Friday, January 20, 2012

Nanotechnology to the rescue?

Ray Kurzweil offers an exciting vision of the future and we learn to engineer alternative biological structures at the molecular level. Think how "positively disruptive" such abilities may be to our existing medical care systems.

The promise and challenges or more personalized medical interventions

In this video Ger Brophy highlights exciting opportunities to improve medical care for individuals and possibly reduce aggregate costs. Success will require a combination of advancements in medical knowledge and advancements in information technologies.

Friday, January 13, 2012

Merger of GHSU and Augusta State University in Georgia

It was recently reported in The New York Times that several pairs of colleges and universities in the University System of Georgia are being merged, including Georgia Health Sciences University (GHSU) and Augusta State University (ASU).

http://thechoice.blogs.nytimes.com/2012/01/11/georgia-university-merge/

I earned the MBA at Augusta State University years ago and am presently a student in the Master of Health Informatics degree program at GHSU. I think two valid reasons to merge institutions are the benefits of synergy and the possible savings of money. Higher education is costly and the desire to reduce costs is understandable. My guess is that the motivation of the Regents for this merger is primarily based upon an anticipation of cost savings. Synergy can be achieved through shared services and cooperation among institutions.

It seems to me that mergers are more likely to be successful if the missions of two institutions are similar. Given that educational services are increasingly being delivered virtually (online), perhaps decisions about mergers should be based upon mission statements rather than geography. And, in any case, I wonder about the hope for cost savings. The resulting complexity of merged institutions may in fact lead to more costly operations. If institutions with different missions are merged, costs may actually increase while the focus of the institutions may be diffused.

In my experiences, both Augusta State University and Georgia Health Sciences University are good and valuable institutions. ASU is more a general-purpose state university, offering a wide variety of kinds of degrees. Augusta, Georgia is certainly large enough to need and merit such an institution. GHSU is, of course, focused on medicine and the administration of health care institutions. There are a number of valuable state universities in the Georgia system similar in mission to ASU. GHSU is a more specialized institution and is already complex in its administrative structures. There is going to be a period of adjustments and transitions resulting from the merger. I wonder if in the short term the quality of health care delivery in the state of Georgia and beyond may be affected while attention is diverted to some degree from mission to adjustment at both existing institutions.

In the long run, is the ASU campus going to become medically oriented throughout its existing degree programs and research? Is GHSU going to become less focused on medicine and healthcare administration? Or will the two institutions each remain pretty much as they are but operate under a single (highly stretched) administration? For starters, there is going to be a struggle to decide who who stays and who leaves among the administrative ranks. And what will the new entity be named? Will selected programs be merged at the college and departmental levels? GHSU just went through the process of changing its name from the former name, "Medical College of Georgia." The new name is intended to emphasize the mission and focus of the University. As a citizen of Georgia my major immediate concern regarding this merger is the continued quality of medical education and the continued quality of medical care. I wonder if in fact any cost savings will be realized by this merger and if the possible synergies might have be realized through the sharing of services rather than merger.

Tuesday, January 10, 2012

Financial challenges of private practice

I am posting this hoping that it will spark some interest and conversation in the foundations of healthcare administration course I am teaching this spring semester.

http://money.cnn.com/galleries/2012/smallbusiness/1201/gallery.doctors-broke/index.html

First responders risk lives solving health hazard mystery in Phoenix, Arizona

I am thankful to Chuck Mitchell, Chairman of the Dougherty Georgia County LEPC for distributing information about this video regarding the potential hazards of storage containers of liquid CO2 and the challenges faced by first responders.

Wednesday, January 4, 2012

Smarter than the average pixel?

What I understand of this TEDMED presentation by Dr. Eric Schadt is that it is not adequate to try to understand complex systems using simple linear thought (unless, of course, you are running for high political office). The part I am struggling to understand regards the idea that the causation of disease cannot be determined by studying populations of people and using statistical methods of analysis. Isn't epidemiology based on the notion that aggregate research designs can lead to insights into the causations of diseases in populations? And if an independent variable is important in the aggregate explanation for a disease or condition, isn't it likely to be important in the understanding of specific cases? It might be helpful to me to hear Dr. Schadt engage in a conversation with an epidemiologist about patterns of medical causations in individuals and populations.



It is the metaphor of the movie and the "average pixel" that I have not yet understood. Yes, there is no perfectly "average" patient. A specific instance of a disease or condition may be unique in causal origin. But I want to believe that understanding the health of populations sheds light on understanding the likely causes of instances of diseases/conditions. Patterns in complex systems are usually fractal in nature, meaning that the same patterns are evident at multiple scales. Perhaps I am trying to think too deeply about this or am simply missing some essential insight. Reader, I would welcome your comment that could shed some light.