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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 today’s ED, patients may enter with a chronic condition that could be better managed by a primary care physician (PCP), but because ED physicians are incented to treat sick people in a fee-for-service model, they continue to take these patients on instead of referring them outside the ED walls. If instead both ED and primary care physicians operate as part of a team of care givers that are incented to ensure patients stay healthy and avoid hospital admissions and readmissions, they are headed in the same direction in terms of focusing on better patient outcomes vs. reimbursement dollars.
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.
This week’s guest post comes from Martin Brown, M.D., FACEP, chairman of the Department of Emergency Medicine at Inova Alexandria Hospital in Alexandria, Va.. A key player in MEDS-ED Link, a grant funded project recently instituted by the Northern Virginia Regional Health Information Organization (NoVaRHIO), Dr. Brown discusses the impact of health information technology on patients in his facility.
We’re all aware that the evolution of healthcare technology is ultimately driven by a desire and need to improve patient care and operational efficiencies. However, many hospitals and clinicians today feel like they’re swimming in a sea of regulations, deadlines, implementations and go-lives. The plus side is that more and more frequently, we’re able to derive some improvements, motivation and gratification from the instances where access and sharing of clinical data across a healthcare community clearly makes an immediate difference in a patient’s treatment.
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:
