In Healthcare, It’s Not Just What You Say, But How You Say It

Coffee Brown,MD University of New Mexico, for Talk Radio News Service

At a Senate hearing on implementing best patient care practices chaired by Sen. Barbara Mikulski (D-MD), experts testified that lives can be saved by a system to evaluate, disseminate, and promote best practices in healthcare. The panel included four physician researchers known for their work on various aspects of best practices.
Dr. Peter J. Pronovost is credited with saving thousands of lives and millions of dollars at Johns Hopkins by instituting medical checklists modeled after those used by the airline industry. He also endorses public-private systems to adapt product design to reduce healthcare accidents.
Dr. Steven D. Pearson works on measures of effectiveness. He favors reimbursement strategies to promote provider adoption of identified best practices. Regulations, he said, are big and slow to respond to respond to changing science. Motivating doctors through reimbursement gets better results faster, and is easier to adapt to moving targets. He clarified for Mikulski that “comparative outcomes” compares options available, whereas “best practices” compares systems. They are not synonyms and are not managed the same way.
Dr. Donald R. Fischer ,Chief Medical Officer for Blue Cross Blue Shield, said data show that preventive employee health, promoting healthy practices through the workplace, returns more money than it costs. In the example he cited, about $1.64 was saved or returned for each dollar spent.
A striking case for using new technology for preventive medicine was presented by Dr. Jeff Gulcher, who had unsuspected cancer detected and treated early because of a new genetic screening test. He had no suggestive family history, and neither do a lot of other people with significant genetic risk, he said. Genomic testing will help to individualize both prevention and treatment strategies.
All four physicians agreed that NIH should dedicate at least five percent of its budget to the study of the healthcare delivery system itself, as opposed to medical research per se’.

 

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