Defining population health

Re: "Which Populations? Whose Health?" by Emily Friedman in H&HN Daily, June 4

This is an excellent article that expands the language for population health. Clinical medicine cannot adequately address the health of entire populations, but physicians, other health care providers and those in administrative leadership can and should be their communities' leaders. We are talking about the social determinants of health when we look at the main drivers of good and bad health within a community. It's a big long-term job, but we have to make our communities grasp the significance of social equity as we work to improve population health.

Art Sutherland, M.D.

A need for young leaders

Re: "Who Will Lead Your Hospital?" by Laura Putre in May H&HN

I wanted to give you thanks for bringing attention to a topic that most health care organizations have been ignoring for years. As a Generation Yer and our youngest director by nearly 10 years, it was nice to see that other organizations are welcoming to the administrative fellowship route. This summer will mark our third commitment to an administrative fellow. As one of the first two administrative fellows, it is nice to hear that other organizations are addressing this concern. Thanks for bringing attention to the need for young leaders.

Zach Treister
St. Elizabeth Physicians
Crestview Hills, Ky.

Sniping about HIT is no help

Re: "The Paper Chase: Why Are Some Providers Reluctant to Embrace Health Information Technology?" by Emily Friedman in H&HN Daily, April 2

Love your serious discussion with humorous overlay. I wish more people on both sides of the EHR/HIT bandwagon would listen more to the other and address real issues rather than shoot the messengers. And that detractors would be realistic about the realities of paper-based systems and the pain of any change.

What I would most like to see is CIS developers admit they are not human factors/user-interface experts, nor do they deeply understand clinician workflow issues. And that vendor executives would realize there could be a huge ROI on investment in time and dollars for better designed systems, not just rushing products to market. Meaningful use has exacerbated this problem. Til now, health care organizations have not held vendors' feet to the fire, and with the cost of changing systems there has been little penalty for poorly designed systems, just a lot of justified griping.

Ann Farrell

One way to reduce readmissions

Re: "Addressing the Human Factors Behind Readmissions" by Asad Zaman, M.D., and Lucy Zielinksi in H&HN Daily, May 30

Dr. Zaman makes an important point in reference to nurse practitioners stationed at long-term care facilities. A strong, involved medical director who supports the NP and intervenes when the NP is unable to reach the attending physician in a timely manner is crucial in reducing readmissions. Furthermore, strong communication between the medical director and the NP stationed at the facility can foster discussions to troubleshoot reasons for readmissions tailored to that particular facility, and the information can be used to decrease future re-admission rates. This was a thoughtful, well-written article with innovative ideas to tackle a timely topic that has far-reaching effects on our health care delivery system.


Relating strategy to execution

Re: "The Discipline of Success" by Dan Beckham in H&HN Daily, June 18

Good article. Yet, we still operate mostly in a market where price is unimportant to the consumer-patient. That is changing, though, and health care organizations will have to think more about, and act on, what you are writing about. My observation, and something I blog about, is that strategy and execution are distant relatives in the health care world. And aligning culture to strategy and execution is still a work not in progress in most places.

Donald Bellefeuille