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The “Piggly Wiggly” Effect

I once worked for a company in Georgia that owned hospitals across the United States. Each year, executives gave every employee a gift certificate for a free Thanksgiving turkey at the grocery store Piggly Wiggly. A nice gesture, but employees in California and Colorado had never heard of the chain, as no branches were within their states. So, although hundreds of employees were given a free turkey, they had no access to Piggly Wiggly. Something akin to this could happen in Texas. Many residents do not have a primary care provider to assist in coordinating their healthcare. They seek treatment… Full Story

No Magic Pill for Prescription Non-adherence

Do you take your medications as you and your healthcare practitioner agreed to? Every day? Exactly as recommended? Surely, as people who work in and around healthcare, we take our medicine correctly—right? In a recent study of 40,000 adults, Express Scripts Inc. found that more than 90 percent of respondents agreed that taking medications as prescribed was important, and 81 percent felt that skipping doses had negative consequences. And interestingly, when ranking healthy behaviors, respondents said taking medications as prescribed was more important than quitting smoking or eating a healthy diet. So, why does the published literature report that on… Full Story

A New Look at Preventive Medicine

Most people go to their doctor when they’re ill. I prefer to see patients when they’re feeling healthy. That way, I can identify any early signs of underlying medical issues. If so, most of the time the problem is preventable and even treatable before any long-term damage occurs. Yet this concept—the practice of preventive medicine—is still not widely known by patients or supported among mainstream primary care settings. The U.S. Preventative Services Task Force is trying to help fix that. The Task Force makes recommendations about which preventive services, such as screenings, counseling services or preventive medications, should be incorporated… Full Story

Economic Impact of Healthcare in DFW

We all interact with the healthcare system. Individuals stop in at their doctor’s office for an annual physical or visit the pharmacy for a prescription refill. Business executives calculate and deduct the cost of care for employees from their budgets. And for more than 600,000 people in the North Texas region, interacting with the healthcare system means going to work each day to provide care and products for the region’s 6.5 million residents. Healthcare is a big business in North Texas. The industry makes up about 15 percent of the local economy—some $52 billion in gross metro product is created… Full Story

Healthcare: The Business We’re In

While standing in line to board a cross-country bus, a middle-aged man crumples to the floor. Stunned momentarily, bystanders gasp then began trying to help. Someone calls 9-1-1. A woman kneels to see if he’s OK. No response. A nearby man begins pushing on the chest, hoping he is doing it right. An approaching siren announces the arrival of the EMS ambulance. Paramedics come through the door and take over. Many things happen at once, each of the medics playing their role. They work on the patient until a decision is made to transport. At the nearest hospital the EMS… Full Story

When Collaboration and Innovation Collide

Innovation is one of the biggest buzzwords in healthcare for 2012. Innovation differs from both invention and improvement in a fundamental way. Invention is original creation of an idea, process, product, technology, etc. Improvement is doing this same thing better. Innovation refers to the notion of doing this existing thing not only better, but differently. In fact, the Latin word innovare means “to change.” Collaboration is yet another hot topic and can be used when discussing anything from bundled payments to patient-centered medical homes. Collaboration is not just working together, but it is a process where two or more organizations… Full Story

Patience and Strategy Needed for Healthcare Reform

Following the U.S. Supreme Court’s ruling on the constitutionality of the Patient Protection and Affordable Care Act (PPACA), Texas will need patience and strategy with two important decisions regarding Medicaid expansion and the implementation of the State Health Insurance Exchange. Texas Governor Rick Perry recently announced Texas would not expand Medicaid coverage or implement a state health insurance exchange. Texas leads the nation with an overall 27 percent uninsured population. Those numbers climb to 30 percent in North Texas. Within our state, 1.2 million children have no medical insurance and 40 percent of Texas women do not receive appropriate prenatal… Full Story

Emergency Medicine Under Pressure

Emergency departments are frequently stereotyped as a hospital’s “money-loser.” Due to the concentration of resources needed to staff an ED, they are expensive to operate and increasingly becoming overcrowded. The Supreme Court’s June 28 ruling pushes forward The Patient Protection and Affordable Care Act, which will extend insurance coverage to millions of uninsured Americans. Healthcare reform is likely to exacerbate the burden on EDs as health insurance does not guarantee access to care. More than 20 million additional people are expected to receive Medicaid, and it is likely that a substantial number of them will visit the ED because of… Full Story

The Power of Evidence-based Design

This past fall I was fortunate enough to take (and pass, whew …) the Evidence-Based Design Accreditation and Certification (EDAC) exam. One of the things I learned from that experience was the whole concept of the “business case”—using empirical evidence to prove why something is worthy to be considered in a particular design. For example, there are a number of current concepts in the healthcare world that some may consider nice to have, but when push comes to shove, they are eliminated from the project in favor of more basic budget needs. Some of these concepts include positive distractions, such… Full Story

NFIB v. Sebelius: More About Law Than Healthcare

As a healthcare lawyer, many friends and acquaintances have asked my opinion on the Patient Protection and Affordable Care Act Supreme Court case. Fortunately, the decision gave me a really easy answer to that question. Although it certainly didn’t break the way I thought it would—or, for that matter, hoped it would—it did vindicate what I have said all along about Obamacare and healthcare reform generally: The Affordable Care Act is much more focused on health insurance reform or health finance reform than it is on healthcare reform. And the Supreme Court case isn’t about healthcare at all; it’s all about… Full Story