Standard Performance Measures
performance measures are a way of collecting data across similar functions,
processes, costs, and providers. Benchmarking against these standards has
proven to be useful in healthcare as a tool to measure many facets of quality.
Carefully evaluating these measures allows for management to design appropriate
programs to assist with healthcare service needs and patients to make decisions
about facility and provider services. Best Doctors, Inc. and WebMD are
examples of these tools. Your discussions will focus on the use of information
from these websites to make healthcare decisions.
Scholarly sources or the Internet, research about these measures and how they
allow management to design appropriate programs to assist with healthcare
on your readings and research, answer the following:
a brief overview of the purpose for each of the Best Doctors, Inc. products.
How are the "Best Doctors" of each type determined?
Visit the official
Best Doctors website at http://www.bestdoctors.com
Next read a case
study about Mary Jones below.
faced several challenges in her ordeal, mainly dealing with her diagnosis and
treatment. This was a result of her ability to seek additional assistance and
to find diagnosis. She reviewed the WebMD website for additional
data and other specialty physician sources.
Visit the official WebMD
you feel this could have been addressed differently? Why?
on the information presented in this case, what are your observations about
current consumer involvement in healthcare? What does this case teach about the
use of computers to seek healthcare information?
a loved one is critically ill, healthcare information that is reliable is
required quickly. There are many ways to access healthcare information, from
Internet searches to panels of specialists. How the information is used in
providing quality care is one of the key points for this discussion. In the
following case study, Mary faces many challenges. For many of us, looking up a
set of symptoms is usually what we think of when using such sources as the
Internet to find healthcare information. However, there are many other aspects
of our healthcare that we need to know and access. As a healthcare consumer we
need to be informed.
in the past weeks, you will respond to discussion questions based on the case
Mary Jones was working at the press bending machine when she suddenly felt
severe pain in the lower right side of her body. She yelled for the shop
foreman who immediately called emergency services. Upon arrival to the local
hospital emergency room (ER), she was rushed to the examination room.
triage nurse evaluated Mary’s pain. Mary had signed a release form at the start
of this process to allow Mr. Jones (Mary’s husband had met them at the
hospital) to complete the necessary paperwork. While filling out forms, Mr.
Jones had informed the intake clerk that he currently is unemployed and they do
not have health insurance. Mary’s employer doesn’t offer healthcare insurance.
The clerk asked what other means will they have to demonstrate their ability to
pay for services. Mr. Jones had informed the clerk that they do have some
personal savings that should be enough to pay for services. Mr. Jones then
signed an agreement to pay for all charges incurred.
talking with Mary and examining her medical history, the ER physician had
concluded the pain may be related to a flare up from a recent work-related
injury (one month prior). She had tripped and fell on an oily floor hurting her
lower back area. At the time, the diagnosis was a deep bruise. He recommended
for her to take a few days off and to take the prescribed pain medication. This
is the same medication Mary was prescribed following her fall a month earlier.
went home and on the doctor’s recommendation she took the next day off;
however, the pain would not go away; even with the pain medications her
condition seemed to be getting worse. Mary and her husband John decided to look
up her symptoms on the Internet.
they found her symptoms (especially when they included nausea) are more related
to gallbladder inflammation (cholecystitis). With that information they called
Dr. Avon with their concerns. Dr. Avon explained that he read the ER report and
examined the test (sonogram and lab tests) and it did not show any indication
with problems with Mary’s gallbladder. Dr. Avon explained Mary doesn’t have a
family history of gallbladder inflammation and doesn’t have the typical risk
factors associated with the illness (e.g., obesity). Dr. Avon is concerned
about the pain and now the nausea that she is experiencing and asks Mary to
meet him at the hospital for more tests.
following morning Mary underwent tests including a magnetic resonance imaging
(MRI), a sonogram, and other lab analysis. Dr. Avon, with the assistance of a
gastrologist, a neurologist, and an oncologist, could not determine an exact
diagnosis for her increasing level of pain and nausea. Dr. Avon suggested using
the service of Best Doctors.Inc. This is a service used to assist patients and
physicians in challenging cases that do not fit the diagnostic protocols and
decision trees. Dr. Avon, with the consent of Mary, contacted Best Doctors.Inc.
They requested all of Mary’s medical records including the records of her
previous injury. The case was reviewed by a panel of doctors from the Harvard
examination, the panel found an oversight in the original diagnosis for the
injury. The initial MRI taken just after the injury revealed no acute or
traumatic issues with her lower lumbar and spinal areas. Upon comparing her
previous MRI results with the one taken now, a minor inflammation between L4
and L5 was revealed. The herniated area was very small but seemed to be causing
a radiating effect for pain. The nausea may be a result of an allergic reaction
to the pain medication Mary resumed taking. Records indicate that she was
nauseated during the initial treatment for her injury but it was attributed to
the injury and not the medications. Dr. Avon took
the information and in consultation with Mary and his medical team, recommended
surgery to repair her disc. The surgery and recovery period were successful.
now three weeks later and Mary received the bills for the ER, hospital stay,
and from the surgeon and anesthesiologist. The hospital bill alone was $12,950;
adding in the physicians’ charges, Mary’s total bill was over $18,000 dollars.
Mary didn’t realize the charges would be that high, especially when the
hospital only told her the charges regarding the hospital stay and supplies.
Her savings was just over $2,000 dollars and she did not have the means to come
up with the monies in the agreed upon twenty-one days after receiving the
contacted the hospital and physicians regarding the bills. The hospital had
agreed to extend the payments to ninety days from the original twenty-one days.
The physicians did not offer a payment plan but agreed to also extend the full
payment due in ninety days. Mary did not have the funds to make such payments.
After several months of attempting to make smaller payments and the increasing
pressures through collection agencies to pay her medical bills, Mary sought legal
assistance. Upon contacting an attorney, it was ascertained that all her
medical bills were associated with her original work-related injury. Mary’s
attorney, through negotiations with her employer’s workers compensation
carrier, corrected this oversight. Mary’s employer and their workers
compensation insurance carrier covered all charges related to the injury and
reimbursed Mary for all payments paid as well as any work lost during this