Ebola Treatment Centers Established Nationally.

No Centers designated in Kentucky.

Earlier this week, the Center for Medicare and Medicaid Services (CMS) announced that 35 U.S. hospitals have been designated as Ebola Treatment Centers. More are said to be announced soon. These hospitals were designated by state or local public health officials as having both the physical and staffing capability to care for these very ill patients. The CDC has published interim guidance outlining the capabilities every Ebola treatment center should have. They are pretty rigorous. Certainly not every hospital is up to the clinical demands, including the many Medicare Critical Access Hospitals in rural or small population centers that must by regulation transfer their sicker patients elsewhere. [The CDC website provides an excellent source of information about Ebola virus disease for professionals and laypeople alike.]

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Continue reading “Ebola Treatment Centers Established Nationally.”

Patient Access Data at Veterans Hospital Medical Centers.

Mixed results at Robley Rex Hospital in Louisville but mostly better than average.

I recently commented about the reaction in Washington to revelations that veterans trying to get appointments at VA medical centers were facing long waits and that utilization data for at least a handful of centers had been altered to make them look better than they were. I was subsequently asked how our local Robley Rex VA Hospital in Louisville stacked up against others. While I have heard good things in support of the Louisville VA from veterans at public hearings, and while the hospital has done well in national accreditation and quality surveys, I had no specific information about waiting times. The release of national patient access data from the Veterans Administration in Washington gives us something to go on and will be presented below. In brief, our hospital has little to be ashamed of, but the data as presented are not easy for me to interpret.

One of the pitfalls in analysis of data-dumps like this one is that without knowledge of exactly what is being counted or measured, how items are defined, or the operational measures used to assemble the data; the robustness of any conclusions may be compromised. My lack of day-to-day working knowledge of how appointments are actually made at VA hospitals or how the various lists of waiting times were compiled for this report limits my confidence. Nonetheless, assuming the data from the various medical centers has been collected in the same way, an overview and some rough comparisons seem reasonable. Continue reading “Patient Access Data at Veterans Hospital Medical Centers.”

Kosair Children’s Hospital Talks in Total Collapse.

As all available indicators gave us reason to believe, the talks between the University of Louisville and NortonHealthcare have utterly collapsed. It was true!  Both sides have released statements to the public describing their version of why the talks failed. As predicted, it seems obvious from the two releases that the sticking point is the University’s reluctance to give up its stranglehold on ownership of the land under Norton Kosair Children’s Hospital. The University’s interpretation of the old land-lease agreements gives them the right to take possession of the hospital building itself if Norton defaults on any of a few rather generally defined agreements. What constitutes “default” is therefore somewhat in the eye of the beholder. Norton asserts that it is fully in compliance with the most current affiliation agreement between it and the University. I am aware of nothing that contradicts that. Continue reading “Kosair Children’s Hospital Talks in Total Collapse.”

University of Louisville Planning Process Criticized.

Insights gained into internal Medical School workings.puzzle

Courier-Journal reporter Andrew Wolfson placed a major piece in today’s Courier-Journal about the University of Louisville’s contracts with Excelcor, the company that facilitated several “Opportunities and Threats” surveys for several University-wide programs including its School of Medicine.  Issues were raised about the sole-source contracts with Excelcor, the qualifications of that company, its previous relationship with UofL officials, potential for conflicts of interest, the large expense of the contracts, the source of funding, and even whether the results were of any practical use. Senior University officials are in my opinion obviously on the defensive.  You can judge for yourself whether their justifications are persuasive. I think not. Continue reading “University of Louisville Planning Process Criticized.”