Last month, the Association of Health Care Journalists (AHCJ), with funding from the Patient-Centered Outcomes Research Institute (PCORI), offered the AHCJ Fellowship on Comparative Effectiveness Research. A group of 12 health care journalists from around the country spent four days in Washington DC at the PCORI offices getting a “crash course” in comparative effectiveness research (CER) and how it can be used to improve health and health care.
Read more about the value of unbiased health care journalism
The third and final population we need to look at when we design patient engagement strategies is the caregiver. Surprised? Yes, they are the wild card in patient engagement. Who are they? Chances are you are one of them.
Read more about why convenience is important to caregivers
Managing the financial mix of patient populations in hospitals or clinics is a bit of science and a bit of an art. Today’s insured may be tomorrow’s at-risk or value-based-payment patient or member. The changes in reimbursement highlight the need for providers to retain patients or members for longer-term relationships versus the episodic care model of the past. These relationships will help promote efficiency in operations as well as financial and quality outcomes. Providers who build strong relationships, customer loyalty, and care coordination will be able to retain patients regardless of the fluid status of each individual’s financial relationship. Financial stability will come from providing appropriate levels of care to each individual.
Read more about the key to retaining your insured population
October 18–24, 2015, is RightCare Action Week, a grassroots initiative of the Lown Institute, a nonprofit think tank, built on taking action to remind patients and health care professionals of “what good medical care can and should be.” Throughout the week, people across the country will take action to show what better health care—“right care”—looks like.
Read more about showing what better health care looks like
I attended the 6th annual Wennberg International Collaborative (WIC) Fall Research Meeting in London September 2–4, 2015. This invitation-only meeting is a collaboration between The Dartmouth Institute (TDI) and the London School of Economics and Political Science (LSE). The WIC is a research network committed to improving health care by examining organizational and regional variation in health care resources, utilization, and outcomes. The goal of the collaboration is to better understand the causes and consequences of unwarranted variation—that is, variation in health care not explained by differences in population needs or preferences—around the world, leading to clinical improvement and policy change.
Read more about an international conference on unwarranted variation
A significant challenge in serving the Medicare population is how to provide quality care while still ensuring financial stability and growth. Looking at the current state of health systems, overall they run a pretty modest profit margin of 6.5%. Overall occupancy rate is 61%, but the majority of that percentage is Medicare patients. This group of patients runs about a -5.4% margin and holds a disproportionate share of the occupied beds in the health system per hospital. What this means is that Medicare patients, whose numbers are increasing, must be managed effectively.
Read more about why efficiency is important for managing your Medicare population
Every other year, members of the shared-decision-making community gather in a different hub of the world to discuss the evolution of patients and providers engaging in a collaborative conversation around health care decisions. This July, the gathering was quite the landmark event as shared decision making and evidence-based practice united at the first joint International Shared Decision-Making/International Society for Evidence-Based Health Care (ISDM/ISEHC) Conference in Sydney, Australia. Over 300 people from around the globe met at the University of Sydney July 19–22 to share knowledge and inspire action to improve the entire care experience.
Read more about the 2015 International Shared Decision Making (ISDM) conference
The following exchange is a conversation between Patty Skolnik and Michael Barry regarding the current controversy about physicians’ maintenance of their licensure and certification.
Read more about the controversy regarding physicians' maintenance of certification
In a 2012 report for The King’s Fund, Foundation cofounder Al Mulley and colleagues described the problem of misdiagnosis of patients’ preferences. “Preference misdiagnosis” may be the most common form of medical error in health care. It can occur when a person has more than one medically reasonable course of action open to him or her. A clinician, sometimes supported by recommendations from clinical practice guidelines, may prescribe or withhold a treatment based on what the evidence best supports and what he or she thinks the patient would want. However, research shows that among fully informed patients who understand a certain treatment’s possible benefits and risks, some would want that prescribed treatment, and some would not want that treatment prescribed. While there is evidence that preference misdiagnosis occurs, its epidemiology and solutions have not been well described.
Read more about how we hope to study preference misdiagnosis for low bone mass
Last week we considered what a “better” decision means and how we can evaluate whether decision aids (DAs) are positively affecting decisions themselves. We’ve also looked at evaluating the effects of DA exposure on the decision-making process and whether DAs were disseminated to the right people. The study designs needed to collect this data vary, and no one study is going to collect data addressing all of these important evaluative questions. However, we very much need more quality data on when and how using DAs affects patient care, and we should try to take advantage of every opportunity to collect good evaluation data when DAs are introduced into a new setting. There are three elements to think about when considering the collection of evaluation data.
Read more about how to improve the evaluation and impact of decision aids