Learning by Surfing: Issue 2

A gathering of good stuff (health care related) around the web…

Maggie Mahar at Health Beat explores the question, “Can we reach a consensus on what we need to do to achieve meaningful health care reform in the U.S.?”

Yet there are still major issues that could divide reformers: Should we acknowledge that we won’t be able to cover everyone unless we learn to “control costs”? Should we move directly to a single-payer system? And finally, should we try to move quickly, to cover everyone, or should we aim for incremental progress while sticking, stubbornly, to first principles?

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Dr. Scott Shreeve on the personalization of medicine:

So lets start this out by talking about the personalization of medicine. This is typically thought of in a genetic sense, wherein people are customizing medications and therapies based on your individual genetic profile. Said in other words, the “Right treatment for the right patient at the right time”. However, most consumers already assume Right/Right/Right is happening, and more likely consider personalized medicine as a type of practice delivery style. This is where the physician knows the patient intimately, their social and demographic context, and the correct diagnostic or therapeutic approach given the patient’s preferences that have been learned throughout the relationship.

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Jen McCabe-Gorman was blogging from the World Health Care Congress this week and posted her thoughts on a developing theme: the medical home concept.

The medical home is about primary care. Primary care puts patients “primarily” at the center of the care spectrum.

The medical home is about care coordination. Care coordination is about putting the patient “primarily” at the center of the care spectrum, and then ensuring they stay there as they seek services at different locations.

Unfortunately, “primary” patient-centric, consumer-directed care in the US has devolved into the desperate pursuit of paperwork needed for payment.

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Nick Jacobs, CEO of Windber Medical Center, writes how his hospital is able to keep infection rates low at Hospital Impact:

Recently, we once again produced annual infection rates that are well below the average national rate of nine percent. In fact, they are eight percent below that figure. Although I believe that our outstanding success is due to our total and complete commitment to patient centered care, for those of you who are in need of more quantitative substantiation that is less subjective, we decided to provide that for you as well. So, we went directly to the source, our infection control specialist, Carol, and asked her to elaborate on some of the steps that she takes on a daily basis.

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The Health Blog talked with a few Democrats this week. They aren’t particularly optimistic of health care reform:

While the candidates talk about plans to cover the country’s 47 million uninsured, some congressional Democrats are, shall we say, lowering expectations.

Learning by Surfing: Issue 1

Often I find things I would like to share but don’t have enough days in the week to do so.  Solution: Learning by Surfing [working title].  Here will be links, comments, other stuff, etc. that time did not allow me to share earlier in the week.

Well, you know, effective markets aren’t created by vacuums. Markets are ways to channel human energy and ingenuity, but only when they’re transparent, when they’re structured, when you’re building on human social capital, when you’ve got talent and investment capital. If we really want to think about new solutions, it’s not just identifying the right people and the right programs; we need to create an environment where these people and solutions are able to thrive.

I am often transfixed by the similarities between health care and education reform.  The above quote is from Frederick Hess, the director of education-policy studies at the American Enterprise Institute, in a New York Times Magazine article discussing education reform through philanthropy.  I don’t know which industry’s problems would be easier to fix, but maybe if were to find solutions that work in one, we could solve the problems in the other.  Interesting outlook by Hess, “We can’t solve it without outside intervention.”

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1 Friday: 4 Futures is one component of a New York community based initiative that “seeks to engage Western New Yorkers in exploring possibilities and setting goals for a stronger, improved health care system for the eight-county region.”

The project’s goals are to 1) promote broader, informed civic engagement in our communities on matters of health and health care; 2) give voice on health care priorities to those who use and those who pay for health care; 3) define a people-driven set of priorities which can be tracked to measure progress toward the desired goals; and 4) learn lessons from other places about ways to improve our health care system.

1 Friday: 4 Futures seeks to help people think about the future of health care in New York through four intertwined stories (pdf) that takes place on one day in the future.  “The date is the same in each story but each Friday has been reached along a different path, with distinctly different outcomes for all involved.”

Just noting a different attempt at laying the groundwork for reform.

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The Comarow on Quality blog turned its forum over to a nurse for a blog post to write about her encounter with the health care system from the patient side when she took her daughter to the ED.  She documents her concerns, demands, and overall thoughts on the entire experience.  I always find it interesting when providers’ experiences with health care shift their thinking.

The discouraging part is that she came back for post two.  This time to address the (many negative) thoughts and comments of other nurses on her experience.  Interesting stuff.

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From the Health Business Blog:

American Public Media, which produces radio shows such as Marketplace, has launched Health Care Idea Generator, a website dedicated to a discussion of how to improve the American health care system. Everyone seems to have an idea or two on what’s wrong with health care and how to fix it, so the site is an attempt to harness that energy.

As I was reading the post, it struck me that all the of the ideas would effectively add costs to the system, which also was the opinion of David Williams:

Like so many of the health care ideas out there, all of these will end up boosting overall health care spending, which isn’t going to help our overall problems.

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Tom Peters and customer service.  Nothing is Irrelevant.

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From Al Dente:

To curtail Japan’s overweight population, the Japanese health ministry recently mandated that all waistlines among its 56 million workers over age 40 be below “regulation size” of 33.5 inches (for men). Any company failing to bring its employees’ weight under control–as well as the weights of their family members–will be fined up to 10% of its earnings by the government.