Notes from the Hotspotters: Finding Flow in Chronic Disease Management

Originally posted December 16, 2014

By Jake Quinton

Madeline – a nursing student and hotspotting teammate – and I got back in the car after our third home visit with “R,” a woman whose complications from diabetes have landed her in the hospital every one to two weeks for the past two years. She is so well-mannered that she shows concern over how much homework we’re able to get done while we’re working with her. As we drive, I’m struck by the discrepancy between R’s health challenges and her resources. 
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Bridging Innovation into Health Care Leadership

By R. Edward Howell

As I read Regina Herzlinger and colleagues’ thoughtful HBR blog post, a call to “alter how we educate future health care leaders,” I am reminded of the classic Michael J. Fox movie, Back to the Future. The writers’ assertion that “business leaders can and should partner with educators” strikes me as a return to the original training construct for health and hospital leaders, in which students in masters’ programs in health administration spent one year in the classroom and a second year under the direction of an experienced health care practitioners. Their urging of academic and business leaders to work together “to integrate the classroom into the real world” is not only timely; it is likely to be well received by the practitioners in the field.

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Duke, Colorado Explore Innovative Payment Models for Specialty Care

By Khin-Kyemon Aung

???????????????????There’s no time like now to test new ways to pay for specialty care, and the federal government has offered immense support in this endeavor. Earlier this year, the Center for Medicare and Medicaid Innovation (CMMI) sought input from stakeholders to develop payment models for diseases cared for by specialists. CMMI is also in the midst of testing bundled payments for 48 different episodes of care, launching a new accountable care organization (ACO) model for patients with end-stage renal disease, and developing an episode-based payment model for oncology care. Additionally, through Health Care Innovation Awards and State Innovation Model funding, the Centers for Medicare and Medicaid Services is aiming to further drive innovation around how specialty care is delivered and paid for to incentivize improved outcomes and higher quality at lower costs.

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Notes From The Hotspotters: Trouble At Home

Originally posted December 2, 2014

By Rebecca Bausinger

Heading into Section 8 housing – also known as “the projects” – our hotspotting team was not sure what to expect. Our task ahead was daunting — we had yet to enroll any of our four required patients. This would be my first home health experience. For a health care provider, going into a patient’s home can be nerve-wracking if you are not used to it. I was glad to have two of my teammates by my side. 
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Health Wonk Review: Post-Turkey Day Edition is Posted at InsureBlog

hlbp-vote3Hank Stern has posted the Post-Turkey Day Edition of Health Wonk Review at InsureBlog. Check it out here. And don’t forget to vote daily between now and January 15 to make Wing of Zock a winner in the Healthline Best Health Blog of 2014 contest!

 

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What’s Your Bias?

By Javeed Sukhera, MD

After a recent consultation,  my patient’s father, a fellow physician, asked me to re-evaluate my recommendations. While I had considered all appropriate practice guidelines and research on the topic, there was an almost obsessive inner monologue that somehow prompted me to reconsider. After all, here was a physician with a young child asking me to change my opinion; I might do the same in a similar situation. I began to wonder, how would I have responded to  a parent who wasn’t a doctor—who perhaps had less education or hailed from a different socio-economic condition? Would I have been as likely to acquiesce to that parent’s wishes and reconsider my recommendation?

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Crowdsourcing Humanitarian Innovation

By Jennifer J. Salopek

The cover of a recent issue of Parade magazine featured a photo of a girl with a bright blue prosthetic hand. The accompanying article was titled, “How 3-D Printing is Transforming Everything from Medicine to Manufacturing.” The writer noted that the girl’s Robohand cost “just $2,000.”

For many people around the globe, $2,000 might as well be $2 million. Fortunately, there’s e-NABLE, a nonprofit organization that exists at the intersection of ingenuity, innovation, and patient care. On a gorgeous fall Sunday in September, more than 400 people gathered at Johns Hopkins Hospital in Baltimore to talk about how they could help get prosthetics to underserved populations, especially children. I was lucky enough to be there.

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Notes from the Hotspotters: Where Everybody Knows Your Name

Originally posted November 18, 2014

By Eliza Hutchinson

“There was one time when I wasn’t here for seven months in a row,” “Pam” told me.
 
I sat with Pam in her third floor hospital room – the floor on which she always stays when admitted to the inpatient medicine service – as nurses, doctors, and janitors poked their heads in the door to say friendly hellos and “Nice to see you again, Pam!” A dining facility staff member entered with a tray, letting Pam know, “I brought you the usual, Pam. I missed you!” Pam smiled and joked with the parade of staff members as I pondered this oddly happy reunion. 
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