Another laptop was stolen. This time from VHA in Canton, Georgia. The computer had patient information from almost 15,000 patients in the Greensboro, North Carolina, area. The laptop data was not encrypted but was password protected. The two hospitals in the area affected are providing free credit monitoring. Top
Massachusetts General Hospital is halting its Pediatric cardiac surgery program. This comes after two patients had serious complications after heart surgery errors. The Republic is now investigating the hospital prior to whitewashing the report. There is some evidence that those programs that do a small amount of surgery have more problems. Near MGH is Children's Hospital which has the largest pediatric cardiac program in the country.
Leapfrog Group that has propagated standards for hospitals has come out with a report that almost half of all hospitals are not meeting these lofty standards. They want CPOE and intensivists, things that cost megabucks. The study found that 5% of hospitals are meeting the standards for abdominal aorta mortality, 16% of the hospitals are meeting the mortality standards for bariatric surgery and 35% of hospitals met the mortality for PCI. The percentage of hospitals with CPOE was a whopping 7%. Maybe Leapfrog should reconsider some of its recommendations to be more reasonable in these economic times.
The times are finally changing for the better. Hospitals are dumping The Joint Commission. As an example, Seattle's Group Health Hospital part of the Group Health Cooperative switched to the new DNV Healthcare as their deeming agent.
The Center for Studying Health System Change, a nonprofit, tested and found that community hospitals were not adversely affected by physician hospital competitors in the three markets studied. They did find that the hospitals lured patients, physician and nurses from the community hospitals but that is fair competition. Scripps Hospital in San Diego disagreed with the study but had no statistics to back up their claims. This is more like sour grapes than fact. Top
In an interesting piece in the Wall Street Journal, two writers, both former employees in the Medicare arena, wrote about four reasons private insurers administrative costs are important. The first is the private sector must build physician networks looking at hopefully quality as well as cost. Medicare is open to all no matter the quality. Secondly, private companies must negotiate rates to the satisfaction of both the insurer and the provider. Medicare pays by fiat, which requires providers to make up the shortfall by charging more to private carriers. If there is to be universal healthcare then there must be the removal of all antitrust laws that forbid providers from negotiating with the government. Third is the area of fraud. The private sector does a fairly good job of ferreting out fraud early. Medicare does a poor job. Even as one reads about the Justice Department doing something to someone regarding fraud, there are many more that are slipping through the cracks. Most of this is due to the chronic underfunding of the Justice Department for detection and prosecution of fraud by the Congress. Lastly, is marketing. Private companies must market their product. Medicare or a public insurer can unfairly use franking or other ways to reach the public. The really good thing about the public model is the lack of pre-existing conditions and the portability of the insurance, two huge major plusses. Hopefully, the authors write, that the debate will be open and not hidden as it was in the past.
Well, it's started. The new strict requirements for physicians wanting to be paid by Medicare started April 1. Now physicians can only bill for 30 days prior to getting into Medicare for the first time or re-enrollment. Also if you do not notify Medicare of any change of address of your practice within 30 days you may be barred from Medicare for up to two years. To make matters a little better the CMS has said the retroactive 30 day period will start from the time of the first filing and not the approval.
In the who cares category, Public Citizen, one of the most biased anti-physician companies in the country, has again stated that states are not disciplining enough doctors. They use raw numbers and never take into account the types of discipline. They take the number of physicians disciplined as the numerator and the total number of physicians in the state with licenses whether practicing or not as the denominator and then make their inaccurate determination. They really like the publicity.
Two state legislatures are looking actively at the med mal in their states. Colorado turned down the trial lawyers attempt at easing the caps. They kept the part where insurers need approval prior to raising premiums over five per cent. In Nevada, the Assembly has passed a bill to raise the caps on physicians for gross negligence such as what happened at the ASC in Los Vegas where many people came down with Hepatitis following the non sterilization of the colonoscopy instruments.
In the People's Republic of Massachusetts with their universal healthcare they are finding that people are human. If they have no payments, they don't care where they go for treatments. The EDs of the Republic are up as re the associated costs for the Republic. The Republic has not enough physicians due to their treatment of physicians and patients must use the ED for their care.
The politics of universal health and government control are interesting. In a new story from Great Britain, a hospital was an absolute disaster with high patient deaths, a high infection rate and overall poor care was apologized for by all the biggies in the government including PM Brown. But, why did this happen? The hospital was trying to be frugal and so cut back on nurses and allowed receptionists screen ED patients. The managers were attempting to meet government targets. The problem was found almost two years ago and per usual nothing was done. Top
The National Committee on Vital and Health statistics met this week and heard alot about the definitions of meaningful use. In the hospital it means they must install and put certified EHR systems to meaningful use in order to exchange health information to improve the quality of healthcare and to submit information on clinical quality and other measures selected by HHS. Physicians have the same plus using the systems for electronic prescribing. Without these things in place no stimulus money will flow. The panel heard testimony from all those in favor of moving rapidly to the EHR. They have heard no one who is real life. An example is someone I talked with this week who is a brittle diabetic who had a toe excised due to chronic infection. When he went to recovery after the procedure, the nurse spent fifteen minutes with him and the next hour entering information onto the computer, a very poor waste of valuable time. This hospital had COPE and the messed up his meds each and every day despite the fact he had twice told them his correct meds. There was no way for the machine to ask the ordering physician if he really wanted to change the dosage of the medicine that the last physician had ordered. This is the problem with electronics, it is good for the administrators but not for the clinicians.
Another writer in Modern Healthcare is warning physicians that they may get stuck with bad systems if they buy before they know what is or is not certified. That will not occur until year end. He believes that good systems do not yet exist. In other and simple words, PHYSICIAN, DO NOT BUY A SYSTEM YET!! Top
DISCLAIMER: Although this
article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the