Health care under Glass

Rhode Island Hospital ER docs will soon have a new instrument: Google Glass.

Physicians at the Providence-based teaching hospital will use Google Glass for real-time consults with consenting patients who need a dermatology consultation. 

"We live in a world of instant gratification, and in many ways, we’re testing that mindset by using Google Glass to enhance telemedicine in the emergency department,” said principal investigator Paul Porter, MD, a physician in the emergency departments of Rhode Island, Hasbro Children’s and The Miriam hospitals. 

Using the video-enabled goggles, the attending ER physician can live stream video of the patient's skin to a consulting dermatologist, who will view the video in real time on a tablet.

The hospital is working with a third party to modify the stock Google Glass so it is HIPAA compliant.

Rhode Island Hospital is the first in the nation to study the efficacy of using Glass in the ER setting.


Is your visit to the "ER" driving up health care costs?

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In Houston, your closest Emergency Room is pretty darn close.

It's part of a hot national trend of building freestanding ERs. They are more convenient and usually speedier than the traditional ER that is attached to a hospital. They also cost more.

Houston already has a bunch, according to a recent piece in Kaiser Heath News (KHN).

Nowhere is the trend hotter than in the Houston metropolitan area, with 41 freestanding ERs and 10 more under development. Counting the freestanding ERs and traditional hospital-based ERs, greater Houston has 150 emergency rooms — twice the number as Greater Miami — even though its population is only slightly bigger, according to a KHN analysis.

These facilities are often co-owned by physicians and are "often located near high-end shopping centers, … target consumers with private insurance [and] bill like regular emergency rooms." 

The KHN piece analyzes the costs to the health care system associated with these new facilities. They can "charge insurers double or triple the amount per patient as an urgent care center or doctor's office." Some patients are using them for routine care that would cost less in their physician's office.


Insurers have little power to stop patients from using the facilities because by state law, they must pay for ER coverage anytime a patient perceives they have an emergency, regardless of whether that turns out to be the case. For that reason, the freestanding ERs have no need to contract with insurers and offer discounts.
The main reason they are more costly than urgent care is that they charge a "facility fee" on top of a fee for the physician's time—just like traditional ERs. The facility fee was originally intended as a way to help hospitals recoup overhead costs including 24-hour staffing, administration and equipment. 

Price and cost are considerations every health care consumer will sooner or later need to address. 

If the Affordable Care Act is going to make care, well, "affordable," health systems and physicians will need to be more assertive in educating patients about using the right facility at the right time to receive the right care.

That way, everyone can win.

Original source: Columbia Journalism Review


Novel approach gets 'Frequent Fliers' out of Oregon ER

Emergency Rooms are good for emergencies. But many people use them as their doctor's office.

These so-called "frequent fliers" often visit ERs for issues that could more easily — and inexpensively — be treated in a physician's office. The result is longer waits, higher costs and less satisfied patients.

Now Oregon is testing a program, Health Share, to see if they can change that.

Health Share of Oregon emerged from a group of private and public organizations addressing a single, complicated question: Can we together improve the quality of care and the care experience of Oregon Health Plan members, and do it for less money?

Early results are anecdotal, but Oregon has five years and almost $2 billion of federal backing to prove it can.

And, along the way, I expect they will have healthier and more satisfied patients.

Listen to an NPR piece jointly reported by NPR, Oregon Public Broadcasting and Kaiser Health News.