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Can Utah innovation lead the way on health care?

Published: Saturday, Dec. 15 2012 6:19 p.m. MST

Premature babies often need assistance that typically comes in the form of expensive medical treatments and devices.

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SALT LAKE CITY — American Fork Hospital delivers its share of babies, some of whom come earlier than planned.

As medical teams rush to care for the premature newborns, they have developed a system that saves lives and money, but also chips away at their own bottom line.

"Better care is nearly always cheaper," said Dr. Brent James, chief quality officer and director for the Institute for Health Care Delivery Research at Intermountain Healthcare, based in Salt Lake City. He said in order to reduce costs in health care, medical providers and insurance organizations "have to continue to do things that support those with the greatest needs in society."

Quality care, he said, depends on more than regulations and government policy and policy-makers can do more for health care reform by investing in public health programs, including mental health treatment, and education than anything else.

"Someone is going to figure this out and when they do, they're going to change the world," James said.

An example of change

As the lungs are one of the last organs to fully mature, premature babies often need assistance with breathing and that assistance typically comes in the form of expensive medical treatments and devices. The babies could die without immediate care.

Instead of transporting the little ones to a nearby, better equipped hospital with an intensive care unit, involving invasive intubation en route, doctors now utilize a simple breathing machine, allowing the babies lungs to expand and compress normally until they are strong enough to work on their own.

The "major improvement in a clinical outcome," James said, has curbed the intubation rate at the hospital, from 78 percent to 18 percent of the 110 babies born between 33 and 37 weeks of gestation each year.

But efficiency and better care has also led Intermountain to a more than $5 million profit margin loss, which is money insurance companies can then count as savings. Both add up to savings for the system and improved outcomes help the community as a whole.

"There are more efficient ways to do what we're already doing," said Jason Cooke, Utah Health Policy Project's Medicaid Policy fellow. He said stakeholders, albeit those who have been most competitive in the past, must come together to do things smarter, resulting in cost savings, but also better community health.

The Utah Health Policy Project hosted the Better Care Conference Friday, including provider groups and insurers from across the state, looking for an information exchange that might lead to better practices in the health care system.

"This lays the foundation for community collaboration that we need to implement facets of the Affordable Care Act in Utah," Cooke said. "We need to work better and more efficiently, figure out ways to arrive at the same goal and be a model for the rest of the country."

Such innovation, he said, is not just about the potential savings, but primarily about a better system of delivering health care.

James, who spoke at the conference, said Intermountain has been using various tools to measure quality within its system for years. The most beneficial methods, he said, are not financial incentives, which government-run plans seem to favor, but those that involve the patient in their own care, and also keep providers up to date on a patient's treatment.

"The best tools are those that blend into the background so providers don't even know they're following any sort of protocol," James said.

Through an aggressive detection and treatment program at Intermountain, providers have decreased the number of in-hospital sepsis-related deaths by more than 14 percent in the past three years. Sepsis is one of the main causes of hospital deaths, specifically among those admitted through emergency rooms, and the condition remains unabated in certain hospitals in the country.

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