http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande?currentPage=all
1% of patients account for 30% of costs
Really inspiring ideas.
Improve care for the most costly patients.
That will bring overall costs down.
That really makes sense considering how prevention can reduce emergency costs.
The idea of health coaches really stood out.
This is taken from the international arena of community health workers.
Also, Dr. Brenner used many of the community mapping ideas widely used in international development.
The analysis of data is vital in improving care.
Use insurance billing data or EMS data to find out where patients come from and then go find out why these patients are not receiving adequate care.
Each ER visit is a failure in the web of society, whether a result of crime, transportation, lack of access, drugs or economic circumstances.
Another great idea is the salaried doctor office. Doctors paid for their time, not for procedures.
This results in better outcomes.
Team approach to care, with nurses, front desk staff and health coaches included.
Nurses as case managers in medical home model.
Calling, following up, being like the patients mother.
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