Ten years ago, a prominent hospital leader offered a blunt response when I asked him to assess the current state of the U.S. health care system. "System? What system?" he said. "There's no health care system in this country."
Who could argue? Health care was delivered mostly by independent practitioners, be they physicians or hospitals. Coordination among providers — even those geographically close — was rare. Too little attention was paid to best practices — clinical or business — identified outside one's narrow sphere of operation. Access to health records by any provider other than a patient's personal physician was difficult if not impossible.
Today we find ourselves in the tumultuous and sometimes painful process of creating a true health care system. That's what "reform" is supposed to be all about. Done right, health care in the long run will be better in terms of quality and safety, efficiency and cost, and accessibility and patient experience.
Hospitals across the country are trying to do it right. The current issue of Hospitals & Health Networks offers a number of articles about hospitals that have targeted specific areas for improvement, such as accountable care or the use of information technology. In all of the articles we publish in H&HN, we focus on real-life examples of hospitals and health systems experimenting with new ways to deliver care and run their organizations better. Figuring out why one effort fails is almost as important as understanding why another succeeds. Spreading the word about all of the efforts, but particularly about the successes so that they can be adopted by providers everywhere, is a big H&HN goal.
Before our March issue comes out in a week or so, I wanted to make sure you didn't miss three articles among many in the February magazine that you might find useful as you and your hospital struggle to thrive in a swiftly changing health care environment:
• Population health is suddenly a priority for all providers as they work to create an effective continuum of care in their communities. But as John Morrissey notes in the February cover story, hospitals have a hard time finding professionals with both the clinical and analytical know-how to create and carry out a robust population health program. He shows how Park Nicollet Healthcare Partners in Minnesota, Catholic Health Initiatives based in Colorado, Norton Healthcare in Kentucky and others are developing competencies among their current staffs or from data experts outside the health care field to fill that void and enable effective population health management.
• In the February installment of our yearlong series "Connecting the Continuum," Morrissey surveys the evolution of health information exchange and finds that there are now three distinct approaches to planning and executing HIE, each with its own strengths and weaknesses. He spells out what those approaches look like and how organizations like the Indiana Health Information Exchange and Jersey Health Connect are maneuvering through the minefields to move steadily forward.
• Jeff Ferenc reports on what may be the most telling sign of the times: the trend toward so-called bedless hospitals. These represent the next level of ambulatory care facility, made possible through advances in high-tech imaging and surgical procedures that allow patients to receive highly sophisticated medical services without being admitted to a hospital. Montefiore Medical Center says it is "reshaping outpatient care" with one such facility — a freestanding 11-story, 280,000-square-foot tower in the Bronx that's set to open next year. It will include 12 operating rooms and four procedure rooms that Montefiore leaders say will make it possible for difficult cases requiring a hospital-type setting to be scheduled more easily and completed quickly.