Friday, November 18, 2016

On Call by Casey Ross

Good Morning! Bob Tedeschi here, sitting in while Casey Ross takes a short break. Here’s what’s happening today in hospitals and healthcare. For more, follow us @statnews on Twitter or like us on Facebook

Mayo leaders: A nine-fold path to preventing burnout

We’ve talked about burnout before, and it seems like lots of hospitals have ideas to combat it. Well, Mayo Clinic has some more ideas – nine of them, to be precise.

In the issue of Mayo Clinic Proceedings released today, Dr. Tait Shanafelt, director of Mayo’s Program on Physician Well-being, and Dr. John Noseworthy, Mayo’s CEO, say administrators can’t force doctors to fight this battle on their own. “Burnout is a system issue, and addressing it is the shared responsibility of both the individuals and health care organizations,” Shanafelt writes.

Among the solutions: Acknowledge the problem, cultivate community and work-life balance, and identify factors that lead to burnout. On that final point, Mayo calls out the elephant in the room: “reduce clerical work,” it advises.

Healthy food in hospitals? It’s happening.

Healthy food in hospitals? It’s happening.

Fans of irony have long appreciated the paradox of the typical hospital café, where high-calorie, low-nutrition foods often dominate.

That ship is slowly turning, according to a new report from the American Heart Association and Aramark, which provides food to many of the nation’s hospitals, schools and corporations. The two organizations last year launched an effort to improve the health of Americans by 2020, and after one year, they said, Aramark’s menus are 8 percent lower in calories, saturated fats and sodium.

That puts the organizations on pace to exceed the 20 percent reduction target set as the 2020 goal.

What does that new menu look like?

Well, more vegetarian, for one thing. Nearly one-third of the main dishes are meatless or vegan and more than 10 percent feature whole grains as the leading ingredient. In areas of “underserved communities” – namely, at community centers in cities like Philadelphia and Chicago – a pilot program aimed at single moms and others increased daily fruit and veggie consumption by about one cup.

C-suite conversations: How money follows good medicine

Dr. Timothy Ferris, chief of population health management for Partners HealthCare, says his team has developed its own litmus test for new hospital initiatives.

Ross spent some time recently talking to Ferris about what works -- and what doesn’t -- in the world of population health, where executives like him are constantly launching experiments to lower costs by keeping patients healthier.

One thing Ferris said must change?

The desire by hospitals to connect every service to a revenue stream.

“For too long providers of health care have considered themselves slaves to the payment system,” he said. “If it’s not paid for, then you don’t provide it.”

The way to fix that, he said, is to do in business what doctors do in medicine: produce evidence of improvement.

For example, Partners is paying for a program that delivers hospital care in patient homes, hoping that insurer’s will see the savings and benefits, and begin paying for it.

“Providers have been going to Washington and say, ‘You should pay for this,’ he said. “A more productive response is, ‘We’re doing this. It works really well for patients, and it would really help if you paid for it.”

Paging John Anderton: Artificial intelligence and the hospital of the future.

The iconic 2002 film “Minority Report” portrays a culture so deeply suffused with artificial intelligence that it can track a person’s movements across wide expanses and anticipate their most basic needs — among less benign possibilities.

What might the health care system look like with that sort of AI built in? The current issue of Harvard Business Review offers a peek, and if you can suspend disbelief for a few moments, it offers a handful of interesting predictions. Among them:

  • Hospital systems will employ facial recognition systems to spot return visitors, and offer them directions to family members’ patient rooms.
  • If you’ve signaled your intention to visit the hospital, it will anticipate your 45-minute drive and point you toward the restroom on your arrival.
  • The hospital system will know the person you’re visiting — maybe better than you. What if the patient is allergic to those flowers you’re about to buy at the hospital gift shop? When you’re at the register, the clerk will replace your bouquet with a fake one.

It’s anyone’s guess how well hospital personnel might handle HIPAA-sensitive conversations that’ll likely follow, not to mention bigger worries about hacked computer systems running amok.

Not to worry, says the report’s author, R “Ray” Wang, of the Silicon Valley firm Constellation Research. Successful AI systems will reduce errors, improve decision speed and prevent disasters, he writes. “While all of this AI-driven automation may make some people anxious, fears of robots taking over the world are overblown."


  • Clinicians writing $5 million in Medicare prescriptions? It’s a trend. (NPR)
  • Surgeon General takes aim at opioid addiction crisis (STAT)
  • Ebola outbreak may have been worse than originally thought (Washington Post)
  • Pulse nightclub survivor’s journey to a possible medical career (Tampa Bay Times)

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Stay well, and we'll see you on Monday.
- Bob

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