Reforming Delivery
Heart Attack Deaths Reduced as Hospitals Get Efficient

Not everything in health care is bad news: the NYT reports on how U.S. hospitals have dramatically lowered the time it takes to treat a heart attack patient, with lower times contributing to the 38 percent reduction in heart attack deaths we saw between 2003 and 2013. The lower wait times happened “with no new medical discoveries, no new technologies, no payment incentives”—rather, hospitals made a systematic effort to locate places where different stages of care could be undertaken more quickly and efficiently, and acted on that knowledge. The Times shows what that process looked like in one Camden hospital. A taste:

They decided to have paramedics do an electrocardiogram, which can show the characteristic electrical pattern of the heart that signals a heart attack, as soon as they reached the patient and transmit it directly to the emergency room. That meant the staff could spring into action the moment the ambulance pulled in. The hospital designated a beige phone on a counter in the E.R. for calls from paramedics […]

They eliminated a big time sink — the requirement that a cardiologist look at the electrocardiogram and decide if an interventional cardiologist, who would open the blocked artery, should see it, too. Why not just give the emergency room doctor authority to call in the specialist?

This story is evidence that the reform of procedures and streamlining of processes can save money and lives. Much more research into this promising topic is needed. The goal of health reform efforts should be care that is both better and cheaper.

The bad news is that U.S. health care is wildly inefficient, with all kinds of perverse incentives and bad practices. But that is also the good news, because it’s a manageable problem. If we were operating at peak efficiency, we’d be in major trouble. But we’re not, and there’s lots of low-hanging fruit around for improving our system. All we need to do is pick it.

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