What follows is excerpted from a recent healthcare reform briefing paper by Chad Karls, “Retooling Medical Professional Liability”:
Clinical guidelines are not a new idea, but the idea of using them to shield doctors from malpractice lawsuits has gained some purchase of late. The idea is to establish a list of agreed-upon, evidence-based guidelines, which, if followed, would give physicians and other healthcare providers safe harbor from claims of malpractice. In addition, if physicians are in fact protected from medical negligence lawsuits provided they follow such guidelines, this could have an additional and significant benefit of reducing the level of defensive medicine that takes place.
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Evidence-based Requirements, Medmal, Reform
Chad Karls, medical malpractice, Milliman Care Guidelines
Milliman clinicians Helen Blumen and Lynn Nemiccolo have published a new healthcare reform research report about the relationship between improving healthcare quality and finding new efficiency in the delivery of care.
Q: How much waste is present in today’s healthcare system?
A: Milliman’s actuaries have concluded that the amount of waste in the U.S. healthcare system is in excess of 25% of total healthcare spending, or more than $600 billion in 2008 dollars. These estimates square with the numbers put forward by other prominent sources.
Q: How does Milliman define waste?
A: Milliman has defined inefficiency or waste within the healthcare delivery system as unnecessary, redundant, or ineffective treatment (and the costs associated with such treatment). This includes treatment that is contrary to, or not demonstrably associated with, healthcare quality and outcomes. Looking beyond the care delivery system, inefficiency also includes costs that are not demonstrably associated with a sound approach to enabling full access for everyone to appropriate healthcare coverage.
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Convergence, Efficiency, Quality of Care
Convergence, Helen Blumen, Lynn Nemiccolo, Milliman Care Guidelines
As the business of healthcare becomes more global, best practices will increasingly migrate around the world. A recent example of this trend has emerged in Austrailia, where hospitals are using the Milliman Care Guidelines via handheld devices in order to improve outcomes, reduce unnecessary care, and optimize length of stay. In the words of Milliman Principal Scott Harris:
“The tool helps avoid delays in care, can reduce underuse, overuse and misuse of medical resources, provides planning tools to anticipate patient needs and includes patient education tools…One of the key outcomes we have shown is that using these tools can appropriately shorten patient length of stay in hospital. This not only improves the patient experience, but reduces the possibility of hospital acquired infections and can place the patient at a more suitable care setting.”
Electronic Health Records, Global, Portablity, Quality of Care
Australia, Milliman Care Guidelines, Scott Harris
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