Population health is not possible in a discounted fee-for-service world, and the significant healthcare business challenge is how to transition from fee-for-service to risk-based capitation in a sustainable way. The following represents an outline for how this transition can be staged so that early steps exploit the benefits of fee-for-service while the latter ones exploit a more capitated model:
Not too long ago, I had the sad task of testifying at a civil litigation and a judicial hearing for two physicians who had been suspended from their respective medical staffs. In both cases, the suspensions and resultant procedural rights were avoidable because proactive communication and management did not effectively take place. Such events should be rare and most medical staffs can easily avoid them by focusing on preventive actions and addressing potential performance issues early in a supportive and assertive manner.
Hospital CEOs may have once cast a wary eye when a retail clinic opened in their backyard, but that paradigm has shifted as health systems are increasingly opening their own retail clinics or affiliating with retail clinic operators.
Regulatory hurdles prevent more hospitals from using e-health to its full potential. Federal and state policies and regulations on care rendered via technology from a remote site spin a tangled web for providers either engaged in e-health or who want to be. A February 2014 article in Health Affairs found strong associations between state policies and hospitals' adoption of e-health, also known as tele-health or telemedicine.
Alarm fatigue has moved to the forefront of hazards on the hospital floor. Nursing staff gets bombarded by hundreds or thousands of beeps, rings, whistles and pings emanating from bedside devices in a shift, and it can be difficult for them to distinguish the critical from the routine. An analysis of hospital alarms at Johns Hopkins Hospital counted a total of 59,000 alarms over a 12-day observation period, an average of 350 alarms per patient per day.1