Time to tackle wasteful practices

We haven’t reached the winter solstice yet, but it looks as if healthcare already is in need of some spring cleaning.

When it comes to waste, why wait?

Let’s start with finances. In the Nov. 15 issue of the New England Journal of Medicine, Harvard’s David P. Cutler and colleagues put a spotlight on the $361 billion burden that administrative expenses place on providers and the healthcare system. The authors argued this is an area where savings can be made—as much as $29,000 per physician, they estimated.

How to avoid getting mired in paperwork, or its electronic equivalent? They pointed to incentives (or disincentives) within the Patient Protection and Affordable Care Act to standardize methods for processing administrative transactions that may spur the adoption of more efficiencies. Credentialing offers another opportunity to remove redundancies that eat into physician and staff schedules.

They astutely added that an effort to simplify administrative tasks would be embraced by everyone, an important feature in the city of political gridlock.

On another front, we also appear to be letting our intellectual capital go to waste. In a study published online in Circulation, Duke’s Emil L. Fosbol and colleagues determined that only about one-third of the abstracts presented at meetings for the big three—the American Heart Association, the American College of Cardiology and the European Society of Cardiology—result in a publication in a peer-reviewed journal.

What’s more, only about one-third of abstract submissions get accepted for the scientific sessions. That is a lot of knowledge that is not being shared.

Fosbol and colleagues saw some silver linings in their findings. They cited a trend among organizations that hold these conferences to require researchers to prepare a full manuscript if their abstract is accepted for a scientific session to jumpstart the publication process. Online first publication in journals is helping to speed dissemination of findings, too.

Fosbol, in an interview with Cardiovascular Business, said this particular paper went through the editorial review process relatively quickly. Not coincidently, it was published online ahead of print just in time for the American Heart Association’s meeting in Los Angeles.

Not every administrative task is a barrier to efficiency. The challenge is targeting the overlap and streamlining. And not every abstract is worthy of publication. “It is not ideal to publish everything,” Fosbol said. “But it is not ideal to publish one-third of the abstract information as well.”

Candace Stuart

Cardiovascular Business, editor