WhiteCoat

Healthcare Update — 04-08-2013

Columbus, OH paper compares hospital wait times from 15 different hospitals throughout central Ohio. Metrics include minutes until diagnostic evaluation, minutes until pain medication, minutes until admission decision, and minutes from admission to room placement. I just wonder how accurate the metrics are. It isn’t like self-reported data like this can’t be manipulated.

Evanston Northwestern Hospital in Chicago suburbs also making news because of its wait times – nearly twice the national average.

The problem with providing patients with insurance: When the insurer cuts payments, what happens if providers won’t take your insurance? Government cuts payments to providers so that it costs more for cancer clinics to provide chemotherapy to some Medicare patients than the government reimburses. To stay afloat, some cancer clinics have now begun turning away Medicare patients needing cancer infusions. Now patients go to hospitals where the charges for cancer treatment are higher and the waits for treatment will likely be longer.
But we’re going to be insured! And we can keep our doctors, too!

Patients gone wild. Two brothers in Lebanon “attack” an emergency department, smashing windows and insulting the doctors and nurses on duty. In other words … a normal day in a typical American emergency department. And their Press Ganey scores probably stink for that day, too.

What a great story. Six year old Long Island kid treated in emergency department raises $275 with a fundraiser and uses the money to buy coloring books for other emergency department children.

Remember how CMS promised to give incentive payments for “meaningful use” of electronic medical records? Not so fast. Rules changing. Now it is doing random audits of 5-10% of all applicants to see whether they should actually get their bonus payments. Self-reporting isn’t good enough any more.
Wouldn’t it be interesting to see what would happen if all providers went back to paper records?

Canadian paramedics visiting patients with “non-urgent” issues to keep them out of emergency departments. The only question I have is who determines whether the issues are “non-urgent”?

A second interesting Medical Economics article. What are the tech trends that will affect how doctors practice medicine in the future? Interesting to consider. Remote patient monitoring. Personal health records with biometric security. Cool stuff.

More than 25% of Oklahoma patients enrolled in Medicaid. Of those, about a quarter used the emergency department a total of 528,000 times at a cost of $170 million. Oklahoma is now trying to determine how to deal with the high utilizers – those who use the ED more than 15 times every 3 months.

Speaking about Oklahoma … Oklahoma Dentistry Board officials are deciding whether to pursue criminal charges against a dentist. Officials found rusty instruments, “potentially contaminated drug vials” and “improper use of a machine designed to sterilize tools” in the dentist’s office.
The Oklahoma Dentistry Board accused the dentist of re-inserting needles in drug vials after their initial use and using the same drug vials on multiple patients. This happens often in medicine. The dentistry board also stated that a sterilization machine hadn’t undergone monthly testing in six years. Concerning, but when the Board officials tested the machine was it not properly sterilizing equipment? They did test the machine, right? Were the rusty instruments used on patients? Where was the rust located – on the handles or on the surfaces that come into contact with patients?
In addition, the dentist allegedly allowed dental assistants to administer IV sedation when only dentists are allowed to perform such acts.
For each charge, the dentist could face up to four years in prison and a $10,000 fine.
Are the alleged actions above worth throwing someone in jail for 8 years over?

Rhode Island emergency department reportedly one of few in country to have an MRI available in the department. Wonder how MRI use at this hospital compares to national averages.

Remember … fast care, quality care, free care – pick any two. Patient upset because she was treated quickly in a freestanding emergency department, but her bill was too high and included a $1,500 “facility fee” typically used by hospitals. Some of those costs to go complying with governmental regulations.

One British Columbia hospital emergency department is in a “state of emergency” due to understaffing and high patient volumes.

Emergency department personnel don’t routinely ask suicidal patients about availability of firearms in the home. Will patients admit to having guns and if so, will intervention make any difference in suicide rates?

Woman with double uterus told not to have any more children due to possibility of dying from complications. Goes for abortion and learns several days later that the abortion was unsuccessful. Instead of going for repeat procedure, keeps pregnancy. Now, after delivering healthy 6 pound girl, woman sues abortion clinic for the pain, suffering, and emotional distress of having undergone an improperly performed abortion.

2 Responses to “Healthcare Update — 04-08-2013”

  1. DefendUSA says:

    WC…I would love that “Paper Only” in terms of that. I know there are many psychiatrists who are paper only and still do SOAP’s with typewriters!! It’s the only way to keep the gov’t out of the physician/patient relationship. It’s not realistic anymore to expect that- given the expedience computers allow but, there are people who want to take things back a few notches and who can blame them?

  2. Aesop says:

    Okay, I know it sounds crazy, but to me, it would seem that the way to keep non-urgent patients out of EDs would be to NOT send the paramedics there. We’ve tried answerring their 9-1-1 calls here, and let’s all recall what Einstein said about the Definition of Insanity.

    But hey, 31 minutes is the nationwide average ED wait time to get seen? What’d they do, average the time for one-bed EDs in Pigknuckle and Hooten Holler with the times for Big City Impacted Diversion ED?
    Why do they make BSNs and MDs take statistics and survey methodology courses, and then not require that level of expertise and common sense from people conducting and promulgating survey results?

    Screw this medical nonsense, I’m opening up a survey shop. I can be full of more crap than a Christmas goose, and wrong more often than the weatherman, and all it does is give me a reason to ask for more money for further irrelevant and idiotic surveys.

    Mark my words, dig to the bottom of this, and you’ll find an ex-DMV employee, a fired disgruntled postal worker, a congressman’s ne’er-do-well nephew, a former S&L CFO, and an idiot savant Rainman whose wicked smart at math, and totally clueless and retarded in life, or all of the above.

Leave a Reply


1 + two =

Popular Authors

  • Greg Henry
  • Rick Bukata
  • Mark Plaster
  • Kevin Klauer
  • Jesse Pines
  • David Newman
  • Rich Levitan
  • Ghazala Sharieff
  • Nicholas Genes
  • Jeannette Wolfe
  • William Sullivan
  • Michael Silverman

Subscribe to EPM