July 30, 2007

IN THIS ISSUE

Editor's Column: Will The Truth Set Us Free?
WSU, Oakwood Bolster Partnership With Agreement
DMC Named In Most Wired Hospitals Survey
Poll Positions IT As Key To Health Care Quality, Efficiency
Rankings And Report Cards
Dem Pres Candidates Espouse Universal Coverage
Children's Health Bill Could Undermine JCAHO

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Editor's Column: Will The Truth Set Us Free?

By JOSEPH WEISS, MD
In the Saturday July 14, New York Times, on a front page article, the public read that oncologists were withholding potentially lifesaving anti-cancer drugs, Bexxar and Zevalin. According to the Times article, the reason is that the drugs don’t provide physicians enough profit.

The growing public outrage that has the potential to shackle the medical community is more dangerous to us than confinement to a prison cell. The heat of public response threatens to warp our integrity and bring congressional rebuke in the form of legislative controls on our prescribing activities.

We need the AMA to rise to our defense. My discussions with oncology colleagues leads me to question whether the problem with Bexxar and Zevalin resides not with physician profit but in governmental policies including unreasonable documentation and uncertain reimbursement. Only the AMA has the resources to assess the real role of the oncologists.

Furthermore, the present controversy over cancer care should set in motion a long term AMA response. We need our foremost organization to act with speed and justice now ;  uncover  for us the truth that will set us free. 

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WSU, Oakwood Bolster Partnership With Agreement

Oakwood Healthcare, Inc. and Wayne State University announced an agreement late last week in which a total of 41 WSU physicians and residents specializing in otolaryngology, urology and dermatology have joined Oakwood Hospital & Medical Center’s specialists who are currently providing exceptional care. In addition, the WSU residents and physicians now have access to Oakwood’s facilities and technology.

“Wayne State University is one of the premier academic medical schools in the country, and we are excited to partner with them in providing a first-rate medical education to the 41 new residents joining our ranks,” said Brian Connolly, president and CEO, OHI. “Oakwood is proud of its long history of service, and with this new partnership, we will be able to offer these exceptionally talented health care professionals a high-quality place to practice medicine, while simultaneously providing the communities we serve greater access to excellent health care.”

The agreement will include undergraduate and graduate medical education and basic, clinical and community-based research and further the goal of both institutions to become an academic health center of national renown.

“This enhanced relationship with Oakwood provides us with a partner that can collaborate with us on all three components of our mission – education, research and patient care,” said Robert M. Mentzer Jr., MD, dean of the Wayne State University School of Medicine. “As the School of Medicine develops its strategic plan for its future as a regional health care partner, relationships like this will be vital to our future.”

In June of 2006, OHI and WSU signed an affiliation agreement to create an academic and clinical care partnership. This latest collaboration is another example of efforts to create a long-term partnership between both institutions that will result over time in the creation of programs that support enhanced medical education, research and clinical care.

Kerith Spicknall, MD, is a WSU resident in Dermatology. Spicknall, 31, has been with Oakwood since September 2006, and is pleased to have access to expert staff, an exceptional surgical clinic and new laser technology; however, the location is also a welcoming factor.

“I live in Detroit, so I wasn’t really interested in being shifted to a hospital that’s further in the suburbs. I like Dearborn, I like where Oakwood is located,” said Spicknall. “I think it’s very convenient, but at the same time, it offers a whole subset of new patients in a state-of-the-art and inviting atmosphere.”

With the increase in medical staffing, OHMC will be able to reduce the time it takes Oakwood patients to see a physician, which will result in better patient outcomes and improved patient satisfaction. Additionally, new technology allows residents to explore many new and exciting aspects of their careers in medicine.

“Having access to high-tech equipment is good for the residency training program because we’ll be using these new innovations once we get out into the new world and practice on our own,” said fifth-year Otolaryngology Chief Resident, Giancarlo Zuliani, MD. “It’s really advantageous for us to get experience with the technologies because patients will want the newest and greatest and, as a physician, you want to be able to provide those services.”

For more information on Oakwood or WSU, visit www.oakwood.org and www.wayne.edu.

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DMC Named In Most Wired Hospital Survey

The Detroit Medical Center has been named in the list of Most Wired Hospitals and Health Systems according to the results of the 2007 Most Wired Survey and Benchmarking Study released July 17 in the July issue of Hospitals & Health Networks magazine.

The Most Wired Survey is conducted annually by Hospitals & Health Networks magazine, which uses the results to name the 100 Most Wired hospitals and health systems. The nation’s 100 Most Wired hospitals show better outcomes in four key areas: mortality rates, patient safety measures from the Agency for Healthcare Research and Quality (AHRQ), core measures from Hospital Compare and average length of stay. The survey focuses on how the nation’s hospitals use information technologies for quality, customer service, public health and safety, business processes and workforce issues. (The July H&HN cover story detailing results is available at www.hhnmag.com.)

"The continued adoption of technology for clinical systems in health care is driving rapid change and great outcomes,” said Lewis Redd, managing partner, Accenture Health & Life Sciences North American Provider Practice and one of the 2007 Survey sponsors. “The leaders in the field are already showing us how technology can help connect hospitals with their patients and enhance clinical outcomes. This survey is a call to action.”  

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Poll Positions IT As Key To Health Care Quality, Efficiency

A survey of health care leaders has found that when it comes to improving health care quality, information technology is the most important solution.

The latest Commonwealth Fund/Modern Healthcare Opinion Leaders Survey found that 66 percent of 214 policy leaders believe that rapid adoption of electronic health records and other IT systems is job No. 1 for solving the problem of widespread inefficiency and uneven quality of care. That was followed by public reporting of provider performance on quality measures (59 percent) and financial incentives for improved quality of care, such as pay-for-performance programs (51 percent). Respondents were allowed to choose more than one solution.

Seventy percent of survey respondents say the federal government should play a leading role in backing providers’ IT investments. Another 58 percent say health plans and insurers have a responsibility to support expansion.

Only 7 percent described the Patient Safety and Quality Improvement Act of 2005, which allows providers to voluntarily report medical errors and ensures the confidentiality of physicians and hospitals that do so, as sufficient to reduce medical errors. Three of four respondents supported mandatory reporting of medical errors; 60 percent say reported errors should be publicly disclosed.

Seventy-three percent of respondents backed the notion of fostering the formation of integrated delivery systems or “virtual integration” by information technology and/or new payment systems.

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Rankings And Report Cards

This column was originally published in AMA eVoice on July 26, 2007. Dr. Davis is president of the American Medical Association and a WCMSSM member.

Readers love rankings and report cards. Every week seems to bring us another list of the best or worst of whatever.

Michael Moore's new movie Sicko highlighted the World Health Organization's ranking of the best health care systems in the world. In my review of the movie in an earlier column, I cited a few compelling critiques of the WHO's ranking scheme.

Click on the link below for the full column:

 http://www.ama-assn.org/ama/pub/category/17873.html

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Dem Pres Candidates Espouse Universal Coverage

Democratic presidential candidates former Sen. John Edwards (N.C.), Sens. Barack Obama (Ill.) and Hillary Rodham Clinton (N.Y.), and Rep. Dennis Kucinich (Ohio) on Friday at an annual conference sponsored by the National Urban League said that they support universal health insurance for children, Long Island Newsday reports (Evans, Long Island Newsday, 7/28).

At the conference, Edwards said that he supports a universal health insurance system for all U.S. residents, adding that he would make changes to the health insurance and pharmaceutical industries. "The system is rigged, it's broken," Edwards said, adding, "We will never create one America until we fix the system" (Mannies, St. Louis Post-Dispatch, 7/28).

Obama praised the Harlem Children's Zone, a coalition of 15 community centers in upper Manhattan that provides health care, nutrition and other services to at-risk children (Long Island Newsday, 7/28).

Kucinich said that the United States could have used the $1 trillion spent on the war in Iraq to fund a universal health insurance system. He added, "The money is there. The question is whether the will is there" (St. Louis Post-Dispatch, 7/28). National Urban League President Marc Morial said that, although the group invited Republican presidential candidates to the conference, none attended (Long Island Newsday, 7/28).

Health Care Professionals Contribute More to Democrats
Democratic candidates for the first time in more than 10 years have received more campaign contributions from health care professionals than Republican candidates, the AP/Wichita Eagle reports. According to the AP/Eagle, the shift has resulted because "Democrats now control Congress and Democratic presidential candidates are raising more money than are Republicans."

Jonathan Oberlander, a health care politics expert at University of North Carolina-Chapel Hill, said, "The health care industry wants to influence the majority in Congress, and ... they are reading the same tea leaves as everyone else that suggest the Democrats could have good results in the 2008 elections" (Kuhnhenn, AP/Wichita Eagle, 7/29).

Letter Asks What Edwards Really Mean
What in the world is John Edwards saying? “New ‘healthcare markets’ would give families and businesses purchasing power and a choice of quality plans, including one public plan.”

Is he proposing “one public plan” or “a choice of quality plans”?

Then he says, “businesses would either cover their employees or help pay their premiums.” I guess this means a new law requiring businesses to pay. Or, do businesses only have to “help to pay”?

 http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20070727/FREE/307270003/1025/FREE

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Children's Health Bill Could Undermine JCAHO

The Joint Commission would lose its deeming authority under a legislative proposal reauthorizing the State Children’s Health Insurance Program and revising other provisions in Medicare and Medicaid. If this bill is passed, a hospital accredited by the commission would no longer automatically meet conditions of participation under Medicare.

"The Joint Commission is aware of that provision (in the bill), and we'll be working with the folks on Capitol Hill," a commission spokeswoman told Modern Healthcare.

This and other controversial provisions are part of the Children’s Health and Medicare Protection Act, which was being worked on by the House Energy and Commerce Committee. The bill was approved by the House Ways and Means Committee early Friday, although partisan debate has stalled progress in the Energy and Commerce Committee, with much of the arguments centering on funding and on the bill’s proposals to expand coverage to older children and immigrants under waiver options.

The bill has received mixed reviews from health care providers: the American Hospital Association recently showed support for the bill’s Medicare provisions in letters to the leadership on Energy and Commerce and Ways and Means. Other groups, such as the Physician Hospitals of America oppose the bill’s permanent ban on physician self-referral to specialty hospitals. Its provisions to freeze reimbursement rate increases to some providers could slash nursing home care by $2.7 billion over five years, the American Health Care Association estimates.

Despite the deadlock in the House, sources on the Hill are expecting that both SCHIP reauthorization bills in the House and Senate will be ready this week—with a Senate vote taking place as early as today or tomorrow.

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