A Health Information System That Puts People First

Healthcare providers that prioritize cost control over innovative care do their patients—and the people that work for them—a serious disservice. Investing in technology that augments patient centered solutions not only turns a profit, but more importantly gives struggling health systems the data, tools, and collective understanding needed to improve human health.

That is precisely what happened at NYU Langone Health, where a comprehensive, real time information system fuels a robust culture of accountability. By inspiring staff to reexamine how and why they work, the system helps the academic medical center drive down costs, elevate safety and quality standards, and above all achieve better patient outcomes.

The full Forbes article can be viewed at this link.  

Healthcare executives look to bring the joy back to medicine

As health systems survey candidates for executive roles, experience, academic achievements and other measures of scholarship typically top the priority list.

Leadership qualities, “coachability” and emotional intelligence are often overlooked, particularly at academic institutions. That represents a fundamental flaw in the hiring process and the medical education system, which hardwires doctors to be self-interested and autonomous, said Dr. Peter Pisters, president of the University of Texas MD Anderson Cancer Center.

“Our search committees have been anchored in a series of biases that include an overemphasis on scholarship and an underemphasis on leadership capabilities, especially emotional intelligence,” Pisters told the audience during Modern Healthcare’s Workplace of the Future conference last month. “That has created real challenges.”

MD Anderson has brought in psychologists specializing in emotional intelligence and incorporated that metric into the selection process. It mandates implicit bias training to ensure objectivity. Like many systems, the academic medical center has also pushed for more diverse leaders and has cast a wider net to attract more applicants.

The full Modern Healthcare article can be viewed at this link.  

In Summer of 2019, eHealth Initiative and UnitedHealthcare’s National Strategic Partnerships Division convened a collaborative meeting of leaders from payer organizations and other stakeholder groups to address the use of ICD-10-CM codes for capturing social determinants of health (SDOH) data. This meeting marked a significant milestone in the shift to value-based care. Despite the competitive nature of healthcare, the private sector is working together to address factors pertinent to patient care and well-being in a sustainable, scalable manner. The group discussed the need for better education of provider and billing coders on the value of collecting and using SDOH data and identified strategies to accomplish this task:

• Develop a consistent and unified approach to communicate and assist providers and coders in utilizing existing ICD-10-CM codes for SDOH.
• Formulate a strategy and unified approach for providers and coders to assist with adoption and utilization of the proposed SDOH codes once approved.

Attendees agreed that the best strategy to communicate and promote the adoption of ICD-10-CM codes for SDOH to various stakeholder audiences was to:

• Develop this document as well as two-page communication tools for various audiences, including providers and coders. The coder tool, Transforming health care: Why including SDOH codes on claims is critical and provider tool, Using SDOH coding to transform health outcomes are available for use.
• Promote the use of the communication tools at various payer organizations through a high-level communication plan that outlines dissemination to stakeholder groups.

For a brief overview on the topic, check out our eHI Explains ICD-10-CM Coding for SDOH. Links to the provider and coder documents are forthcoming.

Spinning the lens on physician power: narratives of humanism and healing

Divisive, disabling and dangerous power has featured heavily in health professions literature, social media and medical education. Negative accounts of the wielding of power have discoloured the lens through which the public sees medicine and distorted the view of a profession long associated with healing, humanism and heart. What has been buried in the midst of this discourse are positive accounts of power where the yielding of power is encouraging, empathetic and empowering. This article offers three personal vignettes illustrating the ability of power to positively affect lives in the practice of medicine, for patients and doctors alike. More of these stories are needed to uplift and rebalance the conversation on physician power and how it can be used for good. It is necessary to provide a narrative framework of what it looks like to be a healer and a humanistic doctor to satisfy the general public through a commitment to cultivate multidimensional future healthcare providers.

The full article can be downloaded below.  

Population Health Vs. Personalized Medicine: Lost In Translation?

Evidence-based medicine, it seems commonsensical; who could argue about using the best evidence available to make treatment decisions? The difficulty, of course, is that the evidence comes from studies of large populations, often expressed in terms of average responses; and as a clinician, you want to tailor the care to the one member of the population in front of you, your patient. How do you reconcile population-based evidence with the desire for personalized care?

The full article from the American Council on Science and Health can be viewed at this link.  

Primary Care Is Integral To Improving U.S. Healthcare, But Is Falling Further Behind

Judging from healthcare advertisements on the Internet, television, and radio, specialists rule the roost as healthcare providers in the U.S. healthcare system. From orthopedic surgeons to cancer centers to ophthalmologists, it's hard to avoid the onslaught of advertising for specialist care. In the U.S., primary care is not featured nearly as prominently in advertising or the media.

But, increasing primary care access is seen as essential to improving population health. Effective primary care can help reduce emergency room visits and hospitalizations. However, in most U.S. states, primary care spending represents 5%-7% of total healthcare expenditures, which is less than half of the 14% average in Western European countries.

The federal government estimates that approximately 84 million Americans presently lack adequate access to primary care.

The full Forbes article can be viewed at this link.  

Deprescribing: Practical Ways to Support Person-Centred, Evidence-Based Deprescribing

Deprescribing is complex and multifactorial with multiple approaches described in the literature. Internationally, there are guidelines and tools available to aid clinicians and patients to identify and safely withdraw inappropriate medications, post a shared decision-making medicines optimisation review. The increase in available treatments and use of single disease model guidelines have led to a healthcare system geared towards prescribing, with deprescribing often seen as a separate activity. Deprescribing should be seen as part of prescribing, and is a key element in ensuring patients remain on the most appropriate medications at the correct doses for them. Due to the complex nature of polypharmacy, every patient experience and relationship with medications is unique. The individual’s history must be incorporated into a patient-centred medication review, in order for medicines to remain optimal through changes in circumstance and health. Knowledge of the law and appropriate recording is important to ensure consent is adequately gained and recorded in line with processes followed when initiating a medication. In recent years, with the increase in interested clinicians globally, a number of prominent networks have grown, creating crucial links for both research and sharing of good practice.

The full article can be downloaded below.  

Personalized Medicine: The Trend That's Sweeping Health Care

From cloud-based medical imaging platforms to artificial intelligence-powered diagnostics, health care continues to be the epicenter of digital innovations that are geared toward boosting patient care. Personalized medicine is another new wave sweeping health care with the dual objectives of achieving more meaningful patient-to-doctor relations and lowering costs. The lynchpin of this concept is leveraging all clinical, genetic and environmental information of the patient to understand and treat diseases in a more holistic manner.

The full Forbes article can be viewed at this link.