The following is a guest post by Dr. Gary Ferguson. Gary Ferguson has a strong background in starting, leading, and turning around healthcare IT organizations. Dr. Ferguson earned his doctorate in pharmacy and pharmacology at the Los Angeles County and University of Southern California Health Network, and gained clinical experience working in a trauma center.
While healthcare often cites a host of somewhat sketchy reasons why they’re different, there is one particular way in which they are: Preventing repeat business is increasingly a good thing.
In this line of work, repeat business for a healthcare facility is known as readmissions, and there is a great deal of focus on this topic at the moment. The Centers for Medicare & Medicaid Services (CMS) decided to penalize hospitals that show consistent, high rates of repeat business for the same medical problem.
Taking a look at what causes preventable readmission brings up some very easy targets:
For starters, evidence-based medicine guidelines are entrusted to doctors memories, which we can expect to be imperfect. If a doctor has more than half of the care guidelines in their head, they’re doing well. And no two doctors will remember the same things.
Take a step back and consider the inconsistencies across the spectrum of healthcare operations, and the opportunity for standardization and measurement is staring us in the face. Business process management in a nutshell.
There are two disconnects at work here…a disconnect between multiple caregivers like nurses, doctors and pharmacists and a disconnect between caregivers and the patient and their support community. Both of these problems should be addressed through better collaboration and open communication, two strengths of social media.
It doesn’t help that written instructions are too often given by busy doctors to busy staff, then delivered to woozy patients more focused on getting home than anything else. This can be improved by better process management, training and communication, also strengths of business-facing BPM.
A Dartmouth Atlas Project found that only 42.9 percent of patients visited their doctor within two weeks of hospital discharge. It is well known in the community that this is a significant factor in readmission. When things go wrong or right, we need to be listening. Event technology has been applied nearly everywhere else with great success for decades.
It will take time and investment to turn around the problem of repeat business, but with CMS estimating the cost of preventable readmissions to be $17B annually and penalties for those who don’t show progress, there is plenty of reason to believe the investment will be made.