A 'new call' for health care

Re: "What about the Poor?" by Joe Flower in H&HN Daily, Jan. 28

Joe, thank you for a great article. It is time for us to not only think about the hospital processes but all the possible touch points where we can help the underinsured manage their health. More than 80 percent of this population have phones or smartphones. These are their lifeblood in managing their complex lives with limited resources.

Studies have shown that texting and engaging with patients on an individual basis have helped with medication compliance and patient education. Large studies are now being done to assess how certain diseases can be better managed outside of the hospital. One study in asthma is defining how technology can help patients and their families better manage the disease at home and away from the ER.

Personalized, disease-specific information can be provided on the patient's device of choice 24/7. It is time organizations develop an enterprise patient engagement strategy that connects patients with their community, health care resources and each other. Prevention and engagement should be the new call to health care. Other industries have learned how to engage us through technology. It is time we learn how to use this powerful resource in concert with face-to-face care.

— Sue Sutton

Compare, but be fair

Re: "Transparency in Health Care: Coming Soon to Your Hospital" by Michael N. Abrams and Daniel King in H&HN Daily, Feb. 20

I agree with transparency. However, I work at an inner-city hospital whose patients are much sicker when they arrive than their counterparts in other private facilities. In fact, they have more comorbidities and more advanced disease that skews their outcomes. Just like a clinical trial where confounding variables and comorbidities are controlled, so, too, any clinical measure must control for these variables.

The point is that there must be an underlying scientific methodology that allows for meaningful comparisons. In the above examples, surgeons and specialists may avoid sicker patients because it will affect their outcome statistics and costs of care. Also, the physicians taking care of these patients may be routinely taking care of more difficult cases with many other things going on which drives up the cost statistics and also is a risk factor for poorer outcomes. Those physicians may be more adept at taking care of sicker patients but look worse than their peers with regard to metrics used to compare care.

So I am asking the medical community to use scientific methodology to create metrics that are more meaningful, otherwise both patients and physicians may ultimately lose out.

— Daniel R. Deakter

Resistance is futile

Re: "Getting Doctors in Sync with Patients and mHealth" by Eric Topol, M.D., in H&HN Daily, Feb. 20

Blockbuster never realized that Netflix can kill their traditional business. Book publishers never realized that Amazon could do a better job than they. Large enterprises never realized that cloud and other technologies are bypassing their IT departments and users are directly accessing mobile apps.

In the name of privacy, HIPAA and medicine, some doctors are still resisting the changes. I guess it is a matter of time before doctors come on board. Also, costs are driven down with new apps and mHealth devices. Unfortunately, consumers have to go with the existing practices until most of the doctors come on board, if not all. Hopefully, it will not be too long.

— Paddu G

Inclusion starts with leaders

Re: "Managing a Generationally Diverse Workforce" by James A. Diegel and Rhoby Tio in H&HN Daily Feb. 13

When leadership is accountable for inclusion, then inclusion becomes the culture. You cannot mandate inclusion or teach classes on valuing differences as a replacement for actually valuing difference. This post gets it right where examples of representation are concerned. When different generations (or any other difference noted) are included in leadership, the discussion can shape the process and the natural result will be an inclusive organization.

— Linda Galindo