Category Archives: Quality

Have Mergers and Acquisitions among Hospitals Improved Our Lot?

While Merger and Acquisition activity in health care has increased, the rationale for these activities seem to have little effect on improving the delivery of health care itself. Continue reading

Posted in Affordable Care Act, Competition, Leadership, Operational effectiveness, Quality | Leave a comment

A Follow-up on the Autopsy

This follow up on the Autopsy has data and suggestions for returning the autopsy to a significant role in medical education (both initial and continuing education of physicians and all other health professionals). Pathologists have reported autopsy findings since before … Continue reading

Posted in General Interest, Policy, Quality, Quality in Medicine | Tagged , , , | 1 Comment

A Tale of Three Autopsies

The autopsy, which has largely been ignored has helped families and physicians some of the deceased. Three stories demonstrate how the autopsy made a difference. This is the first of two posts on the autopsy. Continue reading

Posted in Autopsy in Medical quality, Policy, Quality, Quality in Medicine | 1 Comment

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

Posted in effectiveness/efficacy, General Interest, Guidelines, Quality, Quality in Medicine, treatment options | 2 Comments

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

Posted in General Interest, Policy, Quality | Tagged , | 4 Comments

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

Posted in General Interest, Policy, Quality, treatment options | 2 Comments

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

Posted in effectiveness/efficacy, General Interest, Quality, treatment options | 2 Comments

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

Posted in General Interest, Operational effectiveness, Policy, Quality | Tagged , , | 3 Comments