Technologic innovation — Telephones! — could save health system money

Health-coaching more patients over the phone could help save the system money according to a study published Wednesday in the New England Journal of Medicine and noticed by the Wall Street Journal's Health Blog. "Typically this kind of care management, as it's called, is offered to people who have trouble managing their chronic conditions or who are facing a big treatment decision — such as surgery or medical management for lower back pain. But a randomized study conducted by Health Dialog Services compared that approach to its own program, which offered phone-based health coaching to a larger proportion of those folks … who don't have a chronic illness but, for example, seem to turn to the ER for all their routine care" (Hobson, 9/22).

The Fiscal Times: In the study, the nursing staff targeted people identified as likely to incur more health costs for calls. Nurses would also visit homes for follow-up if needed. "In a twist on previous efforts at using call centers to monitor patient behavior, the call center staff also used electronic medical records to identify patients considering such procedures as prostate, hip, knee, back or uterine surgery, and coronary revascularization. In those cases, the medical consumers were sent web links, video and print materials before the operation, comparing the risks and benefits of surgery with options like watchful waiting, bedrest, anti-inflammatory drugs and diet and exercise changes" (Goozner, 9/22).

Meanwhile, there's good news for health care quality more broadly today. "A report says treatment has improved substantially at U.S. hospitals for several ailments including heart attacks, pneumonia and children's asthma," The Associated Press reports. "The report released Wednesday is based on more than 3,000 hospitals accredited by the Joint Commission, an independent regulatory group." While hospitals gave recommended treatment for asthma and heart attacks more often than in a previous, 2002 survey, numbers remained weak for measures added in 2005, such as giving clot-busting drugs to heart attack patients (Tanner, 9/22).