by Nick Jacobs

Transparency in healthcare will facilitate the improvement of performance and quality by providing hospitals and physicians with the additional information necessary for benchmarking their work. It will obviously assist patients as they attempt to make informed decisions regarding their potential care. Finally, transparency will improve quality and efficiency by encouraging private insurers and public programs through providing necessary information to them to make necessary decisions. Transparency is not the end-all, but it is a solid start.

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by Tony Chen

Can we stop talking about retail clinics as an "emerging" trend? These clinics are here to stay. Plus, there's already 1,000 of them (as we predicted almost 2 years ago), and probably thousands more on the way.

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(We've touched upon hospital-acquired infections in the past. Nick posted previously about how they conquered it in his hospital. Today we highlight one of the most common & costly infections in our nation's hospitals)

Guest post by Thomas Cherry, RN, BSN

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by Tony Chen

I've previously blogged about Partners Healthcare experimenting with the Second Life Medium as a means to deliver healthcare information and educational content.

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by Tony Chen

So, I'm driving to work this morning, drearily listening to my fav sports talk show, Mike and Mike in the Morning on ESPN Radio. I enjoy the show because of the great banter between the two hosts (they play their parts well - klutzy metrosexual and retired linebacker. Today, their show was dedicated to raising money for the V Foundation for Cancer Research. Mike and Mike had donated the opportunity to have them do a live show at your house.

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by Christopher Cornue

Hello - as most of you know, I've had a strong interest in comparing our healthcare system in the United States with those in other countries and have written about it in several posts in the past (and several in the very near future). I just heard about a series of reports from the BBC contrasting the NHS and the US System. Some of these reports will be broadcast on the BBC Channel on the XM Satellite Service (perhaps Sirius, too -- I'm not certain) today at various times. The one time I caught was 8:00 eastern tonight, but there are others earlier (at either 1 or 3 pm today). Also, on the BBC World Service website at the following link (http://www.bbc.co.uk/worldservice/ ) they have a report posted titled "Building Better Health." Take a look (er, listen) if you get a chance and are interested!

Check out the press release. One of ENH's physicians comments on this here.

by Nick Jacobs

As a sophomore in high school biology, I was first introduced to the smell of formaldehyde. My initial rendezvous with a scalpel and a frog’s underside followed shortly thereafter. Having grown up near the woods, it wasn’t as bad as I thought it would be, and it surely allowed me to begin to completely grasp the concepts of dissection, categorization, classification and itemization.

Charles Lauer, former vice president of publishing and editorial director of Modern Healthcare wrote an article this week entitled “The Human Cost.” In this commentary he carefully dissected the 47 million uninsured American’s by category. In fact, he acknowledged the Kiplinger Letter for the actual research that was done for his article. Although there were some very troubling numbers, there were also some extremely revealing statistics. For example, over eight million people are in fact eligible for some type of government program but they either do not realize that they are eligible, do know how to sign up for the program, or do not have the proper documentation to permit them to sign up for this assistance.

During previous itemization discussions, we have often asked the illegal alien question. How many illegal’s are there in this country? Do they have employer based insurance? Are they putting a strain on the system? According to Kiplinger and Modern Healthcare, there are approximately 10.2 M noncitizens in the mix of 47 M, but only 20% are illegal. That one seems a little doubtful to me. We have seen numbers ranging from five to 20 million illegal aliens? When you read the statistics of Texas, California and other border towns where emergency room visits are at near crisis levels, those numbers seem suspect.

Several of the uninsured are still young enough to mistakenly believe that they are invincible. This super hero phenomenon is nothing new to our society. These nearly eight million people are living without a net because they either can't pay for the insurance or believe that they will never need it.

How about those of us who are getting older, but are not old enough to collect Medicare, and the pre-existing conditions uninsured, those individuals who are rejected for coverage because of a health problem that disqualifies them from the insurance pool? There are about eight million people in that 47 M number who are retired or unemployed and everyday run the risk of bad luck or poor health.

Nearly 40% of the uninsured are putting off treatment or going without care, and that is not a good thing. It’s always better to maintain the engine before the plane falls out of the sky.

It is an absolute fact that the high cost of healthcare is serious stuff. As our employers attempt to compete internationally and the rest of us try to make our monthly deductible payments, the healthcare costs have a negative impact on our economy. For those who cannot afford insurance, we face that unique dilemma of hanging on the ledge by our fingernails as the window is being closed.

by Tony Chen

The latest list is out at US News and World Reports. As part of this report, they did a nice 5-day diary at one of the hospitals, Vanderbilt.

And by the way, the best Children's Hospitals were also announced about a month ago.

I've posted before about what being "the best" really means in the hospital business. If it's all about reputation and academics, then where does that leave the small community hospital? Can't they be one of the best, too? Let me pose a question that I posed 2 years ago:

Well, let me ask the question I'm really trying to ask: this blog has been dedicated to helping hospitals become "world-class" organizations. if you don't happen to be an academic medical center, you really can't become a "destination" hospital that people would fly to. Given that, can you really ever have the reputation as a "Best Hospital." And thus, can you really ever be a world-class organization?

Of course, my answer is YES. Just look at Windber Medical Center. In some sense, that hospital had NO business surviving the collapse of that town. When the sole industry (coal-mining) left, that town should have quietly gone away. But instead, now that hospital is the bedrock/driver/growth engine of that town. Go figure. And I'm guessing that's just one story of many that we will never hear about in US News and World Reports.

by Christopher Cornue

A few weeks ago, I wrote about a national effort by the Robert Wood Johnson Foundation that was formally launching in June, and I promised to offer a website when it became available. Well, the "Aligning Forces for Quality" project has been launched and you can learn more about it at the following link: http://www.rwjf.org/qualityequality/af4q/. Much of this work is borne from the RWJF sponsored "Expecting Success: Excellence in Cardiac Care" project that focused on disparities and cardiovascular disease (among others RWJF projects). I was involved in the Expecting Success project, led by the George Washington University as the National Program Office. They are again leading these more far-reaching efforts. It promises to be both a challenging and an impactful endeavor -- to change the care of 14 communities (currently, expanding further in the near future). Go to the link and learn more about this important project and see another step forward in changing healthcare across our nation!

by Nick Jacobs

In the July 3, 2008, Nature, a brief article titled “In rude health” explains the process that has evolved in the National Health Service of the United Kingdom that will result in “A treasure-trove of data in the UK National Health Service . . .that . . .is set to energize biomedical research.” Although the NHS takes a verbal beating from all of the criticism generated by its reported shortcomings, a recent survey showed 91% of 17 M hospital inpatients rated their care good, very good or excellent. More importantly, the NHS was rated above the systems of health-care in Australia, Canada, Germany, New Zealand, and the United States.

If that isn't enough good information, it turns out that the goal of the NHS has been, since its inception 60 years ago, to promote research. Sally Davies, NHS’s Director General of Research and Development has created the National Institute for Health Research which already has plans for virtual organizations to link universities, hospitals and industry, through which researchers will be able to conduct studies on patients more easily.

According to the article, the most important aspect of this plan is that it will open the myriad details of the patient data that has been collected over the past 60 years. This data will allow researchers to readily identify appropriate patients for clinical studies, an internationally unique resource that will swiftly move the concept of translational medicine into the current decade.

The article ended with this quote, “ . . . the NHS’s golden period may be yet to come.”