It’s not easy to make the case that health care innovation can come from within…from the physicians and nurses on the front lines of patient care. Clinically-trained, path-driven, and time-starved, these clinicians may not appear to be the best source of disruptive change in health care.
It seems that nurses are getting a lot of bad press in England lately, coming under fire recently for being “uncaring.” In an article published in Nursing Standard, Linda Aiken of Penn’s School of Nursing contends that this erosion of public trust is the result of high workloads and low investment in nursing education, rather than any attitudes held by English nurses.
How do we get people and organizations to change, especially when what they are currently doing adds little value, is very costly, is perhaps outmoded, and may, at worst, be dangerous? This is the question Benjamin Roman and David Asch raise in their new Annals of Internal Medicine piece on "Faded Promises".
As health care reform rolls out, there is a growing focus on restructuring the health service delivery system in the hope of improving health care quality and "bending the cost curve." A key part of this focus has been on physician organization and, in particular, moving toward large, multispecialty physician groups or hospital-physician systems that can provide integrated, coordinated patient care (e.g., through "Accountable Care Organizations").
What do Edward Snowden and Daniel Ellsberg tell us about the appropriate use of personal health information?
Since Edward Snowden revealed that US agencies have been following social media, telephone data, and other seemingly private communications of US citizens, public reaction to his actions has been mixed. Roughly as many call him a traitor as call him a hero, and some simultaneously criticize his approaches and praise him for what he revealed.
The ugly truth is that health care is often inefficient, costly, and does not meet the needs of its principal constituent -- the patient. This realization has led many physicians and health systems to enthusiastically turn to a new model for delivering primary care, the patient-centered medical home. The patient-centered medical home is a simple idea. It reorganizes care around the needs of the patient, emphasizing coordinated, accessible, and efficient care. In short, it reimagines the health care delivery system in the best image of itself.
If you have read the news lately, you may have noticed two very different types of stories about children's mental health.
A few months ago, I spoke with LDI Senior Fellow Lawton R.
The Affordable Care Act’s Hospital Readmissions Reduction Program (HRRP) penalizes hospitals based on excess readmission rates among Medicare beneficiaries with acute myocardial infarction, heart failure, or pneumonia. In FY2013, the penalties reduced payments to hospitals by an estimated $280 million. The goal is to give hospitals a financial incentive to improve care and to curb the estimated $15 billion Medicare spends annually on these readmissions.
The news from the latest ACO study in JAMA seemed good; not only could ACOs save money in commercially insured patients in Massachusetts, the savings were "contagious," spreading to non-ACO Medicare patients seen by the same providers.