Federal health officials have warned that patients who wear nicotine or other drug patches during MRI scans risk burns, because some patches contain tiny metal elements that can be heated by the device's huge magnet. Patients should consult their doctors on whether to replace or reuse patches after removal for scans, officials said. The alert is the latest in a string of safety warnings involving magnetic resonance imaging that have resulted from the unpredictable effects of the strong magnets used in MRI devices.
This could get complicated. Let me try it this way:
Just in case you've been a.) unconscious; b.) pinned under a heavy object; or c.) both, for the past couple of weeks, we have a $787 billion stimulus package on our hands—the American Recovery and Reinvestment Act of 2009. Within that sweeping package is more than $19 billion dedicated to healthcare information technology adoption.
But you know this. Some of my HealthLeaders Media colleagues have already offered insightful analysis from a variety of angles, anyway. So I'm not going to spend a lot of time talking about whether electronic health records can improve quality, or whether this legislation helps eliminate many providers' financial excuse for not adopting EHRs, or whether questions of interoperability, practicality, and provider culture mean this problem is about more than just money. Although they can, it does, and they do.
In short, there's been considerable talk about how quality improvement can be a monumentally expensive proposition. But what about the costs of inaction—of failing to make patients safer and care more effective?
When patients are harmed or even die because of something that happens to them within the walls of the hospital, that's a human cost that transcends money. But there's a financial price, as well. An Agency for Healthcare Research and Quality study published in the journal Health Services Research found that potentially preventable medical errors occurring during or after surgery may cost up to $1.5 billion a year. In using 14 AHRQ patient safety indicators to identify medical errors among more than 161,000 surgical patients, the authors found that additional expenditures likely due to the PSIs ranged from $646 for problems like accidental laceration to as high as $28,218 for acute respiratory failure.
Twenty-eight grand is a lot of money for a medical mistake when you start doing the math and extrapolate the data to a national annual level. Also, the study found additional costs in numerous other areas when associated with medical errors. Some examples:
Nursing care—33% higher costs than patients who did not experience an error.
Metabolic problems—32% higher costs.
Blood clots or other vascular or pulmonary problems—25% higher costs.
Many of you may not be all that surprised by such numbers. But to me, an even more significant finding of this study is that one-third of the patient deaths attributable to preventable errors occurred after the initial hospital discharge. In other words, the costs—both human and financial—continue to accrue after the patient has left the hospital.
The umpteen-billion-dollar question, of course, is whether EHRs—even if the stimulus package actually does clear the way for their implementation—can reduce those costs in the revolutionary way proponents contend. The fact is, no one knows the answer to that question. Not really. But I do think focusing exclusively on the price and pitfalls of technological advancement is missing part of the cost equation—and that the paralysis that can result from examining the complexities of potential solutions is not an answer.
At stake is not only organizations' financial health, but human lives and, ultimately, the future of an entire healthcare system. So I will continue to watch as this $19 billion attempt at a solution unfolds. What do we have to lose besides everything?
Jay Moore is managing editor for HealthLeaders magazine. He can be reached at jmoore@healthleadersmedia.com.
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The University of Pittsburgh Medical Center said in court papers that a lawsuit filed against it by the son of a woman who died after wandering away from her hospital room was full of "scandalous" and "irrelevant" claims. Rose Lee Diggs, 89, was found on the roof of UPMC Montefiore in December, hours after she had wandered away from her 12th-floor room. The lawsuit, filed by her son in the Allegheny County Court of Common Pleas, alleges negligence by hospital staff and includes claims that hospital workers attempted a cover-up by replacing a broken lock that led to the roof of the hospital where the woman was found.
Doctors claim they are seeing more and more cases of MRSA in children. According to the Centers for Disease Control and Prevention, an estimated 95,000 people in the United States developed serious MRSA infections in 2005, the latest data available. While the CDC cannot say how many children were infected, the agency reported the greatest increase in hospital visits were among those under 18 during an eight-year period ending in 2005. Children are especially vulnerable because of their underdeveloped immune systems, experts say.
Two intensive-care patients at Roseland Community Hospital in Chicago recently died after becoming infected with a common bacterium sometimes found in intensive-care units. Officials learned Feb. 23 that four patients in the hospital's ICU were infected with acinetobacter, the hospital said in a statement. Before the outbreak was contained, seven of the ward's 10 patients were infected. Hospital spokeswoman Sharon Thurman confirmed Monday that two of the patients later died. It is unclear whether the bacterial infections contributed to the two deaths at Roseland.
Atlanta's Grady Memorial Hospital expects to reopen some areas today that were contaminated with Legionnaires' disease, while implementing $700,000 in measures to prevent another outbreak, hospital officials said. The officials said they could not definitively determine whether the four patients with the disease acquired it in the hospital. But widespread testing pinpointed high concentrations of Legionella bacteria in the patient areas of the 11th and 12th floors of the A tower, where those patients were staying, said hospital spokesman Matt Gove.