Maryland health officials told state lawmakers yesterday that they were taking steps to minimize possible abuse of the addiction treatment buprenorphine as they spend millions to expand its availability. While insisting that misuse is currently not a serious problem, they outlined precautions in an appearance before a House of Delegates committee. These include screening for buprenorphine in overdose deaths, coordinating with police to monitor street sales and supporting a bill that would call for monitoring prescription drugs, including buprenorphine.
Last week Alegent Health hosted a forum for hospital leaders called "Power to the Patient." At the event, Alegent CEO Wayne Sensor spoke about the storm clouds on the healthcare horizon, encouraging leaders to embrace the one bright spot that can change the course of the industry: consumer empowerment.
Sensor's message is nothing new to most of us. For two years now, Alegent has been a leader in providing cost, quality, and patient satisfaction data to consumers and received a lot of attention for doing so. In those two years, Sensor says he's heard just about every argument for why the organization shouldn't post its information online: Doctors worry about how quality scores will make them look. Administrators with high scores fear what will happen if their organizations can't maintain high marks. And, perhaps the biggest argument: Do consumers really care?
Until now, all indicators showed that the answer to that question was "no." But earlier this month, The Regence Group, a Portland, OR-based insurance consortium, released a survey that says if given the information they need, patients will shop like consumers for healthcare services, considering the cost and quality of their intended purchase.
The survey was answered online by 2,000 people in four states and is the first to convincingly show consumer interest in price and quality data. Participants were asked to select one of 25 healthcare services that they could potentially need within five years. They were asked questions that surveyed how and if they would find information about the selected procedures. Seven out of 10 respondents reported they would look for information about prices and quality for non-emergency procedures, such as childbirth and diagnostic testing, The Regence Group said in a press release.
Of those who said they would do research to find out more about their particular procedure, 78 percent said they would seek information about quality, while 74 percent said they were more interested in cost information.
So what do the results of this survey mean for hospitals? It means that consumers are paying attention to the quality of the healthcare provided at your facility. They're pulling up your Web site and looking at the survival rate for cardiac surgery patients and stroke victims. They want to know how many patients contracted MRSA and other hospital acquired infections at your facility last year. They're serious about their health and want to know more about what your hospital can do to help them lead better lives. But is your hospital helping them in this quest for information?
I don't know about you, but when I'm looking for information, a list of numbers on a Web site doesn't encourage me to keep reading. In fact, the pages and pages of numbers that most hospitals put up do nothing but make my head spin. Consumers like me want Web sites and publications that are easy to understand--that not only give quick answers to their questions, but tell them why the facts and figures presented there are important and relevant to their healthcare.
The Regent Group's study is proof that healthcare has changed, and it's time for hospitals to not only provide care, but engage consumers in the healthcare experience. It used to be that a patient would take the advice of his or her doctor and see a specialist or have an MRI no questions asked. But that is no longer the case. Patients are going to do their own research. They're going to look online. They're going to talk to friends and family. They're going to go on your hospital's Web site and see what information you're offering. If they don't find what they're looking for, they'll head somewhere else.
Remember when I said a couple of weeks ago that quality was the most talked about subject in healthcare? I didn't mean just among doctors and administrators. Consumers hear about MRSA and medication errors and immediately wonder about the quality of care they or their loved ones will receive at their next visit. More and more hospitals post their quality stories online every day. Why should yours be left out?
When the conversation shifts to who's got the better health system, the United States or Canada, consider this: The quality of hospital care appears to be the same on both sides of the border. The statement is significant given the dramatic differences in how much each country spends on healthcare, according to one of the authors of a study by the Niagara Health Quality Coalition and the University of Toronto.
The time elapsed since a primary care physician's last board certification correlates with a decline in the quality of care provided to patients, according to a study published by researchers at Boston's Brigham and Women's Hospital. The study included 8,127 hypertensive patients with diabetes who had a high blood pressure reading documented in their records at least once between 2000 and 2005. The team analyzed the temporal relationship between board certification and treatment intensification, defined as an increase in dose, a change from one drug to another or the addition of a new drug.
These days, to spend time in the hospital is to be at risk of contracting a hospital-acquired infection. Some of these infections can be life-threatening. But there is a simple way to make that hospital stay safer, devised by Dr. Peter J. Pronovost, a physician-researcher at Johns Hopkins. The method--a five-item checklist to assure that proper precautions are taken to prevent infection--has been thoroughly tested, first at Johns Hopkins and later in 108 intensive-care units in Michigan, saving lives and reducing costs for patients who received the major fluid tube called a central venous catheter.
Death rates climbed significantly higher than expected at 12 Oregon hospitals, according to recently released state data. For example, among patients undergoing cardiac catheterization, death rates were higher than average at OHSU Hospital, Willamette Valley Medical Center in McMinnville and Merle West Medical Center in Klamath Falls. For the past three years, the Office for Oregon Health Policy and Research has posted hospital death rates for selected procedures in which there is some evidence that higher death rates may result from poorer care quality. The state's hospital quality indicators Web site also highlights hospitals' experience with procedures, such as open-heart surgery, in which more practiced centers tend to show better outcomes.