My ideas in reforming the U.S. health care system will relies, also, on the Information Technology (IT) and prevention as developed in my previous blog " Organizing Health Care System: Time is Ripe for Action". I will like to bring to your attention this report as following posted in consulting firm blog.
"Upon assuming office, U.S. President Barack Obama made it clear that reforming healthcare is a top priority for his new administration. But unlike past attempts at healthcare reform that concentrated on the cost of coverage, it appears that today’s healthcare reform debate will revolve around the delivery of healthcare itself. Many experts in the field, such as Dr. Paul Grundy, director of healthcare transformation at IBM, believe this approach is ideal for tackling issues from the quality of care to the cost-effectiveness of medicine. “There is a real understanding this time that there needs to be an adult conversation around ‘what is it we buy,’” he says. “This is the first time we’ve really begun to focus on that issue as part of the reform.”
Technology provides the basis for sweeping reform"Despite the current state of healthcare, Grundy is optimistic about the new administration’s emphasis on modernizing the field with technology, as he notes that developments in technology are poised to make reform economically attractive. Using IT to make healthcare smarter, he explains, may save billions for American businesses—and provide employees with a better quality of life. “We have huge issues around errors and medical errors, which are hugely expensive,” Grundy says. “In a system where you have something as simple as electronic prescribing, you see a 90 percent reduction in medical errors because you have a system in place that identifies, warns you, prevents you from having that error occur.”
"As an example, Grundy points to pilot programs such as the ActiveCare Network pharmaceutical program, which can lower the cost of drug therapies by up to 90 percent by ensuring that the right drug is used on the right patient at the right time. These kinds of programs, he says, are being closely examined by the Obama administration as models for how to prioritize healthcare. “We have the pyramid upside down,” he explains. “We take our money, and we spend it on heart transplants and MRIs until the money goes away—and it never reaches down to covering comprehensive, robust prevention and primary care.”
Click here to read the complete report
Thanks so much for your comments and attention on this blog.
I have been involved in healthcare for nearly 20 years in various capacities. During these years I have seen many items that were in need of change. I was personally involved with a case that had many issues that were need of fixing. One particular issue was the inability of medical professionals to consult online regarding a patient prior to a transfer. So the receiving physician would take a report from the sending physician and the patient would be accepted. The patient then would have his "studies" placed on a CD (ie. CT scans, MRI, ect) for the review of the receiving physician. The patient then would be t ransferred. If the CD was not lost in transfer, the accepting physician may attempt to view the "studies" from the CD. Unbeknown to me, more the 50% of the time the patient's care is delayed once received because they are unable to view the studies from the CD! The patient then is re-radiated from the CT scanner (because the physicians are unable to view the study or the quality is poor) and has an increased chance of developing cancer just from the that scan alone!
+One Chest CT of a 40 year old Male has a one in 500 chance of developing cancer from the CT alone? (Drs. Jeff Tabas and Jeff Kline, EM: RAP March 2007)
+A head CT on a child has a 1 in 1,500 chance of lifetime cancer from the CT alone? (Dr. Daughtery EM: RAP March 2007)
+Cancer is the second leading case of death in the US.
Unnecessary CT scans exposing patients to excessive radiation By Steve Sternberg, USA TODAY
Overuse of diagnostic CT scans may cause as many as 3 million excess cancers in the USA over the next two to three decades, doctors report today. Nov. 29, 2007
I am not usually the one who outwardly promotes new concepts but I truly think the EMDTransfer system will save lives and healthcare dollars.
So, President Elect Obama you may need to have you or a colleague check them out.
www.emdtransfer.com
ealth care is one of those issues that brings out idealogical and philosophical stances in the American political dialog like no other. Whether or not you feel that access to quality health care is a basic human right that must be provided by all civilized countries there are a few basic facts about the American health care system that cannot be ignored. First and foremost, the American health care system is the most costly and inefficient in the world. It also has the lowest return on investment (ROI) when health care expenditure is measured as a function of average life expectancy. (Click on the graphs to enlarge.)
The health care expenditure statistics come from the United Nations Human Development Report, 2007. The average life expectancies come from the CIA World Factbook.
So what is the significance of runaway American health care costs? I guess there are two points. First of all, there is no reason to believe that the American health care system is underfunded. We don't need to spend any more money. In fact, I would suggest that with respect to the 40 million Americans currently uninsured it is arguable that the only way to bring them into the system is to reduce the cost of access to health care. Let me say that again. The reason we have so many uninsured in the United States is because we spend to much money on health care in the first place. This is easy to see. If I open a new private clinic no one who is currently uninsured will be able to afford to pay for my cost recovery and so I will go out of business. Why is health care in America so expensive then you may ask.
I remember seeing the following chart in the Economist that compared relative spending on information technology across different industries. The health care sector spends less money on automation and information technology than virtually any other segment of our economy.
People fully expect that when they roam from state to state that their cellphone will continue to work and that they can go online and check the delivery status of their FedEx packages. And yet, there is no system in place to electronically transfer your medical records or prescriptions from physician to physician or pharmacy to pharmacy. And anyone waiting on the private sector to create its own information management and data transfer standards will be waiting a long time indeed.
This graphic is from the Gartner Worldwide IT Benchmark Service New Trends & Findings for 2007. While there is not clear causality, sectors spending more on information technology as a percent of total operational expense are realizing higher operating profits. It appears that IT increases economic efficiency probably through greater process automation and leverage of existing employees.
Health care is a 3-way value chain with providers (i.e., physicians and hospitals), customers (i.e., patients) and payors (i.e., employers and insurance companies). All of these counterparties need standards to be defined for sharing financial data (e.g., bills and payments), patient data (e.g., medical records), provider data (e.g., capacity, utilization and pricing) as well as medical knowledge (e.g., drug indications, research trials, etc.) In the financial services sector there are numerous standards to facilitate financial transactions, settlements and risk management. In addition, heavy government accounting standards and regulations have given financial institutions greater tools to measure their own internal performance in order to better adjust to ever changing market conditions. We need greater information innovation in health care in order to reduce costs, improve efficiency and increase access. When will America wake up an bring the health care industry into the 21st century?
Harpers Magazine The Next Bubble by Erik Janszen - Superb Read for All
CallMeASeeker : "They Know Nothing" (CNBC clip via Google/Youtube) was Jim Cramer's now immortal take on the Fed and I could not agree with him more. The Fed is clearly clueless and needs a major update in what I will call Tactical Economics and Technology to actually meet its charter. In this absolutely brilliant article by Erik Janszen of Harper's magazine the yawning gap between the Fed's Theories vs Market Realities and its effect on "asset price hyperinflation" are clearly explained. Bubbles have become the Norm rather than the exception and The Fed does not yet understand how to really handle this. This is what Buffett was alluding to as well in the 2002 BerkshireHathaway Annual Report where he termed mortgage backed derivatives as Financial WMDs(See Report Page 14 ). These financial instruments need to be regulated to an extent where they do not wreak the kind of havoc we see today. The days of using interest rates as leverage to control inflation and the money supply are over. The policy and regulatory controls of the Fed should be reviewed and overhauled. The Fed should look to state-of the art Hardware and Economic Model-based Business Intelligence to monitor and pre-empt dangerous fluctuations in the money supply, the credit/asset and securitization markets that can derail the global economy. The Technology is out there but this is not your boiler plate IT implementation and thats putting it mildly, this needs a Google like approach backed 100% by every branch of government concerned. The Googles and Apples of the world have delivered gadgets, toys, search engines and Orkut but nothing that has come out of Silicon Valley has solved any of our real problems in the 2 most critical areas - energy and the economy. The IT industry needs to rise to the occasion and work with the economists of our time to deliver innovation that allows the Fed to monitor the economy. For that to happen the IT industry's techno-whiz kids need to understand economics - period. As dry a subject as it is , it forms the very fabric on which American and global prosperity and peace depend. Mis-informed economic and monetary policy have caused much pain to the poorest amongst us. The food price bubbles in 2008 have already triggered a civil war in Haiti and rioting in Egypt. Economics and Monetary policy is the 10,000 pound gorilla in the room that we have chosen to ignore - and when we ignore something you can be sure our politicians and leaders will do the same. So start right here, Educate yourself ...Change comes from the ground up!! Vote Barack Obama 08 'Harper's Magazine Feb 2008 Erik Janszen : The next bubble:Priming the markets for tomorrow's big crash - Absolutely Brilliant Article - A must Read! "The dot-com crash of the early 2000s should have been followed by decades of soul-searching; instead, even before the old bubble had fully deflated, a new mania began to take hold on the foundation of our long-standing American faith that the wide expansion of home ownership can produce social harmony and national economic well-being. Spurred by the actions of the Federal Reserve, financed by exotic credit derivatives and debt securitization, an already massive real estate sales-and-marketing program expanded to include the desperate issuance of mortgages to the poor and feckless, compounding their troubles and ours. More.....in extended post
