Category Archives: Quality

Does Insurance oversight of clinical practice improve either quality of care, or patient outcomes?

When outside oversight, based solely on published guidelines, interferes with clinical care there are potentially multiple adverse outcomes, including physician and patient frustration, waste of time and interference with delivery of optimal care. There should be ways for insurers to use their databases to mitigate inefficient and intrusive oversight. Continue reading

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What is Quality in Medicine? – It Isn’t Easy!

The definition of Quality in Medicine is in the eye of the beholder. There are several good paradigms, but they all look at different components of the overall concept. Continue reading

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How Can We Align Incentives As We Move From Volume to Value?

Changing payment for health care from volume to value will be facilitated if the stakeholders keep a close eye on “What’s in it for me” Continue reading

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We have “Information Overload” in Clinical Guidelines.

Guidelines should be useful to the provider of health care. However, there are more guidelines than can be digested by these providers. This may make guidelines less useful than intended. Continue reading

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Diagnosis may be the Achilles Heel of Incentive Based Payment.

“Diagnosis is the mental act of selecting the one explanation most compatible with all the facts of clinical observation”.  – Raymond Adams in Harrison’s Principles of Internal Medicine – 4th edition In almost all instances, Government and other third party … Continue reading

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What is Evidence Based Medicine?

One definition would be: Delivery of Medical Care based on results of best available evidence. This usually means finding or relying upon data, some of which will be from outside one’s immediate memory to help answer a clinical question. EBM … Continue reading

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Providers, Patient Care Delivery and Policy: Hospitalist story

There are often perverse incentives in health care. These incentives can, at times, create competing drives where providers are encouraged to do things that directly increase the costs of care.  Consider the reaction to the mandate to cut down hours … Continue reading

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Why do Physicians Behave the Way They Do?

I believe that the vast majority of physicians do “the right thing” for their patients. I don’t think I’m being a Pollyanna. On the other hand, the “The Tragedy of the Commons”, which describes behavior in many cultures, doesn’t bypass … Continue reading

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Registry Participation will help Develop Alignment and Improve Quality

Many hospitals and hospital systems are trying to ensure that they are satisfying quality metrics to help with accreditation, and to confirm that they are satisfying their mission and providing community benefit. Superior performance in achieving clinical quality may allow … Continue reading

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We should work to Identify Problems rather than try to Fix Blame in Medical Service delivery.

Recently there have been stories of inappropriate cardiac procedures being. There are at least four glaring examples of instances in which cardiologists have acted in a way that was not consistent with what others would have considered optimal patient care. … Continue reading

Posted in CV, Peer Review, Policy, Quality, treatment options | 3 Comments