve, if we just think very slightly out of the box and make a commitment. Most people continue to think that budgeting, service return, and the like is a zero sum game. To get more services you must pump in more money, or to save money you must cut services. Lean concepts disprove that erroneous concept every day. But $1 trillion? In 2008, U.S. healthcare costs exceeded $2.4 trillion and are expected to climb to $3.1 trillion by 2012, according to The National Coalition on Health Care. As a health-care quality consultant, I know that 25-40 percent of these costs are caused by delay, defects and deviation. That's $600 billion to almost $1 trillion dollars a year in unnecessary costs. And that's just the cost to the health-care industry; it doesn't include the cost to society, which is perhaps 10 times higher.

http://www.evolvingexcellence.com/blog/2009/01/the-1-trillion-lean-health-care-opportunity.html

Emergency Room Doctors Sue State of California

Kimi Yoshino, LA Times

The class-action suit alleges that the system -- which received a failing grade in access to care -- is on the edge of a breakdown unless more funds are obtained. Frustrated emergency room doctors filed a class-action lawsuit against the state Tuesday, saying that California's overstretched emergency healthcare system -- which ranks last in the country for emergency care access -- is on the verge of collapse unless more funding is provided. Across the state, scores of hospitals and emergency rooms have shut their doors in the last decade, leading to long waits, diverted ambulances and, in the most extreme cases, patient deaths.

http://www.latimes.com/news/local/la-me-erdoctors28-2009jan28,0,7632115.story

Instant Information: The Real Appeal of Social Networking

Kathryn Mackenzie, HealthLeaders IT

For people who have followed the evolution of social networking sites, Henry Ford Health System's use of Twitter to provide real-time surgical updates from the operating room has made Health 2.0 history. General curiosity aside, one reason the Henry Ford Twitter surgeries have garnered so much attention is the educational possibilities they bring to light for medical students, providers, and the public.

http://www.healthleadersmedia.com/content/228371/topic/WS_HLM2_TEC/Instant-Information-The-Real-Appeal-of-Social-Networking.html

HIMSS Adds Stimulus Sessions

Health Data Management

The 2009 HIMSS Conference, to be held April 4-8 in Chicago, has added 10 educational sessions on subjects related to the economic stimulus package that President Obama signed into law Feb. 17. The added sessions cover a broad range of topics. For example, a 2:15 p.m. session April 6 will address how to optimize opportunities for physician practices. Another session at 9:45 a.m. Tuesday, April 7, will discuss how the stimulus could support achieving health information interoperability.

http://www.healthdatamanagement.com/news/HIMSS27741-1.html?ET=healthdatamanagement:e774:117429a:&st=email&channel=policies_regulation

Cleveland Clinic and CVS Unit Will Collaborate, Integrate EMR Systems

Bernie Monegain, Healthcare IT News

Cleveland Clinic and MinuteClinic, a unit of CVS Caremark, have entered a partnership that calls for the full integration of their electronic health-record systems to boost patient care. Under the deal, Cleveland Clinic will provide services at some locations inside certain CVS drugstores in northeast Ohio that cater to individuals with acute minor ailments, giving them direct access to one of the leading hospitals in the U.S., officials said.

http://www.healthcareitnews.com/news/cleveland-clinic-partners-minuteclinic-links-emrs

Comparative-Effectiveness Research Advances with Stimulus Plan

Robert Pear, The New York Times

President Barack Obama's imminent approval of the $787 billion economic-stimulus bill will clear the way for the government to compare the cost-effectiveness of drugs, surgery, medical devices and other methods used in treating particular diseases. The legislation, which calls for the creation of an advisory council of up to 15 members, allocates $1.1 billion to fund the systematic analysis of published research as well as head-to-head clinical studies.

http://www.nytimes.com/2009/02/16/health/policy/16health.html?_r=2

C Side

 

Transformation of Health Care at the Front Line

JAMA, Patrick H. Conway, MD, MSc; Carolyn Clancy, MD

Concern about escalating costs and the quality of health care delivered in the United States continues to mount. This has led to an increasing focus on pay-for-performance, value-driven health care and public reporting of quality and cost information. However, several authors have questioned the effectiveness of pay for performance and public reporting to improve patients' outcomes and have highlighted the potential for unintended negative consequences. Currently, frontline clinicians are exposed to disparate pay-for-performance programs that are often uncoordinated and not clearly aligned with producing better outcomes for patients. Evidence is produced at an astonishing rate, but its incorporation into clinical practice is difficult. (requires registration/subscription)

http://jama.ama-assn.org/cgi/content/short/301/7/763

Quality: A Perception Gap?

HealthLeaders Media

Leaders in the healthcare quality arena are a positive bunch when it comes to their assessments of their organizations, according to the quality portion of the HealthLeaders Media Industry Survey 2009. When asked to rate the quality of 11 aspects of their organizations-including medical quality, information technology, fiscal management, workplace morale, growth prospects, and a host of other areas-on a rating scale of very strong to very weak, quality leaders' top answer was moderately strong for every category. Such optimism, however, also demonstrates a gap in perception between patients and the people charged with improving the quality of care provided to those patients.

http://www.healthleadersmedia.com/content/227854/topic/WS_HLM2_MAG/Quality-A-Perception-Gap.html

Is $19 Billion on Healthcare IT Well-Spent?

HealthLeaders Media blog

The American Recovery and Reinvestment Act contains one of the largest government injections into healthcare since LBJ decided Medicare and Medicaid would be a good idea. Healthcare itself gets $147 billion, the largest chunk put into Medicaid, notes HealthLeaders Media Editor-in-Chief Jim Molpus. But $19 billion gets put into support for healthcare IT, including $2 million in direct grants and other $17 billion in tax credits to providers starting in 2011.

http://blogs.healthleadersmedia.com/leadtime/2009/02/is-19-billion-on-healthcare-it-well-spent/