Comments on: The Death of Health Care Quality http://www.seefirstblog.com/2009/05/04/the-death-of-health-care-quality/?utm_source=rss&utm_medium=rss&utm_campaign=the-death-of-health-care-quality Insights into the uncertain world of healthcare Tue, 29 Nov 2011 22:02:00 +0000 hourly 1 http://wordpress.org/?v=3.1.3 By: Why Would You Pay More for Quality? « See First Blog http://www.seefirstblog.com/2009/05/04/the-death-of-health-care-quality/comment-page-1/#comment-549 Why Would You Pay More for Quality? « See First Blog Wed, 09 Dec 2009 15:44:42 +0000 http://www.seefirstblog.com/?p=436#comment-549 [...] Fair enough.  But it begs the question:  why would we need to pay doctors more for delivering quality service (whatever that term might mean)? [...] [...] Fair enough.  But it begs the question:  why would we need to pay doctors more for delivering quality service (whatever that term might mean)? [...]

]]> By: Three Things the President Won’t Talk About Tonight « See First Blog http://www.seefirstblog.com/2009/05/04/the-death-of-health-care-quality/comment-page-1/#comment-357 Three Things the President Won’t Talk About Tonight « See First Blog Wed, 09 Sep 2009 19:37:14 +0000 http://www.seefirstblog.com/?p=436#comment-357 [...] Health care quality is conventionally thought of as bringing concepts of high-quality manufacturing processes to medicine.  Just as there is a right way and a wrong way to attach a door to a car, there also is a right way and a wrong way to treat a patient.  And so, government and private quality programs have looked for ways to measure process and to ensure doctors adhere to it.  For example, the federal government has catalogued almost 1,500 “quality measures,” everything from whether your pediatrician told you about using a booster seat in your car, to whether your cardiologist took a specific set of steps before prescribing a certain medication.  But medicine isn’t an assembly line process.  Treating it that way fundamentally undervalues the thinking, processing and deciding aspects of medicine – the things that are so important to you as a patient when you are sick.  While some doctors are starting to sound the alarm, the larger point is this: quality ought to be a question of whether the patient got the right care. [...] [...] Health care quality is conventionally thought of as bringing concepts of high-quality manufacturing processes to medicine.  Just as there is a right way and a wrong way to attach a door to a car, there also is a right way and a wrong way to treat a patient.  And so, government and private quality programs have looked for ways to measure process and to ensure doctors adhere to it.  For example, the federal government has catalogued almost 1,500 “quality measures,” everything from whether your pediatrician told you about using a booster seat in your car, to whether your cardiologist took a specific set of steps before prescribing a certain medication.  But medicine isn’t an assembly line process.  Treating it that way fundamentally undervalues the thinking, processing and deciding aspects of medicine – the things that are so important to you as a patient when you are sick.  While some doctors are starting to sound the alarm, the larger point is this: quality ought to be a question of whether the patient got the right care. [...]

]]> By: FY 2010 IPPS: Federales sucker punch the hospital industry | HIPAA Compliance News http://www.seefirstblog.com/2009/05/04/the-death-of-health-care-quality/comment-page-1/#comment-352 FY 2010 IPPS: Federales sucker punch the hospital industry | HIPAA Compliance News Wed, 09 Sep 2009 16:01:12 +0000 http://www.seefirstblog.com/?p=436#comment-352 [...] quite a while) is that the federales — and other payors — are asking providers to track too many indicators.  It is possible to track a small number of indicators that are predictive of other quality [...] [...] quite a while) is that the federales — and other payors — are asking providers to track too many indicators.  It is possible to track a small number of indicators that are predictive of other quality [...]

]]> By: Is This Really How We Should Measure Physician Quality? http://www.seefirstblog.com/2009/05/04/the-death-of-health-care-quality/comment-page-1/#comment-201 Is This Really How We Should Measure Physician Quality? Mon, 20 Jul 2009 10:28:51 +0000 http://www.seefirstblog.com/?p=436#comment-201 [...] OSHA-ization of health care quality [...] [...] OSHA-ization of health care quality [...]

]]> By: Better Health » Is This Really How We Should Measure Physician Quality? http://www.seefirstblog.com/2009/05/04/the-death-of-health-care-quality/comment-page-1/#comment-146 Better Health » Is This Really How We Should Measure Physician Quality? Wed, 10 Jun 2009 19:58:37 +0000 http://www.seefirstblog.com/?p=436#comment-146 [...] OSHA-ization of health care quality [...] [...] OSHA-ization of health care quality [...]

]]> By: Is this Really How We Should Measure Quality? « See First Blog http://www.seefirstblog.com/2009/05/04/the-death-of-health-care-quality/comment-page-1/#comment-145 Is this Really How We Should Measure Quality? « See First Blog Wed, 10 Jun 2009 14:12:57 +0000 http://www.seefirstblog.com/?p=436#comment-145 [...] OSHA-ization of health care quality [...] [...] OSHA-ization of health care quality [...]

]]> By: Evan Falchuk http://www.seefirstblog.com/2009/05/04/the-death-of-health-care-quality/comment-page-1/#comment-142 Evan Falchuk Wed, 03 Jun 2009 19:11:48 +0000 http://www.seefirstblog.com/?p=436#comment-142 Good point, Neal. I could have been more precise in my description. It of course puts further into question the value of all the billions spent on OSHA if there were other, more important factors. I assume that the opportunity to save money on work comp and disability premiums were among the bigger drivers of these improved safety records? Good point, Neal. I could have been more precise in my description. It of course puts further into question the value of all the billions spent on OSHA if there were other, more important factors. I assume that the opportunity to save money on work comp and disability premiums were among the bigger drivers of these improved safety records?

]]> By: Neal Lester http://www.seefirstblog.com/2009/05/04/the-death-of-health-care-quality/comment-page-1/#comment-141 Neal Lester Tue, 02 Jun 2009 01:20:31 +0000 http://www.seefirstblog.com/?p=436#comment-141 I don't think that "accident rates didn’t drop" is quite right. Accident rates have gone down consistently since the start of WWII. OSHA hasn't changed the rate of decrease. See the graph on the top of page 175 of this book: http://books.google.com/books?id=1ixRxAsdLKwC&pg=PA175&dq=united+states+historical+occupational+injury+rates+1950+1960+1970+1980+1990+2000 I don’t think that “accident rates didn’t drop” is quite right. Accident rates have gone down consistently since the start of WWII. OSHA hasn’t changed the rate of decrease. See the graph on the top of page 175 of this book: http://books.google.com/books?id=1ixRxAsdLKwC&pg=PA175&dq=united+states+historical+occupational+injury+rates+1950+1960+1970+1980+1990+2000

]]> By: Twitted by 2healthguru http://www.seefirstblog.com/2009/05/04/the-death-of-health-care-quality/comment-page-1/#comment-95 Twitted by 2healthguru Fri, 08 May 2009 15:03:41 +0000 http://www.seefirstblog.com/?p=436#comment-95 [...] This post was Twitted by 2healthguru - Real-url.org [...] [...] This post was Twitted by 2healthguru – Real-url.org [...]

]]> By: efalchuk http://www.seefirstblog.com/2009/05/04/the-death-of-health-care-quality/comment-page-1/#comment-87 efalchuk Tue, 05 May 2009 21:32:43 +0000 http://www.seefirstblog.com/?p=436#comment-87 Thanks for the thoughtful comments, gents. Another concern is how the quality measures will end up being used. Clever insurers are probably looking at them and thinking what they might mean for coverage decisions. Some enterprising med mal attorney is probably looking at them, too, and thinking of how they can be used to show how the doctor he is suing failed to follow the standard of care. And hospital compliance people are probably thinking if they made rules to implement these measures they might ward off lawsuits. Meanwhile, doctors and patients become buried under a mass of new processes and procedures. Is quality improved? Thanks for the thoughtful comments, gents.

Another concern is how the quality measures will end up being used.

Clever insurers are probably looking at them and thinking what they might mean for coverage decisions.

Some enterprising med mal attorney is probably looking at them, too, and thinking of how they can be used to show how the doctor he is suing failed to follow the standard of care.

And hospital compliance people are probably thinking if they made rules to implement these measures they might ward off lawsuits.

Meanwhile, doctors and patients become buried under a mass of new processes and procedures.

Is quality improved?

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