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More Physicians Using Online Communication
Physicians' use of the internet and social networking media began to take hold in 2007, according to a recent iHealthBeat column. Last year saw the launch of the first blog about running a hospital, by Paul Levy, CEO of Boston's Beth Israel Deaconess Medical Center, and Sermo, a social networking site for physicians. (Sermo, by posing the question "Why consult one colleague when you can consult thousands?," enables users—who self-attest to be physicians living in the U.S. —to post and respond to questions about ways to improve patient care.) Another report, by the market research firm Jupiter Research, found that more physicians are using the Web for professional tasks. It cites, for example, that the number of physicians e-mailing their patients has grown from 20 percent in 2005 to 39 percent in 2007.

Universal Coverage + Health Reform = Real Savings, Report Says
Guaranteed health insurance for all, combined with federal policies to achieve cost savings, could result in $1.5 trillion in reduced spending over 10 years, according to a Commonwealth Fund report published last month. The authors explore 15 policy options focused on: the use of health information technology and evidence-based clinical decision-making; public health measures such as reducing smoking; financial incentives aligned with quality and efficiency such as hospital pay-for-performance and strengthening primary care; and policies that use the health care market to increase efficiency, add value, and reduce costs. For example, if Medicare were to pay primary care physician practices to provide enhanced access to care, manage beneficiaries' chronic conditions, and coordinate their care, and require all Medicare fee-for-service beneficiaries to enroll with such practices, it could result in net health system savings of $194 billion over 10 years.

Health spending in the U.S. is predicted to increase from $2 trillion to more than $4 trillion over the next 10 years—eventually consuming one out of every five dollars of national income. According to the report's findings, it is possible to curb this spending and, at the same time, bring health coverage to all and enhance the health care system's overall performance.

Health Insurers Refuse to Pay for Errors
Following the federal government's lead, private insurers, including Aetna and WellPoint, may refuse to pay for the costs of care related to serious medical errors, according to a Jan. 15 article in the Wall Street Journal (subscription required). Starting this October, Medicare will no longer reimburse hospitals for the costs of treating bed sores, falls, certain hospital-acquired infections, and other preventable conditions developed during hospital stays. This approach is intended to spur hospitals to invest in systems that improve patient safety. For now, private insurers plan to stop paying for only the most egregious errors, such as leaving a sponge in a patient after surgery. Aetna's new hospital contracts will stipulate that it will not pay for costs related to 28 serious errors, which are designated as "never events" by the National Quality Forum. WellPoint's contracts will target four of these "never events."

Physicians Willing to Discuss Errors, But Better Forums Needed
According to a recent study, most physicians—92 percent—are willing to report medical errors or near misses to their hospitals or health care organizations. In fact, 82 percent of physicians said they had reported an error to their risk management staff or filed an incident report. Yet many said such systems, on their own, do little to get at the root cause of errors or improve patient safety. Physicians said they relied on conversations with colleagues to discuss medical errors, indicating that health care organizations may be missing opportunities to uncover system-wide patient safety improvements. The survey of 1,082 U.S. physicians was published in the January/February issue of Health Affairs.

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