Friday, October 5, 2012

Starting with the Facts, and Staying in action to make things better

The first presidential debate contained a lot of talk about our healthcare situation. Let me again say that the United States has the best-trained and hardest working doctors and nurses in the world. Unfortunately, they toil everyday in a broken system that makes their work of trying to prevent and treat illness very difficult. The US spends about 40% more per capita on healthcare than Germany, France, the Netherlands or any other industrialized country and our outcomes are generally no better and sometimes worse. In addition, the citizens of these other countries have significantly higher satisfaction with their systems. We are not buying value with our health care dollar. These are all statements of fact.

After stating the facts, leaders must engage people in creating solutions. In this blog, I have pointed out that these facts should not cause panic; there is great news here! Since we spend so much more on healthcare than these other countries, we could redesign our system and reach the so-called Triple Aim of better health, better care and lower cost. We could end the disgrace of hard working American citizens not having health insurance and being one illness away from bankruptcy and reduce health insurance costs for business, our government, and individuals. I am disappointed that neither debater made this case.

As Maryland Secretary of Health Joshua Sharfstein and his colleagues Laura Herrera and Charles Milligan pointed out in their recent commentary in the Baltimore Sun, the fundamental shift that must happen is moving from a payment system that rewards handsomely the provision of some healthcare services but does not incentivize care coordination, to one in which teams of clinicians help individual patients manage their health. We have many wonderful hospitals and our present system is very good at dealing with acute episodes of illness – there is no better country to be in if you have just been hit by a car or you have acute appendicitis – but not very good if you have a chronic illness like diabetes at assuring that you get only the best care to prevent you from getting sicker. Our system uses the Emergency Department and now Urgent Care Centers as the pathways of least resistance leading to more utilization and less coordination.  The notion of the patient-centered medical home is an outstanding design for coordination. Primary care teams, led by physicians, with office hours 7 days per week and with the use of information technology to have all of the patient’s information available when it is needed, can improve health and the patient’s experience with the care as they are reducing the cost of care by driving out wasteful practices, like extra tests, unnecessary hospital admissions, and Emergency Department and Urgent Care visits.

To get to a better system we have two large challenges. The first is the challenge of redesigning the system – to take resources from our current hospital-centric system and apply them to the new system. We need to let the public know that we have too much hospital capacity. Rather than propping up failing hospitals, we should be funding the new design. The second is to change the reimbursement system so that we are buying the health care we want – that which leads to measurably better health and better care – and not just a lot of services.

The GBMC HealthCare system, a not for profit company with a mission of serving the health care needs of our community is racing to transform itself to get to the Triple Aim. The stakes are high but the people we serve desperately need us to do this. The facts are the facts, there is no debate about this.

Spectacular Saturday in the Country Benefits GBMC HealthCare

The 12th running of The Legacy Chase at Shawan Downs last weekend was a huge success.  Great weather, beautiful horses, a picturesque countryside setting and many family and friends – there were approximately 4,500 attendees this year – coming together equaled a spectacular time.

And it was all for a good cause, as the money raised benefits patient care at the GBMC HealthCare system. In previous years The Legacy Chase at Shawan Downs has generated considerable financial support for GBMC’s Nursing, Emergency and Pediatric Emergency Departments.

Funds raised from the 2012 Legacy Chase will support Emergency Medicine at GBMC. GBMC HealthCare’s own Dr. Jeffrey Sternlicht, Chairman of Emergency Medicine, has served as the Medical Director of Legacy Chase and other high-profile horse races for more than 10 years. We’ve launched an endowment campaign to honor Dr. Sternlicht and the exceptional work of his medical team. Annual income from the endowment will be dedicated solely to GBMC Emergency Services. To date, we have raised more than $1 million towards the $1.5 million campaign and look forward to formally presenting it by the end of the year.

Stretched across 300 acres of green meadows at Shawan Downs in Northern Baltimore County, The Legacy Chase attracts visitors of all ages for the steeplechase races, railside tailgating, live music, great food, and family-friendly activities. Many of the crowd-pleasing traditions continued this year—such as the G. Leslie Grimes Memorial Stick Pony Race for kids— and GBMC added some exciting new components to help make this year’s event a success.

The “Chase on the Hill” wine tasting lecture and luncheon proved very popular; Baltimore-based band GAZZE kept everyone musically satisfied throughout the afternoon – even being accompanied at one point by our own Reggie Davis, M.D., Director of Neurosciences, and Gary Cohen, M.D,, medical director of the Sandra and Malcolm Berman Comprehensive Cancer Institute; the GBMC Kids' Korner with moon bounces and face painting was well attended and people enjoyed the three food trucks (Chowhound, Iced Gems, and Hula Honey's Shaved Ice).

This year’s Legacy Chase was, for the first time, managed by GBMC staff and volunteers. Kudos to the GBMC Foundation team and everyone from across the organization who helped make the 12th annual Legacy Chase the best yet!

Finally, thanks to our friends at the Land Preservation Trust and to Charlie Fenwick, one of the Legacy Chase event founders, himself a champion steeplechase rider and former chairman of the GBMC healthcare board, without whom the event couldn’t have been as successful as it was.

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