What the Health!

2 minute read

“I had had two eye surgeries prior to developing a cataract. I was living in a small town and was told by my optometrist during a routine eye exam about the cataract. He stated I would need an eye surgeon who was extremely skilled to operate on that eye. I had no confidence in the two doctors I consulted locally who did not seem qualified.

4 minute read

Working in the field of clinical navigation, I’m excited to see that Telehealth has grown exponentially in the last nine months and its purported effects on the healthcare system are positive. With the easing of regulations and expansion of coverage for telehealth services, physicians are now increasingly able to safely “visit” with their patients. Talk about a major win for a consumer-friendly, modern approach to delivering care!

As exciting as this news is to someone like me (having two small children), I’m in a quandary about how healthcare quality can be maintained in this new landscape when it’s been a significant endemic challenge to our healthcare system even prior to the pandemic.

“I was twenty-seven years old and I was diagnosed with breast cancer… I was clean for 27 years and then, in 2015, I went for my yearly mammogram, and was blindsided by the fact that they said, ‘We think you have cancer again in the other breast.’”

- Michelle M., QualityCare Connect Member

Part 2 – Healthcare cannot be High Performance without quality-based physician-patient matching

So how do we get to true quality transparency that takes into account access, equity, patient experience and patient safety? It’s Quadruple Aim - the hard way. It may not be in my lifetime when we will wrangle real quality data out of providers, but keep in mind that the audience for this data must understand risk adjustment, facility characteristics and the fact that medicine is messy by nature and bad things happen to the best doctors. Fortunately, CMS is penalizing hospitals for readmissions and you don’t see as many mishaps in the operating room after Atul Gawande’s Checklist Manifesto became infused into common practice for surgery. But quality needs to be recognized as paramount when matching patients with physicians.

Part 1 – Employers are embracing High Performance Healthcare, but what is it?

In 2017, the Joint Commission Journal on Quality and Patient Safety published a paper attempting to define a High-Performance Healthcare System[1] by surveying published literature on the subject. They didn’t come up with a consistent definition, but reported that articles they reviewed cited these criteria: quality (93% of articles), cost (67%), access (35%), equity (26%), patient experience (21%) and patient safety (18%).

Your QualityCare Connect Care Navigators always consider your preferences and call each doctor's office before recommending them to make sure they take your insurance, are accepting new patients and fit your specific needs. Now we ask physicians' offices if they support Telehealth for first and subsequents visits.

The term “Software-as-a-Service” popularized the use of …as-a-Service. It went beyond describing the “Intel-inside” – the technology, but also implied services wrapped around technology - the human element of managing the software – backing it up, applying system updates, troubleshooting and fixing bugs, etc.

3 minute read

It might be the year 2020, but when it comes to getting the right healthcare, gender equality hasn’t quite evolved yet. We haven’t been able to reduce the occurrence of healthcare errors, misdiagnoses and wasted spending either.

3 minute read

Friends who know I work in the healthcare industry often reach out to me with stories about their medical misfortunes and sometimes ask for help. An otherwise healthy friend – Stephanie - recently relayed a story to me about intermittent numbness in her arm which got to the point where it started waking her up at night and turned into her self-navigating down a rabbit hole in healthcare.

3 minute read

It’s 2019. Technology is everywhere. Information is everywhere. So, it should be really easy to find a doctor when you need one. Right? Nope. Unfortunately, many consumers of healthcare don’t even know what the “right” doctor looks like, even though they may think they do. This is not saying people aren’t intelligent. The reality is that navigating the healthcare system is like navigating a mine field whether you have a 6^th grade education or you’re a PhD.