The basics of care delivery are broken. And must be fixed … now.
By George Martin, MD – Senior Medical Director for Health Integrated

The telephone conversation went something like this:

“Good morning.  This is Stan Smith,” I said.

“Hello is this Mr. Smith?,” came the response.

“Yes, this is Dr. Smith. How can I help you?,” I replied

“Mr. Smith, this is Delilah, your wife’s case manager and I need your home address,” said the voice at the far end. (more…)

Limited Resources – Targeted Care
By George Martin, MD – Senior Medical Director for Health Integrated

In July 2008, Congress enacted the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 (P.L. 110-275) which restricted enrollment in chronic condition Special Needs Plans (CCSNPs) to special needs individuals that “have one or more co-morbid and medically complex chronic conditions that are substantially disabling or life-threatening, have a high risk of hospitalization or other significant adverse health outcomes, and require specialized delivery systems across domains of care.” (more…)

Customers, Suppliers and Other Confusing Relationships
By George Martin, MD – Senior Medical Director for Health Integrated

In the world of business and quality improvement, relationships are important, well defined and generally obvious. In the world of healthcare delivery, they are no less important but not as well defined and sometimes not at all obvious. So let’s start by defining  each role and then examine their relationships in the health care context. (more…)

Handoffs and the coordination of care
By George Martin, MD – Senior Medical Director for Health Integrated

Change comes to medicine in various ways. Some are obvious and others are obscure. One obvious change is that of interventions for heart disease. Who does not know someone who has a bypass operation or a stent placed for ischemic heart disease? Another is the use of laparoscopes for abdominal surgery. An open cholecystectomy (gall bladder removal) used to require six weeks of recovery and inpatient care. Now it is an outpatient procedure with return to normal activity is a few days. (more…)

How do you define a Useful Measurement in Healthcare?
By George Martin, MD – Senior Medical Director for Health Integrated

For those of you who remember basic math, the following formula will be familiar: 1/0 = ∞.  This is often referred to as infinity.  Dividing by zero fails to yield a useful number.  This is a useful concept to remember, both in healthcare and business.  In medicine, the concept is useful because of the way we have defined outcomes measures. (more…)