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Consumers Are Catalysts of Health System Innovation

After years of stagnant business innovation, health organizations are now being poked and prodded by consumers to innovate. The consumer cry for change is based on their experiences in other parts of the economy. They want access their medical information on mobile devices and they want to receive care at convenient locations and times. In response, new innovations are on the way from businesses eager to create a better customer experience. It is no secret that the health system has struggled in this arena. Consumers still experience paper medical records, inconsistent quality and inconvenient access points for care. The health… Full Story

Prioritizing C. Diff Infection Prevention

In 2008, my grandmother was admitted to a hospital in Ohio for a heart condition and contracted a Clostridium difficile (also known as “C. diff”) infection, which ultimately ended her life. I witnessed hospital staff subscribing her antibiotics without administering probiotics, washing with alcohol-based sanitizers rather than soap and water, and failing to disinfect her room. The elderly and individuals taking antibiotics are extremely vulnerable to contracting C. diff in the healthcare settings such as nursing homes and hospitals. Individuals older than 65 account for approximately 90 percent of all deaths from CDIs. This is a deadly and costly epidemic, which… Full Story

Cracking Down on Overcoding and Upcoding in the ED

In recent weeks, numerous hospitals and physicians in Texas and across the country have found themselves thrust into the media spotlight over suspected overcoding and upcoding in emergency departments. Between 2001 and 2008, hospitals nationwide dramatically increased their Medicare billing for emergency room care, adding an estimated $1 billion or more to the cost of the program. Among the potential causes for the increased billing is hospitals’ widespread adoption of electronic health records (EHRs). Computerized charting—as opposed to the handwritten and dictation charting methods of the past—captures more of the work that providers perform, so that visits are documented and… Full Story

Healthcare Reform—A Legal Perspective for Physicians

Most would agree that the nation was taken by surprise on June 28, 2012, when the U.S. Supreme Court largely upheld the biggest healthcare overhaul of the last 50 years. Since its inception, the Patient Protection and Affordable Care Act (ACA) has stirred controversy among consumers, physicians, insurers and politicians. The combined federal lawsuit, National Federation of Independent Business v. Sebelius, resulted from a culmination of claims brought by several individuals, 26 different states (including Texas) and the National Federation of Independent Business. The plaintiffs challenged the constitutionality of both the individual mandate requiring Americans to purchase insurance to forego… Full Story

Pharmaceutical Pipeline Forecast

The overall feeling regarding drug industry R&D is mixed. Some analysts would say pipelines are full and strong, others describe as potentially lagging. Over the last couple of years, billions of dollars have been lost by pharmaceutical companies on blockbuster brand name drugs, due to patent expirations and subsequent introduction of generic competitors. Because of this, successful pipelines are even more important to pharmaceutical companies today. Pipeline productivity across all phases of development have has been slowing over the last 10 years. Approval rates of drugs that make it to the last phase of development, just prior to entry into… Full Story

Patient Safety Indicators Require a Comprehensive Approach

The North Texas hospitals support sharing data regarding hospital performance with the public in a transparent manner, as long as the information is complete, accurate, and limitations are fully disclosed. An example of the complexity related to data analysis is the computer error revealed recently impacting the financial penalties against hospitals on Medicare readmissions within 30 days. The Centers for Medicare and Medicaid Services (CMS) inadvertently included data in its calculations that was too old, and had to publish new rates on the day prior to implementation. Patient Safety Indicators (PSIs) are readily available from administrative claims data, which are… Full Story

Is your Medical Home a Tudor, Colonial, or Ranch?

Several years ago, when I first heard the term Medical Home, I was intrigued. As a healthcare designer, my thoughts were immediately consumed by the facility implications. What would this do to the outpatient environment as we know it? How would the space have to change? What would the community building look like? I soon learned “Medical Home” is a concept or strategy for the business of delivering healthcare. But, of course, with this progressive model for resolving a number of pressing issues on today’s care system, facility-related solutions are a must to create optimum team synergy and the best… Full Story

The Retailing of Healthcare

Say the word “Dallas,” and many people immediately think of pastures filled with Longhorn cattle, tumbleweeds along an empty highway, and J.R. Ewing. Luckily, anyone who has visited Dallas in the last half-century knows that the city is a premier destination for business, innovation, tourism, and residential communities. Dallas has become a mecca for several industries, including retail and healthcare. These sectors are long-standing elements to the city’s growth. With hospitals like Baylor, Methodist, and Texas Health Resources dotting the map of North Texas, it’s clear that we know a thing or two about caring for the health of others.… Full Story

Readmissions–A Complex Issue

In October each year, we enjoy the State Fair of Texas, fall festivals, carving pumpkins, and Texas football at all levels. This year a new event began Oct. 1, 2012, resulting from the Patient Protection and Affordable Care Act (ACA). A readmissions provision imposes financial penalties on hospitals for “excess” readmissions, when compared to “expected” levels of readmission. Generally, hospitals will be tagged for Medicare readmissions occurring within 30 days of discharge, which may sound reasonable to the general public. Hospitals support appropriate value-based purchasing and the ACA as signed into law by President Obama on March 23, 2010. However,… Full Story

Healthy Leaders, Healthy Businesses

A company is only as healthy as its employees. This is a scary reality, as employee health is declining and healthcare costs are at an all-time high, posing a serious threat to the ability of U.S. businesses to compete in today’s global marketplace. The benefits of getting and staying healthy are well established. In order to promote wellness in the workplace, company leaders have to be willing to lead by example. It is critical for company leaders to take healthy lifestyle principles and apply them to maintaining a healthy business. Most business leaders now know that the indirect costs of… Full Story