In my two most recent blog posts, ‘Why process improvement, technology and common sense are critical to patient safety’ and ‘Pairing process improvement and technology to increase clinician satisfaction,’ I shared several articles illustrating the essential interplay between clinical process improvement and technology. Today’s post follows the same model to examine approaches for reducing waste in healthcare.
The first article looks at the waste and uncertainty that arise as clinicians try to provide high-quality care in the absence of clear processes. Published in The New York Times Magazine, ‘Can Doctors Choose between Saving Lives and Saving a Fortune?’ presents what the author describes as the doctors’ quandary — the extraordinary price of medical care, the incremental returns of value to a patient and the shifting responsibilities of a doctor — when faced with everyday choices, such as whether to prescribe a less costly blood thinner for a patient who has just survived a heart attack and undergone angioplasty or another medication that costs 25 times as much but is more effective in clot prevention. Is the doctor’s role to deliver the best care possible, period? Or balance medical benefit, financial cost and social responsibility? How are doctors supposed to weigh those choices in the immediacy of the moment?
The article references a study published in JAMA Network in March 2018 titled ‘Health Care Spending in the United States and Other High-Income Countries’ that has received a lot of press. The study focused on this question: Why is healthcare spending in the U.S. so much greater than in other high-income countries? Researchers identified three main drivers — administrative waste, pharmaceutical price and procedural cost. Healthcare providers in the U.S. order more tests and perform more high-cost surgical procedures (which often lead to complications and other downstream implications), we spend much more on medications, and have much higher administrative burdens compared to other high-income countries.
The solution to reducing waste in healthcare, according to The New York Times Magazine article’s author, is not for each doctor to make tough choices about balancing patient care and costs. Instead, through clinical process improvement solutions, healthcare systems need to streamline workflows, remove burdensome paperwork, reduce pharmaceutical prices through use of lower-cost alternatives and limit use of high-cost, low-value procedures when possible. Using LogicStream Health solutions, hundreds of hospitals around the country are making these and other process changes every day to reduce waste.
The second article delves deeper into one of the major drivers of cost – and waste – in the U.S. healthcare system: Prescription medications. ‘Inaccurate Prescriptions, Usage Costs U.S. $528.5 Billion Annually’ reports on a study by researchers at the Skaggs School of Pharmacy at the University of California San Diego. The study found that medications which were inaccurately prescribed or improperly taken led to medical problems and death, resulting in costs that accounted for 16 percent of the total U.S. healthcare budget in 2016. The solution? The authors say it will take better coding and tracking systems, improvements in monitoring patient outcomes, and improved medication management involving doctors working in collaboration with pharmacists so that the right medication and dosage are prescribed and administered for each patient.
Reducing waste in healthcare seems like a daunting task, but it can be done. It requires alignment of electronic health record (EHR) content and workflows with evidence-based strategies and best workflow practices to ensure appropriate utilization of medications, lab tests and other procedures. Collaboration among clinicians is essential to ensure the right clinical processes are put in place, and technology is needed to streamline workflows, track adherence to standardized procedures based on clinical best practices and measure results. Clinical process improvement tools – such as LogicStream Health’s solutions targeting medication, laboratory and opioid utilization – are helping healthcare systems across the country to control costs while improving quality and patient safety. Learn more by clicking the button below.
Brita Hansen, M.D., is Chief Medical Officer of LogicStream Health. She began her career as an internal medicine hospitalist physician after receiving her undergraduate degree at NYU and her Doctorate of Medicine from the University of Minnesota School of Medicine. She served as Chief Health Information Officer for the Hennepin County Medical Center before joining LogicStream Health.