In a step toward reducing mistakes and standardizing medical practices, North Shore-Long Island Jewish Health System, a major hospital group in New York, has announced the most sizeable effort to adopting digital health records.

The group's investment is a $400 million commitment that would put digital health records in 13 of its hospitals. The plan offers "its 7,000 affiliated doctors subsidies of up to $40,000 each over five years to adopt digital patient records. That would be in addition to federal support for computerizing patient records, which can total $44,000 per doctor over five years."

Stated the New York Times, "The federal program includes $19 billion in incentive payments to computerize patient records, as a way to improve care and curb costs. And the government initiative has been getting reinforcement from hospitals. Many are reaching out to their affiliated physicians — doctors with admitting privileges, though not employed by the hospital — offering technical help and some financial assistance to move from paper to electronic health records. "

Digital health records can improve the health outcome for patients and reduce costly administrative fees and costs for hospitals. "Indeed, the rationale for investing in digital records is that the technology can be used to help monitor and measure the results of care, providing the evidence needed to shift remuneration away from the current fee-for-service system, which encourages more tests, more procedures and more pills prescribed."

To read the full article, click here: http://www.nytimes.com/2009/09/28/technology/28records.html?scp=1&sq=September+28+2009&st=nyt

Despite most of the negative limelight forced upon those in Wall Street, more and more headlines are popping up, regaling of the less-than-desirable conditions in the medical field. Insurance companies are being sued for dishonesty; hospitals are starting to crumble financially; patient-doctor trust is waning. At dire times, when the light of srutiny is nearly blinding, we can often get caught up in trying to keep our heads up--trying to survive--that we forget that we are lucky enough to do the very thing that we love the most.

For health professionals, that one thing is medicine. A new book titled, "Cutting for Stone," by Dr. Abraham Verghese of Standard University, helps doctors remember why they do what they do. Verghese, who over the past year, has been reminding doctors, medical educators and medical students about the importance of the physical exam, or what he refers to as “bedside skills,” in modern medical practice, brings out the artistic quality--the aesthetic experience--of medicine in his new book.

The New York Times book reviewer, Dr. Pauline Chen, wrote:

"After reading through several of these passages about doctoring, I could not help but feel about Dr. Verghese as the young Marion Stone did about his first doctor-teacher. “He invited me to a world that wasn’t secret, but it was well hidden. You needed a guide. You had to know what to look for, but also how to look. You had to exert yourself to see this world. But if you did, if you had that kind of curiosity, if you had an innate interest in the welfare of your fellow human beings, and if you went through that door, a strange thing happened: you left your petty troubles on the threshold.”

To read the full book review, please click here: http://www.nytimes.com/2009/02/13/health/12chen.html?ref=health

Tara Parker-Pope, a health and wellness blogger for the New York Times, recently posted a blog deciphering the results of a recent Oregon Health and Science University study that claims that certain scans for back pain might be inefficient and do more harm than good for the patient.

According to the OHSU study, back pain patients who underwent scans didn’t get better any faster or have less pain, depression or anxiety than patients who weren’t scanned. More importantly, Parker-Pope points out that the OHSU data suggested that patients who get scanned for back pain may end up with more pain that those who are left alone.

Why are these results important to health payers and hospitals? Because: Those same studies suggest that more than half the patients who see a doctor for back pain undergo X-rays or another imaging study as a result. These tests might not be necessary, the studies say. Dr. Roger Chou, associate professor of medicine at Oregon Health and author of the study wrote that “We [doctors] think we’re helping patients by doing a test, but we’re adding cost, exposing people to radiation and people may be getting unnecessary surgery.”

Rather than have patients under the impression they are in worse conditions than they might actually be, doctors need to focus on practicing the best standards-of-care to ensure that patients are receiving the correct medicine they need to keep their body and mind healthy. An independent review organization like AllMed can help you, as doctors and payers, make the right decision to ensure the best standards-of-care for patients.

To read the full article and to link to the study, click here

Sparking up an age-old debate between physician-owned hospitals and non-profit hospitals, a new bill passed by the U.S. House of Representatives this month will hamper the expansion of facilities owned by doctors as reported by the Rapid City Journal this week. See article

The concern stems from cases where a patient has an injury and is then scheduled for surgery in the hospital in which the physician owns. It is difficult to monitor the interests of each doctor and whether he/she simply wants to be sure that the patient is receiving the proper care, or if there is a conflict of interest.

One side of the coin is that many doctors run a physician-owned facility to avoid the bureaucracy that typically comes with a larger hospital. Opposing opinions suggest that other factors are considered when there is profit involved, and the existence of these hospitals is due in part to a loophole in a federal law.

It isn’t possible to say that this issue is always a conflict of interest, or strictly to see that the patient receives the proper care. Every facility is different and instead should be monitored accordingly.

Healthcare payers can ease their concerns of over-utilization, while ensuring proper care for their patients by using an independent review organization like AllMed to help make medical necessity determinations for their patients. 

Maintaining a healthy line of communication is key to just about anything in life. But what if it could save lives? An article in the NY Times illustrates the benefits of open communication that doctors and nurses are finding in operating rooms around the world. By utilizing a 19-item checklist that ranges from a brief introduction of each team member, to confirming that all of the necessary equipment for surgery is available and sterilized, team members in the OR are cutting down on surgical complications and deaths.

A study conducted by the World Health Organization monitored statistics for one year in hospitals ranging from the US and Canada, to the Philippines and Tanzania. The results were notable as the average death rate dropped from 1.5 percent to 0.8 percent when a checklist was used. The rate of complications also decreased from 11 to 7 percent.

Taking the time to hear about each team member and what they do creates an open dialogue which is conducive to good communication and thus a safer environment for the patient – which is the first priority.

Patient safety should be considered at all turns, while precautions are taken in any and every area of practice. Using an independent review organization like AllMed to conduct external peer reviews is another option to help facilitate healthy, open communication in a hospital, and helps to increase patient safety.

To read the full article click here.

Should hospitals be allowed to make mistakes? This seems to be the question on mind in a recent New York Times article about University Hospital in Syracuse, New York. University Hospital is reportedly "not a good hospital. In fact, in late 2006 a state commission recommended that it be scaled back and merged with another hospital."

The scale-back and merge suggestions didn't follow through however, despite the fact that the evidence was strongly against University Hospital. Its patients were three times as likely to develop infections stemming from hospitals as were patients at the average New York hospital, according to 2006 statistics.

Patients need to be able to trust their hospitals. They need to be able to walk into the operating room, emergency room and physicians' offices knowing that they are going to be receiving the best care from their doctors. How can hospitals, especially ones that are failing, assure this trust?

One avenue a hospital can take, as suggested by the article, is applying for accreditation by the Joint Commission. Another avenue a hospital can take is outsourcing to an independent review organization, such as AllMed, to ensure that it is making the right decisions for its patients, rather than its doctors. Check our AllMed to learn about best practices, common errors and how AllMed can help hospitals reach standards of care in order to avoid the snowballing errors of University Hospital.

To read the full article, click here.

It is no mystery that doctors work long hours--really long hours. Yet, what can happen when doctors and surgeons work too long and put in too many hours? What's more, who is to say how long is too long? A November article in the New York Times surveyed just this problem. The writer, a well-established doctor, relives her life as an intern and making it into residency. She tells of first year mistakes to more grave problems, like judgment errors that cost her colleagues their jobs and her patients their lives.

The article points out a vital problem in hospitals: In striving to be the best, doctors and hospitals alike can often overlook simple safety issues, such as mandating working hours, allotting for drastic and life-threatening mistakes. Using an independent review organization can help monitor the hours your doctors put in, ensuring that your hospital maintains high patient safety retention. 

Read the full article here: http://www.nytimes.com/2008/11/07/health/chen11-06.html?_r=2&oref=slogin

Cancer is not a word anyone likes to hear, especially when statistics like the fact that 1.4 million new cases of it will be diagnosed this year, float around the media. A New York Times article featuring a Seattle, Wash. woman whose colon cancer puzzled her doctors. 

Karen Pasqualetto was, admittedly, frustrated over the multiple diagnoses and prognoses she received. In the article, Pasqueletto stated, "I don't feel I have a doctor who is looking out for my care. My oncologist is terrific, but he's an oncologist. The surgeon seems terrific, but I have found through my own diligence. I have no confidence in the system."

When patients don't have confidence in the medical system, there are obvious systemic problems within the medical world, especially the oncological one. Cancer is undoubtedly hard to treat, as it requires a minimum of three doctors. Treatment decisions are tough, too. Furthermore, the quality of cancer care varies among doctors and hospitals, muddling the ability to distinguish what is the best treatment.

The inability to choose a best treatment is even admitted by government and medical groups. A 1999 report by the Institute of Medicine in Washington stated that, "There is a wide gulf between what should be construed as the ideal and the reality of one's experience with cancer care."

One avenue hospitals and doctors can travel down to ensure the best practices for cancer treatment is by referring cases to independent review organizations. IROs, like AllMed, can use their clinical expertise to decide what is the best practice for the patient, every time. Moreover, referring difficult-decision cases to IROs helps hospitals establish a consistent treatment plan. 

To read the full article, click here:

Cancer Patients, Lost in a Maze of Uneven Care

Most doctors know what it takes to be a good doctor: High scores in medical school, competent striving during residency and consistent and accurate diagnosis. But what does it take to be a respected doctor?

An article in the New York Times written by a doctor, suggests six habits of highly respected physicians. Dr. Kahn believes that an etiquette-based approach to doctoring abets ensuring that patients aren't just healthy, but are happy as well. Furthermore, adhering to an outline etiquette helps ensure that doctors are held to the same standards and helps to deter possible evaluation.

Kahn's six habits of etiquette are:

1. Ask permission to enter the room; wait for an answer

2. Introduce yourself; show your ID badge

3. Shake hands

4. Sit down. Smile if appropriate

5. Explain your role on the health care team

6. Ask how the patient feels about being in the hospital

Independent Review Organizations such as AllMed can help your hospital and doctors establish an etiquette protocol such as Dr. Kahn's outline. 

To read the full article, click here:

Cancer is not a word anyone likes to hear, especially when statistics like the fact that 1.4 million new cases of it will be diagnosed this year float around the media. A New York Times article featured a Seattle woman whose colon cancer puzzled her doctors.

Karen Pasqualetto was, admittedly, frustrated over the multiple diagnoses and prognoses she received. In the article Pasqualetto claims, “I don’t feel I have a doctor who is looking out for my care. My oncologist is terrific, but he’s an oncologist. The surgeon seems terrific, but I have found him through my own diligence. I have no confidence in the system.”

When patients don’t have confidence in the medical system, obviously there are systemic problems within the oncological medical world. Cancer is undoubtedly hard to treat, as it requires a minimum of three doctors. Treatment decisions are tough, too. Furthermore, the quality of cancer care varies among doctors and hospitals, muddling the ability to distinguish what is the best treatment.

The inability to choose a best treatment is even admitted by government and medical groups. A 1999 report by the Institute of Medicine in Washington stated that, “There is a wide gulf between what could be construed as the ideal and the reality of [one’s] experience with cancer care.”

One avenue hospitals and doctors could travel down to ensure the best practices for cancer treatment is referring cases to independent review organizations. IROs like AllMed can use their clinical expertise to decide what is the best practice for the patient, every time. Moreover, referring difficult-decision cases to IROs helps hospitals establish a consistent treatment plan.
To read the full article, click here:
http://www.nytimes.com/2007/07/29/health/29Cancer.html?_r=1&oref=slogin

The World Health Organization issued a list of safety checks last week that aims to reduce complications and deaths from the rising numbers of operations now being performed worldwide. The list entails safety checks that will improve anesthetic safety, avoid infections and improve communication among surgical team members. According to W.H.O., these safety checks could halve the rate of surgical complications.

With the new safety checks, standards of practice in hospitals will mostly like change…the question is how it will change it.

Read the full article