Monday, May 25, 2015
The way we receive health care today is changing in many ways.
+ On the provider side we see lots of consolidation, which often results in higher fees.
+ The way treatment is covered by our medical benefit plans has been evolving for a few years. Implementation of federal health reform, beginning in Jan 2014, has had a big impact on increasing the cost sharing individuals have to pay.
A couple recent news posts related to these changes caught my eye:
The first is connected to the way we receive healthcare and I believe it is very important - Getting fully involved in your medical treatment.
Jennifer Thew, RN., the Senior Nursing Editor, for HealthLeaders Media brought out some points in her May 19, 2015 article, which I want to share.
I have followed the way medical treatment is delivered and have seen MDs indicating better treatment outcomes can often be gained if there is transparency on the details of a medical treatment session between the MD and patient. One part of improving this transparency, which is not always easy to implement, is to get individuals more involved in their care.
The article reported on a group of Primary Care MDs who are making the results of their visits available to patients online. She indicated in part:
“ - - - a year long study to explore how sharing clinician's notes affected care. The results found that patients frequently accessed visit notes, reported a greater sense of control and understanding of their medical issues, had improved recall of care plans, and adhered better to medication regimens.”
The study was based on a program, which is expanding, called OpenNotes. This effort will be an important step toward people receiving improved health care since in much of today’s treatment not a lot of information is available to the individual. Because of this there can be a negative impact on patients. She shared an example where the lack of information following a person’s first treatment resulted in a complicated medical situation when the situation was later found.
She also brought out a point another professional made on why it is important to get people involved:
"Another really important part of patients reading their notes is the fact that they can contribute to safety monitoring," says Jan Walker, MBA, RN, co-director of OpenNotes and assistant professor at Harvard Medical School. "Care is really complicated, we're all human, we all forget things, and having another set of eyes on what's going on can probably help people avoid errors."
Bottom line – this article provides examples on why it is so important for everyone to talk with their MDs during treatment sessions and to ask for a copy of the notes, which the MD made following the visit.
The second article was connected to to a point I communicate to client employees – A procedure performed by a high volume surgeon has advantages for them.
Cheryl Clark, senior quality editor for HealthLeaders Media reported in a May 21st article 20 hospitals have announced the "Take the Volume Pledge" campaign. Its focus, according to John Birkmeyer, MD, a surgeon, outcomes researcher, and executive vice president for enterprise support services at the Dartmouth-Hitchcock hospital, is to “reduce complications”. He indicated:
"What we're trying to do is minimize the number of patients who wind up getting their care by so-called 'hobbyists,' surgeons and hospitals that seldom do these procedures, certainly not enough to attain a high level of honed proficiency."
Cheryl Clark’s article also reported another point from Dr. Birkmeyer:
“hospitals and surgeons who perform certain procedures infrequently aren't always doing them just because it's lucrative, which it can for smaller organizations.”
"It's less because of the survival instinct and economics of high revenue surgeries. Instead, they're just accommodating the pride and professional autonomy that surgeons believe is their due. What hospitals do care about is running afoul of their surgeons and ultimately losing those surgeons who would go somewhere else."
My sense, in reviewing the article, is outcomes information on surgeries in low volume vs high volume hospitals will be developed in the future. Information and data to determine quality and outcomes is however difficult to gather and report.
In employee meetings, when discussing suggestions for doctor visits, I usually indicate when an MD says the recommended treatment for this situation is surgery it’s very important to get a second opinion. When doing this they should also seek out a surgeon that does lots of procedures like the one you are considering.