United we stand, divided we fall

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Kaitlyn Dmyterko - Portrait - 160.99 Kb
Kaitlyn Dmyterko,
Associate Editor

As I think about the current healthcare system and all of its strong attributes, it is hard to overlook the fact that it also is fragmented, disjointed and laced with high price tags. This week, several stories focused on how to work toward a more cost-efficient, patient centric-based system. I can’t help but revert back to the 1970s Brotherhood of Man classic "United We Stand" and think that perhaps this is the mantra those in the healthcare system must stand behind:  “United we stand, divided we fall.”

First, an exclusive interview in today’s newsletter outlines how integrating a regional cardiovascular emergency care systems across the U.S. could help cancel out many discrepancies within the nation’s healthcare system and improve care. When I spoke with Minneapolis Heart Institute (MHI) cardiologist Craig E. Strauss, MD, MPH, he also was confident that such a system would help crack away at the hefty healthcare costs. But how will we get there?

In Minneapolis, staff already has worked to improve the coordination of care in a 500-mile radius. From STEMI to out-of-hospital cardiac arrest to acute aortic dissection, staff at MHI has fashioned protocols on the best way to treat patients in the least amount of time. The first step may be starting at the pre-hospital level with EMS services to initiate the diagnosis prior to hospital presentation.

Within the report, Strauss et al referenced a previous single-center study that looked at the cost savings of implementing one of these regional programs. In that study, implementing a STEMI system resulted in a cost savings of nearly $10,000 per patient for the index event and an additional $4,000 in savings for each subsequent medical event in the next year.

It’s all about bringing together the appropriate stakeholders and having them believe in the cause, Strauss told me. I wonder if these care models will be imparted into the accountable care model.

Another article focused on integrating performance measures into practice that help improve the care of heart failure patients. Bonow et al outlined nine HF performance measures, some designed to help bridge the gap between the inpatient and outpatient care settings. 

Like Minneapolis Heart, Bonow et al recognized that success will be met by bridging the various stakeholders, including hospitalists, palliative care specialists and family and internal medicine physicians. 

Lastly, Bradley et al from Yale School of Public Health put forth five strategies to help hospitals improve their acute MI performance. Encouraging physicians to problem solve and tapping a physician-nurse champion were some of the tactics that could help lower acute MI mortality rates and improve care. Again, the theme here was employing a multidisciplinary approach to improve care.

Perhaps, rather than debating the exact care model of the future of U.S. healthcare, we should focus first on working together and bringing the correct stakeholders together to improve care. With the correct team in place perhaps lofty healthcare costs in the U.S. will start to be whittled away, and physicians and staff may be able focus only on providing the best care to patients in the most efficient and timely manner. Because like the song, clinicians will provide better care united, than divided. 

Kaitlyn Dmyterko
Associate Editor, Cardiovascular Business