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.

 

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%).

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.

1 minute read

Medicare Advantage is a large growth area where revenue opportunity abounds. Wondering what may be keeping your organization from achieving success with Medicare Advantage STAR ratings? It’s your member experience, starting with how your members access quality healthcare.

1 minute read

Dr. David Shulkin began sharing his skills and talents with our team recently. One of many fascinating facts that surfaced about him is that he started a company more than 20 years ago called DoctorQuality with the mission of doing virtually the same thing that we are – defining quality at the provider level to facilitate value-based care (VBC).

3 minute read

Can Emotional AI rescue us from the imminent invasion of zombie bots!?

Every time I have a hallway conversation with Bharath (we call him “SuperB”), I wish I had a recorder because nearly every exchange could be a blog post.