Disqus - Latest Comments for Giuseppina

Re: 6. Measurement

Giuseppina — Fri, 29 May 2009 16:35:26 -0000

Hoping not to sound too naive – but maybe the simpler perspective is to first define the "problem/s". It isn’t all about providers or incentives. Personal accountability is paramount.

Re: 6. Measurement

Giuseppina — Thu, 28 May 2009 18:35:27 -0000

The idea of an X Prize aimed at improving outcomes in healthcare is tremendously exciting. Personally, I am all for better, faster, cheaper…in anything! But the more I visited this blog and the more I think about the ‘rules of the game’; I come up with: “There’s just no way.” There are way too many individual variables to take into account.
Perhaps a way to approach such a contest would be to “specialize” in particular conditions, such as diabetes> the goal being the reduction of the A1c; or CHF>decreased hospitalizations; or medication adherence>medication adherence!
I do believe we can do SO MUCH BETTER – and I do believe it takes a team.

Re: 8. Teams

Giuseppina — Sat, 25 Apr 2009 17:51:37 -0000

I am in total agreement with Dr Brenner's first two suggestions on patient selection. I would, however, caution going after "the sickest patients in a region." Alas, there are unfortunate situations that defy ethics and economics. Some things we just cannot change.

Re: 1. Introduction

Giuseppina — Sat, 25 Apr 2009 17:39:33 -0000

I am very happy to see comments addressing the accountability of individuals for their own healtcare. Too often I hear about "the insurance companies wanting to dictate care" or that we need to incentivize providers to do a better job. So much of healthcare dollars are spent fixing what we could have prevented in the first place! (And it costs nothing to stop smoking and take a walk!) And I agree with Ron - we need to start with the kids!

Re: 6. Measurement

Giuseppina — Sat, 25 Apr 2009 16:38:17 -0000

What first came to my mind (upon hearing of the cohort of "10,000 files") was a 'case load' of individulas identified as "high risk" for high cost healthcare. Criteria for this status would include recent/ongoing service/s utilization (hospitalizations, frequent ER use), health history (diagnosis of chronic illness such as diabetes, CAD/HTN, asthma/COPD), obesity, tobacco use, polypharmacy (especially large amounts of pain medications) and any other category for which education, life-style changes, access to care would be able to impact.