Historical Hospital Innovations
Different ways in which hospitals in the U.S. have been innovative in the past include implementing electronic health records, implementing telehealth, introducing bundled payments, transplanting organs. Below is an overview of the findings.
Electronic Health RecordS (EHR)
- In 1965, the Mayo Clinic in Rochester, Minnesota, implemented the electronic medical records for the first time in the United States. Electronic health records involves maintaining health records in a digital version on computers.
- The main and immediate goals for implementing electronic health records was to share and track information and medical data on patients as and when required. The long-term goals are to have instant access to patient data, effective procedures, centralized cloud-based computing, and increased patient satisfaction, among others.
- In 2004, President George W. Bush proposed to implement EHR within a decade. In 2009, President Barack Obama signed the "Health Information Technology for Economic and Clinical Health (HITECH) Act" to implement EHR by 2014.
- By 2015, 96% of hospitals had implemented electronic health records in the United States and 87% of doctors had done the same. As the payers and government regulators preferred the EHR, all hospital in the U.S. adopted it.
- In 1959, the hospital of the University of Nebraska first implemented the telehealth system to connect with medical students across its campus. Telehealth is an innovation that enables patients to access and interact with a doctor 24/7 via teleconference and uses technologies such as Facetime and Skype.
- The immediate goal of telemedicine/telehealth was to provide healthcare access to rural areas where there are a limited number of medical specialists. The long-term goals of telehealth include implementing telehealth services across all rural communities in the U.S., using smart gadgets such as smart glasses and smart watches to transcribe medical records, track patient vital data in real-time, and reduce paperwork.
- Around 33 states in the U.S. enacted “parity” laws which promote telehealth insurance. So these laws impacted the implementation of telehealth in U.S. hospitals.
- As of now, 65% of U.S. hospitals have implemented telehealth service. Telehealth parity laws across various states in U.S. mandate hospitals to implement the telehealth system.
- Bundled payments were first initiated in the United States in 1984 by the Texas Heart Institute. Bundled payments is a payment model by means of which the post-acute expenses can be established in advance for an episode of care. It helps in cutting down the cost.
- The main goals of the bundled payments model are to assume risks and reduce the cost of care. The long-term goals of bundled payments are to stimulate accurate decision-making by physicians on treatment procedures, stimulate early mobility, reduce the burden among rural hospitals, and promote the predicted analysis of patients.
- The enactment of the "Patient Protection and Affordable Care Act (PPACA)" promoted the implementation of the bundled payments model.
- As per the JAMA study, the implementation of the bundled payments model saved 20.8% (or $5,577) of the cost for joint replacement care episode per patient in 2017. After launching the CMS mandatory bundled-payment program in 2016, around 400 hospitals implemented this model across the United States.
- The first organ (kidney) transplantation was conducted in the Peter Bent Brigham Hospital in Boston. Organ transplantation is the process of transplanting organs from donors to patients.
- The goal of organ transplantation is to provide the required organs to the 113,000+ people in the U.S. who need them (as of January 2019). Approximately 20 people die each day waiting for an organ. The long-term goal is to nullify these statistics.
- In 1984, the bill, “National Organ Transplant Act” was passed supporting organ transplantation in the United States. In 1987, UNOS implemented UNet℠ to track organ donations and transplantation.
- As of 2018, 36,528 transplants were performed in the United States. Around 250 hospitals across the United States are involved in organ transplantation. Around 95 organ transplantations were conducted per day in the U.S. which led hospitals to follow suit.
We searched for information on different ways in which hospitals in the U.S. have been innovative in the past and were able to locate many articles mentioning multiple innovations in the healthcare system in the past. We filtered the lists of innovations found and chose only hospital-centric innovations, programs that were needed in the healthcare system, and innovations that were implemented on a large scale. Four innovations were chosen: the electronic health records, telehealth, bundled payments, and organ transplantation systems specific to the U.S. For each innovation, we further researched diverse aspects such as the place and year of implementation, the goals, the enactment, and the results of each innovation. For all four innovations, government bills were enacted across the U.S.