An Informative Website, MDs and Guns, and more...

A Very Transparent, Informative Healthcare Site

Curious about how a hospital staffs the unit in which you or a loved one is receiving care? Want to know what types of nurses and assistive personnel are assigned to that unit? Does your floor have access to a Rapid Response Team or a hospitalist? All good questions, right?

Or how about this important question: if a hospital says it plans to staff a unit way and then it actually staffs it differently, how would you know?

The answer to all of those questions – and more – for 713 individual units, including emergency departments, at 82 hospitals across the state are available on the PatientCareLink website. And they have been there in plain view for the past 11 years.

PatientCareLink is the most transparent such website in the U.S. and it was the first in the country where hospitals voluntarily reported the information as opposed to being mandated to do so by government.  You don’t need to log-in to the site or provide personal data to review the hospital information.

“The entire caregiving team is vital to providing safe and high quality care, and PCL’s staffing reports can help patients and families better understand the importance of all personnel involved in their care,”  said Pat Noga, R.N., MHA’s V.P. of clinical affairs. “The staffing section of the PCL site has comments from a number of the hospitals explaining their numbers in greater detail, and it contains multiple years of actual staffing data so patients and the public can get a sense of just how dynamic patient care is, and how hospitals respond to patients’ changing needs.”

Massachusetts hospitals post their planned staffing for each unit once a year and then each March they post actual staffing data. If there is a significant variation between the two figures, the public can read the hospital’s explanation of why the variation occurred.

MHA co-sponsors the PatientCareLink site along with the Organization of Nurse Leaders, the Home Care Alliance of Massachusetts, and the Hospital Association of Rhode Island.

PatientCareLink also includes hospital-specific results on quality performance measures, as well as educational materials to help patients and families with healthcare planning and serious illness care, among many other topics.

Pediatricians for Parkland

Hospitals compassionately treat gun violence victims of all ages and are acutely aware of the ever decreasing age of these patients. Now pediatricians across the U.S. have announced that this Wednesday, March 14, they will stand in solidarity with students from Marjory Stoneman Douglas High School (Parkland, Fla.) – and communities everywhere – to honor the lives of those lost to gun violence and to raise awareness about how the issue affects public health.

In Massachusetts, Boston Medical Center Pediatrics has organized a local banner-signing and a short video that emphasizes gun violence as a pediatric public health issue. It will be circulated on social media. BMC Pediatrics encourages other hospitals to join them and the many students across the country that have planned school walk-outs and other Wednesday events to draw attention to school shootings and gun violence.

Insurance Company Policies in the ED

Another big health insurance company has rolled out an emergency department claims-payment strategy that is raising concern. Modern Healthcare reported last week that UnitedHealth Group announced a plan to review all ED Level 4 and Level 5 evaluation-and-management codes and possibly downgrade them or deny them if United feels the higher level codes are not justified. Higher codes – representing more serious, complex cases – are more expensive for insurers and United says the use of them has increased in recent years. Some hospitals have said the blanket review of the high-end codes is just a convenient way for the insurer to reduce claims payments.

Another large insurer, Anthem, which does not have a presence in Massachusetts, has been receiving great criticism for its new plan to deny claims from patients who show up in emergency rooms with conditions that the insurer later determines not to be emergent. That is, someone in great pain, who rushes to the ED, but who is later found to have an ailment that is painful and frightening – but not necessarily an “emergency” – will have the claim denied.

Last week, two U.S. senators – Ben Cardin (D-Md.) and Claire McCaskill (D-Mo.) – wrote to the U.S. secretaries of Labor and Health & Human Services seeking a federal investigation into Anthem. The senators said Anthem is violating the “prudent layperson standard,” which says, essentially, that an “emergency medical condition” is one in which a prudent layperson, possessing an average knowledge of health and medicine, could reasonably conclude that they need medical attention.

“While we appreciate Anthem on their effort to encourage patients to seek medical care in lower-cost settings, we remain concerned that Anthem’s ED policy still forces patients to determine, before they even leave their home, if their symptoms are serious enough to go to the emergency room ... Patients should not be forced to act as their own doctors and second guess themselves when they truly believe that they are having a medical emergency,” the senators wrote.

Merger Takes Big Step to Fulfillment

The deal involving Lahey Health, the Beth Israel Deaconess system, three independent hospitals, plus a number of physician practices received a favorable report from the Department of Public Health last week. DPH’s sign-off should guide the state’s Public Health Council, which is expected to take up the large merger in April.

In July, the Health Policy Commission is expected to issue its full cost and market impact review, exploring how the merger will affect overall healthcare costs in the state. If the HPC finds a transaction is detrimental to the state’s overall healthcare system it can refer its report to the Attorney General’s office. 

The deal at issue would create a new system consisting of the current Beth Israel Deaconess Medical Center, Beth Israel Deaconess Hospital – Needham, Beth Israel Deaconess Hospital – Plymouth, and Beth Israel Deaconess Hospital – Milton, along with the Lahey-owned Lahey Hospital & Medical Center, Beverly Hospital, and Winchester Hospital. Also included are the independent Anna Jaques Hospital, New England Baptist Hospital, and Mount Auburn Hospital. Under the proposed deal, the new system would control the following contracting entities: Beth Israel Deaconess Care Organization (BIDCO), the Lahey Clinical Performance Network and Lahey Clinical Performance ACO. Mount Auburn Cambridge Independent Practice Association, which currently contracts independently, would be brought under the umbrella of the new system.

Mass. Health Council Spring Forum on “Drugs of Misuse”

The Massachusetts Health Council is holding a spring conference entitled Our Kids and Drugs of Misuse : Nicotine; Marijuana; Opioids on Tuesday, May 22 from 9:30 a.m. to 2 p.m. at Bentley University in Waltham. National health and policy experts will address the current climate of recreational drug use among young people and will examine the risks, trends, and realities surrounding these activities and substances. The keynote will be delivered by Michael Botticelli, executive director of the Grayken Center for Addiction Medicine at Boston Medical Center, and former Obama Administration Drug Czar. Tickets are $50, which includes lunch. Click here for more information and registration info.

Transforming Healthcare to Be Inclusive of LGBTQ Patients

Friday, April 6, 9 a.m. - 12:15 p.m.
MHA Conference Center, Burlington, Mass.

This program will help practitioners better understand the needs of LGBTQ patients. We will review basic principles of practice transformation, LGBTQ-specific health disparities, and steps to take to ensure that all receive access to high-quality, equitable care. Issues affecting organizational structures, systems, and interpersonal communications will be described, including involvement of both leadership and staff. We will look at how to collect data to learn patient needs, and share examples of how to communicate affirmatively with patients regarding issues of their care. Examples of specific systems and clinical efforts to provide inclusive care will be presented along with strategies to both learn from the community and incorporate changes in the care environment. We hope you’ll join us at this timely program.  The program will be led by speakers and panelists from Brigham Health Physician’s Organization, Coverys, Cooley Dickinson Health, Brigham and Women’s Hospital, and Boston Medical Center. Click here for registration information.

John LoDico, Editor