The Health Care Blog – Page 413 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

The Health Care Handbook: Medical Malpractice

Jul 8, 2015• 4

By ASKIN, MOORE & YAGI

Aaron Carroll, “Meme-busting: Tort reform = cost control,” June 2011. Used with permission.

Patients who believe they have been injured in some way by a health care provider can file a medical malpractice claim. To prove malpractice, the patient must show that the injury was caused by the provider’s negligence, meaning that he or she didn’t practice medicine consistent with the accepted medico–legal standard of care.

If a patient wins a case or a favorable settlement, the health care provider, through insurance, may have to compensate the patient for loss of income due to injury and for noneconomic losses, such as pain and suffering. Although most malpractice claims are made against physicians, claims can be brought against any health care provider, including students. To protect against the financial risk of future malpractice lawsuits, most physicians purchase malpractice insurance. Hospitals and health care networks often purchase insurance for their employees, while independent physicians typically purchase their own policies.

Medical malpractice serves two goals: (1) to compensate victims of poor medical care, and (2) to encourage safe and responsible medical practice. Our current system is designed to accomplish both by punishing negligent providers through the court system (called “torts”). Some question whether it wouldn’t be better to handle each goal separately, and to focus on the system rather than on individuals.

The Feminization of Health Care

Jul 7, 2015• 6

By AMY COMPTON-PHILLIPS, MD

Historically, health care providers and health care leaders have been selected for and nurtured traits that are traditionally seen as “masculine” – traits such as heroism, independence, and competition. Yet it is clear that as people live longer with more complex conditions, the more traditionally “feminine” traits of interdependence, empathy, and networking become more important. Even in the most technically challenging health care event, the outcome for the patient is determined by a team.

A successful outcome for surgery on a brain tumor requires the heroic hands of a neurosurgeon, along with the primary care diagnostician, the radiologist, nurses, physical and occupational therapists, oncologists, radiation oncologists, the spouse, children, home health aides, friends, neighbors, and the list goes on. It truly takes a village to create a healing environment around individuals with complex conditions.

A lone hero is a lonely voice. A highly coordinated, synchronized team of participants working in concert with the goals, desires, and wishes of the patient and family create the symphony.

Building a Corporate Venture Group That Matters

Jul 7, 2015

By BILL TARANTO

“Um…Who are you, and why are you in my office?”

This was the verbatim greeting we received from respected Sand Hill Road investors when we first introduced Merck’s Global Health Innovation Fund (GHI) in 2010. However, since that time we’ve come a long way. By investing in digital health, we’ve grown from a $125M venture fund to a $500M venture fund and have added a growth equity fund with M&A capabilities.

Today, these same investors remember our name and co-invest with us.

So how did we get here? Certainly timing, luck and sponsorship are critical to anything done in a corporate environment. Acting as a strategic and financial investor has also helped to earn the trust of entrepreneurs and fellow investors. And, building a great team has been critical; but these are fairly obvious steps.

There are three other strategic maxims we found to be mandatory in building a corporate unit that’s successful.

HIT Newser: CMS & AMA Agree to be Odd ICD-10 Bedfellows

Jul 7, 2015

By MICHELLE RONAN NOTEBOOM

CMS agrees to first-year flexibility in ICD-10 claims processing

CMS releases guidance that will allow for flexibility in the claims auditing and quality reporting process for the new ICD-10 codeset. CMS will keep the October 1 deadline for the transition, but adopt four AMA-proposed steps that include: an agreement that claims lacking specificity will not be denied; an easing of quality reporting and other penalties due to improper coding; an agreement to authorize advance payments to physicians if contractors are unable to process claims; and, the addition of an ICD-10 Ombudman to navigate transition problems.

CMS seemingly recognized that unless some concessions were made, the AMA and other ICD-10 critics would continue to fight for another delay. Maybe now everyone will stay focused and get ready for the inevitable.

HealthStream CEO shares his wealth with employees

HealthStream CEO Bobby Frist gives about 600 of his employees $1.5 million of his personal stock. All of the employees are non-executives and will be given stock that is worth between $300 and $10,000, depending on the employees’ tenure and role.

Frist gets my vote for boss of the year. What a way to boost employee morale and build loyalty.Continue reading…

Yes, Expand Medicaid!

Jul 6, 2015• 4

By STEVE FINDLAY

President Obama was right last week to pivot to two things in the wake of the Supreme Court’s Affordable Care Act (ACA) decision: (a) a plea to Republicans (yet again) to please, pretty please drop their opposition to the law and join him in tweaking it and fixing what remains broken in healthcare, and (b) Medicaid expansion.

It’s probably too much to hope Republicans will drop their fierce attempts to trash, dismember or repeal the law—as the political season leading to the Nov. 2016 elections gets underway in earnest. But Medicaid expansion could prove a fruitful path to concrete results.

As a reminder, the 2012 Supreme Court decision on the ACA nullified the law’s provision compelling states to expand Medicaid. Instead, it made such expansion voluntary. Continue reading…

Stealing a Page From Medicine’s Playbook: The American Board of Baseball

Jul 5, 2015• 2

By RICHARD GUNDERMAN, MD

As kids growing up in the Midwestern United States, my friends and I loved baseball. We spent many hours each summer day playing the game, and when we weren’t out on the sandlot, we were reciting the stats of top players, arguing the merits of our favorite teams, and trading baseball cards. Baseball is more than America’s pastime. It is a sport on which millions of Americans have cut their athletic teeth, laying a lifelong foundation of physical fitness and instilling important lessons about competition and character.

Imagine my distress, then, in beholding the state of major league baseball in 2015. Stalwart players such as Carlos Gonzalez of the Rockies and Robinson Cano of the Mariners have been posting career-worst numbers, and even a venerable team such as the Boston Red Sox, which boasts the fourth-highest payroll in all of baseball, is stuck in last place in its division. And this problem of poor performance is not a fleeting phenomenon. Consider the Chicago Cubs, who have the worst home field record of any team over the last 50 years, and haven’t won a World Series since 1908.

Clearly, the best interests of our youth, the American public, and baseball fans everywhere are not being well served by our current largely unregulated approach to baseball quality. Poorly performing players are appearing in game after game, and losing teams keep showing up on opening day season after season. This isn’t just a matter of pride. The economic implications of Major League Baseball are huge – the Los Angeles Dodgers have a payroll of nearly $300 million, and the New York Yankees franchise has an estimated worth of over $3 billion. Something has to change.

Are Charts Dead?

Jul 4, 2015

By THCBIST

If flying an airplane without cockpit instruments is equivalent to having no data about healthcare delivery, then flying an airplane with an overwhelmingly complex cockpit data environment is probably just as dangerous.

In this compelling webinar (Online, Tues July 7th, 2-3 PM) you’ll learn strategies that will let you visually present data in the most powerful, attention-getting ways possible – giving you the tools to reach patients, clients and colleagues.

Learn the common mistakes that can confuse users, detract from your presentation and ultimately put quality care and patients at risk.

A Declaration of Data Independence Through the Lens of the Patient

Jul 3, 2015• 8

By BRIAN AHIER

This weekend is not only independence day in the US, it’s the culmination of a patient-led uprising to demand that providers hand over their medical data. To that end I & THCB are supporting Health Data Independence Day. Sign the petition at GetMyHealthData.org and please use and encourage others to use the free tool from the associated Vocatus Project to request your data from your doctors and hospitals. I’ll be taking up the cudgels in the continuing story of my son’s “Search for Intr-Aero-Bili-Ty” but for now we’re thrilled to publish this amazing piece from Health IT expert and very recent cardiac patient, Brian Ahier–Matthew Holt
Screen Shot 2015-07-03 at 4.48.19 PM

Data Liberación is our battle cry…

Six years ago I wrote a blog on Independence Day. In 1776 the 56 citizens of the 13 British colonies signed their names to a document declaring that the King was abusing the colonies and violating the basic principles of human decency bestowed by God. So they declared independence from Great Britain and birthed the United States of America.

Abraham Lincoln said in a speech during his Senate race against Stephen A. Douglas of the Declaration of Independence, “This was their majestic interpretation of the economy of the Universe. This was their lofty, and wise, and noble understanding of the justice of the Creator to His creatures.”

We are blessed to live in the greatest country in the world. We have had many struggles and challenges and have had to to overcome the sins of the past, but the Founders wisely put in place a constitutional framework that allows for transformation changes to occur, generally without bloodshed. The Republic is alive and well and actually improves every generation. I wish all of you a peaceful, safe, and joyous Fourth of July celebrating with family, friends, and neighbors. I also hope that you will participate in the first Data Independence Day.

It’s a Bird. It’s a Plane. No, It’s SCOTUS!!

Jul 2, 2015• 16

By SAURABH JHA, MD

In a 6:3 decision, SCOTUS rescued Obamacare once again. Obamacare, untouched by Donald Trump and the Anti-Death Panelists, was almost brought to its knees by a single word; a lowly, miserable, reclusive preposition – “by”.

A brief summary.

Obamacare helps low income families buy health insurance through subsidies doled out by the Internal Revenue Service (IRS). Health insurance is sold at online marketplaces called exchanges. The online exchanges have been created by the state or the federal government. The statutes say that subsidies are available for insurance bought “through an exchange established by the state.”

The plaintiffs in King v. Burwell alleged that the IRS was illegally subsidizing people in over thirty states where the federal government, not the state, established the online exchanges.

The administration claimed that the subsidies applied in all states. That the language was admittedly sloppy and “by the state” also meant “by the federal government.” The country is now so polarized that even prepositions must take sides.

The ABIM Controversy: A Brief History of Board Certification and MOC

Jul 2, 2015• 13

By ROBERT WACHTER, MD

What’s up with the ABIM?” “I just got a note about an alternative board. Should I join it?” “Aren’t you glad to be off the Board?”

These days, I get these questions from friends and colleagues regularly. When I first joined the board of directors of the American Board of Internal Medicine (ABIM) in 2004, the organization was a well-respected pillar of American medicine. Today the organization finds itself in a fight for its life, being painted as everything from out of touch to money-hungry to, more recently, corrupt.

I just completed my decade-long service to the ABIM and, more recently, the ABIM Foundation. I’ve waited until now to write this because I wanted to be clear that I am not speaking for ABIM or its leadership. I am also well aware that there is a vocal group of critics who feel passionately about this matter, whose minds are made up, and who are approaching this fight with a take-no-prisoners zeal. By adding my voice, I am likely to become a target for their anger.

So be it. With the help of social media and a journalist who has turned this matter into a cause célèbre with an unfortunate mixture of half-truths and innuendo, the critics have managed to control the debate, and people who believe in the values of the Board have been cowed into silence. It feels vaguely McCarthyish, and there comes a time when silence is immoral. This feels like such a time.Continue reading…