Friday, April 17, 2009

Field Trip to DC

So we decided to have a family (family of origin as well as husb and kids) vaca to DC for mom's birthday. (She's 29, if anyone asks). We're staying with my brother Mike, and when we arrived last evening there was a small gathering of his friends. I really enjoy meeting people, seeing old faces too, and learning about what they do. And of course, leaping loudly onto my soapbox to anyone who will listen.
Since this is DC, the job options are slightly more varied than they are in Cape May County, and one of the people I met was a "Healthcare Policy Analyst". At the current phase in my life, that was about as exciting to me as it would be to meet the drummer for Van Halen or a pro baseball player. I'm embarrassed to say that I monopolized her attention for at least an hour after the other guests had left! But what a great conversation!
Here's what I learned: The Agency for Healthcare Research and Quality has a program called CAHPS: consumer assesment of healthcare providers and systems.
This group has developed patient surveys for hospitals that have been used for years in order for hospitals to get full medicare payment.
This group has also developed surveys for patients about the healthcare experience in outpatient primary and specialist settings. They are freely available, but I'd never heard of them.

There are people in this group who fear the development of the PCMH model as is stands. This particular individual who would prefer to remain anonymous (as if anyone reads this) could even remember about the time when we all embraced capitation and it didn't work out. She worried about the huge push for technology as the savior of healthcare, and realized that just having a computer and emr didn't make someone a better doctor. This sounds familiar.

So here is someone in Washington, who knows and advises people who make what amount to life changing decisions for me and my patients. (She gave me the example of Medicare D, she communicated with Senator Kennedy about the fact that it was and remains a Really Bad Idea.)

So here I've got this great opportunity, and I'm sure I looked like a total spaz! She is involved in the development of surveys for patients to evaluate healthcare quality, and hasn't heard of howsyourhealth. Correction, hadn't heard of it. I am a little lost on how to follow up on the conversation. I am again overwhelmed with information. I wonder how in this world of information overload, do people who share the same views combine their data and resources to influence policymakers. Or do we need to? Maybe it will all filter up. (Like salmon getting past the status quo of profit driven healthcare policy). And I wish I knew more about the system and how it works.

But mostly I'm just excited every time I meet someone that welcomes system-wide healthcare change.