I have neglected my blogging since leaving HCA and returning to Hopkins full time. The clinical work seems to take all my time, and leaves little time for writing. Sorry, I know if I want to be taken seriously as a blogger, I need to keep up the writing. Anyway, I will attempt to make a better effort starting in 2013.
When I left HCA, I left a few endeavors unfinished. Primary among them was the development of a pharmacy metric. In my previous published blog, I briefly discussed using a metric such as this to evaluate whether the anesthesia service was being fiscally responsible in their delivery of anesthesia according to pharmacy costs. I had hoped to use actual data from HCA facilities to publish an algorithm and establish some benchmarks. Regardless, I plan on continuing this work most likely as a consultant. I hope to provide some guidance on this in future blogs.
I also feel we are just beginning to look at quality and performance metrics. Most anesthesia groups may have minimal financial bonuses or withholds at risk; however, I expect that to increase. I plan on using a future blog to describe the hospital value based purchasing system, and how physicians need to begin working with their facilities to enhance that facility’s performance. It is important to know that today’s performance on these key metrics will determine the hospital’s reimbursement for 2014. Consequently, there is no time to lag on moving the needle on these metrics.
I am also interested in looking at opportunities to change the current delivery models to reduce costs and improve patient safety. With the advent of using drugs like Propofol for endoscopy and other ‘Remote’ locations (out of OR locations for anesthesia), our anesthesia resources have become extremely stretched. Even employing a care team model (CRNA and MD) will not sufficiently provide enough resources to cover all the requests. I do believe the future will see developments in other models that will need to be vetted for patient safety, but that will ultimately come to bear as reasonable substitutes for anesthesia providers.
Finally, I will continue to look and work on solutions that utilize anesthesia information systems that enhance our patient safety, as well as potentially reduce unnecessary expenses. I am an evangelist for the online patient questionnaire, and the successful incorporation of this information into our existing workflows. We have made some good strides in this arena, but there remains a great deal yet to accomplish.
I do plan on continuing to incorporate my interest in wine into this blog. What started as a lark seems to have become one of the more popular elements of this blog. Though I don’t have time to write a comprehensive review, I do want to let you know that recently I had a 2009 Caymus cabernet that was incredible! This wine tasted phenomenal, which is uncommon for such a young cab. It likely means that the wine will not lay down for a long time without turning, so should be drunk now. Good luck finding this great bottle of wine.
Here is hoping everyone who reads this blog will have a prosperous and rewarding 2013. If you follow me on Twitter (@Jstonemetz), I will update when I publish new blogs. Would really appreciate your feedback and comments. Have a great New Year!