HEALTHCARE ECONOMICS
(Un)Wiring the Health System
This is one of the Six Prescriptions for What's Ailing Health Care, that Laura Landro proffers in this article in today's Wall Street Journal. It's the last in a series entitled: Who Gets Health Care? Rationing in an Age of Rising Costs. Here's a brief summary since the WSJ's Web site is a premium service:
Wiring the Health System (I added the "Un" This is probably better described as "Networking" rather than "Wiring" or "Unwiring") - the primary reason cited is the reality of medication mistakes. As many as 20% of such preventable mistakes are life threatening, says the Leapfrog Group, a coalition of major employers tring to cut health-care costs. In addition to the harm suffered by the patients, it is estimated that this adds more than $2 billion in costs per year nationwide. Certainly eprescribing and the use of reference guides for prescribing can help in clinical support and patient safety.
Evidence-Based Medicine - As much as half of the care provided to Americans is unnecessary, including procedures that don't do any good, tests that are repeated, and drugs for which there is no evidence of benefit... In a field such as this were updates are continually being produced, publishing to the handheld with the capability of revising content wirelessly would be the most efficient of providing this content to the clinician.
Fixing Reimbursement - The biggest barrier to improving care, many say, is a reimbursement system that doesn't factor in quality and actually rewards waste. Again, improved clinical support and even better doctor/patient communication regarding preventive health information is best served by digital networking using a handheld. More patient's are using programs such as ePocrates to find drug information to find alternatives to expensive medications.
Disease Management - ...the strategy of monitoring people with chronic conditions such as diabetes, congestive heart failure and coronary artery disease. Not too long ago, I spoke with a product manager with Qualcomm who described for me the various wireless devices that where in development for remote monitoring of patients.
Redesigning the ICU - The sickest 1% of patients--the chronically ill and those in the ICU--account for 27% of all health-care costs. In the ICU, hospital resources can be consumed at a rapid rate. This article mentions eICU, a system designed by former intensivists who launched software maker Visicu, Inc. By providing more organization, it has proven to be able to reduce mortality rates adjusted by the severity of patient illness by 27% and cut hospital costs for the ICU by 25% during a two year study. ICU are using WLAN's to allow clinicians to access lab data in a more efficient manner. It is, however, to have safeguards that prevent electronic interference that can occur with medical monitoring equipment.
Getting Patients Involved - "We have lulled consumers to be dependent on physicians." This is about eliminating the old notion that the patient is a passive agent in the decision-making process. To make the patient more involved requires that the patient have access to information, and with advances in digital communication this is already possible. One scenario I can see is where a patient's personal MD can provide a set of links/resources (or vice versa), in order to begin a discussion about the decisions that need to addressed for better care of the patient.
1:40:39 AM 
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