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Patience & watchful waiting – Key to antibiotic stewardship

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A recent guideline for treatment of sinusitis suggests that most viral sinusitis is persistently symptomatic for nearly 2 weeks.(1) The symptoms peak at 2 – 3 days time and resolve without any antibiotic treatment by 14 days or so. This suggests a longer watcful waiting period before using antibiotics for treatment of sinusitis. Most sinusitis are of viral origin and antibiotics do not have a role in the treatment of such viral sinusitis. Symptomatic relief could be obtained by using intranasal steroids, saline nasal drops, inhalation of steam and with use of analgesics. “Watchful waiting” is beneficial to a great extent and the infection subsides in about the same time it takes even with the use of antibiotics indicating the futility of routine antibiotic usage in sinus infections. Continue reading

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Doctor – Patient Contact Time Metrics

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Thanks for taking the time to read this post. If you were redirected from the survey page, I must thank you for taking 2 minutes of your time to answer the simple questions.View the results of the Doctor Patient Contact Time Metrics  here: Results of the Survey 

If you haven’t taken the survey yet, please do so by clicking Doctor Patient Contact Time Metrics

In general the time spent by the doctor with the patient has come down. It can be represented by Doctor-patient contact time metrics. It may be just one metric that may correlate with the increasing discontent of the patients with their doctors. An attempt was made to use social media to gather information on this aspect.

If you have not yet attempted the survey, please do so here: Doctor Patient Contact Time Metrics

View the results of the Doctor Patient Contact Time Metrics  here: Results of the Survey 

A crowdsourcing technique was attempted to get information on the doctor-patient contact time as an experiment of the value of social media in getting social healthcare metrics. The information provided must be interpreted with restraint and caution.

Important note:

This cannot be considered as a reliable measure of the quality of healthcare received and it should not be interpreted as such, but it can help us understand the general trends of change in how patients are seen in today’s busy practices. The information received should be interpreted with caution and is for use by experts in the field of healthcare planning, policy makers and experts mostly.

View the results of the Doctor Patient Contact Time Metrics  here: Results of the Survey

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Panel Discussion on Inventory Management & Cost cutting without compromising quality
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Healthcare Finance Management Conference – Overview

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“Healthcare Finance Management” is a challenging and ever changing area in healthcare. Entrepreneurs, doctors, management professionals are all constantly at lookout for ways to contain costs in healthcare. I was an invited speaker and panelist at a recently held conference in Bangalore.(My talk)

The discussions and interactions at the “Challenges and Best practices in Healthcare Financial Management and Accounting” turned out to be interesting and engaging. I am presenting a brief overview of this conference on healthcare finance management below. (View Healthcare Finance Management Conference – Agenda.)

The first half of the day was filled with discussions on interesting aspects with majority discussions centre d around insurance, TPAs  and Credit business in healthcare. Active questioning and discussions happened on this important area, considering about 5% of the claims are disallowed by the insurance companies citing various issues. There was also a stress on aspects such as how NOT to submit your documents for insurance and how NOT to manipulate / mismanage the records to make insurance claims. One important point raised was the resistance of the healthcare community for standardisation and protocol / guidelines for standardisation.

Post lunch session saw a panel discussion on “Inventory management and cost cutting without compromising quality” on which we had experts voicing strategies on standardisation tools, pharmacy & stores inventory management and inventory tracking and cost cutting strategies without cutting corners. (I was the expert panelist on cost cutting without compromising quality.)

Panel Discussion – Overview

  1. Decreasing the size of the hospital formulary thus cutting costs. With a small formulary for inpatients, the costs of procurement of drugs can be drastically cut down as you’d be focussing on a fewer medicines. Another aspect is using generic drugs which can cut down the costs multifold.
  2. Inventory tracking was discussed in detail about how it impacts healthcare. A lot was discussed on how to go about it which can cut down the costs.
  3. Standardisation was discussed as a way to cut down costs and improve quality of care. With standardised treatment methods, standardised protocols evaluation of the resources used, assessment of the wastage and areas of improvement could be identified. Subse quent cost cutting strategies can be implemented without a compromise in quality of care.
  4. Quality care comes with involvement of clinicians and nurses. On the same ground, minimising wastage is an important step that improves efficiency, safety and at the same time reduces costs.

My talk immediately followed, on the “Impact of IT on Hospital Profitability” . I have uploaded the pdf version of my talk online Impac t  of IT in Hospital Profitability
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Accountable Healthcare – Lessons from Apple, Pixar, Toyota et al ?

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stethescope on stacks of money

Accountable vs Profitable !

   Can  an accountable healthcare organisation be accountable and yet be profitable ?

Steve Jobs brought a new dimension to quality and it still is living in “Apple products”. Toyota brought a new meaning to “cost containment” and changed the world with its concepts of “lean methods”.

”Quality is the best business plan.” John Lasseter, Pixar

What has healthcare learnt from Apple, Pixar and Toyota ? Can healthcare strive to be quality driven and yet be profitable ? Can you “be” profitable and yet create an affordable healthcare delivery system ? Is healthcare the silver bullet serving as  an answer to all these questions ?

These were exactly what I am trying to analyse and answer in my keynote for the #Conference on #healthcare financial accounting and management to be held in Bangalore on February 28, 2015.
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