June 2009

Going with the Patient Flow Newsletter

First Look at 'Meaningful Use'
Joseph Goedert, Health Data Management
The meaningful use workgroup of the HIT Policy Committee has released its initial recommendations for a definition of "meaningful use" of electronic health records. The definition is important because under the economic stimulus law, providers must "meaningfully use" EHRs to receive financial incentives from Medicare and Medicaid. These initial recommendations do not include a formal definition of meaningful use. But they are the initial recommendation of the functionalities that will be required by 2011 when incentives start.
http://www.healthdatamanagement.com/news/meaningful_use-38487-1.html?ET=healthdatamanagement:e909:117429a:&st=email

Blumenthal: Health Care Reform Impossible Without Health IT
Wall Street Journal

In a recent interview with the Wall Street Journal, National Coordinator for Health IT David Blumenthal spoke about the prospects for health IT adoption and the federal economic stimulus law. Blumenthal said there is "no way to transform the health care system" without health IT. When asked about the potential cost savings, Blumenthal said, "The combination of an improved payment system, an improved education system about health IT and improved governance of the health care system that prioritizes quality and efficiency together with health information technology is where the real payoff is."
http://online.wsj.com/article/SB124404155221081477.html

Hospitals Use Business Intelligence to Boost Patient Throughput
Patty Enrado, HealthcareIT News

The effects of the economic downturn are driving C-level hospital executives to turn to process improvement initiatives. While only large hospitals can afford the expensive and long implementation of lean methodology, small to mid-size hospitals are finding business intelligence solutions are a more cost-effective alternative. Business intelligence provides benefits in many areas, and it makes a significant impact on patient throughput.
http://www.healthcareitnews.com/news/hospitals-use-business-intelligence-boost-patient-throughput

If the AMA Opposes Public Option, What Does it Support?
Janice Simmons, HealthLeaders Media

Sen. Chris Dodd (D-CT), chairing the Senate Committee on Health, Education, Labor, and Pensions hearing on its healthcare reform bill Thursday, aimed his questions at the American Medical Association after a New York Times story noted that the AMA opposed a public insurance option. Samantha Rothman, a member of the AMA's Board of Trustees and a fellow in pediatric emergency medicine in Boston, said "the AMA strongly supports making affordable health insurance available to all Americans," and that this can "best be achieved through a combination of insurance market reforms and healthcare exchanges that offer a variety of affordable private insurance plans."
http://www.healthleadersmedia.com/content.cfm?content_id=234466&topic=WS_HLM2_PHY

Bundling by Decree
Philip Betbeze, HealthLeaders Magazine

While the trite phrase "treat 'em and street 'em" can't be heard much outside the banter within the C-suite at hospitals and health systems, it accurately and succinctly reflects incentives that drive all manner of activities in these organizations, which have operated for decades under a payment system that can be gamed quite easily. The phrase reflects a variety of truths about the current payment system. That's not to suggest that hospitals are only bottom-line driven-many are far from it-but it's difficult to resist the intense appeal of high relative reimbursement. The problem for all consumers of healthcare services is that the current payment regime is wasteful because it reimburses for procedures, not outcomes.
http://www.healthleadersmedia.com/content/234357/topic/WS_HLM2_MAG/Bundling-By-Decree.html

Can Information Technology Cut Healthcare Costs?
International Business Times

Is technology the saving grace that Congress and the current administration think it is? According to Rick Gilkey, executive director of the Center for Healthcare Leadership and a professor at the Emory University School of Medicine in the department of psychiatry and in the Goizueta Business School department of organization and management, there is a right and a wrong way to go about implementing technology initiatives in the healthcare space. First, he notes, medical practitioners need to delineate between "technology implementation on the clinical vs. the business side of the house."
http://www.ibtimes.com/contents/20090612/can-information-technology-healthcare-costs.htm

Health Should Be at the Heart of Health IT
Carol Diamond and Josh Lemieux, McKinsey & Company

We must use health IT as a tool to transform the US healthcare system as a whole, rather than simply computerizing the current setup. Indeed, the literature on computerization, stretching back to the 1980s, is unambiguous on this point. Because, after all, it's use of information, not merely the existence of technology, that enables a consumer to play an active role in maintaining health and getting the best care, prevents a patient from suffering a medical error.
http://whatmatters.mckinseydigital.com/health_care/health-should-be-at-the-heart-of-health-it

 The Road from McAllen to El Paso
Harold S. Luft, The Healthcare Blog

Dr. Atul Gawande has provided a chilling description of the problems facing true health reform in his recent New Yorker article. In  The Cost Conundrum he describes how medical care is provided in McAllen, Texas, which is second only to Miami as the most expensive healthcare market in the country. McAllen's per capita expenditures are twice those in El Paso, Texas, a city with similar demographics. There are no good reasons for the differences. McAllen's population isn't demonstrably sicker and the care isn't measurably better.  There is also little understanding among the participants about what causes the higher spending. What is chilling is how easy the medical care environment in El Paso could become like McAllen's.
http://www.thehealthcareblog.com/the_health_care_blog/2009/06/the-road-from-mcallen-to-el-paso.html

From the C-Side

From HFMA: Five Ways Leaders Fail
Philip Betbeze, HealthLeaders Media
HealthLeaders Media Senior Editor Philip Betbeze blogs about his experiences this week at the HFMA Annual National Institute in Seattle. Lencioni often works with hospitals to adopt ideas around teamwork. Now, it's more important than ever in these difficult economic times, when everyone is expected to do more with less. He gave us five ways leaders often mess up their teams. Pay attention. I've definitely been on some bad teams and some good ones, and this guy has it right.
http://www.healthleadersmedia.com/content/234596/topic/WS_HLM2_FIN/From-HFMA-Five-Ways-Leaders-Fail.html

Is Healthcare Past the Softer Cuts?
Michelle Ponte, HealthLeaders Media

Is healthcare in its first wave of labor cost containment, or has it come to full blown cuts of what used to be the untouchables: salaries and jobs? A recent Hewitt Associates survey of HR execs at 518 large U.S. employers suggests that while healthcare organizations are making some tough cost containment decisions, they are still in the first phase of softer cuts compared to other industries. For example, of the 42 hospital/healthcare organizations that responded to the survey, 83% said they were increasing travel restrictions compared to the 72% overall response.
http://www.healthleadersmedia.com/content/234528/topic/WS_HLM2_FIN/Is-Healthcare-Past-the-Softer-Cuts.html

 Lessons for Hospitals in a Tight Economy
Dom Nicastro, HealthLeaders Media

Have hospitals taken this whole notion of saving too far? My colleague Dom Nicastro, identifies the extremes hospitals are taking to stay in the black. Dunn Memorial Hospital, for example, cancelled a fancy conference junket for its frontline employees and instead had them spend the week back home painting the hospital's waiting room. Much less fun than a trip, but more fun than unemployment. Dunn has implemented other cost savings, too, including restructuring shifts to provide light coverage on low-volume days. It is also working with fewer IT vendors and is spending less on travel.
http://www.healthleadersmedia.com/content/234239/topic/WS_HLM2_FIN/Lessons-for-Hospitals-in-a-Tight-Economy.html

CEOs Say: What's The Most Important Thing We Must Do Right Now?
Javier Espinoza, Forbes.com

What, above all else, does it take for chief executive officers to lead their businesses through this tough time, when life is so difficult for almost every corporation everywhere? Forbes asked 10 chief executive officers that question. CEOs of Bentley, AstraZeneca, BMW and other top companies were asked what one skill a leader needs most in today's business climate. They share insights on courage, adaptability and strategic planning.
http://www.forbes.com/2009/06/11/ceos-strategy-planning-leadership-ceonetwork-future.html