Roji Intel Blog

Theresa Hush 0
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Future of Health CareMedical Decision-MakingPatient EmpowermentValue-Based Health Care
January 3, 2018

Can the New Year Bring A Real Solution to Affordable Health Care–From Providers?

Every New Year, we commence another round of solutions to fix our expensive health care system.  2018 will be no different.  A predicted 5.5 percent increase in medical costs over last year will no doubt spawn new efforts to contain direct payments to providers or transfer costs to consumers—or both. No solution has appeased health system stakeholders, including employers, health plans, consumers and providers. No matter where the system is pinched, another part reacts, and costs continue to outpace inflation. Most solutions, however, have been implemented by payers—government and commercial health plans, as well as employers—against providers and consumers. Why…
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Theresa Hush 0
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Future of Health CareMedical Decision-MakingPatient Empowerment
December 20, 2017

The Crux of Shared Decision-Making: Who Is Actually Deciding?

Shared Decision-Making is an emotionally charged topic for both physicians and patients. Physicians believe they have their patients’ best interests at heart by guiding them into better health through therapies to improve their conditions. Physicians may believe, in fact, that by explaining health status and treatment alternatives (followed by asking the patient to decide), they are already using a Shared Decision-Making process. Patients, in turn, are facing a higher share of costs, yet an ever-worsening health status that requires improvement to avoid financial disaster. Imagine a typical physician-patient discussion about an important medical decision or the path for improving outcomes…
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Theresa Hush 0
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Future of Health CareMedical Decision-MakingPatient EmpowermentPerformance Improvement
December 14, 2017

Is Shared Decision-Making the Path to Improved Provider Performance?

As an escalating percentage of Americans (including children) are diagnosed with diabetes and hypertension, the health care system is straining to control costs and demonstrate good clinical outcomes. No surprise that providers blame patients for lack of compliance with therapies or lifestyle changes that will improve their health status. Hence the uptick—some say warranted—in incentives or penalties assessed by insurers or employers on patients who don’t “behave.” But this punitive finger pointing is neither equitable nor productive. Just as it’s unfair to hold physicians, alone, to be fully accountable for patient outcomes in quality reporting and cost, without giving them…
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Robert McNutt, M.D. 0
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Medical Decision-MakingPatient EmpowermentResearch
December 6, 2017

For Tough Medical Decisions, Hard Choices Require Hard Facts—Not Conventional “Wisdom”

What matters in medical decisions is what we know, not what we think. In the late 1980’s I cared for a pregnant woman with breast cancer. Breast cancer is the most common form of cancer in pregnancy, but uncommon in frequency, occurring in about 1 in 3,000 pregnant women. Providing and receiving treatment is certainly a complex emotional experience; at that time, uncertainty about how to treat was the norm. The woman had a mastectomy but did not take chemotherapy based on concern for her baby. Three months after her delivery, now receiving chemotherapy for her aggressive breast cancer, the…
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Robert McNutt, M.D. 0
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Future of Health CareMedical Decision-MakingPatient Empowerment
October 25, 2017

Medical Treatment Should Be Based on More Than Just “Doing Something”

Memory is malleable. This was made quite clear to me at my recent 50th high school reunion. Despite my fallacious recollections, I could not dispute the data of my forgotten activities, awards and foibles captured in pictures and written comments in my high school yearbook. Then there were the comments about my behaviors “back then,” interpreted or misinterpreted by my former high school comrades. These conversations reinforced for me how difficult it is to correctly intuit the motives and thoughts of others, when my own are occasionally tarnished or refurbished. None of us can truly read another’s mind. Even if…
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Theresa Hush 0
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Patient EmpowermentPerformance Improvement
October 18, 2017

What the Dog Show Taught Me: Performance Improvement Is Not Just Science, But Art

Last week I attended the Bearded Collie Club of America National with my two highly energetic and driven dogs, along with about two hundred other competitors. A calm vacation it was not. My dog athletes enjoyed multiple days of performance competition, capped off by show competition. For people who believe dogs are pets and don’t have emotional lives, let me introduce you to my beardies. They have goals. It’s my job to help them achieve those goals. To do that I need to understand how to get performance, and to improve it. I have learned a lot about meeting goals…
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Theresa Hush 0
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Future of Health CarePatient EmpowermentPerformance Improvement
October 11, 2017

If Federal Policy Can’t Improve Health Care, What’s Next? 5 Trends to Track

Health care has been extraordinarily resistant to change. Escalating costs have been at issue since the early 1980s—think about it!—but continue to rise unabated. Ask anyone participating in the system, be they physicians or other health care providers, payers or patients, and you will be inundated with complaints about health care economics, outcomes or processes. If you ask most health care executives about the future, chances are you’ll be met with a shrug. The fact is, however, that an undercurrent of change is already beginning to transform health care. It is gaining momentum, but the health care system and providers…
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Robert McNutt, M.D. 0
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Future of Health CareMedical Decision-MakingPatient EmpowermentPerformance ImprovementPersonalized Medicine
October 4, 2017

Physician-Patient Interaction: Where We Should Begin to Measure and Improve Medicine

Data is not always the path to identifying good medicine. Quality and cost measures should not be perceived as “scores,” because the health care process is neither simplistic nor deterministic; it involves as much art and perception as science—and never is this more the case than in the first step of that process, making a diagnosis. I share the following story to illustrate this lesson: we should stop behaving as if good quality can be delineated by data alone. Instead, we should be using that data to ask questions. We need to know more about exactly what we are measuring,…
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Theresa Hush 0
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Future of Health CarePatient EmpowermentValue-Based Health Care
September 27, 2017

Redesigning Health Care for the New Consumer

A consumer-driven culture shift is emerging in health care that will change the dynamics of health care purchasing decisions and impact providers’ bottom line. It is being fueled by policies that are increasing the share of health care expenses paid by consumers. Benefit plans with higher deductibles and copayments, choices narrowed to providers who demonstrate lower cost, restriction of medical services, and higher percentages of premium sharing are just some of the tactics used to control and redistribute costs from health care payers to consumers. Much of the discussion focuses on the need for consumers to be “better purchasers” of health…
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Robert McNutt, M.D. 0
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Future of Health CarePatient EmpowermentResearch
August 9, 2017

How to Recognize “Fake” Medical News — And Why It Matters

Is coffee good for you? A recent headline suggested that people who drink coffee live longer. Sounds great to me. I drink a lot of coffee, so maybe I will be immortal. But, wait, another report links coffee to cancer. Dang. Estrogens were once touted as a life saving elixir for women of elegant ages, until these hormone supplements were linked to increased cancer risk. Wine will either add to your life expectancy or increase chances of breast cancer. But if you are married and have cancer, your outcome is better; you live longer (and can drink more wine?). Eggs…
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