1 / 15

Evidence Based Medicine Fact vs. Myth

Evidence Based Medicine Fact vs. Myth. Richard O. Dolinar M.D. Quality Based Purchasing. Evidence Based Medicine – the foundation Best practices – the standard EMR – the monitor Outcomes Measurements – the gauge Pay for Performance – the enforcer.

hammett-barr
Download Presentation

Evidence Based Medicine Fact vs. Myth

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Evidence Based MedicineFact vs. Myth Richard O. Dolinar M.D. Bilao LLC

  2. Quality Based Purchasing • Evidence Based Medicine – the foundation • Best practices – the standard • EMR – the monitor • Outcomes Measurements – the gauge • Pay for Performance – the enforcer Bilao LLC

  3. Evidence Based Medicine – the foundation • Definition of evidence • External validity • Evidence based? Bilao LLC

  4. “Evidence based medicine is managed care masquerading as science.”Twila Brase R.N. President of the Citizens Counsel on Healthcare 2005 Bilao LLC

  5. Best Practices – the standard • Group vs. individual best • Algorithms replace medical judgment • Mistakes institutionalized • The problem of knowledge Bilao LLC

  6. The problem of knowledge:Clinicians practicing medicine apply prudent decisions in reaction to ever changing circumstances that only they can know. Bilao LLC

  7. In Reality: The “Best Practice” is to treat patients according to their individual needs Bilao LLC

  8. Electronic Medical Records – the monitor • Cost effective vs. cost prohibitive • An accurate portrayal of patient care? • Benefits whom? Bilao LLC

  9. Outcomes Measurements – the gauge • Measurements could appear to be improving but in reality things could be getting worse • Physicians vs. patient outcomes Bilao LLC

  10. Pay for Performance - the enforcer • Pay for compliance • Responsibility without power • Fruits/vegetables • Physician misclassification • SGR/No new money Bilao LLC

  11. Pay for performance “Analyzing patient data, measuring physician performance, and calling the process “scientific” is the mechanism being used today to shift power and control away from physicians.”Gary Belkin 2004 Bilao LLC

  12. 3rd Party Doctor Patient Patient Bilao LLC

  13. A buys from B C pays Modified from reference: Kleinert, Richard.Deloitte Consulting LLP Human Capital Practice. WARD’s Auto World, February 2005. 1965 House of Representatives Minority Report regarding the financing of Medicare Bilao LLC

  14. Health Savings Accounts Bilao LLC

  15. Questions??? Bilao LLC

More Related