FEATURE EDITORIAL
FROM LOCAL INDUSTRY LEADERS Leaders in the health care industry weigh in on the changes
and hurdles that hospitals and physicians will face in the near future. Florida Hospital Volusia/Flagler CEO Daryl Tol and Bert Fish Medical Center CEO Steve Harrell lend their expertise on the subject.
What will be the biggest challenges for health care in the coming year?
Harrell: Watching the outcome of the presidential election; with that will come the possibility of repeal of national health care reform or preparation to move forward with transition under the current legislation.
Tol: Transition and uncertainty. The political and legal questions surrounding health care reform leave many question marks and significant layers of fog between now and someday. Meanwhile, government budgets are constrained, leading to drops in Medicaid and Medicare reimbursement.
How will changes outlined in the Patient Protection and Affordable Care Act (PPACA) impact hospitals, physicians and patients in the region?
Harrell: Managing the overall health of our communities, not just the acute episode of care that occurs in the traditional hospital, will represent a huge culture change for the health care industry.
Tol: It is probable that aspects of the act will change prior to implementation, either due to political or legal pressures. This makes it impossible to see the potential impact clearly. However, it is likely that payments for services will be constrained and more likely to be tied to quality of care than volume.
How will proposed changes in reimbursement from fee-for-service to bundle payments, or pay for performance, change the way hospitals and physicians conduct business?
Harrell: Physicians, hospitals and other providers will need to partner to achieve the goal of providing quality care to the communities they serve. Reimbursement will be based on measurable quality outcomes that can only be maximized by working collaboratively.
Tol: We will have to be more integrated, both through our technology infrastructure and pathways of care. Employment and group practice models are growing, hospitals are turning to ownership or unique partnerships with insurance companies, new structures of care are being tested, chronic disease management programs are being developed and more.
How is your hospital using information technology like iPhone apps, Telemedicine, websites and electronic medical records (EMR)?
Harrell: We have a fully implemented electronic medical record and over the next 18 months will continue to enhance its features.
Tol: Technology is everywhere. We are fully paperless with our records and provider orders running through our computer system. Before a patient receives a medication, a bar-coded
2012-2013 The Greater Daytona Healthcare GuideTM
bracelet on their wrist is scanned, as is a bar code on the medications, to ensure the right patient gets the right medication in the right dosage. Patients can interact [through] their televisions, access a full array of entertainment options, or send a compliment, question or concern directly to the CEO.
What are advantages of this technology?
Harrell: Advantages are immediate access to critical patient information delivered directly to the care provider’s device. Two- way interfaces also allow the physician to update or add orders based on the latest patient information, regardless of his location.
Tol: Technology can enhance patient safety, increase the consistency and reliability of care, and allow for better communication amongst caregivers and patients.
What are the disadvantages?
Harrell: Technology and its maintenance require a substantial capital outlay, so expense is always a consideration. Having the right technology to meet the needs of the patient and caregiver is critical and presents another set of challenges. With multigenerational caregivers come different levels of technological skill. However, we believe the investment in people and technology will ultimately enhance the patient experience and create positive patient outcomes.
Tol: Technology can also increase the complexity of the care environment, pull caregivers away from the bedside, and drive up costs for equipment and added staffing.
How does the increased use of information technology affect the interaction between hospital and patient?
Harrell: Today’s health care technology should facilitate the safe, effective and efficient delivery of care to the patient but also be transparent to the patient.
Tol: In the end, it improves safety and our ability to communicate with patients. We have to manage its use carefully, so that it doesn’t drive us away from the personal touch, which is so important in health care.
How can health care professionals keep the human touch in the digital age of health care?
Harrell: The interaction between caregiver and patient needs to be one on one, patient-centered, and in consideration of the whole patient—body, mind and spirit. That can only be accomplished by truly caring individuals who deliver skilled, compassionate care and keep the patient at the center of everything they do. Taking the extra time to explain to patients what is being done to them, and for what purpose, is imperative. Patients and their families need to be allowed to be a part of the caregiver team. Creating an environment of patient-centered care is ultimately all about human interaction.
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