The University of Texas Regents violated state law by meeting in secret to authorize the layoff of 3,800 employees at the University of Texas Medical Branch at Galveston, according to a lawsuit filed by the Texas Faculty Association. The lawsuit accuses the regents of violating the Texas Open Meetings Act when they closed the doors to a meeting and decided to authorize the layoffs to help stem financial losses caused by Hurricane Ike.
At least 50% of hospitals throughout Ontario have been in deficit this year, with nearly 70% of them expected to experience similar financial woes next year. Hospitals province-wide are now looking to substantial budget cuts that would impact workforces and hospital services, according to a recent report by the Ontario Health Coalition.
Talk to CEOs of American hospitals, and they'll freely admit the U.S. health system is fraught with waste. In the next breath they might very well tell you about the efficiencies and cost controls they have tried to implement, but few would point fingers at the local hospital administrator as the source for the country's spiraling healthcare costs.
After all, healthcare here is a competitive business. Margins are thin for most, and some community hospitals are even closing their doors. Some of the real sources of waste are noted in a recent Washington Post story. Top health system CEOs tell the Post that the U.S. needs to pay for results rather than services and that as much as half of the $2.3 trillion spent doesn't improve patient health. If I'm a large employer reading this story, you'll probably be able to see the steam coming out of my ears. Bad enough I'm struggling in a depressed economy, but CEOs of major health institutions are telling me that they knowingly waste half of what I spend on employee healthcare.
We've heard this complaint before, and it comes down to the quality-value equation—which is the very thing that can give global hospitals a competitive edge. Without the burdens of the fee-for-service model and onerous regulations, global providers can concentrate efforts on providing the great outcomes at a good value that consumers, employers, and payers are looking for.
However, as third-party payers enter the global marketplace and private international hospitals continue to feel the pressure of adding expensive technology and amenities, global CEOs should work hard to avoid the pitfalls that lead to unnecessary costs.
With a global physician shortage looming, it is all too easy to give in to the urge to buy the newest technology even if you're not sure it will improve outcomes. Here in Boston, Paul Levy, president and CEO of Beth Israel Deaconess Medical Center, writes in his blog that he's giving in to business pressures to purchase a da Vinci Robot Surgical System because other hospitals in his region already have the technology and he thinks it will help him recruit physicians.
These concerns are hardly limited to Boston academic medical centers. Private hospitals in India, Thailand, Singapore, and the Middle East no doubt want to add the latest—but not necessarily the greatest—technology in their efforts to attract top-notch doctors and patients seeking state-of-the-art care. When it makes business sense, there's certainly nothing wrong with this, but in an increasingly flat world the quality-value equation should rule over adding cost for the sake of marketing strategy.
Nearly every hospital leader wants his or her hospital to be considered a center for innovation, but the more mature leader considers what the value is to the patient and delivers it consistently.
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The TEPR 2009 conference is scheduled for February 2009. The conference is designed to give clinicians, healthcare executives, and HIM and HIT professionals innovative, cutting-edge and practical solutions for today's health IT issues, say organizers.
VMware has renamed and expanded upon its desktop virtualization software, with features that reduce storage requirements and allow offline access to desktops. VMware View, formerly known as Virtual Desktop Infrastructure, gives IT managers an easier way to manage desktops while also providing end users more flexible access to personalized desktops from pretty much any thin client or PC, says Raj Mallempati, a VMware product marketing manager.
While 3-D images has worked wonders in radiology, some technology data managers are getting into the game by using 3-D imaging to analyze power and cooling air flow in data centers. In this Forbes article, two data center consultants say 3-D models can help services professionals pinpoint exactly where air flow improvements are needed or where to help technology managers adjust capacity planning and budgeting for increased energy efficiency.
The Social Security Administration wants to develop a prototype of a system that would automatically pull information from electronic health records to more easily deal with the more than 2.5 million disability claims it receives annually. The SSA currently obtains paper copies of claimants' medical records to verify that the individuals involved are disabled, a process that can take months and costs SSA more than $500 million a year. Some of the records are online in the standard Continuity of Care Document format and could be retrieved electronically much faster and easier, SSA officials said.
Personal health records are gaining wider acceptance among even those who are typically slow to adopt new technologies. Case in point: last month acting Centers for Medicare & Medicaid Services administrator Kerry Weems and HHS Secretary Michael Leavitt announced they have chosen four PHR companies to participate in a pilot program in which Medicare patients can choose one of the selected PHR companies to maintain their health record information electronically.
Under the Medicare PHR Choice Pilot program, which begins in early 2009, seniors in Arizona and Utah can access their personal health data from CMS databases using Google Health, HealthTrio, NoMoreClipboard.com, and PassportMD.
The move by CMS to pilot PHR technology is significant because the agency is widely recognized as being very conservative when it comes to adopting new technologies, as John Halamka, MD, CIO of Harvard Medical School and Beth Israel Deaconess Medical Center points out in his blog.
"The fact that CMS has linked the Medicare database to Google Health and other PHRs implies that CMS has embraced Healthcare 2.0 approaches to infrastructure and has validated the importance of personal health records," he writes.
Under the pilot, Medicare beneficiaries will be able to collect and store personal health information from other authorized sources in their chosen commercial PHR. Depending on the type of PHR selected, members will be able to directly link their pharmacy data with the PHR and also add other personal health information. Members can also connect to tools for tracking diet and exercise, find information about drugs and medical devices, health education information, and applications to detect potential medication reactions. Beneficiaries can authorize care providers and family members to have access to their PHRs. CMS says it will transfer up to two years of the beneficiary's claims data into the individual's PHR, on beneficiary requests.
Medicare's pilot program may also mean more than just the wider adoption of PHRs among the public. Since CMS is the biggest payer of healthcare in the US it can also act as a driver of change through reimbursement policy, writes Halamka. "By offering patients access to their own claims data, CMS will create patient expectations that will motivate the private payer community to do the same."
It will be interesting to see how successful the program is. Are there enough tech-savvy seniors out there to support a program like this? Weems and Leavitt certainly think so. "This pilot is on a fast track. Time is short. Especially given the 'silver tsunami' of baby boomers that are on the cusp of retirement," Weems said during a press conference to announce the Medicare PHR Choice Pilot. Weems says CMS has been working for several years "to build a framework for an interconnected electronic information system that works quickly and seamlessly. PHRs are another piece in this puzzle."
Though CMS has used its significant voice to offer up a vote of confidence for PHRs, it remains to be seen whether the roughly one million fee-for-service Medicare beneficiaries within the pilot project boundaries will choose to participate. Since CMS has left it up to the vendors to educate the residents of Arizona and Utah about how PHRs operate, it will be interesting to see just how much they are able to accomplish before the program launches early next year.
Kathryn Mackenzie is technology editor of HealthLeaders magazine. She can be reached at kmackenzie@healthleadersmedia.com.
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The Laurelhurst Community Club has appealed Seattle's environmental impact statement for Seattle Children's Hospital's proposed expansion plan. The proposed hospital expansion would more than double the number of beds and building sizes on the hospital's 22-acre campus and the 1.8 acres facing it. The environmental impact statement considers the effects on issues such as traffic, housing, noise, aesthetics, light and shadows, and air and water quality. Laurelhurst residents appealed the review to the Seattle Hearing Examiner, saying it "understates the expansion's harmful impacts, including gridlock, and refuses to study any compromise alternatives that would help prevent them."
Blue Cross Blue Shield of Michigan and its opponents are continuing their high-profile fight over legislation the health insurer wants approved by the end of the year. Blue Cross said it projects losses of nearly $264 million on its health insurance plans covering individuals in 2009 and that changes in state law are urgently needed to keep the nonprofit on solid financial footing. Critics say the changes long sought by Blue Cross would hurt consumers and give the nonprofit unfair advantages over its for-profit competitors.
