In the Wall Street Journal , surgeon Dr. Marty Makary discusses the alarming costs of medical errors and offers suggestions to improve the system. In medicine, particularly during the training years of residency and fellowship, young doctors are not given the opportunity or security to report shortcomings of their superiors.
Answer: Yes. This week, the two heavyweight medical journals, JAMA and the New England Journal of Medicine, featured papers describing the effect of certain intravenous fluids on the incidence of renal failure in critically ill ICU patients. The JAMA paper compared normal saline (relative to human plasma, a high chloride-containing solution) administration to more physiologic, low chloride-containing IV fluids such as Hartmann’s solution (very similar to Ringer’s lactate) or Plasma-Lyte 148.
Jens Ruppert, Vice President and General Manager, Surgical Business Unit NDS Surgical Imaging www.ndssi.com When considering the features of a surgical video and visualization system, it’s important to remember there are a number of critical elements that impact the overall quality of the video equipment chain.
There’s a big discussion going on in the health tech community about a controversial keynote speech given by Vinod Khosla at the Health Innovation Summit (HIS), in which he stated that 80 percent of what doctors do could be replaced by machines. If you’re a doc like me who has no idea who the heck Vinod Khosla is (he’s a venture capitalist and co-founder of Sun Microsystems), why he’d be a keynote speaker at a healthcare event and what the heck HIS is, well, that’s the point of this post.
Amid the mounting concern about radiation exposure and future increases in cancer rates comes a report from Washington State describing the benefits of imaging, particularly CT scanning, for the diagnosis of appendicitis. The authors collected data from some 55 hospitals of all types and sizes over a six-year period for more than 19,300 patients older than age 15; 91% of patients underwent one or more imaging studies.
A Medicare payment policy designed to push hospitals to cut their infection rates has had no effect in reducing two types of preventable infections among patients in intensive care units, researchers say in a study out Wednesday in the New England Journal of Medicine. In 2008, the Centers for Medicare and Medicaid Services began denying additional payments to hospitals whose patients became sicker as a result of bloodstream infections and urinary tract infections associated with the use of central lines or catheters.
In the 23 years since New York State began publishing hospital death rates of coronary artery-bypass graft patients, the number of publicly reported outcome measures has proliferated. There are now 258 public reports on health care quality available around the country, according to the Robert Wood Johnson Foundation.
“Healthcare costs are sky-rocketing!” “The percentage of the U.S. GDP devoted to heath care costs is the highest in the world.” “The cost of Medicare is unsustainable.” For most of us, the cost of healthcare (i.e., the dollars required by the system to produce and deliver care) isn’t what brings us the most anxiety.
The talk on the street is all about patient safety. Institutions are striving to improve care and improve outcomes. The Centers for Medicare and Medicaid Services (CMS) is no longer going to reimburse for preventable healthcare acquired conditions or for healthcare acquired infections. CMS had appointed the Joint Commission as their watchdog.
As new Medicare rules kick in, some 2200 hospitals nationwide are facing financial penalties for high 30-day readmission rates for myocardial infarction, congestive heart failure and pneumonia. Medicare payments will be lowered by as much as 1 percent. Investigators at the Skeptical Scalpel Institute for Evidence-Based Outcomes and Advanced Research (SSIEBOAR, catchy acronym, don’t you think?) have come up with a plan that is certain to lower readmission rates across the board.
I open the heavy, wooden door to the unit. On my left are the patient rooms, equipped with minimal privacy; to my right are members of the healthcare team shuffling around. I continue toward my destination, a small room containing a couple desks and computers dedicated to mid-level providers, but cannot help but notice how eerie the unit is.
Questions such as this from proactive, increasingly knowledgeable patients place a physician on the horns of an ethical dilemma. Although fellows are closely supervised and trained under a gradually increasing responsibility principle (based upon subjective evaluation), a time will come when there is no one available to back you up in the catheterization lab.
Monday is the start of the federal fiscal year, and with it begins Medicare’s biggest effort yet at paying for performance. Starting Oct. 1, Medicare is withholding 1 percent of its regular hospital reimbursements in the new Value-Based Purchasing Program, which was created by the 2010 health care law.
There is nothing more powerful than an idea whose time has come. There is nothing less powerful than an idea whose time has come and gone. In 1846, and for more than 100 years after that, the American Medical Association as a nationwide organization for all physicians was a powerful idea whose time had come.
Several recent articles should dispel any remaining notion that care provided under the so-called Affordable Care Act will in fact be affordable. Just the opposite is true. The Wall Street Journal reported that when physicians sell their practice to hospitals and become hospital employees, services they provide to patients become significantly more expensive.