Some hospital emergency rooms have seen record-breaking numbers of patients as those with coughs, sore throats, and fevers—and sometimes no symptoms at all—have sought reassurance that they do not have the deadly H1N1 virus. The surges have been particularly heavy at children's hospitals, presumably because the young are so susceptible to respiratory diseases with comparable symptoms. Some hospitals have had to increase staffing and enact specialized triage plans. Waiting times have billowed in some emergency rooms, even for the seriously ill.
In a country where just 1.5 % of US hospitals have fully computerized records, West Virginia has created a paperless records system for its state-run hospitals and nursing homes serving the indigent elderly and mentally ill. The state did it on the cheap by using an electronic medical records system built by the Veterans Administration with taxpayer dollars, saving millions in software licensing fees charged by commercial software vendors. The VA software, known as VistA, is open-source software and it includes features such as a bar-coding system to track drug dispensations.
As the economic recession persists, people who are unemployed or worried about losing their jobs are putting off medical care and living with illnesses and conditions that aren't critical, but can be debilitating. Some are delaying having precancerous tumors removed; others are forgoing knee or shoulder surgery. While insurance often covers much of the costs associated with such procedures, there are expenses that can add up to thousands of dollars. For those lacking insurance, the price of most elective procedures is beyond their reach. And as more people forgo treatment, hospitals are suffering financially, industry specialists say.
Florida lawmakers learned that former Gov. Jeb Bush's controversial Medicaid reform plan from 2005 includes a time bomb for hospitals: A $300 million penalty. That's the amount Florida could lose in federal charity healthcare money if legislators don't reorganize Medicaid statewide within two years. This is about an experimental program designed to shift more Medicaid patients to managed-care plans and make the public health system run more like private companies. It currently operates in Broward County and the Jacksonville area.
Franklin, TN-based Health Research Insights is riding a wave of interest among self-insured employers intent on examining bills from physicians and other providers for what could be overpayment errors. For employers, it is all part of a push to control rising healthcare costs while fulfilling obligations to ensure that their health plan dollars are spent wisely. But some doctors question HRI's techniques, suggesting that the approach seems to assume wrongdoing took place after studying payment data that doesn't necessarily take into account all the details of a particular patient's case.
In the emergency room at Long Beach Memorial Medical Center, the triage was simple: Those complaining of flu symptoms were masked and separated from the rest of the ER patients until they could be further evaluated. Those who were visibly ill were immediately isolated pending tests. Those determined to be the "worried well" were reassured and sent home. One thing officials there and elsewhere have learned is the need to educate potential patients to be as calm and collected as the hospital staff has been.