Three years ago, Oak Lawn, IL-based Advocate Christ Medical Center teamed up with CeaseFire, an initiative of the Chicago Project for Violence Prevention with the goal of reducing gun violence and acts of retaliation. Now that budget cuts have cost CeaseFire its state funding, the hospital has committed its chaplain staff, a budget of $95,000 and management support to the partnership. Hospital officials are banking that their investment will pay off with fewer victims of violence.
Blue Cross and Blue Shield of Massachusetts is proposing to overhaul the way it pays doctors and hospitals, in what company officials said is an attempt to slow runaway healthcare costs and improve quality. The insurer wants to stop paying providers for each patient visit or treatment and instead pay a flat sum per patient each year, adjusted for age and sickness, plus a significant bonus if the providers improve care.
Massachusetts hospitals have revealed the rates of pressure ulcers their patients have acquired during hospital stays. The measures follow criteria used by the National Quality Forum, and the rates are compared with state averages for hospitals of similar size and type, said representatives from the Massachusetts Hospital Association. Only two hospitals had rates significantly above average.
With CVS planning to open dozens of medical clinics in Massachusetts, critics have warned of inferior care driven by profit. Some have predicted that patients would sacrifice an ongoing relationship with a doctor because of the clinics. Increasing evidence presented by independent researchers, insurers, and regulators in other states have painted a far more positive portrait, however.
Adventist Health Care Systems has developed a program that trains already-bilingual staff in the technical terms and cultural nuances of interpreting in a hospital setting. The program is one healthcare providers are trying to meet the demand for qualified interpreters to help inform and reassure the growing number of non-English-speaking patients.
Roselawn Lutheran Church has opened its door to host a new eye clinic in partnership with the Cincinnati Eye Institute Foundation. The volunteer-run clinic serves low-income adults who do not have health insurance coverage for vision care. The church is also home to a children's dental clinic, and has received more than $150,000 in aid and services.
New state-of-the-art equipment is allowing the staff at Jefferson Memorial Hospital in Crystal City, MO to make faster and more accurate diagnoses. The machine combine nuclear medicine and CT scan technology into one event.
Midwest healthcare startups attracted a record $1.2 billion in new investments in 2007, according to the Midwest Health Care Venture Investment Report released by BioEnterprise. The total represents a 55 percent increase over 2006, a sharp rise that both outpaces national venture industry growth and even surpasses the 25 percent increase that occurred in the previous year.
Several recent studies and surveys suggest growing skepticism about the longevity of regional health information organizations, aka "RHIOs." Nearly 70 percent of respondents to our own recent unscientific online poll agreed that most RHIOs will cease operations within the near future. Although most people understand the importance of data sharing across competitive organizations, many are wondering if the multitude of RHIOs will have staying power. Financial and governance issues--not the technological capability in play--are often cited as stumbling blocks.
I have been fascinated and mystified over the sheer number of RHIOs that have sprung up in the last few years. It's as if someone waved a wand over the country and said, "Let's set up healthcare data exchanges." I suppose you could argue that this someone is George Bush, whose call to action on EMRs a few years back (supplemented by enhanced federal visibility and grant money) may have prompted all the action.
Despite the growing doubts, RHIO organizers are continuing to push forward. Last week, I sat in on a press conference staged by HealthInfoNet, a Maine-based data exchange that is just getting under way. HealthInfoNet is launching a 24-month demonstration project that includes 15 hospitals and more than one-third of the practicing physicians in the state. The primary vendor partner is 3M, which is providing interoperability technology, the clinical data repository, and the master patient index. To sidestep the inevitable privacy issues, the exchange will grant patients the ability to completely opt out of the exchange, in essence making their data off-limits. Now that's a preemptive strike against paranoia! It could backfire, I suppose, if enough people were scared off by the prospects of their medical record traversing a state-wide electronic network.
The group has secured $4 million out of the $6 million it says it will need to complete the effort. Half of that money has come from foundations, with the rest from business, providers, government, and--are you ready for this?--payers (health plans have anted up a whopping 1 percent of the budget so far). Exactly where the rest of the budget will come from is unclear, although the exchange's leaders do understand the importance of a sustainable business model. By sharing medication lists, lab values, and other clinical reports, the exchange hopes to improve care and reduce costs by eliminating the redundant testing that plagues the industry. "We have huge potential to reduce cost," said Chuck Hewitt, chief operating officer at Jackson Laboratory, Bar Harbor and a member of the HealthInfoNet board of directors.
Few might challenge that assumption. Making it come to life, however, is another issue. The state of Maine is about to become a highly visible test case.
A recent article on The Wall Street Journal online reported on a poll the newspaper conducted along with Harris Interactive that found most Americans think electronic medical records can improve healthcare in this country and that EMR benefits overshadow any potential privacy risks.
As those who are familiar with MEDecision might imagine, this was music to our collective ears (or eyes, as it were). The WSJ/Harris poll bears out an important belief we've held for some time; one that I've represented in various public forums on several occasions: By all means, privacy concerns are real and legitimate when we talk about the proliferation of health information exchange and EMRs. However, we can't let ourselves get so caught up in the privacy issue that we compromise progress on the greater matter at hand, which is electronically gathering and deploying clinical information to improve care. In other words, the greater risk right now is not the misuse of clinical information, it's the non-use of it.
Apparently, a majority of Americans agree with our reasoning. According to the WSJ/Harris poll, about 60 percent of the people surveyed said that the benefits of EMRs outweigh potential security risks. Three-quarters of people surveyed said they think that care would improve if doctors and other parties could share information electronically. More than 60 percent thought that sharing information would decrease medical errors and over 50 percent think doing so could lower costs.
The WSJ article went on to mention that technology is likely to become a large part of the healthcare debate in the 2008 elections, and I'm inclined to agree. Based on the results of the poll, however, it looks like consumer confidence in EMRs is growing, which should send a message to our politicians that America is ready to move forward with them.
David St.Clair is founder and CEO of MEDecision.
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