I’m currently working in the hospital where I was born, on both coasts of Florida and both coasts of New Jersey. Okay, New Jersey doesn’t have a west coast, but I’m working both sides of that state as well. Don’t get me wrong,, it’s not the New York City/Philadelphia sides of New Jersey, it’s the Jersey Shore/Mountain sides of Jersey. Here’s what’s happening: In Florida, we’re working on establishing a tissue repository that will provide tissue to the Department of Defense project that we helped birth back in 2001. We’re also looking to establish a research capability on the East Coast that will focus on, among other things, Single Nucleotide Polymorphisms.
Back in PA we’re working on the Breast Cancer Program and behavioral health. Its been four years since I was a hospital CEO, and, interestingly enough, it seems that many of the changes that we watched in the late 80’s are the topics of conversation again due to the legislation now being implemented in the U.S. Healthcare system. The major difference between the decades is that the Baby Boomers are “hitting the proverbial wall” and with their furious entry into the health system, they are demanding changes that will help everyone.
You see, qualitative is finally meeting quantitative in a very big way. HCAHPS are changing the way hospitals do business as Medicare patients fill out their evaluation forms in the safeness and confidientality of their own homes. Did your doctor communicate appropriately with you? Did you get any rest? Were you happy with nursing? These are the types of questions that are literally changing the face of health care.
How does this equate with the way hospitals treat you? Well, their reimbursements are based upon the scores that they receive. Consequently, as one of my friends often says, “If your HCAHP evaluations are lower than a typical prison hospital, your reimbursement will reflect that as well.” In other words, if you don’t take exceptional care of your patients, you will get less money from Medicare which eventually means that you will get less money from ALL insurance companies because, as Medicare goes, the business world soon follows.
Let’s recap, no money for wrongful site surgeries, no reimbursements for hospital acquired infections, less money if your evaluations from the patients do not come in with high scores, oh, and finally, quality. By forcing all hospitals to go to Electronic Medical Records, CMS (Centers for Medicare and Medicaid Services) will have almost instant access to numerous important data points that will become transparent to the public. Follow this scenario: You want to know which hospital has the best outcomes in Cancer treatment or Heart Disease, no problem, you’ll find it on the websites. If you want to know infection rates, that will be available, too. TRANSPARENCY!
So, everything changes, and it changes pretty dramatically. If you wonder where the $715B or so that was cut from the Health Insurance Providers and Hospitals is going, this should give you a little insight. Now, let’s take a look at what a new genetic test called Single Nucleotide Polymorphism will potentially do for medical care. By testing about 300 genes, not 30,000, these tests will analyze the ability of your individual body to metabolize various medications. The important news is that is ALL this test will do. There will be no exposure of your future medical challenges or genetic weaknesses. That improvement alone will change the way medicine is prescribed and utilized, and it will also cut out millions of dollars in drugs that would otherwise be given unnecessarily or, in some cases, inappropriately.
In New Jersey we are implementing Integrative Medicine in various health systems. Why is this important? It’s important because it is not only what individual patients are demanding, it is also a means of treating people that leads to prevention and wellness opportunities. It’s proven to raise HCAHP scores, and it will lower the overall costs of medicine in the U.S.
Florida equals discovery. PA and New Jersey equal implementation. The new world order is here and it’s starting now.