Hoping to capitalize on patients who might otherwise go to the U.S. for speedier care, a network of technically illegal private clinics and surgical centers has sprung up Canada. The more than 70 private health providers in British Columbia now schedule simple surgeries and tests such as MRIs with waits as short as a week or two, compared with the months it takes for a public surgical suite to become available for nonessential operations in the country.
The fight to prevent the spread of H1N1 is in full swing, as hospitals all over the world are reporting a surge in patients as the predicted second wave of the pandemic continues its spread during this flu season.
In its weekly update of H1N1 delivered on Sept. 25, the Centers for Disease Control and Prevention announced that worldwide, there has been at least 318,925 laboratory-confirmed cases of H1N1 with more than 9,917 deaths. That marked a dramatic increase since September 13, when there was a reported 22,454 cases and 431 deaths. And the latest numbers could be largely skewed, as many countries focus surveillance and laboratory testing only on those with severe illness, the CDC reported.
Authorities are now scrambling to develop a vaccine. Also last week, the World Health Organization announced that regulatory authorities have licensed pandemic vaccines in Australia, China, and the United States, soon to be followed by Japan and several European countries.
"The length of the approval process depends on factors such as each country's regulatory pathway, the type of vaccine being licensed, and the state of manufacturer's readiness to submit appropriate information to regulatory authorities," according to a WHO announcement.
The WHO estimates that worldwide production capacity for pandemic vaccines at three billion per year—a figure that is lower than expected—but early data from clinical trials suggest a single dose, rather than two, will be sufficient to provide immunity in adults in older children.
However, "these supplies will still be inadequate to cover a world population of 6.8 billion people in which virtually everyone is susceptible to infection by a new and readily contagious virus," the WHO concludes in its briefing. "Global manufacturing capacity for influenza vaccines is limited, inadequate, and not readily augmented."
This could be troubling news for hospitals, which have been reporting a dramatic surge in patients in recent weeks due to H1N1, and the accompanying scare. On Sept. 23, parents and their sick children overflowed the emergency room at Children's Medical Center Dallas seeking tests and treatments for H1N1. In the two weeks prior, 60 children were sick enough with the flu to be admitted to the hospital, officials told the Dallas Morning News.
In addition, Mexico reported last week that daily diagnoses reached higher levels than the H1N1 peak in April, with 483 new cases reported in just one September day alone. Jose Angel Cordova, Mexico's Health Secretary, told the Associated Press that the country could see up to 5 million cases of swine flu this winter, and deaths could reach 2,000.
Surges such as these could prove to problematic for health officials across the globe, even in developed countries such as the United States: On Sept. 21, the U.S. Office of the Inspector General issued two reports that found health systems in 10 localities in five sampled states still aren't ready for a pandemic flu, despite years of preparation.
So what can providers do? For one, they can continue to follow continuous updates that are provided online at sites such as the CDC.gov, at WHO.int, and flu.gov. And countries continue to work together on this global problem: No doubt health leaders all over the world are holding their breath as authorities continue the development of an effective, and safe, vaccine.
"International sharing of data . . . will be vital in guiding risk-benefit assessments and determining whether changes in vaccination policies are needed," according to the WHO Web site. "WHO has developed standardized protocols for data collection and reporting in real time, and will communicate findings to the international community via its Web site."
Editor's Note: This column will mark the final edition of HealthLeaders Media Global Report, but continue visiting HealthLeadersMedia.com for coverage of global health issues in our Daily News and Analysis and weekly e-zines, including HealthLeaders Media Corner Office. Next week, we will launch a new pillar and eNewsletter targeting Nursing Leadership.
If you have seen one physician practice, you have seen one physician practice. I often hear that phrase when talking with healthcare executives about best practices and lessons learned from successful electronic health record implementations. Health systems, hospitals, and clinics all have their own unique personality that is shaped by their geographic and organizational culture. That means there is no set formula to guarantee a successful EHR implementation. Organizations must find the path that works best for them.
A recent report by healthcare market research firm IDC Health Insights analyzed how two Norwegian hospitals—St. Olavs Hospital in Trondheim and Ahus Hospital in Oslo—successfully adopted digital technologies. The study, "Best practices: Norway's hospital evolution—A tale of two cities," concluded that there wasn't a single template for successful health IT implementations. Both projects were full replacements of aging facilities, but they used different methods to realize the vision of a digital hospital.
For example, St Olavs chose a single-vendor and an outsourced solution, whereas, Ahus worked with multiple vendors, retained some of its legacy systems, and managed its IT transformation internally. Even though Ahus was able to adopt more mature technology, since it began its implementation two years later than St. Olavs' project, both systems are now fully operational and their digital transformations deemed a success by their staff members and communities.
Similarly, there are various examples of successful EHR implementations here in the United States. All one has to do is take a look at the 2009 HIMSS Davies Award of Excellence recipients, which were announced this past week by the Healthcare Information and Management Systems Society.
These institutions are viewed as leaders in the IT world for their ability to not just implement EHR technology, but realize better patient safety, outcomes, and return on investment as a result of the technology. The 2009 Davies Award recipients are
MultiCare Health System, a four-hospital system in Tacoma, WA, that includes a children's hospital, primary and urgent care clinics, home health, and hospice programs, won the Organizational Davies Award.
Virginia Women's Center, which is the largest provider of individualized obstetric and gynecologic care in Central VA, with 26 physicians and 12 nurse practitioners at five clinical sites, won the Ambulatory Davies Award.
The Community Health Davies Award recipients were Urban Health Plan, a network of federally qualified community health centers based in the South Bronx and Queens, and Heart of Texas, a federally qualified health center serving some 90,000 residents of McLennan County, TX. Both organizations serve impoverished communities.
The Public Health Davies Award went to the Boston Public Health Commission and Denver Public Health, a division within Denver Health and Hospital Authority.
Even though these institutions are all different, they do share one trait—the recognition that adopting EHR technology is a journey to provide better care for their patients not a destination.
The best place for healthcare providers to start on their path to adopting EHR systems is to ensure their board members, C-suite executives, staff members, and physicians truly understand that adopting an EHR system will require continual investment and support. Successfully implementing electronic health record systems is just the beginning.
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Energy efficiency and reducing your carbon footprint are key objectives in the medical industry today. Whether it is the impact on the environment or just the desire to go green, medical facilities are seeking new, alternative renewable fuel sources.
Recently, the Environmental Protection Agency (EPA) proposed new standards under the Clean Air Act to improve the nation's air quality. Health institutions are now looking for renewable energy options to reduce their impact on the environment. In addition, earlier this year healthcare sector leaders urged President Obama to invest in alternative energy and green jobs in healthcare under the Renewable Energy and Green Healthcare Jobs Initiative.
One option for health institutions is to utilize alternative renewable fuel sources in boilers and generators to heat and power buildings. Generally, alternative fuels have been perceived as costing more than traditional fossil fuels. However, that is not the case. Some biofuels in today's market are cost-competitive with existing fuel oils, and include the added benefit of being environmentally friendly.
It can seem like a daunting task for hospitals to build new green construction or retrofit older buildings. In reality, one simple way to reduce a carbon footprint is to switch to an alternative fuel with lower emissions – with no capital costs for construction or retrofitting. Switching boilers from standard diesel fuel to a biofuel can have a significant, positive impact on a building's carbon footprint and emissions for medical facilities. But what exactly is biofuel?
Biofuel can be broadly defined as solid, liquid, or gas fuel consisting of, or derived from, renewable, recently living biological material—most commonly plants. This is in contrast to fossil fuels, which are derived from non-renewable biological material formed from decayed remains of prehistoric plants and animals. Benefits of biofuel include the ability to reduce greenhouse gas emissions and promote energy independence through the growth of domestic energy sources to establish a sustainable, renewable future energy supply.
But are all biofuels the same? No. Biodiesels have been on the market for a while, but now health institutions can take advantage of second-generation biofuels, which are not only sustainable but are also cost competitive with traditional fuels. Second-generation biofuels are ready to use in boiler applications as a 100% replacement for distillate fuels without mixing or blending with other fuels, complicated equipment modification, or loss of significant engine performance.
Medical facilities switching to biofuel may receive incentives at the local, state, or federal level encouraging them to reduce their carbon footprint. New governmental programs such as the recently proposed Carbon Cap and Trade legislation foster clean-energy technologies while eliminating pollution. In this scenario, Carbon, NOX, and SO2 credits will potentially be available to offset against overall emission levels.
This newly proposed legislation is particularly interesting for health facilities because of the numerous health issues associated with both NOX and SOX emissions including respiratory issues caused from "acid rain" and the aggravation of existing heart and lung diseases. The Carbon Cap and Trade legislation has the potential to convert "waste streams to profit streams" by significantly improving the public's overall health and welfare.
The reduction of a facility's carbon footprint is growing in importance with no signs of slowing down. Thus, the question for health institutions becomes not if they are going to make a switch to alternative energy, but rather when. Biofuels are the easy answer for organizations looking to make a quick, low cost change with a great impact. Easy to implement as a boiler fuel, with no capital modifications, biofuel can significantly cut greenhouse gas emissions. A simple fuel switch offers a perfect renewable energy option for medical facilities.
Phil Wallis is the Chief Marketing Officer for New Generation Biofuels. Phil joined New Generation Biofuels in January 2008 and previously worked for Chevron Corporation where he held several senior level marketing positions including Manager, Regional Sales and Solutions for Asia Pacific and Africa.For information on how you can contribute to HealthLeaders Media online, please read our Editorial Guidelines.
Hospitals launching programs to offer subsidies to help area physicians adopt electronic health records should prepare for skepticism from their finance departments, Doug Blair, director of ambulatory technology at Christ Hospital in Cincinnati, told Health Data Management. In this article, Blair provides some lessons learned from EHR subsidy projects he spearheaded at Christ Hospital and Mount Carmel Health System in Columbus, OH.
The government is starting a system to track possible side effects as mass flu vaccinations begin, with a goal to detect any problems quickly. On top of routine vaccine tracking, there are several government-sponsored projects that include efforts by Harvard Medical School scientists and Johns Hopkins University. The Centers for Disease Control and Prevention, for example, is preparing take-home cards that tell vaccine recipients how to report any suspected side effects to the nation's Vaccine Adverse Event Reporting system.
Jana Skewes, the CEO of Shared Health, discusses the role of health information exchanges in reducing costs and improving healthcare outcomes. Shared Health manages the data of more than 2.6 million patients in Tennessee and has more than 2,500 clinical users. Recently, it was awarded the State of Mississippi's Medicaid contract for health information exchange for some 600,000 Medicaid beneficiaries.
Congressional Democrats are set to push toward showdowns on two of the toughest issues in the healthcare debate: whether to create a government alternative to private insurance, and how to pay the approximately $1-trillion cost of the overhaul. Neither issue will be settled until after the House and Senate have voted on complete bills and start negotiating the final legislation, but it could help define what any compromise would look like, according to the Los Angeles Times.
A small but growing group of lawmakers is pressing for state constitutional amendments that would outlaw any health reform requirements that nearly everyone buy insurance or pay a penalty. Approval of the measures, the lawmakers suggest, would set off a legal battle over the rights of states versus the reach of federal power. So far, the notion has been presented in at least 10 states, and lawmakers in four other states have said they will soon offer similar measures in what has grown into a coordinated effort at resistance.
At least 60 Massachusetts doctors collectively have earned more than a half-million dollars in 2009 as speakers paid by Eli Lilly & Co. The doctors in question include two Boston Medical Center physicians whose participation is being reviewed for possible violation of a hospital policy against marketing activities by its doctors. Boston Medical Center said it would investigate the matter and directed the physicians not to make any further presentations on behalf of Lilly in the meantime.
