Category Archives: Value-based purchasing

Oct 8 2012
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Improving Medical Education to Focus on Delivering Value to Patients

The Robert Wood Johnson Foundation Human Capital Blog is asking diverse experts: What is and isn’t working in health professions education today, and what changes are needed to prepare a high-functioning health and health care workforce that can meet the country’s current and emerging needs? Today’s post is by Mitesh Patel, MD, MBA, a Robert Wood Johnson Foundation Clinical Scholar and senior fellow at the Leonard Davis Institute for Health Economics at the University of Pennsylvania, a member of the AAIM-ACP High-Value, Cost-Conscious Care Curriculum Development Committee, and a practicing physician at the Philadelphia Veteran Affairs Medical Center.  He is also the author of Clinical Wards Secrets, a guide for medical students transitioning from the classroom to hospital wards.

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Health care costs continue to escalate.  Concurrently, the amount of published medical research has increased 10-fold over the last decade.  Each of these changes combined with recent health care reform has led to a rapidly evolving health care system.  Unfortunately, medical education has been unable to keep pace with these changes. 

Health care professionals find themselves searching for ways to deliver better value for their patients.  They are looking for an opportunity to become a part of the solution to stemming the rising costs while still providing high-quality, evidence-based care.

The American College of Physicians (ACP), the Accreditation Council for Graduate Medical Education (ACGME), and the Medicare Payment Advisory Commission (MedPAC) have each recognized these deficits among the health care workforce.  They’ve called for a restructuring of medical education to address these issues.  However, teaching hospitals and medical educators lack a common strategy to accomplish this daunting task.  To address these issues, my research team and I studied approaches to transforming medical education to help prepare providers to assess and deliver value-based care for their patients.

To better prepare a high-functioning health and health care workforce, we must start by gaining a better understanding of the problem.  In 2009, we published the first study that shed light on this issue on a national scale.  We found that among U.S. medical students, less than half felt they were appropriately trained in topics relating to the practice of medicine such as medical economics.  In addition, we found that a higher intensity curriculum in health care systems resulted in a payoff, not a tradeoff.

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Sep 6 2012
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Human Capital News Roundup: Nursing environments, value-based care, recognizing signs of violence, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

Zachary Goldberger, MD, an RWJF Clinical Scholar, spoke to the New York Times about a study he led that examined the ideal amount of time to continue cardiopulmonary resuscitation (CPR) on patients in cardiac arrest. “The study found that patients have a better chance of surviving in hospitals that persist with CPR for just nine minutes longer, on average, than hospitals where efforts are halted earlier,” the story reports.  First published in The Lancet, the study is one of the first to link the duration of CPR efforts with survival rates.  It is expected to prompt hospitals to reconsider their protocols.

RWJF Health & Society Scholar Jason Houle, PhD, continues to receive media coverage for his study that finds students from middle-income families leave school with an average of $6,000 more in student loan debt than their lower-income peers. The students were also more likely to have more student loan debt than their higher-income peers. Among the outlets to report on the findings: United Press International, Bloomberg Business Week, the Atlanta Journal-Constitution, and the Wisconsin State Journal.

A study supported by the RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) finds that “when nurses take steps to intervene in the medication process, they are more likely to catch would-be errors before they reach the patient,” Fierce Healthcare reports. The findings also indicate that a supportive practice environment is associated with a higher quality of nursing care. Read more about the study.

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