April 04, 2011
1:58 pm
Last week, my organization, the Healthcare Leadership Council, joined with two distinguished healthcare leaders, Dr. Louis W. Sullivan and Tommy Thompson, both former secretaries of the Department of Health and Human Services, in filing a ‘friend of the court’ brief with the U.S. Supreme Court. We did so because of the critical nature of medical information and the importance of keeping databases accurate, up-to-date and accessible to medical professionals.
The case in question is Sorrell v. IMS Health and it concerns a Vermont law that bans the commercial use of de-identified patient data that is part of a physician’s prescribing history. It’s the kind of law that plays to the kneejerk instinct to keep patient information in a sealed and inaccessible lockbox, but the ramifications of this approach to quality healthcare are quite severe.
What’s important to note here is that the Vermont law really isn’t protecting anybody. The patient data in question is already de-identified. Anyone making use of this information won’t see patient names. Furthermore, there are already rigorous federal and state regulations in effect to protect against wrongful use of medical information.
The downside of the Vermont law is that barring all commercial use of such data also stops the flow of resources that is used to maintain current, accurate databases and to create new analytical tools that enable the use of data for health system improvements.
Secretaries Sullivan and Thompson and the HLC are far from alone in holding this point of view. Over 50 organizations and individuals, including the U.S. Chamber of Commerce and the Associated Press, have also filed amicus briefs to invalidate Vermont’s statute.
January 28, 2011
10:23 am
Medical liability reform is one of those causes that, up to now, has seemed a political impossibility at the federal level. Even in years when Republicans controlled both the U.S. Senate and House, tort reform advocates couldn’t muster sufficient votes to get legislation passed. A number of states have enacted reform measures, but Congress – encouraged by strong lobbying from the nation’s trial attorneys – has stubbornly refused to rein in even the most meritless lawsuits.
Now, though, we’re seeing a number of actions taking place that indicate there may be an opening to get something done on liability reform. Among them:
• President Obama made it a point to mention medical liability reform in his State of the Union speech.
• The President’s deficit reduction commission has cited comprehensive liability reform as a recommended action to contain healthcare costs.
• Medical liability reform legislation has just been introduced in the House of Representatives, and it has bipartisan sponsorship.
• There is increasing interest in innovative measures such as tying liability protections to usage of health information technology and evidence-based medicine.
There are compelling reasons for Congress to move on this issue. We have to be concerned about having a sufficient supply of physicians to serve an insured patient population that will increase as a result of health reform. In many states, the liability climate forces physicians into early retirement. We’re concerned about making our healthcare system more cost efficient, and yet the current liability system forces the expenditure of dollars in ways that don’t benefit patients. President Obama’s right. It’s time to make progress on this issue.
January 10, 2011
4:43 pm
Even before Congress passed the Affordable Care Act, the actual process of reforming our healthcare system was already taking place at locales throughout the country. In all sectors of American healthcare, we’re seeing innovators who are developing new and better ways of delivering high-quality, cost-effective care to patients.
The publication SmartBusiness spotlighted one of these innovators, Barry Arbuckle, Ph.D., the president and CEO of the MemorialCare Health System in southern California. In an interview, Dr. Arbuckle discussed how physicians in the MemorialCare system are practicing evidence-based medicine that is bringing about patient outcomes that “frequently exceed state and national averages for most diseases.”
In the interview, Dr. Arbuckle, a member of the Healthcare Leadership Council, also discussed the critical role of electronic patient records and offers advice for employers on the questions they need to ask to ensure the best possible healthcare for their employees.
The theme of best practice, evidence-based medicine is one we’re going to hear about frequently as the nation’s healthcare system continues to transform itself.
July 13, 2010
3:57 pm
An organization of health industry chief executives today applauded federal regulators for being responsive to the concerns of hospitals and physicians in constructing the final “meaningful use” regulations that will determine the allocation of health information technology (HIT) incentive funds. But, said the president of the Healthcare Leadership Council (HLC), the newly-released rules leave some critical issues still unaddressed.
HLC president Mary R. Grealy said that, even though her organization was still analyzing the regulations, “it’s clear that federal regulators paid close attention to the more than 2,000 comments they received on the proposed rule, and that they have been responsive to concerns that the initial regulations placed the “meaningful use” bar so unrealistically high that the health technology revolution would have been slowed instead of accelerated.”
The “meaningful use” regulations establish standards that health providers must meet in order to qualify for a share of the more than $27 billion authorized by Congress in last year’s economic stimulus legislation.
The Healthcare Leadership Council is a coalition of chief executives from all sectors of American healthcare.
Ms. Grealy said, “An example of this responsiveness is seen in the fact that the rules no longer require that, in the initial stage of implementation, all of a health provider’s administrative transactions must be included in an electronic health record. That simply wasn’t realistic. Those requirements are now in Phase 2 of implementation, which is achievable.”
She said, though, that legitimate concerns remain. For example, the regulations should consider each campus of a multi-campus hospital system as a separate entity in qualifying for HIT incentive payments. And, she said, health providers who have built and succeeded with their own information technology systems should be grandfathered into the universe of successful “meaningful use” qualifiers, but that doesn’t appear to be the case based on an initial review of the rules released today.
Nonetheless, Ms. Grealy said, “we’re seeing important progress with these regulations. Clearly, the administration saw there was a gap between the theoretical standards they initially wanted to apply and the real-world challenges that physicians and hospitals face in achieving HIT advancement. We all want the benefits that come from information technology – enhanced patient safety, more cost-efficient operations, greater use of evidence-based medicine – but to make strides forward, regulators and providers need to be moving at a coordinated pace.”
June 25, 2010
10:39 am
There is an interview well worth reading on Kaiser Health News today. Kate Lorig is the director of the Patient Education Research Center at Stanford University and is the creator of an initiative called the Chronic Disease Self-Management Program.
With eight out of every 10 over-65 adults having at least one chronic disease, and with chronic illnesses accounting for over 70 percent of our nation’s $2 trillion annual healthcare bill, Dr. Lorig’s program is a valuable one. The workshops and classes she initiated help chronic disease sufferers better communicate about their conditions engage in healthier lifestyles and do a more effective job handling their medication regimens.
The Kaiser interview caught my attention because Dr. Lorig makes an important point about the flaws in our healthcare system when it comes to treating many patients with chronic diseases. She said:
“Right now, it addresses diseases or even parts of diseases or small sub-parts of the body. It does not address the whole, complex person with multiple chronic diseases. So, right now, what happens, if you’re lucky, you go to a primary care doc who kind of does the day-to-day stuff and then you see four or five specialists each of which do their little specialty part — none of whom really talk to each other except maybe to look at your laboratory tests on an electronic medical record if you’re really lucky. It is totally uncoordinated. It’s chaotic. It serves pieces of people, not whole people.”
To be fair, there are a number of forward-thinking healthcare systems in the United States that have adopted coordinated care models and do an outstanding job bringing primary care physicians and specialists together to treat patients with a holistic approach. But, I can also attest personally, from overseeing my own father’s medical care, that there are too many cases where physicians aren’t communicating and don’t see the whole picture of a patient’s care when they recommend a new treatment or medication.
With over 50 percent of our senior population having multiple chronic diseases, it is clearly essential that coordinated care be the rule rather than the exception. And, as we move forward with the implementation of health reform, this has to be one of the most important priorities.
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