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Data on surgeries
unwieldy, but a good step
Dallas Business Journal, 7.7.2006
The federal government has released another tool for consumers to
compare health care providers by price -- but, because it is so
complicated, area hospital officials are skeptical about whether the
data will be used by consumers as the government intends. That said, any
step toward making clearer information available to the public is a good
step, they say. Government officials agree.
Doctor’s note?
It might cost you
Los Angeles Times, 8.28.2006
Doctors — particularly primary care
doctors — are increasingly billing for services that patients have long
expected to get gratis: prescription refills, photocopies of medical
records, phone consultations, family medical leave forms, medical
disability forms, waivers of insurance premiums, waivers for handicapped
plates. Automotive forms. And life insurance premium forms. Travel
insurance forms. And now, e-mail responses. The practice, almost unheard
of five years ago, has disgruntled some patients and is starting to come
to the attention of consumer advocates, who denounce it as one more sign
of a broken-down medical system.
Doctors launch remedy
for ER chaos
Mass High Tech: The Journal of New England Technology,
4.10.2006
The emergency department of an urban hospital is
among the busiest places in medicine, but a group of local ER doctors
has helped launch a tech business built on a desire to improve
communications in this harried area.
Drug makers pay for lunch
as they pitch
The New York Times, 7.28.2006
Free lunches like those at the medical building in New Hyde Park, N.Y.,
occur regularly at doctors’ offices nationwide, where delivery people
arrive with lunch for the whole office, ordered and paid for by drug
makers to the tune of hundreds of millions of dollars a year. Like the
“free” vacation that comes with a time-share pitch attached, the lunches
go down along with a pitch from pharmaceutical representatives hoping to
bolster prescription sales. The cost of the lunches is ultimately
factored in to drug company marketing expenses, working its way into the
price of prescription drugs. Doing business over lunch is a common
practice in many fields, but drug makers have honed it to perfection,
particularly since 2002, when the drug industry adopted a new code
banning many other free enticements — golf outings, athletic tickets,
trips and lavish dinners for doctors. The code gives approval to modest
meals in the course of business. And conventional wisdom in both the
pharmaceutical industry and the medical profession is that a lunch is
too small to pose an ethical problem. But a growing number of critics
say that even those small lunches should be banned.
Feeling the Impact:
Key Operational Trends in Healthcare
HealthLeaders News, 4.6.2006
Healthcare reform usually focuses on high level policy
issues like mandated employer coverage, tax credit subsidies, Medicare
and Medicaid, health saving accounts, quality incentives, and universal
vouchers. In reality, observing bottom-up “operational” adjustments
might offer greater insight than watching for signs in top-down
machinations. Operational trends may fly under the radar, but they are
profoundly transforming healthcare.
First on the beam
The Boston Globe, 8.28.2006
Tufts-New England Medical Center has
asked the state for permission to use proton beams to zap cancerous
tumors, betting on new technology that could lower costs and increase
the availability of the most advanced form of radiation treatment. The
new type of proton beam unit would cost $19 million, according to the
hospital's application, compared to the $150 million or more it costs to
install conventional proton therapy systems. But the system is unlikely
to be installed before 2008. It is still in development.
High-tech Rx for hospitals
East Valley Tribune, 8.20.2006
When people think of technology in
health care, usually what comes to mind are rapidly advancing treatments
that could one day cure diseases like diabetes and AIDS. But technology,
as well as innovation, has the potential to play a big role in
controlling increasing health care costs, say professors in the School
of Health Management and Policy in the W.P. Carey School of Business at
Arizona State University. Technology and innovation also offer the best
hope for easing the ongoing conflict between health care providers and
consumers over health care costs.
Hospital chiefs get paid
for advice on selling
The New York Times, 7.17.2006
While the financial relationship between doctors and drug companies has
come under intense scrutiny, much less is known about how hospital
executives interact with companies that sell products as varied as
syringes and financial services. In the case of the Healthcare Research
and Development Institute, executives benefit from payments made by
companies their hospitals do business with.
Hospitals say medical devices provide the Rx for
health The Business Review (Albany, NY), 6.23.2006
A $3 million imaging and information system. A $1 million CT scanner. A
whole new intensive care unit with a price tag of $18 million. Over the
past few months, the region's hospitals have invested big bucks in
technology and equipment said to be the easiest, the fastest, the
safest, the best. This is happening even as the industry complains about
financial pressures and a state commission tries to determine if some
institutions should close or change focus. As the hospitals see it, it
is technology that will make them more efficient and better able to meet
society's changing health care needs.
Hospitals turn to robots,
bar codes to organize pharmacies
Baltimore Business Journal, 3.6.2006
Giant,
drug-dispensing robots are in some ways yesterday's news. A robot in
Greater Baltimore Medical Center's inpatient pharmacy has been operating
for five years now, filling orders that are sent out to units and
keeping track of drug inventory. Happy with how that robot is working
out, GBMC officials are now pondering their next move and are giving
serious thought to bar code systems to be used in administration of
medication directly to patients.
Illness
simulators boost medical empathy
New
Scientist, 4.6.2006
HANK is walking through the park,
and it's a struggle. His chest is tightening, his breath is short, and
his legs feel like lead. He can feel his heart pounding. Maybe Hank
should have listened to his wife, who wishes he would tell his doctor
just how bad things have become. Hank is typical of many thousands of
patients with undiagnosed heart failure. Now doctors and nurses are
experiencing his world - for a few minutes, at least - through a device
called the Heart FX Pod. Sitting in a booth with a projection of a city
park in front of them, they "walk" using pedals like those on a gym
machine, listening to snippets of Hank's story. Then, as the pedals'
resistance increases, a pneumatic vest tightens, making breathing
difficult, and the chair thumps to mimic a straining heart.
Is clinical HIPAA on the way?
HealthLeaders News, 6.22.2006
All signs are pointing to the government getting serious about
electronic health records. The president, members of Congress, Medicare,
state Medicaid, and state governors are all addressing electronic health
records; in addition, many healthcare consumer groups are touting the
merits of such records. Many medical societies have published studies
supporting electronic medical records and digitized clinical data.
Latest Retail Niche: Clinics
Los Angeles Times, 7.18.2006
Coming soon to a store near you: health clinics. Seeking to capitalize
on the country's costly and often slow healthcare delivery system, a
number of start-ups are building storefront clinics that offer quick and
cheap medical services inside chain pharmacies and large retailers such
as Wal-Mart Stores Inc. and Target Corp.
New knife for killing
cancer
The Business Journal of Milwaukee, 4.7.2006
Aurora St. Luke's Medical Center
is attacking cancer cells with a robot that helps some automakers build
cars. The system, called CyberKnife radiosurgery, directs multiple
radiation beams on tumor cells in cancer patients, which prevents the
cells from reproducing. Its beams can treat tumors as small as 5
millimeters, allowing doctors to provide stronger radiation doses in
soft tissue areas and from more positions than previously available
equipment.
New Standards for
Hospitals Call For Patients
to Get Private Rooms
The Wall Street Journal, 3.22.2006
The private patient room, once a
luxury for the privileged few, is about to become the standard for the
nation's hospitals, as evidence mounts that shared rooms lead to higher
infection rates, more medical errors, privacy violations and harmful
stress. New guidelines for hospital design, due out next month, will for
the first time call for single-patient rooms as a minimum requirement
for most new hospital construction.
Paradigm Lost:
The
Strategic Impact of Revised DRG Payments
HealthLeaders News, 7.13.2006
We are on the eve of a seismic change in revenue reimbursement for
hospitals with the expected reconfiguration of diagnostic related groups
as recalibrated by the Centers for Medicare and Medicaid Services. The
new configuration is a modification to the Inpatient Prospective Payment
System. Surprisingly, other than running the numbers and issuing a
cursory first-pass analysis, many hospitals and health systems are not
undergoing or undertaking the kind of in-depth review and on-deck
evaluation that the kind of recalculation that the IPPS rebasing should
merit. When all is said and done, healthcare leaders need to recognize
that much of their world is about to change—prompting a veritable
paradigm shift in long-range planning considerations.
Patching New Orleans
HealthLeaders Magazine, 8.15.2006
Katrina did not destroy one healthcare system in New Orleans. It
destroyed both of them. Unlike the other 49 states, Louisiana maintains
a system of public hospitals to care for the indigent. Before Katrina,
10 acute-care hospitals operated in New Orleans, but it was Charity and
University, part of the LSU Health Care Services Division’s statewide
network of charity hospitals, that cared for the majority of the poor.
With the city’s public hospitals down, the burden now falls to the
city’s private hospitals.
Pricing health
care?
It's not that easy
Chicago Tribune, 8.10.2006
Health insurers are aggressively marketing medical policies with high
deductibles--the amount people pay before coverage kicks in. Many experts
contend these products will motivate Americans to shop for medical care, as they
do for cars or computers. But basic data about what services cost generally
aren't available. Medical providers and insurers consider this to be highly
sensitive competitive information, and their contracts require that it remain
secret.
Safe & Sound:
Hospitals team to reduce infection rates
The Business Journal of Phoenix, 8.18.2006
Arizona hospitals are banding together to create ways to reduce infection rates
at a time when there is a national movement to require hospitals to report the
growing number of incidents. Eighty percent of the state's hospitals are
implementing a new program called "Safe & Sound," in which there's a push to
collaborate on efforts for developing benchmarks to standardize how patient care
is provided.
Smart care via a mouse, but what will it cost?
The New York Times, 8.21.2006
The [electronic medical record]
technology itself is simply a software storehouse of a person’s medical
history, including chronic conditions, medical tests, drug
prescriptions, diagnoses and doctors’ comments. Yet bringing pen-and-ink
patient records and prescriptions into the computer age is seen as a
vital step toward modernizing the nation’s inefficient, paper-clogged
health system. Various studies say that it should reduce medical errors
and costs, saving lives and saving dollars — about $80 billion a year,
according to the RAND Corporation. Yet even the technological optimists
expect turmoil from the information revolution they see coming in health
care. Electronic patient records woven into a national digital network
will help identify cost-saving opportunities, they say, but when
combined with the emerging field of genomics, the records will also open
the door to personalized medicine, new treatments — and, ultimately,
more care. While that is by no means a bad thing, it is also not the
hoped-for fix for the nation’s rising health care bill.
Supply squeeze:
Hospitals grapple with soaring building costs
Nashville Business Journal, 6.23.2006
Health care providers are facing a spike in construction costs as they
grapple with shortages of materials because of extreme weather, global
growth and rising prices for petroleum-based products. The upshot:
Delaying health care construction by even a few months could mean
millions in additional costs.
The RFID Hype
Effect
eWeek.com, 2.27.2006
RFID was supposed to revolutionize the supply chain
and—by mid-2006—dominate most aspects of product handling within retail
and manufacturing. Today, even the most ardent RFID advocates are
conceding that hasn't happened and it's quite frankly not even close.
Time to retire the scalpel?
Los Angeles Times, 6.19.2006
In only the last few years, minimally invasive surgery has evolved from
a popular technique used for the simplest of abdominal surgeries — such
as a gallbladder removal or hernia repair — to a method that can treat
even life-threatening diseases such as cancer, heart problems and
emphysema. An increasing number of these surgeries are augmented with
sophisticated computer and imaging technology — such as robots. Such
techniques elevate ordinary doctor skills to the super-human level by
providing magnified, high-definition images and by preventing mistakes,
such as cutting into the wrong tissue. Some doctors are even taking the
first tentative steps toward operating without incisions, using the
body's natural openings — the nose, mouth and anus — to gain access to
its inner workings. Think of it as surgery without scars.
Top hospital systems
budgeting millions for
medical records
Houston Business Journal, 8.18.2006
Government pressure is prodding Houston-area hospitals to
spend millions on going electronic with medical records.
The federal government pays almost half of all healthcare
claims through Medicare and Medicaid, and is primarily
pushing he value of going paperless.
Va. seeks to become
leader in nanotechnology
Richmond (VA) Times-Dispatch, 4.6.2006
Everett E. Carpenter and his team are
experimenting with a no-knife-necessary cancer treatment. It uses
magnetized iron particles that could one day travel through the body to
target and obliterate tumor cells. Through research, the assistant
professor of chemistry at Virginia Commonwealth University is aiding
Virginia's quest to become a leader in the field of nanotechnology.
Vendormate helps
hospitals with regulatory aches
Atlanta Business Chronicle, 7.21.2006
When Andy Monin started Vendormate Inc. in February 2005, he anticipated
helping banking, retail and health-care organizations manage the
complexity that arises from working with thousands of vendors. However,
while Monin still leaves the door open to other types of businesses, he
realized that he could devote an entire career just to helping hospitals
and health-care organizations keep tabs on their vendor relationships.
Waist packs track ER
patients
The Boston Globe, 3.20.2006
Emergency room doctors and nurses at Brigham and
Women's Hospital are getting some high-tech help watching vital signs
and rapidly locating patients in the waiting room. Under a trial funded
by a $3.1 million grant from the National Institutes of Health, the
hospital will today begin distributing 10 waist packs to patients that
contain sensors, transmitters, and tracking gear. The packs will allow
medical staff to constantly monitor patients' heart rates and
blood-oxygen levels while they await treatment.
Deploying New Healthcare Technology: Failure or Success?
HealthLeaders News, 9.14.2006
Somewhere a healthcare administrator
awoke today after tossing and turning through a nightmarish experience:
Forced to buy the latest expensive technology, the executive wrestled
for months with vendors to make it work properly, then tried in vain to
achieve adoption from physicians and staff. Unfortunately, this scenario
is not just a bad dream—it’s repeated almost daily in hospitals and
medical group practices around the nation.
State calls for more
cancer facilities
The Boston Globe, 9.18.2006
The rising number of Massachusetts
residents with cancer will outstrip the capacity of radiation treatment
facilities within four years, say public health officials, who for the
first time in 13 years are asking hospitals that do not already offer
such therapy to build expensive new treatment centers. Doctors will
diagnose 38,248 residents with cancer in 2010, health officials
estimate, 18 percent more than the number of new cases diagnosed in
2000. Treating these patients will require at least eight additional
multi-million-dollar radiation facilities, and health officials in July
changed state regulations to allow more hospitals to build such centers.
The facilities cost at least $5 million to build, largely because the
machine that produces the radiation must be housed in a thick-walled
vault to keep the damaging rays from escaping. It's unclear how many
smaller hospitals will be willing to shoulder the expense.
The
Connected Patient
HealthLeaders News, 9.19.2006
Healthcare — whether supplying medical
information from a physician or billing information from a hospital —
has advanced the art of information obfuscation. Just ask any patient
who has played rounds of phone tag just to book an appointment. Or
patients who wait a week to get lab test results in the mail—and then go
through another round of hoops to talk to a physician about their
meaning. Then the bills come, often a bewildering array of confusing
statements and unclear accountabilities. But the era is approaching an
involuntary end for the industry as consumer expectation for information
has forced healthcare to open its information technology cache.
Fatigue in hospitals:
an Rx for danger
The Boston Globe, 9.22.2006
IS ANYONE awake in America's teaching
hospitals? Just barely, according to several new studies. In spite of
limits on hospital residency program hours , interns are still too
exhausted to protect either their patients or themselves. In addition,
nurses -- who used to be alert enough to catch the errors of an
inexperienced or exhausted resident -- are now working too long and
making more errors themselves.
ID Theft Infects Medical
Records
Los Angeles Times, 9.25.2006
Although the most typical of the
millions of identity theft cases in the U.S. each year involve credit
cards, a 2003 federal report estimated that at least 200,000 instances
involved medical identity fraud. Experts believe that the rising cost of
healthcare is driving more identity theft, and that many people are
unaware they have become victims unless they receive a hospital bill or
query from their insurer.
Illinois Hospitals Put Competition Aside to Partner with Cardiologists
HealthLeaders News, 9.26.2006
Long waits in hospital waiting rooms
and rescheduled procedures were unacceptable to cardiologists in the
Prairie Cardiovascular group. They contemplated the need for a
free-standing outpatient diagnostic facility with expanded capacity to
provide care to patients within the timeframe they are promised.
Although the cardiology group was capable of taking on the financial
burden alone, the physicians didn’t intend to damage the hospitals'
business. Before they went out on their own to construct a new care
center, the physicians turned to the hospitals with the idea of entering
into the venture together. The resulting development of a joint medical
facility and the way it came into being is where the story of PDC's
creation takes an uncommon turn.
Lessons Learned: New York Downtown Hospital and 9/11
HealthLeaders News, 10.5.2006
New York Downtown Hospital, founded two
years after the Broad Street bombing of 1920, sits just four blocks from
the northeast corner of what was the World Trade Center. On a typical
day, the hospital's emergency department handles five patients per hour,
which can rise to 10 patients per hour during peak times. On Sept. 11,
2001, our small community hospital treated 1,500 patients, including 350
in two hours--35 times the usual number of patients.
Doctors Slow to
Adopt E-Records for Patients
Washington Post, 10.12.2006
About one in four doctors use some form
of electronic health records, suggesting that a technology frequently
billed as a way to improve the quality and efficiency of care has yet to
win widespread acceptance, according to a study released yesterday.
Fewer than 1 in 10 use such records in the most effective way -- as part
of a system that collects patient information, displays test results,
helps doctors make treatment decisions and allows health-care providers
to document prescriptions and medical orders electronically, the study
found.
Need Health
Care Prices? Several Websites Can Help
Hartford Courant, 10.23.2006
As much as many consumers hate shopping
for cars, that's nothing compared with trying to price out a medical
procedure or a routine visit to the doctor. There's really no reason you
shouldn't get the best deal on a car. There are many resources available
with the most up-to-date dollar figures on how much it costs to buy a
certain model and anything in it. But try finding out the cost for a
knee repair or giving birth by a cesarean section. More people probably
know the whereabouts of Osama bin Laden than the average cost of their
health services.
The Hospital Leader and the Powerful Physician:
7 Top Strategies for the New Relationship
HealthLeaders News, 10.23.2006
The hospital CEO’s handbook on
physician relations used to be relatively straightforward. All you
really had to do was meet with the clinical staff leaders every now and
then. When the folks in white coats made the inevitable pleas for a new
piece of equipment or to transfer a troublesome nurse, the CEO could
take it all “under advisement.” The physicians needed the hospital;
after all, it was the only place to admit their sick patients. It was
also the only place with those rooms full of big, expensive CT scanners.
Hospitals helped those physicians make a good living and enjoy the
social benefits of being a doctor in the community. But soon the
expensive clinical technology wasn’t quite as expensive anymore, and
physicians realized they didn’t need the hospital quite as much. CEOs
suddenly found themselves balancing a complex string of relationships
with key physician partners that encompassed everything from basic
satisfaction issues to increasingly intricate and creative business
partnership models.
Doctors
Rethink Widespread Use of Heart Stents
The New York Times, 10.21.2006
The medical community is having second
thoughts about stents. Tiny metal sleeves placed in arteries to keep
blood flowing, stents have become such a popular quick fix for clogged
coronary vessels that Americans will receive more than 1.5 million of
them this year. And stents are a big business, generating $6 billion a
year in sales for their makers and thousands of dollars in fees for each
procedure performed by the specialists implanting them. But now stent
sales are falling and some doctors are rethinking their faith in the
devices, driven by emerging evidence that the newest and most common
type — drug-coated stents — can sometimes cause potentially fatal blood
clots months or even years after they are implanted.
John Stossel:
Health Insurance Isn’t All It’s Cracked Up to Be
ABC News, 10.16.2006
Why on earth would we want mandated insurance from employers?! Do our
employers pay for our food, clothing or shelter? If they did, why would
that be good? Having my health care tied to my boss invites him to snoop
into my private health issues, and if I change jobs I lose coverage.
Employer paid health insurance isn't free. It just means we get
insurance instead of higher salaries. Companies only provide it because
of a World War II-era tax break that never went away. Anyway, insurance
is a terrible way to pay for things. It burdens us with paperwork,
invites cheating and, worst of all, creates a moral hazard that distorts
incentives. It raises costs by insulating consumers from medicine's real
prices.
Hospital cost, quality are
at odds
The Denver
Business Journal, 10.27.2006
The cost of a
hospital stay and the quality of patient care seem like they would go
hand in hand, but a study by the state's largest health insurer seems to
suggest otherwise.
In metro Denver at
least, UnitedHealthcare found that, on average, hospitals charging the
least also provide the highest-quality care. Hospitals and health care
experts say that's because lower quality often leads to more
complications and infections, which means more days in the hospital and
much higher medical bills.
New
specialists are ready to help -- inpatients, that is
Boston Globe,
10.30.2006
Hospitalists are
members of the fastest-growing medical specialty in the country. They
work exclusively in the hospital and do not have their own community or
family practices outside the hospital walls. The job of these dedicated
inpatient physicians is to make sure patients are getting the right
treatment and tests, help patients and families understand what is
happening, and make sure patients do not stay in the hospital longer
than necessary. Those may sound like obvious goals. But in traditional
hospital care models, in which busy primary care physicians travel to
the hospital and make rounds once a day, usually early in the morning,
patients are frequently frustrated because they can't find out what is
going on with their care.
Hospitals
struggle with soaring building costs
The Business
Journal of Milwaukee, 10.30.2006
Health care providers
are facing a spike in construction costs as they grapple with shortages
of materials because of extreme weather, global growth and rising prices
for petroleum-based products. The upshot: Postponement of health care
construction projects by even a few months could mean millions in
additional costs.
What
Pilots Can Teach Hospitals About Patient Safety
The New York
Times, 10.31.2006
A growing number
of health care providers are trying to learn from aviation accidents
and, more specifically, from what the airlines have done to prevent
them. In the last five years, several major hospitals have hired
professional pilots to train their critical-care staff members on how to
apply aviation safety principles to their work. They learn standard
cockpit procedures like communication protocols, checklists and crew
briefings to improve patient care, if not save patients’ lives. Though
health care experts disagree on how to incorporate aviation-based safety
measures, few argue about the parallels between the two industries or
the value of borrowing the best practices.
Steps to prepare
now for reimbursement cuts
Ambulatory Surgery
Compliance and Reimbursement Insider, 10.31.2006
In 2007, all
procedures on the Medicare-approved ASC list that CMS currently
reimburses at a higher rate than the same procedures performed in
hospital outpatient departments will have their rates reduced to the
lower HOPD level, as mandated by the Deficit Reduction Act of 2005. If
CMS adopts the proposed hospital Outpatient Prospective Payment System
rule — which outlines the proposed 2007 rates for procedures performed
in HOPDs — without any amendments, the reductions would affect 274
procedures.
Survey Raises Doubt Consumers Will Use New Sources of Healthcare
Information
HealthLeaders
News, 10.31.2006
President George
W. Bush's executive order calling for federal agencies to report
healthcare price and quality data was welcome news, but the question
remains: Will Americans avail themselves of that information? Will
increased transparency alone have the desired effect of transforming our
fellow citizens into savvy and demanding healthcare shoppers?
Unfortunately, in a majority of cases, the answer may well be "no"
unless supported by mechanisms that give consumers a financial incentive
in their healthcare purchasing decision.
Done deal:
Final rule on physician payment cuts
Private Practice
Success, 11.2.2006
The Centers for
Medicare & Medicaid Services released a final rule this week that will
update payment rates and policies under the Medicare Physician Fee
Schedule. As anticipated by the proposed rule released in August,
physicians will see a 5 percent reduction in payment for services in
2007, “to account for the combined growth in volume and intensity of
physician services,” according to a CMS statement.
Outpatient PPS final rule contains a few surprises
Briefings on APCs,
11.2.2006
The Centers for
Medicare & Medicaid Services showed a willingness to listen to providers
and make changes to several proposed operational and payment changes, as
evidenced by the release of the 2007 Outpatient Prospective Payment
System final rule. In other words, if you think you know what to expect
in 2007 based on a reading of the OPPS proposed rule released in August,
think again, says one experts, because a lot has changed between the
proposed and final rule, and much of it for the better.
Running on Empty:
Healthcare As the Engine of the Economy
HealthLeaders News,
11.7.2006
Recently, a flurry
of national articles has explored the notion--held by several prominent
economists--that increased healthcare spending reflects the choices of
an affluent population, and will continue to drive a strong economy.
Many healthcare professionals--physicians, hospital executives,
insurance administrators and analysts--see it differently. As one
colleague bluntly puts it, “It's a train wreck everyone knows is just
around the corner." Healthcare insiders know that the industry's rosy
prospects can continue only if its funding remains stable. Most also
acknowledge that the dollars are not likely to flow as they have in the
past.
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