Many Changes Bring the Hope of Better Care for Heart Failure

In my last blog, I discussed our abysmal record in treating heart failure.  A great deal of effort is being directed to this health care challenge as it represents a great economic opportunity.  The opportunity is on both sides of the equation with biomedical and drug companies on one side, hospitals and provider organizations on the other.

Medicare is relaxing some of the antitrust and Stark rules that govern the interaction between hospitals and doctors to allow for pilot projects that allow the division of money that is saved between participants.  This topic alone is the subject of many very large books and I can not do it justice. 

In brief, the projects allow for the joining of divergent groups to participate in clinical practice that is accountable for outcomes.  In other words, you just can’t save money by denying care; you have to save money by doing it better.  This process will allow for innovation to flourish, and let’s face it, innovation does better if there is reward at the end of it.  All sides will be winners the hospitals will not lose as much money, practitioners will be compensated and patients won’t end up in the endless and damaging spiral of repeated admissions and hopefully will achieve a better quality of life.

Some of the biomedical companies have provided unique tools for our use and are now in the approval phase of them.  The approval of these devices is interesting in itself.  Since the devices do what they say they do i.e. measure something and that is not at issue the FDA requires that the “measuring” has some clinical benefit.  To that end studies have been set up to determine whether by measuring “something” patients can obtain better treatment, have a better quality of life, and stay out of the hospital.

Now we as practitioners use a patient’s daily weight as a measure of whether a patient is stable in their condition.  The increase in a patient’s weight signals a worsening of their condition and the need for intervention.  That seemed pretty reasonable until it was shown that the weight gain comes 10-14 days after the worsening of the condition begins, so not only is it delayed but almost to late when it arrives.

In my next series of blogs I will detail the innovation that the medical industry is bringing to the problem.

Tags: Heart Failure, Medicare
Posted in Heart Failure | No Comments »