New patient-care model could avoid mistakes

By Lana Groves, Asst. News Editor

When 18-month-old David didn’t receive proper follow-up care after a regular hospital visit in Pennsylvania, he was brought in to a doctor months later with severe malnutrition. Years later, he was diagnosed with a seizure disorder and hearing loss and will have developmental problems for which hospitals and insurance companies will provide treatment and pay.

“It often happens,” said Michael Magill, a professor and chairman of the U’s family and preventive medicine department. “When patients get sick, they don’t receive comprehensive care. Our medical system is set up to pay for acute care8212;it’s not set up for us to treat a patient with pneumonia and then have the nurse call and make sure the patient is getting better.”

But with a new patient-centered medical home design, Magill said patients can receive the kind of comprehensive care that David didn’t.

The U is hosting a symposium to explain the new program that would “transform” medical care across the country. Magill said the lectures will bring insurance companies, local health providers, physicians and state agencies interested in hearing about a medical system that could raise the bar for Utah health care.

“Patients have to go to one doctor for the heart, another for stomach problems and another doctor for high blood pressure, but what happens is a patient falls through the cracks,” Magill said. “One hospital doesn’t tell another hospital what happened and the care becomes fragmented.”

Paul Grundy, the director of Global Health Care Transformation for International Business Machines Corp., an information technology company, is leading the initiative to transform health care and working with Magill to host the symposium.

“We’re one of the few countries that hasn’t transformed health care,” Grundy said. “In many other countries, the primary care doctors are the ones that deliver primary care service, but not here.”

The Utah Legislative Task Force on Health System Reform called for projects that would demonstrate a medical home model to transform health care, which Magill said state leaders will likely test by early 2010. Part of the reform will change to help more patients be seen by physicians on a regular basis.

“It was one of the things the task force encouraged,” Magill said. “The two sides of it are health care delivery and what the buyers of health care will pay.”

For Medicare payments, Magill said the government would pay about $50 per month for each patient, and then after medical care has been issued or a hospital visit, they would pay the hospital additional funds.

“Tests have shown that some of the best results in reducing cost of care is by treating patients up front instead of letting it go,” Magill said. “Uninsured folks go to the emergency room, and the hospital ends up swallowing the cost. It’s cheaper to treat problems early, which is why Medicare would be willing to pay more for that treatment.”

Grundy said it could take a few years to alter the system of patient care and organize an environment where patients could visit physicians at any time and receive reminder notices about hospital visits and medicines.

Physicians will need to work together at all levels, but the Utah Health Information Network can be used to document detailed patient information, Magill said.

“It’s the same idea being used in banks where customers receive updates and can check account information online,” Magill said.

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