The Health Care Blog

Medicare Policy Might Discourage Proper Care for Hospital-Acquired Infections

By MAYA SEQUEIRA Medicare's recent policy of refusing to pay hospitals' additional costs to treat hospital-acquired infections fails to adequately incentivize prevention and proper treatment of these complications, associated with 99,000 deaths annually. A recent analysis by Peter McNair and...
September 29, 2009 in Medicare, Quality | Permalink | Comments (3)

To Change Health Care, Change Diabetes.

By DANA HAZA As we work to change health care in America, we must recognize the need to dramatically change diabetes. Twenty-four million Americans have diabetes at a cost to our nation of an estimated $218 billion for diabetes and...
September 29, 2009 in Chronic conditions, prevention, Quality | Permalink | Comments (9)

Joint Commission Apes Newt, Takes on IHI

By MICHAEL L. MILLENSON Not content with handing out demerits for bad behavior, the Joint Commission has launched an effort to help those who misbehave change their ways. As detailed in the Wall Street Journal’s Health Blog, the mission of...
September 12, 2009 in Michael Millenson, Quality | Permalink | Comments (5)

Separating Fact from Fiction and Health from Health Care

By JAMES S. MARKS, ROBERT WOOD JOHNSON FOUNDATION In an editorial on Wednesday, The New York Times debunks the often-cited claim that America has the best health care system in the world. For the politicians who routinely use this as...
August 31, 2009 in prevention, Quality, Reform, RWJF | Permalink | Comments (22)

E-Health - It All Depends on How It's Used

By MERRILL GOOZNER Technology isn’t a quick fix. Just ask General Motors. In the 1980s, the auto giant spent $50 billion to automate and computerize its plants in an effort to compete with Toyota. Today, GM is emerging from bankruptcy...
July 29, 2009 in Electronic Medical Records, Merrill Goozner, Quality, Technology | Permalink | Comments (15)

Op-Ed: Healthcare Reform Lessons From Mayo Clinic

By LEONARD L. BERRY and KENT D. SELTMAN Three goals underscore our nation's ongoing healthcare reform debate:1) insurance for the uninsured, 2) improved quality, and 3) reduced cost. Mayo Clinic serves as a model for higher quality healthcare at a...
July 21, 2009 in Costs, Mayo Clinic, Patient Safety, Quality, Reform | Permalink | Comments (43)

Op-Ed: The Unintended Consequences of “No Pay for Errors”

By BOB WACHTER Medicare’s policy to withhold payment for “never events” – the first effort to use the payment system to promote patient safety – remains intriguing and controversial. To date, most of the discussion has focused on the policy...
July 21, 2009 in Bob Wachter, evidenced-based medicine, Medicare, Patient Safety, Quality | Permalink | Comments (3)

Schwarzenegger replaces most of state nursing board

By TRACY WEBER AND CHARLES ORNSTEIN Gov. Arnold Schwarzenegger replaced most members of the California Board of Registered Nursing on Monday, citing the unacceptable time it takes to discipline nurses accused of egregious misconduct. He fired three of six sitting...
July 14, 2009 in California, Nursing, ProPublica, Quality | Permalink | Comments (5)

Musings on Payment Reform

By CHARLIE BAKER Charlie Baker is the president and CEO of Harvard Pilgrim, a nonprofit health plan that covers more than 1 million New Englanders. Charlie is a regular contributor to THCB, where he has authored posts on national health...
July 12, 2009 in Charlie Baker, Costs, Massachusetts, primary care, Quality, Reform | Permalink | Comments (38)

Meaningful Use vs. Meaningless Adoption of Electronic Health Records

By RICK WEINHAUS MD Dr. David Blumenthal, the new National Coordinator for Health Information Technology, has stressed that the goal of the ARRA/HITECH initiative is to improve patient care, not to mindlessly adopt health information technology. In this regard, he...
July 7, 2009 in Electronic Medical Records, Health 2.0, Meaningful Use, Physicians, Policy, Policy/Politics, Quality, Reform, Technology, Web/Tech | Permalink | Comments (9)

The Health Industry's Achilles Heel

By BRIAN KLEPPER and DAVID C. KIBBE "You never want a serious crisis to go to waste." - Rahm Emanuel, White House Chief of Staff Timing matters. The health industry has demonstrated steadfast resistance to reforms, but its recently diminished...
June 10, 2009 in Brian Klepper, David Kibbe, Health Plans, Obama administration, Policy, Policy/Politics, Quality, The Industry, Transparency | Permalink | Comments (15) | TrackBack

Alex Drane -- Engage with Grace

By Matthew Holt Alex Drane is at AHIP in San Diego and she’s talking not about Eliza, or health plans, but is talking about Engage with Grace. It’s a wonderful interview, although Alex knows that associating end of life care...
June 9, 2009 in Policy/Politics, Quality | Permalink | Comments (0)

Data-Driven Health Care: An Interview with Jerry Reeves, MD

An under-the-radar debate is occurring in health care between those who say data shows that practice variations across the land are “unwarranted” and those who maintain that such variation is inevitable given socioeconomic population differences and cost of practice differences...
June 8, 2009 in Dartmouth Atlas, Economics, evidenced-based medicine, Health Plans, Obama administration, Patient Safety, Physicians, Policy/Politics, primary care, Quality, The Industry, Transparency | Permalink | Comments (17)

Thomas Kuhn, Health Care Reform and Vascular Disease

By WILLIAM BESTERMANN The puzzle of improving care and reducing costs in American medicine and in vascular conditions (that is, diseases associated with blood vessel metabolism) in particular - these are responsible for 60 percent of all cost - has...
May 24, 2009 in Chronic conditions, evidenced-based medicine, Medicine, Obesity, Policy, primary care, Quality, Science | Permalink | Comments (8)

An Open Letter to the New National Coordinator for Health IT: Part 3 -- Certification As The Elephant in Health IT's Living Room

By DAVID C. KIBBE and BRIAN KLEPPER In the first and second parts of this series we talked about how and why there is no universal definition for the term "EHR." Instead there is a legitimate, growing debate about the...
May 8, 2009 in Brian Klepper, David Kibbe, e-patients, Electronic Medical Records, Health 2.0, Obama administration, Online Communities, Policy, Policy/Politics, Quality, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (20)

Following the Science To A New Era In Medicine

By WILLIAM BESTERMANN, MD "The current care systems cannot do the job. Trying harder will not work. Changing systems of care will." Crossing the Quality Chasm, Institute of Medicine, 2001 Medical leadership in the United States has not yet come...
April 20, 2009 in evidenced-based medicine, Physicians, prevention, primary care, Quality, The Industry | Permalink | Comments (4)

Five Recommendations for an ONC Head Who Understands Health IT Innovation

By David C. Kibbe, Brian Klepper and John Moore. Now that the legislative language of the HITECH Act -- the $20 billion health IT allocation within the economic stimulus package -- has been set, it's time to identify a National...
March 6, 2009 in Brian Klepper, Current Affairs, David Kibbe, Electronic Medical Records, evidenced-based medicine, Health 2.0, Physicians, Policy, Policy/Politics, primary care, public health, Quality, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (14)

The AMA Wins a Round Against Accountability and Patient Information

By Brian Klepper On January 30th, a 3-judge DC appeals court overturned a lower court decision that would have forced public release of Medicare physician data. Writing for the majority in a split 2-1 judgment, Circuit Judge Karen LeCraft Henderson...
February 6, 2009 in Brian Klepper, Consumers, Current Affairs, Health Plans, Policy, Policy/Politics, Quality, Technology, The Industry, Transparency | Permalink | Comments (12)

The New Science of Vascular Disease

By William H. Bestermann M.D. Vascular disease and the conditions that produce arterial problems consume roughly one- third to one-half of the $2 trillion annual spend in American health care. The science and systems exist today to dramatically improve the...
January 28, 2009 in Economics, Policy/Politics, primary care, Quality, Science | Permalink | Comments (9)

CEOs' Urgent, Shared Commitment to Change

By Gary S. Kaplan A few weeks ago, I joined five of my peers in health care leadership throughout the country to help launch Health CEOs for Health Reform, a coalition dedicated to transforming health care and creating a more...
January 27, 2009 in Current Affairs, Marketplace, Policy, Policy/Politics, Quality, The Industry | Permalink | Comments (25)

Five "Shovel-Ready" Health Care Reforms

By Brian Klepper & David C. Kibbe Microsoft Health Vault's leader Peter Neupert has a wonderful blog post that makes two important points really well. One message is that health care reform is about the outcomes, not the technology. We...
January 21, 2009 in Brian Klepper, David Kibbe, evidenced-based medicine, Health Plans, Marketplace, Obama administration, Physicians, Policy, Policy/Politics, primary care, Quality, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (18)

OP-ED: The MRI Safety Gap

By Tobias Gilk In health care, particularly in patient safety, there is a cultural predisposition towards excellence. There’s a fundamental desire to create better, safer environments in support of care. That applies to staff qualifications, policies & procedures, medical technology,...
January 19, 2009 in Hospitals, Policy, Quality, Technology | Permalink | Comments (6)

Confessions of a Cultural Anthropologist: The Cause and Cure of High Health Costs

By Richard Reece Today’s medical students are being inducted into a culture in which their profession is seen increasingly in financial terms. Add in such pressures as the need to pay off enormous debts, and it is not surprising that...
January 13, 2009 in Marketplace, Physicians, primary care, Quality, Technology, The Industry, Web/Tech | Permalink | Comments (13)

New NRC Report Finds "Health Care IT Chasm," Seeks New Course Toward Quality Improvement and Cost Savings

By DAVID C. KIBBE Like the Institute of Medicine's (IOM) 2001 counterpart report, "Crossing the Quality Chasm," a new report from the National Research Council of the National Academies is complex, full of new ideas assembled from multiple disciplines, and...
January 12, 2009 in Electronic Medical Records, Marketplace, Obama administration, Policy, Policy/Politics, Quality, The Industry, Web/Tech | Permalink | Comments (20)

Persistent Nondiagnosis

By Brad Kittredge Brad Kittredge is an MBA/MPH student at the Haas Business School at UC, Berkeley. He is working to build an online tool to assist with complex and difficult diagnoses, which, as you’ll see, he considers among the...
January 9, 2009 in Quality | Permalink | Comments (9)

The demise of Medicare Health Support

By Matthew Holt I guess we knew it, but here’s the confirmation in the analysis of the first 18 months from CMS. The summary: DM companies in Medicare Health Support enrolled healthier than average populations; they had limited to no...
January 6, 2009 in Medicare Advantage, Policy, Policy/Politics, Quality | Permalink | Comments (4)

A new year's resolution for greater hospital transparency

By Paul Levy Just thinking, along the lines of a New Year's resolution. What if all of the hospitals in the Boston metropolitan area -- academic medical centers and community hospitals -- decided as a group to eliminate certain kinds...
January 3, 2009 in Hospitals, Patient Safety, Paul Levy, Quality, Transparency | Permalink | Comments (4)

Washington, Please Don't Bail Out the Health Care Industry

By RICK PETERS A health care Marshall Plan -- $50 Billion stimulus to get electronic health records (EHRs) in every doctor’s hands or $50,000 to each physician -– what an incredible marketing job. Detroit, are you listening? Stop whining to...
December 19, 2008 in Economics, Electronic Medical Records, Obama administration, Physicians, Policy, Quality, Technology | Permalink | Comments (45)

Low tech ways to improve patient care: sleep and manners

By Michael Miller, MD A few recent reports point to ways for improving the quality of physician delivered care that has little to do with technology or complex interventions. The first involves how physicians interact with patients, and the second...
December 17, 2008 in Patient Safety, Physicians, Quality | Permalink | Comments (2)

Dispatches from IHI's quality forum

By Amanda Goltz Don Berwick is one of the leading lights of the health care quality world; an oft-quoted and published visionary who founded the Institute for Healthcare Improvement to spread the gospel of transformation and improvement around the world....
December 14, 2008 in evidenced-based medicine, Hospitals, Patient Safety, Quality | Permalink | Comments (2)

Transforming medicine and saving lives

By Sarah Arnquist This week, Don Berwick will announce the results of the 5 Million Lives Campaign before thousands of people in Nashville attending the National Forum on Quality Improvement in Health Care. Twenty years ago, it was almost heretical...
December 9, 2008 in Electronic Medical Records, Hospitals, Patient Safety, Physicians, public health, Quality | Permalink | Comments (5)

Resident Duty Hours and Patient Safety: Did The IOM Get It Right?

By Bob Wachter The Institute of Medicine just released its long-awaited report on trainee duty hours. It is well researched and balanced, and its recommendations appropriately reflect what we know vs. what we believe. Now the fun begins. Let’s start...
December 9, 2008 in Bob Wachter, Hospitals, Patient Safety, Physicians, Quality | Permalink | Comments (1)

Nudging the value glacier

By Sarah Arnquist In just two years, seniors will spend a quarter of their monthly Social Security checks on Medicare out-of-pocket expenses, including premiums, co-payments and deductibles. Meanwhile, Medicare bookkeepers predict total health spending in the U.S. to increase from...
December 4, 2008 in Conferences, Economics, evidenced-based medicine, Medical Devices, Policy/Politics, Quality, Sarah Arnquist | Permalink | Comments (2)

There's waste in the medical system--Duh!

By Robert Laszewski As we begin the health care reform discussion in earnest, many are pointing out all of the waste in the system and the need to research what works best, provide the incentives to do it, manage the...
December 3, 2008 in Economics, Policy/Politics, Quality, Robert Laszewski | Permalink | Comments (6)

Addressing an epidemic of overtreatment

By John Halamka & Rich Parker Health care costs in the U.S. are approaching 17 percent of the GDP and may be as high as 20 percent in the next few years. What is causing the US to have the...
December 3, 2008 in Economics, evidenced-based medicine, Policy, Quality | Permalink | Comments (6)

Embracing palliative care as mainstream medicine

By Bob Wachter I’m on clinical service now and my patients are dying left and right. And I’ve never been prouder of my own care, and that delivered by my colleagues and hospital. When I was in training, a patient’s...
November 30, 2008 in Hospitals, Physicians, Quality | Permalink | Comments (11)

Rethinking compassion in medicine

By Michael Miller Two recent events made me think about how traditional medical care and medical education address the issue of compassion. The first was at the annual dinner for the Kenneth B. Schwartz Center when they gave out their...
November 26, 2008 in Physicians, Quality | Permalink | Comments (5)

Electronic health records provide the foundation for clinical excellence

By Scott Shreeve I have mentioned this many times but it bears repeating with three recent news articles - the electronic health record itself is not a game changer but it is a powerful information gathering tool. However, by gathering...
November 24, 2008 in Electronic Medical Records, Quality, Scott Shreeve, Technology | Permalink | Comments (5)

America's CEOs set priorities for Obama Administration

By Brian Klepper This past Monday and Tuesday, The Wall Street Journal convened an extraordinary conference of about 100 CEOs to develop and recommend issue priorities for the new Administration. (See the participant list here.) This meeting brought together the...
November 21, 2008 in Brian Klepper, Conferences, Economics, Quality, The Industry, Transparency | Permalink | Comments (11)

CAP's Blueprint for reform

By Joshua Seidman The Center for American Progress (CAP) released a new “Blueprint for Reform” that focuses on how to fix the delivery system. This well-constructed document and provocative forum was spearheaded by CAP CEO John Podesta (former Clinton White...
November 11, 2008 in Joshua Seidman, Policy/Politics, Quality | Permalink | Comments (2)

A little more Engaging with Grace

Alex Drane talks about how she hopes Engage with Grace will become a viral movement of the good type!
November 9, 2008 in Consumers, Quality | Permalink | Comments (2)

Baseball and Health Care: Only One Is a Spectator Sport

By Joshua Seidman It’s fascinating when two of my passions collide in the opinion pages of the New York Times like they did over the last week. On Friday, October 24, some seriously strange bedfellows came together to write about,...
November 4, 2008 in Joshua Seidman, Policy/Politics, Quality | Permalink | Comments (3)

Pitfalls of VIP Syndrome

By Sarah Arnquist Slate has an article today by two doctors discussing VIP syndrome in health care and how it can lead to worse care for the rich and powerful, such as Sen. Ted Kennedy, who following a diagnosis of...
October 30, 2008 in Patient Safety, Quality | Permalink | Comments (2)

An Impending Hanging: Will Health 2.0 Be Compromised By The Economic Downturn?

By Brian Klepper Nothing focuses the mind like an impending hanging. -- Samuel Johnson I've been preparing for tomorrow's 3rd Health 2.0 conference in San Francisco, where I'll join my pals Matthew, Indu Subaiya, Jane Sarasohn-Kahn and Michael Millenson amid...
October 21, 2008 in Brian Klepper, Economics, evidenced-based medicine, Health 2.0, Online Communities, Quality, The Industry, Transparency, User Generated Content, Web/Tech | Permalink | Comments (3)

Using clinical decision support to get the right diagnosis the first time

By Joseph Britto, MD Joseph Britto is co-CEO of Isabel Healthcare, a clinical software vendor that helps clinicians with diagnosis. He practiced medicine in the UK before joining with co-CEO Joseph Maude to start Isabel, named after Joseph's daughter who...
October 10, 2008 in Electronic Medical Records, Hospitals, Patient Safety, Quality | Permalink | Comments (6)

Google Health: Is It Good For You?

By AMY TENDERICH Note: Amy Tenderich, who writes and maintains the wonderful Diabetes Mine, just did this very illuminating interview with Google Health's Missy Krassner. As you'll see, she doesn't slow-pitch to Missy. This is a sure-footed, tough-minded exchange about...
October 7, 2008 in Google, Health 2.0, Marketplace, Online Communities, Privacy, Quality, Technology, The Industry, User Generated Content, Web/Tech | Permalink | Comments (2)

Big administrator is watching you

By Bob Wachter Last week, came the announcement that Suzanne Delbanco, founding director of the Leapfrog Group, has assumed the presidency of a company that tracks compliance with safety and quality practices via remote video. Big Brother, meet the Joint...
September 29, 2008 in Bob Wachter, Patient Safety, Quality | Permalink | Comments (4)

Mixed reception for hospital ID bracelets

By Sarah Arnquist Color-coded hospital bracelets intending to identify categories of patients and prevent errors by ensuring they receive proper care have received a mixed reception, the New York Times reports. Red bracelets indicate allergies, amber says the patient has...
September 26, 2008 in Hospitals, Patient Safety, Quality | Permalink | Comments (2)

A Genius Shines…And, Where the Light Doesn’t, Hospitals Don’t

By Michael L. Millenson It doesn’t take a genius to figure out that hospitals could dramatically reduce the hundreds of thousands of deaths and injuries they unintentionally cause patients ever year, but it may take a genius to coax change...
September 25, 2008 in Patient Safety, Quality, Transparency | Permalink | Comments (0)

Evidence of a Need for Change

By THCB Staff The Health Care Blog regular Michael Millenson wrote a great piece recently in Miller-McCune Magazine on the necessity of practicing more evidenced-based medicine, and why it's not happening. Here is a powerful snippet but it's definitely worth...
September 24, 2008 in Economics, evidenced-based medicine, Patient Safety, Quality | Permalink | Comments (3)