Medicare recently delayed a plan to issue a simple “star” rating of individual hospitals’ care after 60 senators and 225 House members signed letters supported by major industry groups that questioned Medicare’s methodology.
Rick Pollack, president and chief executive officer of the American Hospital Association (AHA), hailed the hiatus and pledged to make ratings more “useful and helpful for patients.” Perhaps. But while a summary grade for care quality has never fit hospitals—where the orthopedists could have a leg up on competitors, while the cardiac surgeons’ results are disheartening—it’s also true that hospitals have consistently fought attempts at transparency. Over an astonishing stretch of almost 100 years, they’ve done so crudely (burning the results of the first national quality survey in a hotel furnace to keep them from the press), through the courts (suing to prevent release of infection data), and using political clout.
In 2011 and 2012 I wrote about the increasing problem of 
Physicians well know the rapid advance of information technology in medicine over the last decade. Pushed by federal and state regulations and requirements, the adoption of electronic medical records has been swift. Today, some 90 percent of physicians in Massachusetts use some form of electronic medical records.
At Health Datapalooza, we heard plenty about the importance of addressing the myriad information needs health care consumers have – when choosing plans and providers, receiving care, or trying to become more engaged in their own health. Therefore it seems fitting to follow the ‘palooza with an update on this year’s RWJF challenge program and introduce the next for 2017.
With healthcare mergers now announced seemingly every week, I’ve been giving some thought to scale: How big can/ should health systems be?
Hospital administrators are finding that true continuous quality improvement (CQI) requires a radical change in thinking. 
