Healthcare Reform

Forbes Reports States Fail on Transparency – How Are You Doing?

 

By DrScott – Posted on March 27, 2014 on www.compassphs.com

Transparency transforms employee’s relationship with health care. Actionable data delivered in a way that allows informed decision making has the potential to save tens of millions for both organizations and individuals at risk for health benefit expenditures.

The Accountable Care Act requires making transparency information more available and actionable for the public. This article points out that our states have not navigated this challenge successfully – yet. As Suzanne Delbanco executive director for Catalyst for Payment Reform states, “As much discussion and activity as there is around transparency, the truth is that today it’s a very rare instance when a consumer can easily find meaningful information about health care prices. We’ve got a long way to go.”

The challenge is even bigger than this article acknowledges. In order to go from an F to an A in the state transparency ratings, all that had to occur was for the data to be put on a web site. As the article states “In order to get a good grade, the groups say a state needs to provide public access to a “fully functioning website” as well as ensure regulations on price information are accessible for a long period of time.”

Engagement data suggests that having access to a web portal is only a beginning. Translating the web information into action often requires human support and interpretation. The moment questions like “is the MRI with or without contrast” are asked, many users are stumped and abandon their transparency exercise.

Avoiding the #3 Cause of Death in the USA: US Hospitals & What You Need To Know About It – Part 1

By DrScott – Posted on March 18, 2014 on www.compassphs.com

Preventable Adverse Events (PAE’s) are the #3 cause of death in the US, leading to between 210,000 and 440,000 American deaths annually.  This must stop.  But how?  The answer involves one of the best stories in US healthcare history.

It started when Dr. Donald Berwick, the co-founder, president and CEO of the Cambridge-based Institute for Healthcare Improvement (IHI), was driving with his son, Dan to the airport.  Dan, a political campaign strategist, explained that he was bringing 350 volunteers to Florida for a weekend to knock on 50,000 doors for his candidate.

Awed by the numbers, Berwick, 57 at the time and a clinical Professor of Pediatrics and Health Care Policy at Harvard, shared IHI’s frustration about the slow pace of change in medicine when it came to adopting practices known to improve care and reduce errors.  As the former head of quality-of-care measurement for a large HMO, Berwick knew the numbers: As many as 98,000 American hospital patients die annually from poor care or medical errors. IHI researchers estimate that approximately 15 million incidents of medical harm occur in U.S. hospitals annually, roughly 40,000 every single day.

So, Berwick asked his son the critical question: “What makes your work so effective?” Dan explained what it takes to run a successful political campaign – coming up with concrete numbers (i.e. how many people you want to reach), establishing field offices to reach more people locally, inviting the widest possible participation, giving specific instructions to workers, and setting a deadline.

The IHI  only had 75 people on staff at the time and no way to mount the national campaign needed to create any significant change, or did they?  On December 14th 2004, Dr. Berwick gave a speech to a room full of hospital administrators.  He said, “Here is what I think we should do.  I think we should save 100,000 lives.  And I think we should do that by June 14, 2006 – 18 months from today.  Some is not a number; soon is not a time.  Here’s the number: 100,000.  Here’s the time: June 14, 2006.”

To accomplish this the IHI proposed six specific interventions for hospitals to adopt that had been proven to reduce unnecessary deaths.  If you have been reading the blogs on the book Switch by Dan and Chip Heath, you will appreciate that the “rider” now has a clearly defined goal to achieve.

But this was a challenge for hospitals to embrace and get behind.  If they did embrace it, it implied that unnecessary deaths were occurring in their hospitals.  So, Dr. Berwick made it personal.  At his speech he asked the mother of a girl who had been killed by a medical error to join him.  She said, “I’m a little speechless, and I’m a little sad, because I know that if this campaign had been in place four or five years ago, that Josie would be fine….  But, I’m happy, and thrilled to be a part of this, because I know you can do it, because you have to do it.”  Another guest on the stage, the North Carolina State Hospital Association Chair, then spoke up: “An awful lot of people for a long time have had their heads in the sand on this issue, and it’s time to do the right thing.  It’s as simple as that.”  (Switch: the elephant was motivated).

The IHI made joining the campaign easy; hospital CEO’s only had to sign a one page form.  Once a hospital enrolled, the IHI team helped them embrace the new interventions.  Research, step by step instructions guide and training were provided, and regular teleconferences with the hospital leaders to share their victories and struggles were arranged.  Hospitals with early successes were encouraged to become mentors of hospitals who joined the campaign later. (Switch: the path had been made easy).

But would they achieve the goal? Eliminating errors and documenting the results had never been done this way in the US Healthcare system. As a patient, the challenge of finding an excellent facility and doctor to use can be daunting.