Patient Care Challenges Hit Home
Last year I helped a close friend of mine get through some tough times: his mother was diagnosed with Stage 2 breast cancer and required a double mastectomy. Several months after receiving a clean bill of health, he called her primary doctor to set up her annual physical. The doctor asked: “Would you also like to schedule her annual mammogram?” My friend’s jaw dropped. You see, his mother had a double mastectomy with no reconstruction and no breast tissue remaining—a circumstance that does not require any future mammograms. It was performed at a hospital with which his primary doctor is affiliated. After a few embarrassed apologizes a mammogram was not scheduled. Apparently, the doctor’s office appointment system did not flag a mammogram as not necessary for my friend’s mom. If that system had been somehow better integrated with the affiliated hospital’s system, the situation probably would never have arisen.
What if his mom had the mammogram anyway? Although the radiation from a mammogram is low (70 millrems—around the same dose we get from the environment over two and half months), the less radiation one unnecessarily receives the better. Considering she is on a fixed income, what cost implications would the mammogram have had on her insurance? Would they have paid? Would she have had to pay?
My friend avoided a situation that can be characterized as “overuse” of beneficial care. The Commonwealth Fund Commission on a High Performance Health System has produced several reports and scorecards over the years that measure this type of healthcare information. In their 2011 report, “Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2011,” their scorecard includes key indicators of national health system performance organized into five core dimensions: healthy lives, quality, access, efficiency and equity. They define efficiency as assessing “…the overuse or inappropriate use of health services, preventable hospitalizations and readmissions, regional variation in quality and cost, administrative complexity, and use of information systems.” (page 21). Regarding efficiency performance, the report shows that “Performance on indicators of health system efficiency remains especially low, with the U.S. scoring 53 out of 100….” My friend’s incident is representative of the kinds of integrated care challenges that healthcare organizations, physicians, and insurance companies face today.
My work life and my personal life rarely intersect. This time it did. It turns out that the company I work for provides an enterprise master data application, OMNI Patient™, that facilitates the improvement of patient care. Not to oversimplify, but one of its benefits is that it enables healthcare organizations to produce a single view of a patient through the creation of a master patient record. It is helping healthcare organizations like Henry Ford Health Systems create unique identifiers for patients across healthcare systems and applications, which in turn have their own patient identifiers (master patient index) making it possible to have a complete view of a patient at the point of service.
Could this technology have helped avoid the erroneous scheduling of a mammogram for my friend’s mother? Improving patient care is a complicated process involving many areas, disciplines, applications, systems, technologies, regulations and requirements. My friend’s experience is a small view onto the complex and challenging healthcare landscape. One thing is for sure: the conversation with my friend brought home the importance of how technology can be used to meet the challenges of integrated care and improving the patient journey.
Have you run into an integrated care or patient care challenge? Sound off below.
Articles and references:
- “Data prescription for better healthcare,” April Dembosky of Financial Times
- Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2011,” by the Commonwealth Fund Commission on a High Performance Health System