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January 27, 2010 -- Hospital Impact has been ranked one of the top 50 healthcare blogs by Wikio.
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Florida hospitals had a front-row seat to the genesis of the Recovery Audit Contractor program due to the Sunshine State's participation in the three-year RAC demonstration project. FierceHealthFinance recently spoke with Bruce Rueben, CEO of the Florida Hospital Association, to find out what his member hospitals have learned from the RAC program so far.
FierceHealthFinance: Based on the experiences of your member hospitals, what is your global forecast for hospitals nationwide in 2010 as the national RAC program ramps up?
Rueben: Florida, like New York and California, served as the initial testing ground for the Centers for Medicare and Medicaid Services to develop the RAC program.
In Part II of our Q&A interview with the CEO of Boston's Beth Israel Deaconess Medical Center, Paul Levy shares how Massachusetts' mandatory insurance coverage law has impacted his institution, and his thoughts on how healthcare reform should play out at the national level.
FierceHealthcare: Do you have a prediction, or even a personal preference, as to what type of insurance model is going to work?
Paul Levy: The approach we're using in Massachusetts which, I think works pretty well, basically requires people to have insurance--in other words, there's a personal mandate that you have to have insurance, and then the state has created an insurance exchange. The insurance companies in the state have to live by the rules of that exchange and provide the insurance coverage, and then subsidies exist for the lower income people. I think that's a pretty practical way to do it.
"We have some issues here," a CEO of a mid-sized community hospital told me.
"We have a pluralistic medical staff of employed, contracted, and independent doctors who are in revolt. After our residency was put on probation several years ago, we set up a hospitalist teaching service, where a third of unassigned patients went, which angered the private doctors.
"Also, we have adopted a more hands-on policy with our case managers, to meet state and federal core-measure guidelines, which physicians feel interferes with their autonomy to care for patients. And we just divested a service line that lost over $2 million in the past five years, which meant that some physicians who've been with us for more than 30 years lost their jobs.
by Wendy Johnson
Every once in a while, a hospital error comes to light that's so tragic and egregious, it makes national news headlines and holds our attention: Josie King, the child who died at Johns Hopkins Hospital due to severe dehydration and a medication error; Jesica Santillan, who died after receiving organs with the wrong blood type at Duke University Hospital.
This month, we learned of the latest shocking error; massive radiation overdoses at Los Angeles-based Cedars-Sinai Medical Center.
As many of you know, Paul Levy, CEO of Boston's Beth Israel Deaconess Medical Center, is an avid blogger who advocates for more transparency in healthcare (he even disclosed his own compensation package and asked folks to comment on whether they think he's overpaid).
Anne Zieger, FierceHealthcare's senior editor who named Levy as one of nine people to watch in healthcare, recently talked with Levy about how his views on blogging have evolved over the years.
FierceHealthcare: So what do you think has been the net benefit to the hospital--or you--with having this ongoing relationship with the blog?
Paul Levy: I'd be hard-pressed to say that it's had any benefit to the hospital, per se; at least it's hard to measure that kind of thing. My only hope in the blog is that it would be interesting for people to read, and that it would promote some debate and maybe educate some people as to the issues that are going on. That's all it is. It's kind of a news magazine from my point of view.
by Neil Versel, FierceEMR
While dozens of media outlets picked up on a Kaiser Permanente-led study, published in the American Journal of Managed Care, about how a "bundle" of two low-cost medications could prevent heart attacks, nearly every report I saw missed out on one major detail of the report: The researchers would never have found a link without the help of EMRs and predictive modeling technology.
Kaiser mined its KP HealthConnect EMR--its name for the Epic Systems installation across all nine Kaiser regions--to find patients at risk for heart attack or stroke to participate in the study. Once the program started, the EMR helped Kaiser clinicians track their patients' adherence to the recommended treatment.
by Joseph Ingemi
Compliance will be a central issue, for HHS and for providers, once the Office of the National Coordinator (ONC) releases its meaningful use criteria for physician practices and hospitals. (It's expected to be published in the Federal Register by the end of the year.)
To receive federal funding, each entity will have to comply with the criteria. Translation: All providers will need to set up quality assurance programs to ensure compliance. That's where skilled, thorough IT auditors will come in handy. But even the most experienced IT auditor will be charting new territory in evaluating meaningful use compliance.
Based on the current work of ONC, here's where an auditor's system evaluation might take two approaches:
by Paul Roemer
I built a deck one day simply because I wanted to build it. I called Home Depot, told them what I thought I needed, and the next day they delivered the necessary supplies to my house. Twelve hours later, I had an 800 foot multi-level deck with a railing and benches. Prior to that day, I'd never built anything. I had no plan, just and idea. I got lucky.
Several years later, my friends and I climbed two 19,000 ft. volcanoes in Mexico. We had a detailed plan, talked to people who'd climbed them, read about the climbs, practiced climbing on glaciers, and practiced using crampons, ice axes, and ropes. We even spoke with a doctor about how to deal with some of the health dangers we might encounter. Good thing: We almost died from pulmonary edema. Had we not planned, we would have died.
I've been thinking a lot about why projects fail. My most demonstrable failures can be traced back to two things: a lack of leadership and a lack of planning. Planning doesn't guarantee success, but I like my odds a whole lot better with it than without it.
by Nancy Cawley Jean
Do hospitals need to enter the world of social media? That's the exact question we asked ourselves last year at Lifespan, a large, Rhode Island-based health system comprised of a parent and five affiliated hospitals. We started to realize that communication as we know it has changed dramatically in the last five years alone, giving consumers more of a voice than ever before.
No longer are disgruntled customers (or patients) left with the sole option of writing a letter to the editor of their local newspaper to get their voices heard. Now they can blog about it, tell their friends through Facebook, or even share their experience with the entire world through Twitter. Unlike the past, consumers now expect to be heard.
by Paul Roemer
Those I've had the pleasure to meet online know one thing about me: I view the selection and implementation of an electronics health record (EHR) system to be a very non-trivial event. What makes it so difficult?
Hospitals typically spend more money on EHR than they may have spent on adding a new hospital wing. And yet, many hospital leaders make EHR decisions without clearly understanding their business need or their business requirements. Sorry, but obtaining ARRA money is does not count as a "business justification."
It's no wonder, then, that 70 percent of large IT projects--those in excess of $10 million--fail. Failure is defined as missing the budget, the timeline, or not meeting the desired functionality.
by Anne Zieger, FierceHealthcare
As any web user knows, there are thousands of healthcare bloggers out there. But of course, all blogs are not made equal. Some offer that soupcon of personality, great insider insights or just the ability to make us laugh at ourselves in a way few of their peers do. And those are the blogs (and tweets) worth putting on your must-read list.
We've compiled a list of nine of our favorite healthcare bloggers and tweeters, a diverse mix with a wide range of information and commentary to share. We hope you enjoy them as much as we do. Start the slideshow
Read more!