Located in Parrish, AL, the Capstone Rural Health Center has something even big-city medical practices lack: a functioning electronic medical records system. At the center, exam rooms have computers, medical histories are entered into databases, bills are transferred over the Internet to insurers, and patients are tracked automatically during appointments. The center is a rarity, according to a recent poll that found only 4% of medical practices in the U.S. have fully functional systems to handle EMRs, and most of those are in large practices.
Although more Americans are being diagnosed with diabetes, some St. Louis-area hospitals are scaling back or eliminating their diabetes education programs. Advocates say can these programs can prevent a lifetime of unnecessary complications and cost. But the hospitals say these programs are costly to provide and fewer patients are interested. St. Mary's Health Center, for example, watched enrollment drop to an expected 120 patients this year from 160 patients in 2006.
River Oaks Hospital is closing both of its Houston campuses after struggling for four years to turn a profit there, says parent company Hospital Partners of America.
The hospital stopped accepting new patients at both campuses last week and transferred about 100 current patients to the 362-bed St. Joseph Medical Center, also operated by HPA. In a written statement, Chris Vasquez CEO of River Oaks, called the closure, "a very difficult decision for us to make."
Despite what HPA says were significant capital and operating investments, the hospital failed to thrive. The company blames a "challenging cost and reimbursement environment" for the hospital's financial downfall. "We have all worked diligently to turn the hospital around and have invested significant effort and financial resources in the facility. Unfortunately we have been unsuccessful in achieving an economically sustainable facility," says Vasquez.
Although HPA is not commenting on what will happen to the hospital's more than 500 employees, sources say at least some of them will be absorbed by St. Joseph's because a number of patients are being transferred there. HPA will also hold a job fair to place employees in other jobs. River Oaks—which has 524 beds between the two campuses—is a joint venture between HPA and a group of more than 40 Houston doctors. The hospitals were considered general acute-care facilities, but also performed a large number of orthopedic and bariatric surgeries.
Airline carriers are scrambling for ways to offset rising fuel costs. The solution? Pass those costs onto someone else. Three major U.S. carriers—US Airways Inc., United Airlines Inc., and American Airlines Inc.—have announced plans to charge their coach passengers $15 for the first checked piece of luggage. In addition, US Airways will start charging its coach passengers $2 for a soda.
So what does all this have to do with community hospitals? Your purse strings are about to get tighter with likely reimbursement cuts, as well. So how do you plan to offset those losses? I asked this question a few months back and didn't get any real solutions. Instead, I heard from CEOs hoping to find some answers, as well.
Hospitals need to figure out how to get more dollars in the door. But raising the price of services may not be the most consumer-friendly option—nonprofit hospitals' list prices and billing and collection policies are already being scrutinized. I'm not sure how well it will work for the airline industry, either. Why would I choose to fly with a carrier that will charge me for a soda and checked bags, when I could fly another carrier and not incur those costs? I think American Airlines has a better strategy with its partnership with Aircell LLC to offer Internet services to its passengers for $12.95 for flights three hours or longer and $9.95 for shorter flights. I think that a number of business travelers would be willing to pay for this service.
But what services will patients pay for? With all the talk of consumer-driven healthcare, hospitals haven't been very innovative in this regard. Sure, hospitals are upgrading their facilities so that they are less institutional and more hotel-like. Some even offer concierge services to employees and patients—someone who can pick up dry cleaning, arrange child or pet care, and make hotel or dinner reservations, among other services. Personally, I'm not too worried about getting my dry cleaning picked up while I'm in the hospital. And while the waterfall wall or healing garden may help contribute to the overall patient experience and satisfaction, I think hospitals can do more to appeal to the consumer and get a few more dollars in the door at the same time. What about offering patients massages—$15 for a 15-minute shoulder, hand, or foot massage? I, for one, would feel better, and it's something that I never take the time to do. Better yet, sell these services in the gift shop, so family and friends can buy you a massage versus flowers or a stuffed animal.
Or you can offer catering services through the hospital cafeteria. You may be thinking, "Who wants to hire a hospital to cater a meal?" But some hospital cafeterias offer some of the best food in town and have successful catering services. Many hospitals also offer retail services, providing nursing materials for new moms or bandage materials for wound care patients. But how well are these items actually marketed? Are these services in a nondescript-looking room down a hallway or mixed in with the candies and stuffed animals in the gift shop? Prominently displaying these items in the women's center or wound care center may increase revenues. I've even heard of a gift shop on wheels—volunteers wheel a cart into patients' rooms to let them know about the concierge services and offer them free newspapers. In addition, the cart is stocked with chocolate, toothpaste, and other items that patients can purchase. Five dollars for a box of chocolates may not solve your reimbursement woes, but every penny counts.
Carrie Vaughan is editor of HealthLeaders Media Community and Rural Hospital Weekly. She can be reached at cvaughan@healthleadersmedia.com.
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Oklahoma State University is using "job shadowing" among its students to help ensure today's medical students are quality healthcare providers tomorrow. Students involved in the program at the Oklahoma State University College of Osteopathic Medicine is two years in the classroom, then the two years of clinical work. Job shadowing between the first and second years provides a good clinical preview, they said.
A national study led by researchers at Denver Health Medical Center has determined that a blood substitute could save lives in emergencies. Denver Health was among 31 trauma centers across the country that participated in the study, which looked at whether a blood substitute called polyheme could help when there's no immediate access to real blood for a transfusion. The problem is common in rural areas because it takes longer for an ambulance to get to a hospital.