Posts by Chris Moriates

Is It Time for Health Policy M&Ms?

[caption id="attachment_16917" align="alignnone" width="609"] https://twitter.com/ChrisMoriates/status/890259986873450508[/caption] There are few experiences in my medical training that felt more intimidating, and ultimately more impactful, than our Mortality and Morbidity (M&M) conferences. The patients whose diagnoses I missed. The times I should have called my attending or pushed harder for the cardiologist to come in overnight. They stick with me and I believe ultimately have helped make me a better doctor. This is why I was intrigued by the idea of explicitly incorporating health policy issues into M&M. Over the past few years, I increasingly have seen adverse events that result from issues related to health policy. Inability to access care for appropriate hospital follow-up. Failure to fill a critical prescription due to cost or gaps in coverage. A patient I admitted for “expedited work-up” for rectal bleeding after he told me he had been trying to get a recommended colonoscopy for many months…

A New Face For Online Modules

It is hard for me to get excited by online modules. Perhaps my reflex repulsion stems from my experience – ok, experiences – completing online traffic school courses. Those timers forcing you to stay on a page for a specific amount of time. The quizzes that might not actually teach you anything. Maybe you are a more cautious driver than I am, but if so, just think of the last time you had to complete a mandatory online module for your hospital. I doubt it gripped your attention. The future of education may increasingly be online, but I am unconvinced that mandatory online modules are a format that will change the world. This is why I have spent so much time working with innovative teams to develop interactive learning modules that do not feel like online modules. Vinny Arora and I recently described on this blog our Costs of Care…

From SXSW to SHM: Our Tour to Promote Value Conversations Between Doctors & Patients

By Chris Moriates, MD, SFHM and Vineet Arora, MD, MAPP, SFHM At a movie premiere for the new Terrence Malick flick, “Song to Song”, Ryan Gosling, Michael Fassbender, and Rooney Mara walked the red carpet to flashing cameras and screaming fans in front of the famous Paramount Theatre in Austin. The next day, down the street, to a lot less fanfare, our Costs of Care team – Neel Shah and both of us – took the stage at the annual SXSW festival for own version of a premiere. We were about to step out of the normal medical conference crowd (i.e. no screaming fans but some with #pinksocks on) and see for the first time if videos we made depicting scenarios of doctors and patients confronting healthcare costs would translate to the real world. Would it work, or would the critics, like with the “Song to Song” premier, give us…

Should Resource Overutilization Be Considered an Adverse Event?

We have all seen the Choosing Wisely lists and the new “Things We Do for No Reason” section in the Journal of Hospital Medicine. We have heard a lot about common areas of overuse in hospitals. Sure, there have been some success stories of hospitalists leading projects to decrease an area of overuse, but when you get down to it, have we really done much to not just recognize overuse but to actually decrease it? Think about the patient safety movement over the last two decades. Telling horrifying stories of wrong-limb surgeries may have caught headlines, but that did not do much to stop the problem from still happening. The medical world had to shift our thinking from one of individual blame to recognizing the role of systems and environments in creating these problems. We had to put structures in place, such as safety review committees and mandated processes for…

3 Tips for Bringing Doctors and Data Specialists Together

By: Victoria Valencia, MPH, Assistant Director of Healthcare Value Christopher Moriates, MD, Assistant Dean of Healthcare Value Dell Medical School at The University of Texas at Austin With tele-machines beeping, robots rolling by and so many different people rotating in and out of rooms, the hospital environment can be chaotic. Similarly, the data environment of many of our electronic health records (EHRs) can be quite unruly. EHR systems are not always designed for clinicians to input data in a way that can be researched and used in quality improvement. Just as hospitalists become comfortable working amongst the whir of the wards, data specialists learn how to handle the thicket of data libraries. Report writers and clinicians who request reports often have little to no experience with the workflow and context of the other. It’s no wonder why it often feels like we are speaking different languages and why the reports…
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