Become, Behave, Bespoke: Reduce healthcare waste, improve profit and reputation

November 11, 2016

6 Habits of High Value Health Care Organizations In recent years there has been a drive to improve the value obtained from healthcare spending. When questioned, most health system analysts focus on improvements in quality of care, or on reduction of wasteful spending. What does value-based care look like to the doctors and nurses who deliver it?  More importantly though, how does it look to the patients who receive it? The U.S. Secretary of Health and Human Services announced just last year that a majority of healthcare payments in the U.S. Medicare and Medicaid programs will move to value-based payments by 2018. Many health systems have reorganized with a goal of improving the value of care. In reality though, what does this change?  As more healthcare delivery systems begin to refocus on improving outcomes and reducing costs, six principles have emerged of what value-based care looks like in practice. Number One – Common sense prevails An increasing issue seems to be that the structure of healthcare financing is getting in the way of medical staff and patients. Common sense needs to come into play. If a patient can be treated just as well at home by using remote monitoring devices, appropriate medication and home visits, this saves thousands of dollars that might otherwise have been spent on unnecessarily hospitalising the patient.

Posted in Uncategorised by YSA LEGASPI
September 20, 2016

Western countries are extremely lucky to benefit from both wealth and longevity. This is something that hasn’t happened in previous generations. It is widely believed that healthcare, including public health, has contributed immensely to this increased longevity. However, McKeown, McKinlay et al, Illich and others have questioned the role of medical care within this, and are unwilling to give it full credit. On the other hand, Mackenbach and Bunker believe that medical care has in fact played a fairly significant part in reducing mortality, hence increasing longevity. So what is helping to ensure longevity, and what must shape the modern day public health system? This discussion can be broken up into four different factors, listed in order of their estimated importance in driving better health and longevity, and as displayed in the attached infographic.   1. Social and Economic factors (40%). Education plays a key role in this category. Low education levels are linked with poor health, more stress and lower self confidence. Poorly educated people are deprived of information and understanding to health services and behaviours that help them prevent and treat disease. Expert-led educational and wellness programmes, early identification and prevention programmes all therefore have a significant part to play in the teaching of this group. Unemployment and low

Posted in Uncategorised by YSA LEGASPI
June 27, 2016

Healthcare is usually planned as an implementation exercise. However, strategy is no less important than other industries – even more so now that 24/7 interconnectedness allows us to move from a system of intermittent, reactive disease treatment to one of proactive optimisation of health.

1 – For a CEO, strategy is job one.

A CEO must ensure competencies and capabilities are at the forefront of their business.  Other business areas such as human resources, marketing and finance are all jobs which should be delegated to others.

Often it is thought, quite incorrectly, employees will resent and resist the efforts of leaders who want to clearly set overall direction. They do not at all. They welcome and expect a clear direction and are far more likely to follow when insight and commitment come from the top of the organisation.

The commonest problem that I see in my daily work is frustration in employees lacking direction.

2 – Organisations succeed because they generate value.

Quality is assumed in healthcare – no one buys that, however they

Posted in Uncategorised by Douglas Fahlbusch
June 17, 2016
High rate of infections or avoidable complications such as blood clots, bed sores or sepsis, will now have implications on how much money hospitals receive each year. Medicare has restricted budgets to 758 hospitals in America, many of which are prestigious teaching hospitals. The ‘no messing’ attitude , comes from the federal government, highlighting the ever growing issue of patient safety in hospitals. Many of the top hospitals argue this attitude and penalty is unfair. Surely it is the hospitals job to seek out infections and treat possible complications? This is showing they are doing their job and being vigilant. Not so, according to the federal government and Medicare, who say these issues should be avoided right from the start and have refused to reimburse hospitals for complications they have created. This is all well and good, but studies have shown that even with these tough measures which have been in operation since 2014, the figure remains high of those going on to get a complication – 12 out of every 100 in fact. Hospitals are losing 1% of their payments which on average affects budgets by $480,000, but in reality most academic centres will lose more than that because they have higher revenues. So the amount lost is significant. Perhaps a little unfairly, eve

Posted in Uncategorised by Douglas Fahlbusch
June 15, 2016

No matter which country a medical student is studying in, the main principles for survival are the same. 1. Hard Work. Studying medicine is hard work. Medical students put in far more hours than any other students and sometimes it is overwhelming. Everyone feels like this at some point, but if you persevere and carry on, things will get easier. Remember it’s not forever and all students get long holidays for rest and relaxation. 2. All Essential Knowledge. The great thing about training to be a doctor is  what’s learnt over the years will always be used. This is not the case for many other courses.  For these students it is a case of learning information to pass the course and then never using it again. It seems almost pointless. Every scrap of information studied as a medical student however will come in useful at some point, so nothing feels like a waste of time. 
3. Friendships. Although there is a lot of work, medical students still find time during each term to let their hair down and take time out. Whether this is pursuing a hobby or interest, or enjoying a drink or two in the bar, be assured, it is not all work, work. work. Spending so much time together will result in some great friendships. Often these might be with students from different courses that you might have met through sports and other hobbies.

Posted in Uncategorised by Douglas Fahlbusch
June 8, 2016

A new study has shown that critically ill children who are in intensive care do not need to be artificially fed to aid recovery. This news comes after similar research that was carried out in 2011 and 2014 by Professor Van den Berghe and her team, claimed early artificial feeding of adults in intensive care should not happen either.

Universally, medical staff have always been of the opinion that shortly after a child (or adult) arrives in intensive care they should be fed through an IV tube which goes into the blood stream. As well as for the purpose of strengthening muscles, it was also thought it would help prevent complications and in general speed up recovery, returning patients to main wards and home, as soon as possible.

However, these new findings completely contravene what typically happens. The research team made up of professors from the University Hospital Leuven in Belgium, Sophia Children’s Hospital Rotterdam, in the Netherlands and Stollery Children’s Hospital Edmonton in Canada, focused their study purely on children.

The trial consisted of 1,440 critically ill children and the effects of having little or no food during the first week of critical care. Very interestingly it was discovered that those children who had built up a nutritional deficiency after having limited or no food, had fe

Posted in Uncategorised by Douglas Fahlbusch
May 19, 2016

Post-acute care provider networks are taking on a growing importance for hospital executives, a recent survey of hospital leaders found. 95% of executives surveyed across 82 hospitals agreed, a 5% rise in opinion from last year. From April 1st 2016, nearly 800 US hospitals began participating in Medicare’s first compulsory payment programme ‘the Comprehensive Care for Joint Replacement’. All costs on discharged patients with hip and knee replacements after 90 days are scrutinised. If all goes well bonuses are offered, but on the other hand, if a patient is re-admitted needing more care, the hospital will receive a penalty. It is no coincidence this area is being focused on. In a recent Avalere analysis, it was discovered that 39% of total hip and knee replacement expenditure was connected to post-discharge care and hospital readmissions. This area is clearly crying out for better management. James Garnham, director of contract and payment innovation for University of Rochester Medical Center, has taken the problem very seriously. Garnham formed a large working party of all involved, and created a unified front on fighting the problem. It worked! Complication figures dropped in the share of joint replacement patients from 74% to just 15%. In addition visits to the emergency departments dropped from 33% of patients to 12%. Interestingly, readmissions were largely unchanged.

Posted in Uncategorised by Douglas Fahlbusch
March 30, 2016

Press Release 30th March 2016

‘Larry’ – the Digital Analyst Set to Help Shape Better Healthcare

Complexica Pty Ltd, a leading provider of Artificial Intelligence software that helps organisations sell more products and services, and reduce their labour costs and headcount, announced today that it has signed a partnership with healthcare consulting company, Perioperative to provide a more comprehensive, end-to-end solution for healthcare organisations wanting to enable automated analytics, insights and data-driven decisions.

Matt Michalewicz, Managing Director of Complexica, said: ‘ This is an exciting partnership we are embarking on and one of which I hope will make a significant improvement of healthcare for patients, staff and clinicians.

Under the partnership, Complexica will provide its flagship software product – Larry, the Digital Analyst – for automating complex analytical tasks, while Perioperative will provide related specialist healthcare consulting services. Beginning in 2016, Complexica and Perioperative will hold joint events and presentations on how companies and government organisations can leverage automated data analytics to drive improvements in clinical and commercial indicators in healthcare.

Dr Douglas Fah

Posted in Uncategorised by Douglas Fahlbusch
March 23, 2016

Help prevent hospital readmissions – be ‘SMART’ It’s a hot topic prioritized by hospitals – but what really can be done to reduce hospital readmissions? We can flip it around and regard it as ‘Improving patient care’ – after all this is what it will do – and be proactive with every inpatient. A patient with a long term chronic illness shouldn’t have to endure a life time of unnecessary hospital admissions. Likewise, an admitted patient shouldn’t be left in an uncertain state about how to care for themselves at home, without instructions to follow, and not knowing when to seek appropriate follow up care. For a hospital, readmitted patients become very costly as well as put the hospital reputation on the line. By following a few simple steps, these issues can be addressed and numbers of readmission lowered. To prevent readmissions, we need to:

  • Target the people most likely to benefit, followed by assessing their health related needs and risks.
  • Develop a care plan tailored to their needs, whilst also engaging other family members for support in carrying it out.
  • Ensure they have access to the appropriate medical support and
  • Facilitate communication and progress among all providers.

To prevent readmissions – use ‘SMART’ Hospitals should use ‘SMART’ forms for every pa

Posted in Uncategorised by Douglas Fahlbusch