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Some of these "quality report cards" provide data on preventive services, such as the percentage of age-eligible women receiving mammograms or Pap smears. Others focus directly on life-and-death matters, including mortality rates after serious illness or high-risk surgeries. Performance can vary enormously. In the several states now reporting risk-adjusted mortality rates following coronary-artery bypass surgery, for example, top-performing surgeons often have mortality rates half those of the lowest performers.

With such striking differences, one might expect quality report cards to play a key role in medical decision-making. Yet patients rarely use them, and many doctors question their reliability, especially when data pertain to individual physicians. Doctors also worry that calling public attention to inadequacies will impede professional efforts to improve care. Nonetheless, quality report cards work: repeatedly we see that when poor quality of care is made public, providers intensify efforts to improve it.

So how do we take the best advantage of this medical Zagat's? Most important, we stay the course. Yes, work must continue to improve fairness and accuracy, but shedding sunlight on medical practice is unquestionably healthy medicine for patients.
Arnold M. Epstein, M.D. Chair of the Department of Health Care Policy and Management at Harvard School of Public Health and professor of Medicine at Harvard Medical School and Brigham and Women's Hospital

Wire American Medicine
Polls show that most Americans think their doctors routinely use computers to care for them. After all, this is supposed to be the most technologically advanced medical-care system in the world. But when it comes to patients' records, the great majority of U.S. doctors still rely on technology that predates the printing press: scrawled, often illegible notes that have an uncanny tendency to go missing just when they're needed most.

Experts believe that if hospitals and doctors used electronic health records (EHRs)—systems that store and manage patients' medical information—they could vastly improve the quality of care and reduce costs. For example, such records would routinely warn doctors against giving medicines to patients who are allergic. In the typical paper-based record, it can be hard to find test results—leading to unnecessary repeat tests, and costs. President Bush is so convinced of the value of EHRs that he wants all doctors to adopt them by 2014.

But progress has been slow. The first reason is money. To wire our entire health-care system would cost an estimated $160 billion, and many small physician practices and hospitals are balking. They also fear that installing EHRs will disrupt their work and increase malpractice liability.

 
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Member Comments
  • Posted By: Micky Marsh @ 05/27/2008 11:20:25 AM

    Comment: I strongly believe that the upgrading of women's maternity leave, before and after delivery should be on the top five medical fix list.

  • Posted By: concerned4u @ 05/26/2008 1:30:27 PM

    Comment: Health care in the U.S. is beyond crisis. I am ashamed that our presidential candidates can pump millions into campaigns while we have people in our own country dying from lack of proper medical care from not being able to afford the cost. This has touched me personally and the more I look into the situation the uglier it gets. It's all in the name of "greed". No one should be turned away for not having medical insurance and not being able to quality for some type of assistance. The problem is so massive that we may have to start on a local scale to address the problem and work our way up to national. I don't have the answer but am working with many people trying to address the issue.

  • Posted By: azlizird @ 05/26/2008 12:04:29 AM

    Comment: Stop floating money into space and put it to use solving the drug and health care problem. Viola, end of problem. azlizird

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