Hospital Administration: Cost Containment, Safety and Compliance

Hospital Administration: Cost Containment, Safety & Compliance:

(US copyright granted and US patent pending)
   

Introduction:

America has the indisputable distinction among the industrialized countries including the G7 countries (Canada, France, United Kingdom, Germany, Italy and Japan) of having the highest per capita expenditure on health care and waste.1 Berwick and Hackbarth identified2 six domain of health care waste in America, a) Failure of Care Delivery, b) Failure of Care Coordination, c) Overtreatment of Low-Value-Care, d) Pricing Failure, e) Fraud and Abuse, f) Administrative Complexity. A recent review by William H. Shrank, et.al., based on these six domain of health care waste indicated that originally $760 billion to $935 billion accounted for the cost of waste in health care system in America.3 After intervention to reduce waste in health care, approximately 25% reduction was noticed in America, but the health care waste in America is still much greater than in any industrialized country of the world.

A moral imperative for the health care professionals is to eliminate this enormous waste in health care in America.

We have worked for the last five years to reduce waste in health care employing the cutting edge technology (artificial intelligence, telemedicine-cloud, etc.). The three projects completed by us, if instituted in all the hospitals of America shall significantly reduce the waste in health care.

I. Telemedicine-cloud: Clostridium difficile infection control in hospitals

II. Hand Hygiene

III. Physician Tool for Laboratory Testing

References:

1) Papanicolas I, Woskie LR, Jha AK. Health care spending in the United States and other high-income countries. JAMA 2018; 319(10): 1024-1039

2) Berwick DM, Hackbarth AD. Eliminating waste in US health care. JAMA2012; 307(14):1513-1516

3) Shrank WH, Rogstad TL, Parekh N. Waste in the US Health Care System: Estimated Costs and Potential for Savings. JAMA 2019; 322(15): 1501-1509

I. Telemedicine-cloud: Clostridium difficile infection control in hospitals:

What is Clostridium Difficile Infection?

Clostridium difficile (CD) is a gram-negative, spore forming, obligate anaerobic bacillus. A recent study indicated1 > 600,000 /year reports of Clostridium difficile infection (CDI) in America, > 15,000 deaths/year primarily due to the recurrence (25-45%) of CDI and the economic cost to the hospitals was > $4.5 billion/year. Magill et al, recommended prevention strategies against CDI in hospitals. 2 Diagnosis of CDI is also difficult. Audrey Schuetz summarized various testing methodologies for CDI and provided an algorithm for its diagnosis. 3 The clinical practice guidelines and treatment modalities of CDI have been recently reviewed. 4,5,6 Mermel et al, proposed a CDI control plan 7 for the hospitals but it was labor intensive to execute thus financially not feasible in most of the hospitals (Appendix I). We have achieved a computerized standard operating procedure for the CDI control in hospitals. Our procedure is not labor intensive, therefore economically feasible in all hospitals.

References

1) Desai k, et al. Epidemiological and economic burden of Clostridium difficile in the United States: estimates from a modeling approach. BMC Infectious Diseases 2016; 16(303); 1- 10.

2) Magill et al. Changes in Prevalence of Health Care-Associated Infections in U.S. Hospitals. N Engl J Med 2018; 379(18): 1732

3) Schuerz AN. Diagnosis of C. Difficile-Why so Difficult. CLN November 2018, 13.

4) Hopkins RY, Wilson RB. Treatment of recurrent Clostridium difficile colitis: a narrative review. Gastroenterol Rep. (Oxf) 2018; 6(1): 21-29

5) McDonald LC et al. Clinical Practice Guidelines for Clostridium Difficile Infections in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Disease 2018. Available from: http://www.idsociety.org/Guidelines/Patient_Care/IDSA_Practice_Guidelines/Infections_By_Or gan_System-81567/Gastrointestinal/Clostridium_difficle/

6) Wilcox MH et al. Bezlotoxumab for Prevention of Recurrent Clostridium difficle Infection. N Engl J Med 2017; 376: 305-317.

7) Mermel LA et al. Reducing Clostridium difficle Incidence, Colectomies and Mortality in the Hospital Setting: A successful Multidisciplinary Approach. The Joint Commission Journal on Quality and Patient Safety 2013; 39(7): 208-305 (AP1-AP4)

II. Hand Hygiene:

This project is executed by the installation of the cameras and employing the server of the hospital. Agreement has to be signed with TelemedEdu, USA, Inc. and the hospital intented to use this product.

III. Physician Tool for Laboratory Testing:

US Copyright has been granted and US Patent pending.

Abstract:

Keywords: Cost containment, laboratory testing, app software, laboratory information system, cloud computing, physician education.

Introduction: