Chronic Disease

Holy Cross Hospital, just outside Washington, has created a special emergency room section for older patients, complete with staff trained in geriatrics and communication, wooden handrails for safe walking, comfy chairs for family members, and extra thick ER mattresses designed to protect the fragile skin of the elderly against fast-developing bedsores.

We wrote the other day about the failures and limitations of Medicare's disease management experiments. Les Masterson at Health Leaders Media writes that we need to know a lot more about where the Medicare Health Support projects in particular fell short, what aspects might have worked, and how to build better disease management for the future.

A few days ago, we wrote about hype and hopes in health care reform, the constant search for the magic low-cost, high-quality elixir.

Kaiser Permanente, the Mayo Clinic and Intermountain Health Care, three health systems known for their emphasis on primary

It is not every day the U.S. loses to the Dutch. Heck, even when our wooden-shod friends were favored in soccer over the U.S. in group play at the Olympics this summer, the U.S. came from behind to tie.

But when it comes to the quality of health care services, particularly taking care of people with chronic disease, the Netherlands runs way ahead of us.

The folks over at the Center for American Progress believe, as we do, that health reform is about more than making sure people have insurance. It's about retooling our health care delivery system so that it provides high quality care, spends health dollars sensibly, addresses chronic disease, and promotes public health. (In the unlikely case that you need any reminder about the chronic disease and public health messages, check out the CDC report that the diabetes rate has nearly doubled in the U.S.)

There are lots of ideas about how to repair our health care system. We write about them a lot, and MedPac has pulled a lot of the ideas together in its own reform roadmap for the elderly. CAP pulled together some of its own health experts as well as some other think-tankers and policy types to try to further braid the strands of these reform ideas. The result is a new book, The Health Care Delivery System: A Blueprint for Reform. You can download it here, and or read the Overview and Recommendations. We haven't read the whole book yet (although in the past we've spoken with and blogged about quite a few of the contributors), but here are a few key points from the summary:

Dr. Glenn Steele, the president and CEO of Geisinger Health System, recently co-authored an article in Health Affairs and appeared at a Health Affairs forum here in DC to talk about the innovations at Geisinger, and the ways that Geisinger's unique characteristics might limit their adaptability elsewhere.

More evidence that it's not just the uninsured clogging up our ERs. It's the whole flawed health care system clogging up the ERs.

We've mentioned Community Care, North Carolina's innovative Medicaid program for chronic disease management, briefly in the past but today's News and Observer takes a detailed look. Community Care has been shown to save money —and improve the quality of care for Medicaid patients with conditions such as diabetes and asthma.

Here's a classic half-full, half-empty health care scenario.

Some hospitals and communities are vastly improving the way they take care of seriously ill patients.

Some aren't.