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  1. Nov 2018
    1. At a time of once-in-a-generation reform to healthcare in this country, the leaders of HM can’t afford to rest on their laurels, says Dr. Goldman. Three years ago, he wrote a paper for the Journal of Hospital Medicine titled “An Intellectual Agenda for Hospitalists.” In short, Dr. Goldman would like to see hospitalists move more into advancing science themselves rather than implementing the scientific discoveries of others. He cautions anyone against taking that as criticism of the field. “If hospitalists are going to be the people who implement what other people have found, they run the risk of being the ones who make sure everybody gets perioperative beta-blockers even if they don’t really work,” he says. “If you want to take it to the illogical extreme, you could have people who were experts in how most efficiently to do bloodletting. “The future for hospitalists, if they’re going to get to the next level—I think they can and will—is that they have to be in the discovery zone as well as the implementation zone.” Dr. Wachter says it’s about staying ahead of the curve. For 20 years, the field has been on the cutting edge of how hospitals treat patients. To grow even more, it will be crucial to keep that focus.

      Hospitalists can learn these skills through residency and fellowship training. In addition, through mentorship models that create evergrowing

    2. Dr. Bessler of Sound Physicians notes that advances in technology have come with their hurdles as well. Take the oft-maligned world of electronic medical records (EMRs). “EMRs are great for data, but they’re not workflow solutions,” Dr. Bessler says. “They don’t tell you what do next.” So Sound Physicians created its own technology platform, dubbed Sound Connect, that interacts with in-place EMRs at hospitals across the country. The in-house system takes the functional documentation of EMRs and overlays productivity protocols, Dr. Bessler says. “It allows us to run a standard workflow and drive reproducible results and put meaningful data in the hands of the docs on a daily basis in the way that an EMR is just not set up to do,” he adds. Technology will continue “to be instrumental, of course, but I think the key thing is interoperability, which plenty has been written on, so we’re not unique in that. The more the public demands and the clinicians demand … the better patient care will be. I think the concept of EMR companies not being easy to work with has to end.”

      Biggest challenge will be integration of different technological solutions and sources of data - workflows for delivering care and for research purposes (e.g., person-level QI initiatives, passive baseline data)

    1. Poor health literacy is a silent and ubiquitous health care issue, and the field of neurosurgery is particularly prone to the consequent adverse effects. Failure to address low health literacy has several detrimental health and economic consequences, and numerous policies have been initiated to address these. Better facilitating patient understanding of neurosurgical disease, treatment options, and care surrounding the operative period may have a positive impact on the health care economy and ultimately achieve improved outcomes for patients.

      Certain disciplines are particularly prone to consequent adverse effects of poor health literacy.