The Missouri Senate has approved legislation that includes a new version of Gov. Matt Blunt's plan to help the uninsured. The bill includes a wide range of programs intended to make consumers more aware of the true cost of healthcare and to help them make informed choices. It would also set up an organization to publish reports on medical mistakes. Democrats are criticizing the plan, saying that it fails to provide coverage for all of the 90,604 low-income residents kicked off Missouri's Medicaid program three years ago.
North Carolina has cited a federal investigation involving the death of a 76-year-old man at a Franklin Regional Medical Center as one reason its request to move from the center of Franklin County to its frontier with Wake County was denied. A state report said the federal investigation was proof that Franklin Regional had not provided a past record of quality care. In March, CMS reported on elective surgical procedures at the hospital, and threatened to pull federal funding to treat poor and elderly patients at Franklin Regional as a result.
Just 16 months after opening, Methodist Mansfield (TX) Medical Center has announced a $37 million expansion. Construction will happen in two phases and is slated for completion by fall 2009. The first phase calls for the addition of a 36-bed medical-surgical unit. The emergency department will be also be expanded several months later to create a total of 32 treatment rooms. The addition of eight beds will double the size of the intensive-care unit.
During an appearance in Baltimore, former House Speaker Newt Gingrich stressed the merits of switching to electronic medical records. Gingrich was in Baltimore to speak at a healthcare symposium concentrating on preventable medication errors, healthcare information technology and healthcare issues. The federal government will spend up to $150 million over the next five years on electronic records, but many other countries spend more. The United Kingdom allocated more than $11 billion to digitize its healthcare system, and Canada is spending a billion dollars. Gingrich also advocated increasing the focus on preventive care instead of treatment, which he said would save billions in health costs.
I was going through my daily ritual of scanning the news when the headline “Duh! Science confirms the obvious” caught my eye. What I found was a number of studies trying to scientifically prove conventional wisdom, such as vacations are better without your cell phone, teenagers drink to have fun, and you catch the flu in winter.
I paused when I got to, "Long ambulance rides make you more likely to die." Not because it is an earth-shattering revelation—if you're having a heart attack and it takes you 50 minutes to get to the nearest emergency department versus 15 minutes, you're likely to incur more damage, of course. The story caught my eye because the number of emergency departments has decreased by 14% since 1993, according to the American College of Emergency Physicians.
The study, "The Relationship between Distance to Hospital and Patient Mortality in Emergencies: An Observational Study," researched four British ambulance services and determined that every six miles between the patient and hospital increased the risk of death by 1%.
I am sure that a similar statistic holds true here in the United States. Not the best news for rural America when you consider the number of EDs has decreased by 425 between 1993 and 2003 while the number of ED visits has increased from 90.3 million to 113.9 million during the same time period, according to the Institute of Medicine.
The uninsured certainly play a large role in the spike in ED usage. But hospitals have also seen an increase in the number of people with insurance who turn to the ED when their primary-care doctor is unavailable. It's no wonder the nation's emergency system as a whole earned a C- from ACEP, which posts grades for every state's emergency system based on access, quality and public safety, public health and safety, and medical liability. While no state earned a failing grade, 12 states--Alabama, Arizona, Arkansas, Idaho, Indiana, New Mexico, Oklahoma, South Dakota, Utah, Virginia, Washington, and Wyoming—weren't too far off, receiving a D+ or D.
I read about communities every week struggling to get a hospital approved in their town to improve access to quality healthcare for their residents. Personally, I would be happy to have an emergency department just 10 minutes away from my house, as well (which may soon be the case). Yet, I also read about community hospitals closing because they don't have the volumes, payer mix, or staff to be successful. Take New Jersey, for instance. Of the state's 78 hospitals, four hospitals closed in the past 18 months, four others announced plans to close, and five filed for bankruptcy protection. Twenty years ago, the state had 112 hospitals. This seems to suggest that New Jersey had too many hospital beds. Now, hopefully, New Jersey's other community hospitals will be stronger—at least that's what the state's health commissioner says.
No town wants to see its hospital close, and others would like nothing more than to build a hospital for its residents. But for those struggling to keep their hospital open or get approval for a hospital in their neighborhood, what options are there? The critical-access-hospital designation helps provide healthcare to some of the most remote and vulnerable areas. Yet not all facilities qualify. So how can our healthcare system improve access to emergency medical services?
I am reading more and more about freestanding EDs. Advocates hype the convenience for patients, increased access to emergency services, and their ability to offset overcrowding in nearby hospitals. But critics question their limited services and their impact on healthcare spending. I wonder how these facilities will impact nearby community hospitals. Will these facilities force more community hospitals to shut their doors? Can community hospitals and freestanding EDs work together successfully?
It has been said that EDs are the gateway into the hospital, so what happens when fewer people stroll through your doors, opting to go to a freestanding ED closer to home? I don't have the answers. But I am curious what you think about freestanding EDs. Will we continue to see more of them? What impact will they have on community and rural hospitals? After all, who wants to travel an hour to an ED when they are having a heart attack?
Carrie Vaughan is editor of HealthLeaders Media Community and Rural Hospital Weekly. She can be reached at cvaughan@healthleadersmedia.com.
Health plans are not effectively reaching the sickest Americans, and consequently not spurring them to make the proper health and lifestyle changes to improve their wellbeing, according to the Silverlink HealthComm Behavior Index.
Silverlink Communications, a Burlington, MA-based healthcare communications company with 50 clients representing 150 million lives, shows the disconnect between health plans’ communication programs and their members. This finding is troubling, most notably because so many health plans are trying to engage and empower members via consumer-driven health plans and disease management programs.
Respondents consistently put their health plans in the mediocre range. The most striking finding was that respondents reacted negatively to the questions as to whether health plan communications helped them improve their health or adopt a healthier lifestyle.
The findings did not surprise Stan Nowak, Silverlink’s CEO. “What we have been talking about a number of years now is clearly a high degree of personalization in your communications will increase the effectiveness, and I think that was borne out by this work,” says Nowak.
The index’s first results, which are being released for the first time in this column, show four items that health plans should take note of:
Americans are lukewarm about healthcare communications.
A person’s satisfaction and the personalization of healthcare communications correlate to the person taking action.
A person’s health status—not demographics—is a better predictor of whether a person takes action.
Unhealthy people are especially dissatisfied with healthcare communications.
Nowak says communication is a weakness for health plans because most don’t see them as a strategy. Rather than creating a company-wide communication program, health plans often create disjointed communications that are repetitive and not coordinated. This not only doesn’t help members, but is wasteful, says Nowak.
“The more personalization I think you’re going to increasingly see yields of higher impact,” says Nowak.
Here are four ways to improve healthcare communications:
Create a company-wide communication program
Focus on those who are the most unhealthy
Create a system in which each member’s communications are tracked so you don’t inundate members with redundant information
Personalize the message to the individual
Silverlink kicked off the quarterly index as a way to measure the effectiveness and behavioral impact of healthcare communications. A total of 1,176 people completed the phone survey conducted through Silverlink’s SAVS 5.0 Technology Platform’s automated phone call system.
In addition to screening and demographics questions, the survey, which took participants between five and eight minutes, asked participants 10 questions focusing on personalization, satisfaction, and action.
Respondents, who were either commercially insured or seniors in Medicare Advantage plans, answered each question by rating their health plans’ communication on a scale of one to five.
With the first index survey behind them, Silverlink officials expect to conduct the index quarterly to gauge healthcare communication. They also hope to offer the services to clients so they can gauge their communication programs against the national average.
Nowak says creating personalized communications that engage members and spur them to action is the right way to connect and activate members.
“The most important thing in my view is the actions of the patient themselves will be the single largest driver for health plan expenses over the next several years. We need that patient to take action based on the communications,” says Nowak.
To be honest, I’m a little sick of the Baby Boomers. And because we’ve been talking about the impact they’ll have on the healthcare system for so long, I thought it was high time to change the subject. That’s why I set out to write a story about the ways that healthcare marketers can reach out to younger generations of healthcare consumers. Earn their loyalty early on, I figured, and you’ll collect the dividends down the road, when they need more than annual physicals, help losing weight, treatment for the occasional sports injury, maternity services, or a referral to a good pediatrician.
I based my theory on a tactic that the Apple computer company has employed for years. There’s a reason the company was so aggressive about getting their products into elementary schools across the country: They wanted to get those students hooked on their products, ensuring future sales.
Hey, it worked for the tobacco industry.
But my theory as it pertains to healthcare marketing didn’t hold water with most of the sources I talked to for the story, “Who Needs the Boomers?” (The subtitle hedged a bit: “Well, you do. But marketing to the next generation of healthcare consumers might not be a bad idea, either.”)
In a perfect world, hospitals would have the resources to go after every demographic, Chris Bevolo, a partner in GeigerBevolo, Inc., a branding agency in Minneapolis, told me. But many healthcare organizations are barely holding on to their market share—and the youth market isn’t going save them, he added.
Others agreed that the so-called “blue skies” approach is a difficult one, especially for hospital and health system marketers, who are already working with limited budgets and, quite frankly, some skepticism and confusion from other departments about what it is, exactly, that they do.
There are some hospitals trying it, including St. Mary’s Medical Center in San Francisco, which is going after a demographic they call “transitional professionals.” But they’re not just doing it because it seems like a good idea or because they’re sick of the Baby Boomers. There’s a real strategy behind their marketing efforts.
So my story about generations x, y, and next didn’t turn out exactly as I thought it would. It’s still an interesting topic—it’s just that no one can afford to market to future healthcare consumers to the exclusion of the current ones.
As it turns out, Apple’s '80s-era marketing strategy didn’t turn out exactly as they thought it would, either. It still enjoys a stronghold in the education market, and sales are on the upswing, but various studies and pundits suggest the brand is not as sticky as the company once thought. Adults who had Macs in their classrooms 15 or 20 years ago aren’t necessarily buying them today. And the company still has a relatively small share of the personal computer market in the U.S. despite those clever ads, a couple of i-crazes, and one of the strongest name brands in retail.
A bogus nurse treated hundreds of patients in England’s National Health Service over five years before it was discovered she was not qualified. Christina Barrett, a former student nurse, pleaded guilty to obtaining services by deception, obtaining a pecuniary advantage by deception and fraud. As she was given a suspended prison sentence after admitting deception, it was revealed how easy it was for her to dupe the hospital into giving her work.
In a country with some 76 million people and only 138 hospitals, Ethiopia is looking to make the most of limited resources. To do so, the country is working with Yale and the Clinton Foundation to train hospital administrators. The Ethiopian Hospital Management Initiative uses a partnership-mentorship model with the goal of mentoring Ethiopian hospital management staff so the improved practices can be sustained in the future.
U.S. Senator Amy Klobuchar is introducing federal legislation designed to relieve the shortage of emergency medical personnel, especially in rural areas. The legislation, called the "Veterans-to-Paramedics Transition Act," would accelerate and streamline the transition to civilian employment for returning veterans who already have emergency medical training, Klobuchar said. The legislation would provide federal grants for universities, colleges and technical schools to develop an appropriate curriculum to train these veterans and fast-track their eligibility for paramedic certification.
