Tuesday, April 24, 2012

Healthcare Issues on the Agenda

HHS Secretary Kathleen Sebelius views the surge to form the healthcare of the future as truly transformative. According to the Secretary, innovative and effective changes are being made not only at the federal level but also at the state and local levels. As a keynote speaker at the Atlantic’s Fourth Annual Health Care Forum on April 19th held in Washington D.C., she touched on the efforts being made to reduce healthcare-associated infections.

According to the just released HHS updated National Action Plan to eliminate healthcare-associated infections, everyday one in 20 patients has an infection related to their hospital care. These infections cost the U.S. healthcare system billions of dollars each year and lead to the loss of tens of thousands of lives. Public comments are now requested on the plan.

In a new state-by-state breakdown by CDC, current data shows that central line- associated bloodstream infections have declined by 33 percent saving 1,250 lives and saving $82 million. Also, surgical site infections have declined by 10 percent with catheter-associated urinary tract infections declining by 7 percent.

Secretary Sebelius stressed how the HHS “Partnership for Patients” program is going to stop millions of preventable injuries and complications in patient care over the next three years. This is to be accomplished by establishing structured learning collaboratives to support hospitals nationwide adopt proven interventions. The hope is that the proven interventions become the standard of care and 60,000 lives could be saved and thereby reducing costs by millions.

Farzad Mostashari, National Coordinator for HIT, at the opening panel discussion commented “In the past two years, we have made as much progress on the adoption of health IT as we have in the past 20 years. There is an entirely new level of interest in using technology by young providers.”

He mentioned three trends that are not going to go away and will affect the growth of health IT. For one, doctors will need to have EHRs, the system can’t continue to pay for care based on volume, and smart phones are really affecting how people relate to connected health and medical information.

As he pointed out, there are new financial incentives being studied along with new care models. For example, the medical home will be used to manage chronic care and is expected to produce an amazing transformation in care across the country. 

Atul Grover, Chief Policy Officer for the Association of American Medical Colleges opened the next panel to discuss the enormous shortage of primary care physicians facing this country. As he said, “Primary care is the foundation for the healthcare system but with long hours, too many patients to see, not enough time to spend with patients, physicians enticed financially to move into other specialties, and physicians not having financial incentives to go into primary care, a shortage is occurring now and in the future.” 

The panel was moderated by Derek Thompson, Senior Editor, The Atlantic. Panelists included Carolyn Clancy M.D., Director of AHRQ, Jill Rubin Hummel, Vice President, Payment Innovation, Well Point, Inc., Steve Miller, Senior Vice President and Chief Medical Officer, Express Scripts, and Marci Nielsen, Executive Director, for the Patient-Centered Primary Care Collaborative.

All of the panelists were in agreement on several critical issues related to the lack of patient care doctors such as:

·        Practicing in underserved and rural areas can be difficult when dealing with so many chronic illnesses among the elderly
·        The lack of health IT in rural areas to meet the needs of so many chronically ill patients
·        Lack of financial incentives along with an effective business model
·        Lack of appropriate team training in medical schools needed to provide coordinated care
·        The need to resolve the debt issue for this specialty which could include financial incentives to practice in underserved areas
·        Lack of medical homes pilots and in general the ability to provide coordinated care in rural and isolated areas
·        The temptation for medical students to go into research to further their career

The panelists were all in agreement that health IT is needed to help meet the needs of primary care physicians. All agreed that it would be easier for smaller practices to be networked in order to help coordinate care for patients with chronic illnesses especially the elderly, health IT would help to support the flow of data, and new technology would help primary care physicians, patients, laboratories, and pharmacies to operate more as partners with each other. As Dr. Clancy emphasized, primary care is all about relationships and for the right person; the field can be terribly exciting.