Project offers road map to local health care innovations
A new, but time-limited – looks like the emails may just be going out for just for 30 days – resource has been pouring into my inbox faster than I can read it. It’s called Care about your Care, and it’s sponsored by the Robert Wood Johnson Foundation and a bunch of other groups (about 30 in fact: find the list here).
What questions do you have about health reform and how to cover it?
Joanne Kenen (@JoanneKenen) is AHCJ’s health reform topic leader. She is writing blog posts, tip sheets, articles and gathering resources to help our members cover the complex implementation of health reform. If you have questions or suggestions for future resources on the topic, please send them to joanne@healthjournalism.org.
Part of the “Care” material is very consumer oriented- learning some of the basics about health care quality, such as “more is not always better” and how people can engage in their own care. That may help those of you who are trying to communicate the basics to your audience. There’s also a link to an RWJF site that pulls together in one place a lot of publicly available information about both cost and quality of care (people often ask questions about tracking down such data on the AHCJ electronic discussion list.)
But what really caught my attention about Care about your Care is that it’s a terrific road map to a lot of the innovation going on across the country, much of which hasn’t registered in the national media or in some cases even in the policy conversation. Some of the sites mentioned are Beacon communities – pace setters in using health IT to improve care. Some are part of RWJF’s Aligning Forces for Quality.
Looking though these Care about your Care alerts, I found a few initiatives that were particularly interesting because they brought so many difference branches of the community together – health care powerbrokers and local neighborhood groups.
Healthy Memphis: The Common Table, for instance, has programs ranging from diabetes control to encouraging farmers markets to training neighborhood health advocates who can then spread the work about quality care, including in low-income and underserved areas. Results can be measured: More people with diabetes are getting their blood sugar screened appropriately, the adult smoking rate has dropped, farmers markets are springing up, mammograms … well, maybe we shouldn’t go there.
So explore the site. Find out what’s going on in your state. And if the answer is nothing, find out why. Maybe you’ll discover that these ideas about quality and change are slowly begin to percolate, not just to “early adopters” aligned with groups like RWJF but through ordinary cities and towns. “Health reform” can be seen as more than a piece of legislation to fight about in Washington.
It is, potentially at least, a new way of thinking about, talking about, and doing something about both “health” and “care.”
Higher health care costs, lack of safety innovations traced to group purchasing organizations
Filed under: Health policy, Hospitals, Hot Health Headline
The Washington Monthly’s Mariah Blake writes about the ins and outs of group purchasing organizations (GPOs) and their effect on the development of newer, potentially safer, medical equipment. She reports the system has kept potentially lifesaving innovations off the market and may be contributing to the rising costs of health care.
Among the products she cites as having been created but largely kept out of the supply chain as a result of the GPO system are a syringe with a retractable needle, a syringe designed to reduce bloodstream infections and a surgical towel that can be spotted on X-rays to keep towels from being left in the body after surgery. Those products were developed by small suppliers who seem to be squeezed out of the market by the system.
Blake’s combination of narrative about the small suppliers who have been stymied by the system and her investigation into how GPOs became such a game changer will be of great interest to anyone who writes about health care costs and innovations in patient safety.
Blake explains the evolution of GPOs, “a system built on a seemingly minor provision in Medicare law that few people even know about.”
It’s a system that has stifled innovation and kept lifesaving medical devices off the market. And while it’s supposed to curb prices, it may actually be driving up the cost of medical supplies, the second largest expenditure for our nation’s hospitals and clinics and a major contributor to the ballooning cost of health care, which consumes nearly a fifth of our gross domestic product.
Through a series of court cases, one of which granted GPOs protection from antitrust actions, and their subsequent consolidation, GPOs revenues became “tied to the profits of the suppliers they were supposed to be pressing for lower prices.”
A former GPO employee explains, “But GPOs make their money by charging vendors fees. And if you get a percentage of sales, going with a lower bid from a little company just loses you money and pisses off the big vendors with multiple contracts.”
Blake reports that most small suppliers are wary of speaking out about GPOs. “Several talked to me off the record. At least a half dozen more agreed to speak, only to back out at the last minute or retract their statements after we had spoken.”
Blake points out that this incentive system has an effect on health care costs. GPOs contend that they keep costs down by pooling hospitals’ buying power, but Blake reports one company has kept data on hospital purchases and found that “bids hospitals got through their GPO contracts were substantially higher” than what could be had by negotiating directly with vendors for the same equipment.
More about GPOs
- Modern Healthcare surveys GPOs annually and a list of about 11 of them and their addresses is available.
- The Health Industry Group Purchasing Association represents 16 GPOs.
Insider offers view of health innovation
Filed under: Health care reform, Health policy, Hospitals
Blogging for the Harvard Business Review, Simon Stevens (chairman of the UnitedHealth Center for Health Reform & Modernization) seeks to explain why the field of health care is so agonizingly slow to adopt innovation, whether it be 15 years and counting for e-mail communication or several generations for scurvy-preventing limes. Without spoiling Stevens well-chosen analogies and explanations, I can say he makes a case that it comes down to three factors:
- The labor intensive nature of health care
- Failure to spread organizational innovation
- Barriers to new entrants in care delivery
To Stevens’ way of thinking, there is one group positioned to overcome those barriers and push the system forward: Health plans. UnitedHealth and its competitors have the data, platforms and connections to become major change agents in the field of health care delivery, as well as the incentive to put it all to work improving outcomes and decreasing costs.
The Economist tackles ‘Health 2.0′
An extensive special report in the April 16 edition of The Economist examines the ways technology is changing approaches to health care. The package covers everything from fancy new technologies to the public health potential of mobile phones in the developing world.
It is easy to be sceptical about such online communities. A fatal illness will not be cured by Twittering about it. And for many people nothing will replace the personal relationship between a patient and his doctor. But it seems clear that patients are going online to get more information on their illness, to see what other consumers think of new medications and to get emotional support from fellow sufferers.
The Economist also discovers significant shifts in the way consumers access and respond to health information.
The most influential health blogs on the web, he finds, are those that offer people with chronic illnesses medically relevant and accurate information. One post from a trusted surgeon blogger, he says, now has a far more immediate impact on improving surgical care globally than a peer-reviewed trial published in a prestigious journal.
Articles in the special report include:
- Medicine goes digital: Speculation that, as they begins to converge with the field of engineering, biology and medicine are transitioning into industries based on information, rather than discovery
- Health and information technology: The growth and future of electronic medical records
- Digital medicine: “…health-care providers and drug companies must shift to a culture of continuous improvement of the sort that made Toyota famous”
- Personalised medicine: The promises and pitfalls of widely available, cheap personal genome sequencing
- Developing countries and health: “Developing countries are using mobile phones to leapfrog to personalised medicine”
- Micro-technology and health: How micro-technology is driving advances in surgery, diagnostics and doctor-patient interactions
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