Fixing the Health Care system from the inside out

by Dr. Reese,  http://medinnovationblog.blogspot.com

In my last blog, August 13, “Physicians Moving Towards the Internet; Slowly but Not So Surely,” I expressed the opinion that health care will not be fixed from the “outside” – by IT experts or policy or management wonks outside of medicine who think their software solutions hold the key to improving care and will overcome unwilling, un-enabled, and un-incented doctors who resist change for their own personal gain rather than for the good of the system.

The counter-view is that physicians leaders and innovators may be able to fix the system from the “inside out” by creating solutions within the physician community that are workable, flexible, practical, and acceptable to doctors. One such physician leader is Lyle Berkowitz, MD, a practicing internist and the chief medical information officer for the 120 person Northwestern Memorial medical group in Chicago. Berkowitz, who has an educational background in biomedical engineering, head the recently formed nonprofit Szollosi Healthcare Innovation Program at Northwestern Memorial. He recently returned from a tour of leading health care innovation centers across America.

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From the AATN (aatn.us)Team:

For years JCAHO has been the sole source of “certifying” health care providers and the data JCAHO and the Common Wealth Fund show clearly the JCAHO methods and requirements fail miserably to meet the needs of Health Care Providers

Below is an excerpt from Legal Nurse Consultant (http://legalnurseconsultanttom.com) on their their view of the culture JCAHO has helped create. Additionally, below is the latest score card showing just how much the JCAHO standards have impacted. Source the Commonwealth fund score card for 2008.

First a few questions to ponder.

First, as a health care professional or administrator, you should ask yourself a question, what is out there that goes beyond the “business as usual” of taking part of your budget every three years to hang the JCAHO certificate on your wall and is it adding value to your organization?

The second question is, does it pay or is it really mandated that health care providers be certified to JCAHO?  And how many times will JCAHO change what they feel is meaningful to track?

JCAHO is loosing its long term control of being the ‘experts” in Health Care quality

The Tale of this story continues,

In 2004, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) instituted a major change in their survey methodology. They moved from conducting documentation and plant inspections to observing and following the care rendered to randomly selected patients from start to finish.

Kurt Patton, JCAHO’s executive director of the Hospital Accreditation Program, said on October 18, 2004 that the tracer methodology was going to improve the assessment of healthcare facilities; “After a complex analysis, we determined that tracing a patient’s stay in a facility is real assessment of a hospital organization.” 

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