Hospitals with automated notes and records, order entry, and clinical decision support had fewer complications, lower mortality rates, and lower costs, according to a study published in the Archives of Internal Medicine. Researchers conducted a cross-sectional study of urban hospitals in Texas using the Clinical Information Technology Assessment Tool, which measures a hospital's level of automation based on physician interactions with the information system. After adjustment for potential confounders, they examined whether greater automation of hospital information was associated with reduced rates of inpatient mortality, complications, costs, and length of stay.
The 62nd annual Society of Surgical Oncology Cancer Symposium is scheduled for March 4-8, 2009, in Phoenix. The program is intended for all surgeons who are involved in the treatment of patients with cancer, according to the Society's Web site.
There will be a weekend conference exclusively on Free Open Source Software scheduled for July 31, 2009 through Sunday, August 2, 2009, in Houston. The conference will be the first U.S.-based conference focused solely on healthcare FOSS since OSCHA in 2002, according to this posting on the HIT Transition Weblog.
The Health and Human Services Department has formally recognized three new interoperability specifications related to electronic health records, personal health records, and electronic quality monitoring. Formal recognition is part of a two-step process in which specifications are first accepted by the HHS secretary and then recognized a year later. The recognition process "is critical to advancing both federal and private sector use of health IT standards," according to HHS representatives. The official recognition was noted Jan. 21 in the Federal Register.
David Title, a 35-year-old new-media manager at a film production company in New York, has dropped his cable subscription and moved to watching most of his television online . While shopping for a new laptop for his girlfriend recently, he picked a bare-bones, $200 Asus EeePC laptop. Silicon Valley has been gripped by a growing sense that the economic retreat might do more than depress earnings, but the fear now is that consumers like Title, and businesses operating with the same cost-cutting mind-set, will erode the high-margin businesses of the information technology industry—slowing some technologies and companies but giving new momentum to others.
Like most writers, when I'm assigned a long-form article I try to craft it in a way that doesn't just report on current happenings, but points out a few trends that might take hold in the near future. So it was with this month's cover story, Flat-World Healthcare.
In the article, I presented some key events that could perpetuate the medical travel movement. For instance, the increased pressure of U.S. businesses to pass along healthcare costs to employees will likely continue. So this could be an opportunity for businesses to add a medical travel benefit to let employees get the most cost-effective care since they will be shouldering more of the burden.
But with my lens so honed on the future, perhaps I didn't spell out bluntly enough a few of the big challenges facing medical travel today. With so much coverage on the topic over the past calendar year, I might have assumed this was well-treaded ground. However, recently a couple of readers e-mailed me to ask: What happens when the knee-replacement patient returns home to the U.S. and has a post-operative infection?
The good news is that after a year of reporting on global healthcare, I haven't yet heard of a post-operative complication that wasn't resolved. As we know, however, even in hospitals with outstanding complication rates, surgeries can go wrong.
I point out in HealthLeaders magazine that if employers push payers toward medical travel benefits, some of these continuity of care issues go away—for insured patients anyway. Post-op infections and other complications are things that global healthcare providers are actively addressing now, but I haven't yet seen a single best practice. Here are a few strategies I've heard of:
Some medical travel facilitators have agreements with local providers to accept their patients for post-op care. This could give the patient the comfort of knowing that there's a U.S. provider in place to assist in the case of complications. However, if this provider is in Florida, for instance, it wouldn't likely do much good for a patient in Spokane, WA.
I've also heard of global providers, such as Medtral New Zealand, that offer contingency insurance to cover the risk of major surgical complications.
Some global providers and facilitators are acting carefully and deliberately when it comes to continuity of care. Luke B. Johnson, director of international business development for Christus Health, tells me that Christus Muguerza won't accept a U.S. medical traveler who doesn't document a local physician for follow-up care.
Even though global providers and medical travel facilitators have rightly identified ways to deal with the continuity of care issue, the opportunity remains for an uninsured patient to fall between the gaps in care. That's why I'm interested in seeing how partnerships between U.S. and global providers might take shape in the coming years to create a true network solution of local and distant care providers.