- TEDMED of #GreatChallenges: Rethinking labor health care
recently, Whitney Zatzkin of TEDMED organized a major challenge program "Work Shifting: May Rethink workforce healthcare reduce medical costs?" This session, as name suggests, explored the long-standing challenges and possible solutions regarding the labor health of the nation. Here is an overview of the group discussion and key points.
The panel
Audrey Lum is Clinical Director at Union Health Center in New York City. She oversees the improvement and innovation of quality projects, such as a medical assistant program of continuing education and a health coach training program. The center, partly thanks to these courses has been very successful in building a team care delivery system.
Edward Salsberg teaches health policy at the School of Medicine and Health Sciences at George Washington University and was the founding director of the Centre for Studies of the workforce the Association of American Medical Colleges (AAMC). He was also director of the National Centre for the analysis of labor Health set up by Law Affordable Care 2010 (ACA) Protecting Patients and.
Troy Trygstad is the Vice President of Pharmacy Programs for Community Care of North Carolina, overseeing 14 regional networks that provide support to nearly 1,700 medical centers, bringing together medical practices, health services County, hospital systems and mental health providers in a medical district model. Trygstad also serves on advisory committees on non-compliance medications and has developed several programs around the theme.
Challenges of key labor
The shortage of primary care physicians has been well documented in several reports and studies . The call for the improvement of these figures was heard by educational entities but, as detailed by Salsberg, the real challenge is the distribution of primary care physicians. rural status and low socioeconomic areas suffer most from the uneven distribution, as doctors flock to richer or urban places.
Another challenge is the medical training doctors and non-medical staff in areas that support the growing trend centered care patient, medical homes and coordinated care. In turn, these models of care and patient-centered care coordination centralized help solve the primary care shortage problems because they rely heavily on non-physician health workers. There are challenges facing the implementation of these symbiotic initiatives in terms of manpower, most having to do with the skills that are slightly beyond the scope of training required for certain positions. For example, the Union Health Center Lum had to create a curriculum for their medical assistants to improve the skills and knowledge of the pathological process of communication beyond what they learned in schools. For all medical personnel in a medical team environment, support and training is necessary to teach them to manage patients outside the medical visits, prepare patients for medical purposes encountersand followed after the meetings effectively - this way which patients are part of the medical team, and not from outside.
What's the point of all these changes? Hopefully better health outcomes and lower costs. Invest in team-based care and non-medical personnel can reduce costs. For example, Community Care of North Carolina Trygstad found that investments in one area could improve the care that their model has seen the increase of drugs and the use of primary care, but 20 percent less in admissions of hospitalized patients. Disease prevention and early treatment meant fewer patients had serious health problems down the road. Union Health Center Lum found that the costs associated with training received their beneficiaries. In 07, the Union Health studied a small business self-funded and found that it spent 17 percent less per member per month overall, and the costs of emergency room was 50 percent lower for participants in their program, which used medical assistants who have gone through communication and process of the formation and disease self-management education for patients. Lum cited the success of the program in ensuring that all those involved, including the patient, was
Fun Facts of @HRSAgov "on the same page. " - 94% of nurse practitioners hold a graduate degree: http://t.co/WUqobGaivx #GreatChallenges pic.twitter.com/I9pLJ7o1xK
- Whitney Zatzkin (@MsWZ) May 20, 2014 Takeaways
- pressure to deliver services profitably is the engine of innovation and different delivery systems. But there is no data that the combination of professional and para-professional works best for costs and patient outcomes.
- In the future, it will be important to reach a consensus on what some job titles should be for non -traditional medical staff as community health workers.
- Turf wars between clinicians, staff and patients is inevitable that things change. It will be essential to develop a culture in which clinicians, team members and all patients seeking to be helpful to develop meaningful relationships and adhere to a common set of key performance indicators.
The bottom line? There is no single solution to meet the evolving needs of patients and the changing composition of the workforce of health in an era of changing care delivery models. Patient and stakeholder involvement will be key in the development of solutions that work. What changes have you seen as a patient or in your professional work related to labor health? What do you think of the right combination of medical staff look like your organization?
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