Quote of the Day:
Quote of the Day:
When you come to a fork in the road...take it.
--Yogi Berra
Dr Thulasira Ravilla speaks about efficient methods of delivering surgical care and creating an environment of change process at a T.E.D. conference.
This is a timely subject given that in the United States an attempt is being made to reduce costs, and deliver more care by placing additional burdens upon the healthcare system, physicians, hospitals and other caregivers.
Necessity has a way of driving improvement and reducing costs, however we have chosen the easy path.
His talk outlines the deep understanding of what up-regulates health care costs which is totally ignored in the equation for the United States.
The US health system has exhibited inflation, and we are told its rate of inflation exceeds that for the overall economy. It is estimated that it represents over 16% of the economy.
Healthcare institutions, medical clinics, hospitals all must operate in a general economy and thus compete with not only other health providers for patients, and also for durable medical goods, utilities, operating space, personnel costs, taxes, training and education.
Dr Ravilla explains in the T.E.D. video how his organization, , has become not only efficient, but how they deal with the side of the equation not addressed in the United States, overhead.
Currently large medical institutions will ask for RFIs or offer competitive bidding to obtain volume discounts. Smaller entities will form or joking a buying group to scale their purchasing power.
What is not addressed is the control of escalating cost for producing items.
In health care (which in some ways is like the military) there is a constant obsolescence factor for technology, in diagnostic equipment, therapeutics, new facilities and R & D. This cost is significant not only to manufacturers but to medical business. Recently we are adding Electronic Medical Records and Health Information Exchange, purportedly to improve efficiency and deliver improved outcomes. This will be subsidized by an incentive program for the federal government for almost 20 billion dollars. The immediate effect is to stimulate adoption of EMR, necessary because most entities can little afford this jump in technological advance, at the same time as maintaining technical competence in medical equipment.
While a significant amount it appears to be inadequate to offset the adoption and long term support for EMR. The additional expense will fall upon each medical clinic and hospital. The incentive program is a dual edge sword, both incentive and penalty if users do not convert to EMR with certain basic meaningful uses spelled out by HHS. The incentive program ignores continuing maintenance cost and periodic software and/or hardware updates and replacement.
The net effect is to increase operating expense and fuel further health care inflation. The $ 20 billion stimulus attracts new industry to health care in a massive manner. Health care’s primary goal is patient health. All other businesses surrounding this goal are a cost of delivering services. Adding another layer of bureaucracy, or personnel adds to operating cost.
Also change itself creates expense. The adoption and transition form one paradigm to another interrupts business productivity, requires personnel training and capital investment.
Lt. Col Ava Huchun is the chief eye surgeon, a board certified ophthalmologist with advanced training in corneal disease and refractive surgery, and the principal who is responsible for the planning and development of this world class laser refractive surgery unit.The laser eye center occupies it’s own 15,000 square foot building and had over 1 million dollars in technology and surgical devices. Military ophthalmology is second to none. Dr. Huchun trained at the Wilmer Eye Institute, a department of the world renowned Johns Hopkins University. Some 20 soldiers, or more, each week, would have laser refractive surgery under her supervision with a staff of 4 optometrists, one additional eye surgeon and 8 technicians. The eye facility also provided general ophthalmology to other active duty soldiers as well as families and retired personnel. Many former active duty soldiers retire in the surrounding area of Hinesville just 40 minutes from Savannah, GA.
