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I appreciated all the dialogue that my recent post on KevinMD’s blog, “The emergency department in an ACO world,” has generated over the past week or so – the number of comments is a great indicator that ED physicians are not just letting this topic go by. I’ve compiled the following post to address as many as I can:
In the era of accountable care, you’ll notice that many hospitals and health systems are already driving towards more collaborative workflow. The integrated delivery network (IDN) is changing significantly, and for the better. But in high-acuity care areas, like the emergency department (ED), the challenge of treating patients more holistically in what is already a fast-paced environment is concerning for physicians evaluating the pay-for-performance model.
In this provider snapshot, Lu Mulla, Vice President of Emergency services and disaster management at Catholic Medical Center (CMC) explains how they leveraged a top-to-bottom evaluation of the emergency department (ED) and ancillary processes to improve patient flow, efficiency and revenue management.
In the emergency department (ED), where split-second decisions decide the life or death of a patient, coordinated clinical collaboration and protocols are needed to ensure rapid response, efficient patient flow and a high level of customer 
service. Identifying and evaluating work flow strategies can drive departmental changes that can help support these goals.
In our next ‘provider snapshot’, Jenny Blank, executive director of patient services at Winter Haven Hospital, shares the story of how her ED team achieved national recognition for their initiative to transform patient satisfaction and revitalize the department using technology.
The inevitable shift towards a pay-for-performance health care system has intensified the impact of patient satisfaction on hospital success, motivating hospitals and health systems to seek patient-centered solutions that promote quality of care. Access to patient data 
and efficient flow of information between clinicians, patients, and patient families are key to meeting both of these goals.
At this year’s Picis Exchange meeting in Miami, FL, I had a chance to sit down with Tommy G. Thompson, whose resume will take up half of this blog post – former secretary of Health & Human Services, four-term governor of Wisconsin, member of Picis’ board of directors and a personal friend and resource – to talk about where today’s healthcare system is headed.
The most compelling part of our discussion was his take on President Obama’s approach to healthcare reform and his direct advice on next steps.
Let us know if you agree or disagree with his advice – and what yours might be? And stay tuned for more from our discussion in the weeks ahead!
- Todd Cozzens
I don’t know about you, but I was thrilled to hear about today’s launch of MEDS-ED Link, a project of the Northern Virginia Regional Health Information Organization (NoVaRHIO) in conjunction with Inova Health System and GE Healthcare.
In a move that caught many by surprise, the recently-installed coalition government of Britain has proposed a radical reorganization of the National Health Service (NHS). The goals of the reorganization are to decentralize the control of the NHS budget, dismantle layers of bureaucracy, empower patients, and realize some £20 billion in savings through increased efficiency. All of this is set against a backdrop that calls for doing more with less – improving outcomes, ensuring high quality care and patient safety and giving providers and hospitals more autonomy while requiring more accountability. The UK, like much of Europe, is looking at ways to restructure budgets and social programs, in an attempt to reduce deficit spending and overall debt. And while the original goals of healthcare reform in the US included cost control, we on this side of the Atlantic did not take the courageous steps necessary to “bend the curve” on health care costs.
Health care leaders and policy makers should be commended for making several smart moves in this week’s delivery of the final rule for the meaningful use (MU) criteria, but one of the most critical is the committee’s decision to include the emergency department (ED) as a viable place of service.
For the past several months, several of my colleagues and I have been part of the ongoing effort, working directly with legislators and other industry leaders to ensure that the ED “gets its due” in the MU final rule. One of the most cost and care intensive areas of every health system, but neglected in the initial rounds of MU criteria, the ED is where the flow of patient care most often begins and consistently feeds patients throughout the rest of the hospital – and I’m thrilled that policy makers have now shown that they agree.
A recent Wall Street Journal Health Blog post addressed a growing complaint in the industry: that deadlines for digitizing medical records are “too much, too soon.” I’ve worked hand in hand with a range of hospitals – from some of the country’s largest IDNs to smaller, community-based hospitals – that are knee-deep in preparations for the myriad of “meaningful use” requirements set in 2011, and while I can report that healthcare organizations are at varying degrees of readiness, that is not my utmost concern.
Most likely, the meaningful use deadlines as they stand today will be met in part by some, missed by others. However, while the deadline debate is certainly part of the story, the oversight of the emergency department (ED) within the guidelines is criminal. Take the following information into account:
Today we welcome guest blogger Geoff Brown, Senior Vice President and Chief Information Officer at Inova Health System, a nonprofit hospital system based in Falls Church, Va. that includes six hospitals and fields approximately 400,000 emergency room visits annually. We tapped Geoff for his thoughts on a common debate in HIS circles: Will hospital-wide HIT oust specialty systems?
Many hospital CIOs are facing a similar question: will house-wide hospital information systems (HIS) reign supreme, or is there still a place for specialty systems? We faced this very question at Inova Health Systems and found that, while a house-wide information system is important to the overall flow of data, a hybrid approach with specialized departmental systems that support the workflow and interoperate with our core HIS met our needs.
At Inova, our busy emergency departments and free-standing emergency care centers were central to our decision to supplement our HIS with specialty systems. Most CIOs would agree that an ED has different IT needs than other departments – from decision-making support to complicated levels of documentation required for reimbursement – and these needs require specific functionality that not all systems provide. Furthermore, EDs are fast-paced and highly stressful environments that represent the front door of a hospital, a gateway for the rest of the building and the hub from which many diagnostic decisions are made and patients are funneled to different departments. One size fits all in some areas, but one built for admissions would not be the best for physicians or patients.
