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Union demands ‘quality care’

The members of Service Employees International Union Local 250 in San Jose, Calif., will “rally for quality care and jobs” on Thursday at 11 a.m. PDT at O’Connor Hospital in San Jose and three other Daughters of Charity Health System hospitals in the Bay Area.

According to a press release, union workers from O’Connor, St. Louise Regional Hospital in Gilroy, Calif., Seton Medical Center in Daly City, Calif., and Seton Medical Center Coastside in Moss Beach, Calif., will gather outside each hospital to ask Daughters of Charity to “institute the same patient care and job standards at their facility as have been put in place at Kaiser [Permanente] and Catholic Healthcare West‘s California hospitals.”

The union wants “a set of common-sense solutions that include an education and training fund for hospital employees, improved retirement benefits and other important issues that would improve the quality of patient care and jobs at California hospitals” as a means of reducing staff turnover, improving recruitment and alleviating understaffing.

“If a hospital corporation wants to provide quality care, they have to retain dedicated staff and be interested in training and developing the staff they do have. Catholic Healthcare West and Kaiser Permanente have contracts that encourage quality employees to stick around, and it’s time for the Daughters of Charity to make those same improvements to job standards and patient care,” O’Connor obstetrical technician Tracey Garges says in the press release.

Naturally, the union is trying to protect jobs and perhaps recruit a few more members, but it will be interesting to hear if anyone will mention better information technology as a safety tool at any of the rallies.

Kaiser is in the second year of a three-year, $2 billion project to bring full inpatient and outpatient electronic health records, clinical decision support and online patient-clinician communication to its 12,000 physicians and 8.4 million enrollees in nine states. The system is up and running in Hawaii now, but has not reached California, where Kaiser runs the two largest group practices in America.

San Francisco-based CHW announced in February that it would spend $137 million on patient safety-related technology in its 41 hospitals during the next seven years.

Although the union does not mention it, another massive Northern California health system, Sutter Health is ponying up a cool $1.2 billion over 10 years for clinical IT.

Could it be that the rank-and-file workers in the Daughters of Charity facilities want the same type of technology? Where does the medical staff stand on this issue? I will be watching this story carefully.

June 30, 2004 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

An alternate view

My June 21 iHealthBeat column was critical of the AMA on the issue of information technology. The American College of Physicians took issue with my characterization of the “medical establishment,” although I did not mention that organization anywhere in the column. My column was limited to the AMA.

Regardless, in the interest of promoting a range of opinions, here is what ACP Senior Vice President and Washington lobbyist Bob Doherty had to say:

Contrary to your assertion that “the medical establishment has not gotten the message” regarding electronic health records (AMA Meeting Leaves IT in the Dust, iHealthBeat, June 21, 2004), some medical organizations are getting the message.

The American College of Physicians (ACP) has taken a leadership role in advocating for the adoption of health information technology (HIT).

In the past year ACP has released several papers regarding the use of information technology in medical practices. Including The Changing Face of Ambulatory Medicine — Reimbursing Physicians for Computer-Based Care (http://www.acponline.org/hpp/e-consult.htm), The Paperless Medical Office: Digital Technology’s Potential for the Internist (http://www.acponline.org/hpp/paperless.htm), and Enhancing the Quality of Patient Care Through Interoperable Exchange of Electronic Healthcare Information (http://www.acponline.org/hpp/quality_care.pdf).

ACP has also developed a highly regarded clinical decision support (CDS) tool, the Physicians’ Information and Education Resource (PIER) (http://pier.acponline.org/index.html?hp). PIER aids physicians in the diagnosis and treatment of hundreds of conditions and also offers educational support to patients, with physician-selected print-outs available at the push of a button. ACP believes that PIER’s CDS software could be easily integrated with EHRs to improve the quality of patient care.

And, finally ACP has been influential in many federal regulations regarding HIT. Patricia L. Hale, MD, the chair of ACP’s Medical Informatics Subcommittee, has testified on the e-prescribing standards to the National Committee on Vital and Health Statistics. Regarding the use of information technology in the Medicare Chronic Care Improvement Program, Dr. Hale has testified, and ACP has submitted comments to CMS. ACP has also drafted language for a bill to amend Title XI of the Social Security Act to achieve a national health information infrastructure.

As you can see from the above ACP is a leader in shaping policy, educating physicians, and developing practical tools to advance the use of HIT.

I welcome further comments on this issue at nversel@rcn.com. – NV

June 29, 2004 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Belated NAHIT report

In case you didn’t notice, I never did post any updates from the AMA or NAHIT conferences last week. My iHealthBeat column covered my thoughts from the AMA. (See previous post.)

National health IT czar Dr. David Brailer keynoted at the NAHIT meeting. He again touted the power of the free markets, but said that it is “appropriate for the government to lead when private efforts are insufficient.”

Brailer called his office “traffic cop” for all health IT efforts within the federal government, which includes the Consolidated Health Informatics initiative, the National Health Information Infrastructure project and collaborations between the public and private sectors.

He will unveil his strategic plan for national IT implementation on July 21 at the second national NHII conference in Washington.

Brailer did offer a few hints of the plan. Some elements his office is considering include supporting technology at the point of care, interoperability and determining how to invest in technology so patients can reap the benefits.

Brailer acknowledged that private entities “are trying to take their cues from Washington,” but all but ruled out any mandates along the lines of HIPAA.

“This is a call to arms for the private sector,” Brailer said.

He said that the case for quality already has been made, so he is turning his attention toward the business case from the perspectives of the healthcare enterprise, the payer and society as a whole.

“No one has looked at the returns on investment of healthcare IT in terms of its impact on other industries,” Brailer said in a post-speech press conference. He suggested that health plans should look at improved productivity and a decline in lost work days for their customers, better known as employers.

The other NAHIT keynote came from a Washington-based AARP lobbyist, who made broad, soundbite-friendly pronouncements like: “AARP does support the potential of IT to improve the quality of healthcare.”

But he offered no specifics, even when pressed by certain reporter types. The organization, which was front and center in the debate over the much-maligned Medicare drug benefit adopted last year, has not taken a stand on legislation to fund the cost of health IT.

A NAHIT publicist explained that AARP joined the alliance about a year ago as a means of educating its leadership about this issue. Clearly, they have a lot more learning to do.

June 23, 2004 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Tooting my own horn

The second of my two iHealthBeat columns ran Monday and Tuesday. I criticize the AMA for ignoring how technology can help address the problem of high malpractice premiums by assuring quality and preventing medical errors. The annual House of Delegates meeting was all lawyer-bashing all the time.

Click here to read my column.

So far, I have not gotten any hate mail. :)

Also, I have changed some of the links in the right-hand column.

I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

I try to stay informed politically, though I prefer not to get political in my writing, lest I lose my objectivity.

A recent development may cause me to reconsider.

I have watched with great interest the apparent transformation of former House Speaker Newt Gingrich from bombastic leader of the 1994 Republican Revolution and unabashed foe of all things government-centric and all things Clinton into the Newt for the New Millennium, champion of a partially government-funded national health information technology infrastructure and yes, supporter of ideas advanced by Sen. Hillary Clinton.

Just last week, Gingrich and his Washington-based Center for Health Transformation kicked off their latest project, dubbed the Interoperable Health Information Technology Initiative.

The Center for Health Transformation will expound on its ideas Tuesday at a forum it is hosting at the tony Willard InterContinental Hotel, kitty-corner from the White House.

Among the very lofty goals of this initiative is to assure that the benchmark physicals that will begin in January 2005 for all new Medicare enrollees will be electronic. Every last one of them. Starting seven months from now.

In case anyone had forgotten, Medicare is a federally funded program. The slow pace of change in the federal government notwithstanding, didn’t Gingrich used to be the loudest drum-beater for small government when he swept to power a decade ago?

Am I the only one who is incredulous at the fact that Gingrich put his proposal out the very same week they buried his ideological godfather, Ronald Reagan?

Newt always did have impeccable timing.

Note: Check this space later this week for updates from the annual AMA House of Delegates and the National Alliance for Health Information Technology meetings, both here in Chicago.

June 13, 2004 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Patient safety for the masses?

I have been a little derelict in blogging recently, so I am going to mention something that has been sitting on my dining table for three weeks and that deserves some attention: The May 23 issue of Parade magazine, the insert that appears in more than 340 newspapers every Sunday.

The lead story that week (though not the cover, which belonged to Harry Potter) focused on how people can prevent medical errors. Part of the headline was the statement, “Almost 100,000 Americans die each year as a result of preventable errors in hospitals,”

Yes, the Institute of Medicine statistic of 44,000 to 98,000 preventable deaths in U.S. hospitals each year, cited so often in the healthcare press since the 1999 publication of “To Err Is Human,” was right there for all of Parade’s estimated 79.9 million readers to see.

Author Tom Clavin leads with the story of Jesica Santillán, the 17-year-old from Mexico who died at Duke University Medical Center last year following a botched heart-lung transplant. That incident had the attention of national media for weeks and still resonates with the general public.

Clavin goes on to explain why medical errors happen and how one mistake can lead to numerous complications and long-term health problems. The story talks about error prevention through error reporting, better patient education and, yes, the use of technology, including electronic medical records and computerized physician order entry.

In a sidebar, Parade health editor Dr. Isadore Rosenfeld offers some tips for patients to protect themselves. Another Web-only addendum mentions the Agency for Healthcare Research and Quality and the Leapfrog Group, two entities that, I imagine, 99% or more of the public have never heard of.

Hopefully now, more will be aware of the importance of protecting one’s own safety when navigating the healthcare system. Pass this link around: http://archive.parade.com/2004/0523/0523_protect_yourself.html.

I have a few other recent developments to comment on, but I’ll write those separately so they do not get buried at the bottom of this entry.

June 11, 2004 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.