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The Confused and Bewildered Hospital: Adverse Event Discovery, Pay-for-Performance, and Big Data Tools as Halfway Technologies.
American Journal of Law & Medicine ( IF 0.694 ) Pub Date : 2020-05-01 , DOI: 10.1177/0098858820933496
Barry R Furrow 1
Affiliation  

Running a hospital is a tough business. Patients must be attracted, admitted, treated, and discharged; physicians and staff hired, trained, and retained; new technology mastered; and most importantly, reimbursement dollars from payors captured and retained. The hospital Board of Directors and top administrators must also keep an eagle eye on staff practices and patient outcomes or hospital revenue will suffer. The United States has over 6,000 hospitals, many in health care systems that provide almost ninety percent of U.S. hospital beds. These hospitals are the major providers of emergency care and highly complicated surgical and other procedures in the United States. They are also producers of patient harms. Hospitals in the United States now face a perfect storm—the confluence of (1) a rising tide of hospital adverse events, (2) a tsunami of Artificial Intelligence (“AI”) technological developments changing hospital practice, and (3) the rapid onslaught of Medicare reimbursement tools. These three pressure fronts together are battering the management of hospitals. Each corresponding technology— patient adverse event spotting, the use of powerful AI data analytic tools to improve health care delivery, and pay-for-performance reimbursement using incentives to improve institutional behavior— has promise, and one day they will work well together. At present, however, I will argue that all three—adverse event discovery, AI tools, and

中文翻译:

困惑和困惑的医院:不良事件发现,按绩效付费以及作为中途技术的大数据工具。

经营医院是一项艰巨的任务。必须吸引,接纳,治疗和出院患者;雇用,培训和保留的医师和工作人员;掌握新技术;最重要的是,捕获并保留了来自付款人的偿还款。医院董事会和最高管理者还必须密切注意员工的做法,否则患者的病情或医院收入将受到损失。美国拥有6,000多家医院,其中许多医疗保健系统提供了美国90%的病床。这些医院是美国急诊护理和高度复杂的外科手术及其他程序的主要提供者。他们也是患者伤害的产生者。现在,美国的医院正面临一场完美的风暴-(1)医院不良事件的上升趋势的汇合,(2)人工智能(“ AI”)技术发展的海啸改变了医院的实践,并且(3)Medicare报销工具迅速受到冲击。这三个压力前沿共同打击了医院的管理。每种相应的技术都有望实现,有一天,它们会很好地协同工作,这些技术包括发现患者不良事件,使用功能强大的AI数据分析工具来改善医疗服务,以及通过奖励措施来提高绩效报酬。但是,目前,我将争论所有这三个方面-不良事件发现,人工智能工具和 每种相应的技术都有望实现,有一天,它们会很好地协同工作,这些技术包括发现患者不良事件,使用功能强大的AI数据分析工具来改善医疗服务,以及通过奖励措施来提高绩效报酬。但是,目前,我将争论所有这三个方面-不良事件发现,人工智能工具和 每种相应的技术都有望实现,有一天,它们会很好地协同工作,这些技术包括发现患者不良事件,使用功能强大的AI数据分析工具来改善医疗服务,以及通过奖励措施来提高绩效报酬。但是,目前,我将争论所有这三个方面-不良事件发现,人工智能工具和
更新日期:2020-05-01
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