Category Archives: Health Care Quality

Visiting Machu Picchu

Today we went to Machu Picchu.

It is called one of the seven wonders of the modern world — and now I know why.

It was an incredible experience. I am sure it will be the highpoint of our entire trip to Peru.

We took a half hour bus ride, a three hour train ride, then another half hour bus ride to get there.

We spent almost four hours with a guide walking and climbing around Machu Picchu. And then we reversed the trip back.

But it was totally worth it all!

You can Google and get a fuller description of this marvelous place, but here are major points —

About 500 years ago, the Incas built the city of Machu Picchu, high in the mountains. It was a city for the elites of Incan society, and it included houses, public spaces, temples and other buildings.

The Spanish conquered the region shortly thereafter, and ruled it for hundreds of years. But they never discovered Machu Picchu, given its very remote location.

It was not until about a hundred years ago that it was found by Yale archeologist Hiram Bingham. Since that time it has been visited by vast numbers of people, despite how hard it is to get to.

I am about out of superlatives to use to describe it — you simply have to see it to believe it.

Health reform is integral to the economy

I have applauded President Obama's actions in making health care reform a prominent issue, and I was very glad to see that he mentioned health care, and science, repeatedly during his press conference Tuesday night.

The purpose for the press conference was to address the economy, and I think this is the context in which health reform belongs. Indeed, these tough economic times highlight the need for reform as unemployment, and costs, continue to rise. Unfortunately, our state of North Carolina recently received the dubious claim of having the highest rate of unemployment. We feel this as a very real pinch in the UNC Health Care System, but, more importantly, we feel for our patients and the people of the state.

I urge President Obama to seize this opportunity to make fundamental, meaningful, lasting changes that make health care more economical, and that provides high-quality coverage for everyone.

We do not need a more expensive health care system, we need to use the resources we now have more wisely.

Tomorrow I'll have the pleasure of speaking with the health care providers of the Mountain Area Health Education Center in Asheville, N.C., about our the state of North Carolina's health care system.

On March 31, 2009, in Greensboro, N.C., I hope to have the opportunity to raise some of these critical issues at President Obama's Regional Forum on Health Reform.

I go into a little detail in this video, recorded yesterday with one of our staff at UNC. I hope you will watch, and let me know your thoughts.

Health Reform 2009

It is clear that the new Obama Administration and the Congress are going to have a serious go at health reform this year.

As someone who has been trying to help accomplish a substantial overhaul of our flawed health care financing and delivery system for decades, this is a really interesting and even exciting time. A lot is at stake, but we have a major opportunity to make major improvements in health and health care in America.

Last week, President Obama hosted a health policy summit at the White House that focused primarily on covering the uninsured and cutting costs. He also asserted that now, more than ever, is the time to discuss how we will implement health care in the future. This time is a time for opportunity and evaluation.

In regard to the summit, I spoke with several people about my thoughts. I think we ought to target covering the uninsured, in an efficient manner that controls (and does not add to) costs. There are real opportunities for making progress on implementing electronic health records, doing comparative effectiveness research to guide practice and payment, etc.

The White House Office for Health Reform, headed by my friend Nancy-Ann DeParle, is going to be hosting several regional forums on health reform around the country. One of them will be in Greensboro, North Carolina, on March 31. The others will be in California, Iowa, Michigan and Vermont in March and early April, with the intent of gathering ideas from local communities about how to fix the system.

The problems of the country's and the state's health system are mirrored at UNC Health Care. We're the state's safety net hospital. At UNC, we've seen a dramatic increase in uncompensated care, to unprecedented levels. In some of our clinics, 40 percent of our patients are uninsured now. As North Carolina's unemployment rate worsens (yesterday it was announced as 9.7 percent), this tidal wave of uncompensated care will get much worse, I fear.

I'm pleased that our country and our state are making headway in the discussion of health care policy. I look forward to sharing what we are doing with others at the White House forum in Greensboro.

President Obama said in his speech to the summit attendees on March 5, what better time than now and what better cause for us to take up?”

Council for Entrepreneurial Development’s Biotech 2009 Conference

A few days ago, I participated in a panel discussion at Biotech 2009, a conference in Raleigh, put on by the Council for Entrepreneurial Development.

My fellow panelists included Dennis Gillings of Quintiles, Victor Dzau, of Duke, Maureen Kelley O'Connor, of Blue Cross, and Michael Baldock, of Quattro Partners. We were asked to talk about what the new Obama Administration and the Congress mean for the biotech industry and for health care in general.

I said that the Obama Administration is still likely to make a major push for health care reform, despite not having Senator Tom Daschle to lead the effort. I remain rather hopeful but the challenges got much more difficult when he dropped out.

I also said that the new FDA is likely to be much more skeptical toward the pharma and biotech industries than has been the case in recent years.

And I also talked about the push toward investment in comparative effectiveness, including more than a billion dollars in the just enacted stimulus package. I am a great believer in the importance of producing more information on what works in medical practice, and how to compare therapies. I said that this will be a major challenge to the drug industry, as it will require much more rigorous demonstration of the worthiness of new therapies.

The new landscape presents many opportunities and challenges. I very much hope we do take advantage of the new leadership in Washington to make major improvements in health care financing and delivery. It will be VERY difficult, but our current system has tremendous problems.

Interview with UAB School of Medicine’s quarterly publication

I recently discussed my thoughts on health policy issues the new president should address with my alma mater, the University of Alabama Birmingham School of Medicine, for its alumni newsletter. I talked about health insurance, budget needs for federal health programs and the possible reorganization of the Department of Health and Human Services. To read the Fall 2008 issue, click here.

UNC Wins Leapfrog Top Hospitals Award Again

Improving safety and quality of care for our patients is usually difficult work that often goes unsung. That is why I was so excited to see our hospitals named among the 41 top hospitals in the U.S. for safety and quality for the second year running.

This recognition from The Leapfrog Group, a leading national health care quality organization, is evidence that we continue to make tremendous progress in our safety and quality efforts. Our hard work in improving the quality of care at UNC is getting attention and truly making a difference.

In awarding us this honor, Leapfrog certifies that we are meeting its highest quality standards, which evolve each year to keep pace with important advancements like electronic medical records and computerized physician order entry. We are ahead of the curve and that's where I plan for us to stay. In fact, we were the only hospital in the Carolinas to make Leapfrog's 2007 list after more stringent quality measures were added to this year's survey.

The recognition is great. It feels even better seeing the company we keep among those recognized with this award. My thanks go to the entire UNC Health Care team for their hard work to improve continuously the quality and safety of care for our patients.

To read more about Leapfrog's Top Hospitals Award, please click here.

Discussing the Quality of Care

Late last fall, I participated in a HealthLeaders roundtable discussion on the quality of health care with Dr. Donald M. Berwick, president and CEO of the Institute for Healthcare Improvement; Margaret O'Kane, president of the National Committee for Quality Assurance; and Mark Pickrell of Waller Lansden Dortch & Davis. We talked about lessons learned and best practices for the future. I'm please to report that it looks promising.

Winston Churchill once said, “This is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Our progress in quality and patient safety has made them legitimate, top-of-mind considerations to the leadership of operations in our hospitals and our clinics. We have begun changing the way we think about health care quality, but we have a challenging road ahead.

One of our guiding principles of the National Quality Forum, which I'm involved with, and Peggy and Don are as well, is to bring all relevant groups government, nonprofit, hospitals together to discuss health care quality, including consumers. I think we've made some real progress in that regard, but we still have to improve how we involve more consumers.

Semiannual Medical Staff Meeting

I had the great privilege of giving an address to our medical staff at their semiannual meeting last Wednesday, and wanted to post my remarks here to share them even more broadly.

Several hundred UNC Health Care doctors and medical staff attended the meeting. It was a pleasure to meet many of them to discuss what was on their minds and how we can continue to improve the patient experience at our hospitals and clinics.

Click on the “More” below to read my speech in its entirety.

Continue reading

UNC Wins Leapfrog Top Hospitals Award

About two years ago, we placed an increased emphasis on quality at UNC Health Care, and the results of those efforts are becoming more and more apparent to the third party organizations that evaluate us.

Last week UNC Health Care's hospitals were named among the 50 best in the United States, based on results from the Leapfrog Hospital Quality and Safety Survey. This recognition by Leapfrog is yet another telling benchmark that indicates we are moving in the right direction. Close attention to the quality of health care our patients and their families receive is at the heart of everything we do here.

Continue reading