Re: “Taking that First Key Step Toward Population Health Management” by Marty Stempniak, H&HN Daily, Oct. 20 The post is right on, but I do believe that there is a shortcoming and it centers on one word — “traditional,” i.e. “a traditional physician-hospital organization might not be able to pull off shared savings …” Population health calls on leaders in health care to move away from the traditional ways we provide services to new models. Breaking away from the old also suggests that we need to break away from the old “physician-hospital” based leadership structure to a new, more complete population health-related structure, one that recognizes that there is a third force that needs to be part of the governing structure, the home and community health care sector. The bulk of the population — the pre and post-acute population — live in the community. Services are the least costly. It is the sector where the vast majority of chronically ill patients live. It is the sector where prevention has its greatest potential. It is the sector where the re-hospitalized patients come from. While not a traditional member of the health care power elite, it is the sector that offers the most potential. Involving this critical sector has the potential of accelerating the development of new models, lowering of cost and improvement in patient care and quality.

— Bob Fazzi

Equal Access

Re: “ONC Eyes Ways to Improve Patient Engagement” by Marty Stempniak in H&HN Daily, Oct. 13.

Patient engagement is an emergent property of a patient-centered health care system and reflects the well-known concept that systems-level problems require systems-level interventions. Patients, in fact, are already fully engaged — what they seek in many cases is autonomy and a “divorce” from the sick care system as much as possible.

Patient engagement has very little to do with data (vs. information or changing roles) and everything to do with ensuring that everyone on the care team (which includes patients) has equal access to their health information (both in the EHR and in their devices). Projects like Open Notes (patients are given full and equal access to their EHRs) should be highighted and encouraged and ways found to spread this rapidly.

As many of us have told ONC for over five years, they need to shift from “engagement” or communication strategies that focus on "blue button data" to patient-centered design (in both tech and policy) and partner with EHR vendors, medical associations and national organizations that share the view of patient-centered care.

— Sherry

ICD-10 and the CEO

Re: "ICD: Why Should the CEO Care?" by Marty Fattig in H&HN Daily, Oct. 10

Without the proper planning and support, ICD-10 can have an enormous impact on an organization’s revenue and cash flow. The new requirements for documentation and specificity will test even the most prepared providers. It’s worth making sure your internal team has the support and resources needed to help minimize the possible negative impact on revenues. CEO support is essential to get the job done.

— Charlie Saponaro

So Long, Mary, and Good Luck

Mary Grayson’s October farewell column before she retired as Health Forum’s editorial director of executive publications prompted numerous responses and best wishes from longtime readers. Here is a representative selection:

Mary is someone I've long admired — as I'm sure many have — without having taken the time to let her know. We appreciate her style, smarts and "soul" — and ability to cut to the chase. There really are few people who make such an impression; they are irreplaceable, but Mary is surely one of them. Touche on a great job and best wishes for her next adventure.

— Ann Farrell

Thank you, Mary, for always making it real. Have a wonderful after career!

— Gwenmarie Hilleary

A classy finale from one of the best journalists in health care publishing ... I will miss her ... as a reader and a friend!

— Rick Wade

Mary, it is wonderful to know you will be thinking of "us", but please, don't think of us too often. Enjoy the new period in your life.

— Jamie Kowalski


The September article "Treating the Patient's Voice as a Strategic Imperative" contained misleading information. The article explained that the University of Pittsburgh Medical Center was one of the first organizations to set up rapid-response teams in 2005 following the death of an 18-month-old girl from dehydration and drug misuse, among other factors. The article should have noted that the incident occurred at another hospital, not at UPMC.