As part of a larges-scale rebuilding program, St. Helens and Knowsley Teaching Hospitals NHS Trust has been prompted to move to electronic records. It currently has around 1 million case files in its health records library, containing an estimated 250 million paper pages, and expects the gradual transfer of records to the electronic system to pay for itself within two and a half years. The project's priority is to ensure quality of care by making records are available virtually all the time, officials said.
A ban on recruitment in the health service is threatening the future of cancer services at St Luke's Hospital in Rathgar, according to Ireland's Services, Industrial, Professional and Technical Union. A third of the staff in the radiation therapy unit are on temporary fixed-term contracts which are due to come to an end in one month, and hospital management have given "no indication" these contracts will be renewed, according to the union. Union representatives said there was no way patient's needs could be met if a third of the staff in the radiation therapy unit were laid off.
Patients' lives will be put at risk and hospitals forced to close because of the new United Kingdom rules that limit doctors to working a 48-hour week, says John Black, president of The Royal College of Surgeons. Black said he is concerned that the new rules, which begin August 1, will lead to operations being cancelled and wards closed down.
Premier healthcare alliance has bolstered its hospital consulting business with the announced acquisition today of Salt Lake City-based Phase 2 Consulting. Details of the deal were not disclosed.
"We believe that P2C's strengths complement Premier's capabilities," says Susan DeVore, Premier's incoming president and CEO. "(This) will help create new opportunities for knowledge-sharing among our alliance hospitals, as well as for the development of new products and services."
P2C, a division of RehabCare Group Inc., specializes in consulting for revenue cycle improvement, including RAC readiness and charge capture, strategic planning, and service line analysis.
In 2008, PCS added more than 60 new customers, along with 225 new customer engagements. Revenue growth for PCS is forecast to be more than 30% for FY2009, on top of 22% growth last year.
"Given the issues hospitals are facing in the current economic environment, we expect demand to continue to grow, especially in the areas of transformational consulting, revenue cycle improvement, supply chain efficiency, and labor management," says Wes Champion, PCS senior vice president. "This acquisition allows PCS to quickly ramp up the capacity and skills necessary to meet anticipated demand."
Left-leaning groups meeting in Washington Monday said they want reform legislation that "guarantees healthcare for all" this year.
"Progressives are fired up and excited about the possibility of what could be the greatest era of progressive reform since 1960," said Richard Borosage, co-director of one of the groups, the Campaign for America's Future.
Also joining in this collective effort are Health Care for America Now, which represents more than 1,000 organizations with 30 million members; two of the main labor federations--the AFL CIO and Change to Win; and other left-leaning groups, such as MoveOn.org and Democracy for America.
"It is very clear in America that working people want healthcare reform now. They believe that this is the time that the government needs to step up and help them solve this problem," said Anna Burger, chairman of Change To Win. "We cannot fix the economy without fixing healthcare."
These efforts are coming at a time when may workers are concerned about their health insurance--especially losing it. When questioned about their views of "the American dream," pollster Celinda Lake of Lake Research Partners found that there has been a shift in defining this dream as seeing it as one of opportunity to one of security.
While having a job that pays enough to support a family was on the top of the list of what the American Dream means (cited by 75% of those interviewed), having "affordable quality healthcare that you can depend on" also ranked high among 65% of those surveyed. Lake's company interviewed 800 nonsupervisory workers by phone in late May.
On a scale of 1 to 10, 46% said they would rate as "10" on an "action agenda for the American dream" a move to "enact healthcare reform to guarantee every American access to quality, affordable healthcare giving the choice of a private plan or a public health insurance plan."
In terms of healthcare, energy and education, 62% of those working said they believe "the time to act" is now on those issues. Surprisingly, a majority (52%) thought that it would be somewhat likely that someone in their family or a close acquaintance will lose their health insurance and/or job in the next year.
As for what changes will occur with healthcare reform, "I think everybody here thinks a public option is essential," said Howard Dean, MD, former chairman of the Democratic National Committee and presidential candidate, who is now authoring a book on healthcare reform.
He added that in countries where there are public options, there is also private insurance. "So the idea that the public option is going to wipe out private insurance is historically incorrect," Dean said. "We know public option works. We know administration costs are much, much cheaper than they are in the private sector."
Americans who want to keep their current private insurance will still be able to keep it if a public option in enacted, he said. "The great thing about the president's plan is if you like what you have, you can keep it," Dean said.
The Medical Tourism Association has released preliminary results from its first patient surveys on medical travel. The survey was created by the MTA as part of a larger research project to study the medical tourism industry, and seeks to provide a better understanding why patients are traveling and where they are traveling to, as well as to provide insight to increase international patient flow, according to MTA officials.
After meeting at the White House three weeks ago, members of the six healthcare organizations that promised to find ways to save $2 trillion over the next decade—by decreasing by 1.5% the annual healthcare spending growth rate—yesterday sent their game plan "to bend the cost curve" in the form of a 28-page letter to the White House.
After convening seven all-day meetings and multiple conference calls, the group came up with the following projected savings:
Utilization of care ($150 to $180 billion)
Chronic care ($350 to $850 billion)
Administrative simplification and the cost of doing business ($500 to $700 billion)
Individualized savings are not specifically included in the sections submitted by the groups.
While it's likely that their proposals could be considered during healthcare reform discussion on Capitol Hill, the idea of whether the plan would actually work is drawing questions. "I'm skeptical that these proposals will add up to anywhere near $2 trillion," Sen. Charles Grassley, the ranking minority member of the Senate Finance Committee, said in a statement yesterday.
American Hospital Association President and CEO Rich Umbdenstock, said in a separate statement that the groups will implement selected initiatives "individually and collaboratively."
AHA said it will launch a national campaign—"Hospitals in Pursuit of Excellence"—to "build upon quality improvement efforts that are already underway in the industry." These include initiatives, such as reducing surgical infections and complications, reducing pressure ulcers, and reducing adverse drug events from high-hazard medications.
Each hospital will choose which issues on the list are the next for it to tackle, but the "most important objective will be accelerating the pace of improvement while broadening and deepening the success" across the field, Umbdenstock said. The group also cited focusing on longer-term initiatives, such as improving care coordination, implementing health information technology, preventing patient falls, and reducing supply costs.
The American Medical Association called for actions that reduced variations in care and improved quality of care, which emphasized appropriate utilization of healthcare services and treatments. The group proposed as the areas of focus:
Reduction of hospital admissions within 30 days of initial discharge
Reduction in the overuse of certain procedures (such as surgical and nonsurgical management of back pain and use of antibiotic prescription and sinus radiography with sinusitis)
Use of medication reconciliation
America's Health Insurance Plans called in part for administrative simplification that would overhaul and automate "five key" functions—claims submissions, eligibility, claims status, payment, and remittance. AHIP also called for expanded use of personal health records and improving health literacy.
The other groups signing in on the plans are the Pharmaceutical Research and Manufacturers of America, the Service Employees International Union, and the Advanced Medical Technology Association.
Hospitals protect paper medical records from fire by installing sprinkler systems and building features that enclose storage rooms.
But with electronic recordkeeping growing more prominent, the strategies for safeguarding patient data are shifting to systems that protect electronic equipment.
"As the healthcare industry transitions from file storage to electronic storage of personal medical records, the fire hazards associated with medical record storage will also change," says Anthony Gee, a product manager for Victaulic in Easton, PA, which manufactures grooved pipe joining systems used in fire protection.
Start with a well-known approach
At the heart of electronic medical record protection is the common strategy of conducting risk assessments, says Lance Harry, PE, director of sales for Chemetron Fire Systems based in Matteson, IL.
As Harry views it, hospital CEOs and administrators must ask themselves these questions:
What is the value of medical records?
What is the risk of losing those records?
How can we best protect them?
Compare protection strategies
Facilities generally protect paper records using a wet pipe or pre-action sprinkler system. As its name implies, wet systems feature pipes that are always filled with water, while pre-action systems are filled with pressurized air and only charge with water when a smoke detector in a protected space signals the fire alarm panel.
Staff members may also be able to protect paper records rooms using portable fire extinguishers, if workers can safely use the extinguishers to suppress the flames quickly, Gee says.
By comparison, safeguards for electronic medical records storage generally include some form of precise early warning (e.g., air sampling or a high-sensitivity smoke detection system) combined with fire protection equipment that discharges a clean extinguishing agent. Such clean agents don't leave residue after discharge.
Clean agent systems cost more than traditional sprinkler systems. Water mist systems and quick-response sprinklers can also protect electronic records.
Don't forget to back up files
Gee raises a last important point: Clean agent systems will extinguish fires on sensitive electronic records equipment, but they won't prevent fires from starting. Therefore, facilities must ensure medical files are backed up elsewhere, because even a short-lived fire can damage enough equipment to render data irretrievable.
If electronic files are backed up and a fire occurs, that data can be loaded back onto the original storage equipment later or onto new equipment as needed, Gee says.
President Obama will meet with influential Senate Democrats to discuss overhauling healthcare, as the White House releases a report asserting that revamping the system would increase the income of a typical family of four by $2,600 in 2020, and by $10,000 in 2030. The Democrats on two Senate committees that are drafting health legislation have been invited to the White House to meet with Obama. As part of a push to secure Congressional passage of a bill this year, the administration will also make the case that reforming healthcare is critical to fixing the economy.
Slowing the growth in healthcare spending from 6% a year to 4.5% would have enormous benefits for the nation's economy, creating as many as 500,000 jobs a year, President Obama's chief economic advisers said yesterday. In a report, the Council of Economic Advisers concludes that cutting costs while extending coverage to the 46 million people who lack health insurance would also dramatically improve the federal budget outlook, remove "unnecessary barriers" to job mobility and increase the nation's overall economic well-being by "roughly" $100 billion a year.
