If any state is poised to be ready, it's Maryland. One of the first to pass a law establishing an exchange, back in April 2011, it's moved swiftly to begin building a $51 million computer system that citizens will use to shop for insurance online as they do for airline tickets on Expedia (EXPE). "We want to be the model," says Lieutenant Governor Anthony Brown, who oversees the state's healthcare reform efforts. Yet even with its early lead, Maryland faces big challenges as it tries to assemble all the pieces of the massive law. That computer system the state’s building? It will have to connect seamlessly with both Maryland’s Medicaid system and the federal government's computers.
A new information exchange will allow hospitals, doctors, long-term facilities and other medical personnel to exchange clinical data via a secure statewide network. The White House approved $16.9 million for the project. Massachusetts contracted with Orion Health to develop the statewide network. The project is designed to improve communication between these institutions and reduce redundancies.
Last month, The New York Times reported that President Obama's Affordable Care Act will worsen America's already steep shortage of doctors, particularly in the valuable field of primary care. With an estimated 30 million people set to gain insurance coverage under the law in 2014, there won't be enough physicians to serve all these new patients. Because it takes about ten years to train a new doctor, little can be done to reduce this deficit in the short term. But Congress can begin to address the problem in the coming decades if it alters its investment strategy in medical education.
No community hospital board easily votes to give up the hospital's independence and tie its fate to a larger health system. But that is what the boards in control of the 120-year-old Chester County Hospital did this month, after deciding that the $150 million to $275 million needed over the next decade to fulfill their vision for the institution was more than it could get on its own. What Michael J. Duncan, president and chief executive of the Chester County Hospital & Health System, and other Chester County Hospital leaders see in the future of the institution, one of the few remaining independent hospitals in the region, is more outpatient centers, an expanded physician network, and heavy investment in information technology to accommodate large-scale changes in health-care delivery.
Too much security can make a tense trip to the hospital that much more stressful, said Mike Angeline, the safety and security director for Mount Carmel Health System. "Do I want to put a 90-year-old lady through a metal detector?" Still, a Dispatch survey found that local hospitals are, in general, putting more precautions in place. Children's, for example, installed metal detectors in the emergency department of its new hospital, which opened this year. Visitors also must be included on a list of approved guests before they can access an upper floor to see an ill child. Even then, they have access only to that patient's unit.
After three years of legal wrangling, Boone Memorial Hospital in Madison is now an independently run, nonprofit organization. The change occurred July 1. Tommy Mullins, Boone Memorial's longtime chief executive officer, said becoming a nonprofit would speed the hospital's campaign to replace its aging facility. Boone Memorial's current facility was built in 1964. Administrators want to replace the old, cramped building with a new hospital. On Aug. 1, the hospital applied for a $34 million loan from the U.S. Department of Agriculture. The loan would cover the full cost of the new building. "We should know in 60 days if we qualify, and for what amount," Mullins said.