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Headlines- August 15, 2005
THE GRACE REPORT

Headlines- August 15, 2005

Robert L. Michel: Clinical Decision Support Comes to Obstetrics Care

VERY OBSTETRICIAN AND GYNECOLOGIST SHOULD INFORM THEMSELVES about the subject of “clinical decision support.”I use this term to collectively describe specific efforts by hospitals, large medical groups, and payers to raise the quality of healthcare delivered to patients.The objective is to provide the clinician—at the point of care—with some type of assistance when making treatment decisions.

Study after study demonstrates that patients fail to get the care recommended for their condition. This means that someone on that patient’s care team did not do the right thing, at the right time. Employers, government health officials, and private payers are using studies documenting this failing to make a compelling argument: “Healthcare costs to us are increasing at double-digit rates each year.Yet, you doctors and hospitals tell us our beneficiaries can’t get better health outcomes for this increased spending.We will not accept this status quo.”This explains why hospitals, health systems, and large medical groups are taking the first steps to introduce some form of “clinical decision support” into their particular care continuum.

In an unusual article in the Journal of American Medical Association on August 17, physicians at Beth Israel Medical Center in Boston said they hired airline pilots to train the staff in teamwork and conflict resolution.What’s more,Beth Israel, affiliated with Harvard University School of Medicine, decided to limit the workload of obstetricians
and instituted the two-challenge rule. If a staff member disagrees with a colleague’s decision, he or she must state his or her concerns twice. If the colleague takes no action, he/she can ask a supervisor to intervene.

Also, Beth Israel’s obstetrics department set up three types of patient-care teams. One treats patients, while another oversees the first team’s decisions and workload.A third team would be activated in an emergency. The hospital also changed the way nurses and physicians communicate during shift changes so that all staff are responsible for all patients. These efforts at Beth Israel, initiated following the death of a newborn in 2000, have contributed to a reduced number of lawsuits, pre-lawsuit claims, and the types of cases the hospital and its malpractice insurer believe could result in a claim.

On pages 3-8, you will read about similar efforts by 21-hospital Banner Health in Phoenix, Arizona to raise clinical outcomes in obstetrics by providing physicians and nurses with an intelligent EMR system that incorporates a comprehensive clinical decision support capability.Together with the Beth Israel experience, both are examples of reforms to traditional clinical practice patterns in obstetrics.

“Intelligent OB Info” System Going Into 17 Banner Hospitals

Integrated electronic medical record system offers clinical decision support, documentation

CEO Summary: In an effort to transform the delivery of ob-gyn care, hospitals in the Banner Health system are installing an integrated EMR solution that incorporates customized care protocols to help prevent medical errors. This sophisticated system, called the Intelligent Patient Record OB (or IPRob), will improve care, increase safety, boost efficiency, and decrease malpractice costs. In fact, some projections indicate that the $8 million smart EMR system may reduce Banner Health’s obstetrics-related malpractice costs by significant amounts during its first 24 months in use.

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Hospitals Moving to Introduce “Smart EMRs” Into Obstetrics

New EMR systems support improved outcomes and reduced medical malpractice costs in OB

CEO Summary: As it implements an intelligent electronic medical record (EMR) system in the obstetrics departments of its hospitals, Banner Health expects to achieve three objectives. One, improved healthcare outcomes. Two, fewer medical errors. Three, significant reduction in medical malpractice costs associated with obstetrics care. In fact, Banner Health projects that the $8 million cost of this intelligent EMR system might be recouped in as few as 24 months, just from the expected reduction in medical malpractice expenses!

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More Payer Consolidation: United Buys PacifiCare

Consolidation may be a result of larger trends soon to pressure major health insurers

CEO Summary: For the second time in nine months, a health insurer
has spent around $9 billion to grow by acquisition. This time it’s
UnitedHealth Group purchasing Pacificare Health Systems. These types of deals will have a direct impact on ob-gyn group practices, particularly as existing contracts expire.However, the most interesting wild card is consumer-driven healthcare and how payers intend to respond to this rapidly-growing type of health insurance. Experts believe more consolidation may occur among the nation’s larger insurers.

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Mango Speaks About Consumer-Directed Health

McKinsey & Co. executive generates national attention with strategic analysis

CEO Summary: This former healthcare executive declares that
Consumer-Driven Healthcare Plans (CDHPs) are “the most significant
development in health insurance since the widespread introduction
of HMOs in the 1980s.” Paul Mango, now at McKinsey & Co., has plenty of good news for ob-gyns and their practice administrators. He predicts that CDHPs, the fastest-growing segment of health insurance plans, will drive deep and positive reforms across
the American healthcare system.

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Managed Care UPDATE: What a Turnaround! Now Payers Want Docs to be Paid Faster

“Swipe card” readers and other similar systems will help ob-gyns collect more $s from patients

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Info Technology UPDATE: Amazing New IT Products Arriving in Healthcare Market

How about cell phones as “pulse oximeters”? Advances in info technology drive this trend

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INTELLIGENCE: Late & Latent

HOSPITAL REPORTING OF MD DISCIPLINARY ACTIONS IS CRITICIZED

PAYER PROFITS UP

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