Earlier this year, some leading chief information officers gathered for an event that was touted by its sponsor, IT vendor Picis, as "Forward Thinking CIOs Debate Hot Issues Facing Hospitals in 2008." However, there was actually little debate—the panelists quickly reached consensus on any number of issues. They represented a diverse group of facilities, yet struck on multiple common themes.
The event showed the modern hospital CIO role as one requiring equal planting in operations and strategy. Representing San Diego-based Sharp HealthCare, Bill Spooner observed that demonstrating value to expensive IT systems would be one of his most pressing challenges in the near future. "We ought to take it as a personal challenge," he said. In the next breath, Spooner went on to note that the industry will be challenged by a new president and must cope with the growth of consumer-driven care. "If healthcare continues to consume more and more of our GDP, and our costs continue to go up, having consumers in charge of healthcare is not going to be wonderful for us."
Later, the discussion turned to the topic of system interoperability, the very cornerstone of deriving value from IT. Again, Spooner led the charge, expressing dismay that few vendors have adopted the continuity of care standard from HL7. Fellow panelist Richard McKnight, representing North Carolina-based Novant Health, echoed Spooner. "If somebody out there gets it right, we will probably crush them with new business because that is exactly what we are looking for." McKnight noted that although individual buyers lack adequate clout to compel IT vendors to adopt common standards, CIO user groups, acting collectively, could drive change. "If we continue to talk about it individually, it will take a much, much longer time, and the result will be less satisfactory."
Do I hear a call for government action in the making? Well, to be realistic, it's a long way from a CIO panel to Washington, DC. A more likely scenario might be that IT vendors listen up and act on the concerns of their customers. But even that scenario, as Spooner noted, is taking time to play out. Of course, the prospects of the "crush of new business" might get some attention in the software vendor corporate suites. Consensus has a way of making itself known.
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In what I expect to be a sign of things to come, BasicPlus Health Insurance of Roswell, GA, is now offering those enrolled in two of its limited benefit plans the option of traveling to global destination hospitals for care.
"To our knowledge, we're the first fully insured, limited plan to offer a global healthcare benefit," says BasicPlus CEO Chuck Green. "It allows [plan members] to get greater value without increasing premiums."
I'm told by a former health plan executive that OptiMed Health/United Group Programs was the first carrier to offer medical travel as an option for its members, but regardless BasicPlus made this benefit possible through an agreement with Companion Global Healthcare, the Columbia, SC, company that provides clients access to JCI-accredited hospitals.
"We think this is a pretty big step, as employer-sponsored limited plans continue to grow across the country," says David Boucher, president of Companion Global Healthcare.
Green told me BasicPlus has been selling these products—FlexMed (for employers) and Basic Plus (for individuals)—for about two-and-a-half years, and he considers the new global benefit as a way to entice employers that have more than 100 employees but cannot afford comprehensive plans. This is a group Green expects to increase over time, given the complaints he hears from employers about the escalating cost of healthcare.
"What we've learned is the larger the employer, the more they want to talk about that 10% population that wouldn't be covered by the limited plan," says Green. And the global option is a way of stretching the benefits to cover certain surgeries and other services that can be provided by Companion's network. "Generally, the available benefit would cover the cost of travel," adds Green.
I asked Green how much employers really know about medical travel, since his company's deal with Companion is based on the assumption that the new benefit will drive an increase of employer clients. He told me I'd be surprised how many employers are not only aware of medical travel as an option, but also open to the concept.
By 2009, Boucher anticipates a steady stream of insured patients leaving the U.S. for care. For sure, the caps on limited insurance plans make them a good vehicle to promote medical travel. With BasicPlus' steps toward offering this benefit, we will see if consumers are ready to make that move.
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Using free online services like CaringBridge and CarePages and their user-friendly formats, patients can quickly set up a Web site to share news about their treatments. Patients themselves or family members write about treatment and recovery from illnesses, accidents or other medical crises, such as a premature births. Both online services were born out of medical emergencies, and have been used by tens of thousands of patients.
Florida Gov. Charlie Crist's office is telling Jackson Memorial Hospital in Miami to participate in a new healthcare project or risk a $20 million budget veto, according to the Florida House leader and sources familiar with the conversations. Faced with the hint of losing money in a mean budget year, the hospitals have spread the word that they're ready to negotiate with Crist over his "hospital emergency-room diversion program." The program could help spread Crist's new plan to offer low-cost health insurance, and would also force Jackson to transfer at least $1.2 million in services to the Miami-Dade County Health Department for community disease and healthcare management work.
Obese twentysomethings will have lifetime medical bills that are $5,000 to $21,000 higher than their normal-weight peers, and extremely obese young adults will incur $15,000 to $29,000 more in lifetime medical expenditures than their healthy-weight peers, according to a study. The data add to mounting evidence that obese people have significantly higher medical costs.
Grady Memorial Hospital in Atlanta will get about half the money it wanted to help pay for its underfunded trauma center, a Georgia panel has decided. The Georgia Trauma Care Network Commission voted to give Grady $12.7 million to help defray the costs of care for patients with traumatic injuries who cannot pay for their treatment.
The amount is twice the allocation for any other trauma center in the state. The commission's vote capped a meeting in which the panel, composed of physicians, hospital administrators and EMS specialists, laid out a funding plan for 15 trauma centers across the state. All the centers, the commission decided, need more cash.
The Georgia Department of Community Health is taking steps to improve breast cancer services for the state's uninsured population through a $1.2 million initiative that will provide grants to organizations offering breast cancer health promotion, screening and treatment to indigent women. The grants will range from $25,000 to $50,000 for screening projects and up to $300,000 for treatment programs. Community groups applying for treatment grants must demonstrate "strong, comprehensive partnerships with various healthcare providers to provide breast cancer services to underserved populations."
Many hospitals have begun to implement programs that urge patients to speak up if they have concerns or don't understand what nurses or doctors are doing. The Joint Commission's "Speak Up" program, for example, encourages patients to ask questions about their medications, medical tests, research studies, surgeries and living organ donation. But even with encouragement, many people are uncomfortable questioning a medical provider for fear of appearing too aggressive, mistrustful and unappreciative.
Massachusetts health plans that rate doctors individually are spreading beyond the state's Group Insurance Commission, despite the Massachusetts Medical Society's opposition to the ranking systems. Tufts Health Plan, the third-largest health insurer in Massachusetts, says it will expand its health plan that features doctor rankings. And Harvard Pilgrim Health Care, the second-largest insurer, says it is considering offering health plans with doctor rankings later this year to consumers who are not covered through the Group Insurance Commission. The Commission negotiates health insurance for about 295,000 municipal and state employees and their families.
Hospitals that receive high marks for coronary-bypass outcomes still may not be doing all they can to avoid preventable deaths from the procedure, according to a study. Researchers reviewed 347 deaths from coronary-bypass surgery at nine Ontario hospitals and found that 32% of them likely resulted from lapses in established procedures and other preventable shortcomings. The findings indicate that relying solely on hospital report cards misses a critical opportunity to improve quality of care.
