The Collaborative Forum

Right before Christmas, Atul Gawande, a surgeon at Brigham and Women’s Hospital in Boston and a prolific writer at The New Yorker who writes about the problems and challenges of modern medicine, published a book titled The Checklist Manifesto–How to get things right.

The gist of the book is that by employing simple checklists in hospitals, procedures are performed with fewer complications and patients get healthier. Gawande has been making the rounds on The Daily Show, PBS’ News Hour with Jim Lehrer, NPR and other media outlets promoting his book and discussing the remarkable success checklists can produce. Read the rest of this entry →

Clearly, the need to reduce healthcare costs without affecting the quality of healthcare delivered is at the center of our country’s healthcare debate.  However, a recent BusinessWeek article of February 4, 2010, by Chad Terhune and Arlene Weintraub, makes the mistake of lumping together all disease management programs and then goes on to cite examples in which particular programs have demonstrated no cost-savings nor any apparent increase in the health of patients. 

That is not, however, true of all programs that aim to manage chronic disease and demonstrate reduced costs.

As a cardiologist and CEO of Pharos Innovations, a company that focuses on managing chronic disease while demonstrating real reductions in avoidable hospital admissions and overall healthcare costs for Medicaid, Medicare, the VA, commercial health plans and provider systems, I think it’s important to set the record straight. There ARE well-proven ways to reduce costs AND keep patients healthier. Read the rest of this entry →

Just a few weeks ago, the American Heart Association (AHA) released a scientific statement, State of the Science: Promoting Self-Care in Persons with Heart Failure: A Scientific Statement from the American Heart Association, that discusses the importance of patient self-care (PSC) and provides evidence-based recommendations to clinicians to promote self-care in their heart failure (HF) patients. The AHA placed significant emphasis on teaching patients how to recognize condition symptoms and what to do with that information, how to make appropriate behavior changes and the importance of transitions of care and depression screening.  In addition, the statement acknowledged that systems of care, such as care coordination and telehealth, hold promise for improving the self-care abilities of persons with HF.

Clearly, this set of recommendations resonates with us at Pharos Innovations. These recommendations are directly aligned with the paradigm of physician- and patient-centric care coordination that we created with Tel-Assurance^®.  The AHA recommendations are all about accountability: the patient’s as well as the physician’s. Accountability brings better results with healthier patients and reduced hospital readmission rates—both which on the face of it, are great things.

Unfortunately, our healthcare delivery system, as currently designed, is not set up to maximize patient and physician accountability. Specifically, in the way healthcare providers are currently incented for the quantity of care, not the quality. The good news is that this is changing. Read the rest of this entry →