To Combat Physician Burnout and Improve Care, Fix the Electronic Health Record
Fix the EHR! The so-called Electronic Health Record has become a major source of professional dissatisfaction in healthcare. With Dr. Robert Wachter, Chair of Medicine at the University of California at San Francisco and author of Digital Doctors, Jeff discusses what has gone wrong with the design of this complex tool, and lays out the major changes that need to be made in EHRs for them to achieve their potential in improving both care and the patient experience.
5 Ways U.S. Hospitals Can Handle Financial Losses from Medicare Patients
What to Do About Hospitals’ Medicare Financial Losses. This Harvard Business Review blog posting is a follow up to the October blog, and explores why losses in treating Medicare patients have soared (to more than triple the losses from Medicaid patients!), and how hospitals can work with their clinicians to improve care processes, eliminate needless variation in use of the hospital’s services and reduce those losses.
How U.S. Hospitals and Health Systems Can Reverse Their Sliding Financial Performance
What Hospitals Can Do to Reverse their Sliding Financial Performance. This Harvard Business Review blog posting examine the causes of the sharp deterioration in hospital operating earnings during 2016 and early 2017, and outlines essential strategies managements should pursue to reverse those declines.
Confessions of a Healthcare Super User
Confessions of a SuperUser This posting explores what Jeff Goldsmith learned about the health system he has worked in for over forty years as a patient. It examines his experience of five complex surgical episodes in four different health systems, and how theories of how the health system works match up against the patient experience.
Guest commentary: To profit from uncertainty, health enterprises must become anti-fragile
To Profit from Uncertainty, Hospitals Must Become Anti-Fragile This Modern Healthcare OpEd discusses Nasim Taleb’s book Anti-Fragile: Things that Gain from Disorder and its relevance to healthcare management. In particular, health systems actually become more difficult to manage and their business risks increase as they become larger, and diversify into unrelated businesses. How hospital managements can manage uncertainty is an increasing challenge as the industry consolidates.
Geisinger’s Transformation: Balancing Growth And Risk
Geisinger’s Transformation: Balancing Risk and Growth This posting in Health Affairs blog examines the unconventional turnaround Strategy which Glenn Steele pursued as CEO of the Geisinger Health System that led both to financial success and a remarkable clinical transformation that made Geisinger one of the national leaders in healthcare redesign.
Fail to Scale: Why Great Ideas In Healthcare Don’t Thrive Everywhere
Fail to Scale In winemaking, some wines only grow in highly defined localities. The concept is terroir. In US health policy, multiple examples of the same phenomenon exist: Kaiser, physician sponsored independent practice associations, hospital system sponsored health plans thrive in some parts of the US and wither in others. Why is this? Why do great ideas in healthcare repeatedly fail to scale up nationally? Read Fail to Scale:
All Risk is Local
All Risk is Local We all knew how this was going to go, or thought we did. Healthcare payment is moving from volume to value, led by the Medicare program’s historic ACO program, and private markets are going to be fundamentally restructured by ObamaCare. Well, it didn’t work out as we expected, and the shift to value is HIGHLY dependent not on the federal government, but rather state Medicaid programs, some of which pay at 65 cents on the dollar relative to cost. Private insurance markets are in turmoil as a result of ACA, and new payment models are taking a back seat to major underwriting losses. What difference does it make? Read All Risk is Local and find out.
The Tangled Hospital-Physician Relationship
The Tangled Hospital Physician Relationship Hospitals have employed tens of thousands of physicians in the past decade, a sixty percent increase from 2003 to 2014. Tens of thousands more depend on hospital subsidies of various kinds. And yet the private practice of medicine is far from dead, as single specialty physician groups increasingly dominate lucrative medical and surgical specialty markets. Power is shifting between hospitals and physicians with the growth in new payment models, but in which direction? How to make sense of this troubled and tangled relationship is discussed in The Tangled Hospital Physician Relationship.
The C Word
The C Word: Why Calling Patients “Consumers” Is an Insulting Caricature: That patients are becoming consumers of healthcare implies both discretionary purchasing power and leverage that, in most real world situations does not accurately reflect either their powerlessness or their priorities. Why we need to find better language to describe the patient role in the health system.