Healthcare Update — 05-25-2012


Simulated training improves skills in real life cardiac resuscitations. Not sure that I believe sim training should be a replacement for real-life resuscitations, though, which is were I see this headed.

To heck with medical malpractice cases – this is a whole lot easier. Plaintiff attorneys begin gravitating toward cases in which there have been health care data privacy breaches. One of these days, hospitals will learn how to encrypt data.

Patients gone wild. Or possibly … “hey, I wanted to cook marshmallows while I was waiting.” Patient starts blanket on fire in emergency department. Fire spread to a stool. Swears at staff who try to curtail his fun, then kicks a police officer who comes to arrest him.

More patients gone wild. Or perhaps visitors gone wild. West Virginia man brings girlfriend to emergency department. Sees his own mother sitting in waiting room and beats her unconscious, then attacks another person who tries to break up fight.

New study by Healthleaders Media (.pdf file) shows that a perfect storm may be brewing. Nearly half of healthcare leaders believed that their own emergency departments were overcrowded and 93% of those leaders believed that the overcrowding affected patient safety. 56% of leaders noted an increase in emergency department volumes. 78% believe that reimbursement for emergency care will decrease under health reform. Patient flow remains the largest concern for the healthcare leaders, but reimbursement, physician staffing, nurse staffing, and compliance with “quality goals” are also large concerns. One third of hospitals surveyed attempt to divert patients from the emergency department — psychiatric problems, drug abuse, and alcohol abuse problems being the most commonly diverted complaints.

Study in Journal of Pediatrics (.pdf file) shows that pediatric emergency department patients with private insurance receive diagnostic testing and undergo procedures more often that pediatric emergency department patients with Medicaid or patients without insurance.
The natural inclination is to think that doctors are discriminating against patients without insurance or with public insurance in order to make more money. However, keep in mind that a vast majority of emergency physicians are paid by the hour and receive the same income whether they see 50 patients per shift or they see 5 patients per shift.
I think that a more plausible explanation is that pediatric patients with no insurance or with public insurance don’t have the same access to primary care physicians and therefore come to the emergency department with less serious complaints that don’t require testing or procedures.

TeamHealth and InQuickER join forces. TeamHealth is one of the larger ED staffing companies in the country and InQuickER is a company that uses computer technology to allow patients to make appointments for emergency department care.
Timing is interesting. A few weeks ago someone e-mailed me an article from the ED Legal Letter suggesting that scheduling appointments for care in emergency departments likely violates EMTALA because scheduled patients receive disparate (i.e. “QuickER”) care after they arrive. I recall reading something about this same issue oh … 3 years ago.


  1. Another potential explanation for the pediatric emergency department finding is that patients (or their parents) are requesting/refusing testing based on their ability to pay. Believe it or not, some people actually plan on paying their bills and make decisions based on whether they will be able to pay or not. Just a thought.

  2. There was not a difference between pediatric patients with public insurance vs. no insurance. What are the implications of this observation?

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