Greetings!

While Congress is actually moving forward with system reform, we need systemic reform in the ways we deliver health care services.

The current issue of Newsweek has a powerful article: What You Don't Know Might Kill You

http://www.newsweek.com/id/218235

Earlier, Atul Gawande in The New Yorker talked about care variations between cities and regions,

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

We also have Shannon Brownlee's wonderful book: Overtreated.

I think we will have significant reform coming our of Congress this year. As our Congressman from Washington State said recently, "What we are building now is the foundation for reform." Which is a good way of looking at what is in the offing. So far, this reform is reflecting our finding of what the public wants.

InTheirVoices.pdf

Care Variations

But, if we are to have long-term and meaningful reform, we need to look at the tremendous care variations for the same procedure as Gawande so artfully outlined. Few groups are doing that in any claims data, which one reflects what was coded and billed.

One group in Washington State has been addressing these care variation for years with excellent outcomes: The Foundation for Health Care Quality.

http://www.qualityhealth.org

Their Clinical Outcomes Assessment Program (COAP) just listed the performance of participating hospitals on how their cardiac care met state standards.

http://www.coap.org/public/metrics.html

The Surgical Clinical Outcomes Assessment Program (SCOAP)

http://www.scoapchecklist.org

now has a surgical and ambulatory surgical care checklists in half the hospitals in Washington State. Why these checklists are not in every hospital in the country is beyond me.

Their Washington Patient Safety Coalition now has a Medication Safety Initiative

http://www.mymedicinelist.org

"My Medicine List" can now be shared with all the patient's health care providers from MD to Pharmacy.

While these are not simple steps in all cases, they do have an impact. We should be doing this on a national level.

"Why a patient can put their lives in the hand of a doctor and have no idea of the doctor's prior experience, is totally beyond me," Terry Rogers, MD, CEO, Foundation for Health Care Quality. "Right now, you can't get that information quickly and reliably anywhere."

"What is also true is that there is a 3 to 40% variation in care for maternal deliveries. This is something women have been doing for thousands of years. It is astonishing such a range of variations exists, right here in Puget Sound, one of the most sophisticated medical markets in the country," Rogers added.

Interested in following patient safety issues? Here is an interesting blog:

http://community.the-hospitalist.org/blogs/default.aspx

Compared to Airlines

Two pilots missed Minneapolis by 100 miles. No one died. The plane arrived safely. They will probably lose their jobs. Or fly desks instead of planes. Over 100,000 people die every year from medical errors. That is the equivalent of 400 Boeing 747 crashes every year.

We need a health care FAA and we need it now.

Remember the White House Challenge?

Organizing for America challenged the public to send in 30 second video clips on health care. They have selected the top videos. You can vote!

Finally, while we urge you to urge your Congressional delegation to pass the upcoming legislation, we also want to urge the delegations to start looking at the true transformation of our health care and providing services that are at least as safe as airlines.

Sincerely,

Kathleen.